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Sample records for diagnostic reference levels

  1. Diagnostic reference levels in medical imaging

    International Nuclear Information System (INIS)

    Rosenstein, M.

    2001-01-01

    The paper proposes additional advice to national or local authorities and the clinical community on the application of diagnostic reference levels as a practical tool to manage radiation doses to patients in diagnostic radiology and nuclear medicine. A survey was made of the various approaches that have been taken by authoritative bodies to establish diagnostic reference levels for medical imaging tasks. There are a variety of ways to implement the idea of diagnostic reference levels, depending on the medical imaging task of interest, the national or local state of practice and the national or local preferences for technical implementation. The existing International Commission on Radiological Protection (ICRP) guidance is reviewed, the survey information is summarized, a set of unifying principles is espoused and a statement of additional advice that has been proposed to ICRP Committee 3 is presented. The proposed advice would meet a need for a unifying set of principles to provide a framework for diagnostic reference levels but would allow flexibility in their selection and use. While some illustrative examples are given, the proposed advice does not specify the specific quantities to be used, the numerical values to be set for the quantities or the technical details of how national or local authorities should implement diagnostic reference levels. (author)

  2. Establishing diagnostic reference levels in digital radiology

    International Nuclear Information System (INIS)

    Bana, Remy Wilson

    2016-04-01

    Medical application of radiation has gained wider study since diagnostic radiology plays a very important role in modern medicine. The need of the service seems to increase since the invention of digital radiology as a new technology that promises greater accuracy while minimizing patient dose. However, it is not exempted in the harmonization of doses delivered to the patient undergoing same radiologic examination in different institutions either regional or nationwide. The objective of this project was to review the establishment of Diagnostic Reference Levels (DRLs) in digital radiology at National level with the aim to reduce patient dose while maintaining appropriate image quality. A general discussion on digital radiology has been presented focusing on the optimization of patient dose as well as dosimetric quantities used for the establishment of DRLs. Recommendations have been provided for Rwanda to initiate steps to establish National Diagnostic Reference Levels for common procedures in digital radiology. (au)

  3. Patient dose with quality image under diagnostic reference levels

    International Nuclear Information System (INIS)

    Akula, Suresh Kumar; Singh, Gurvinder; Chougule, Arun

    2016-01-01

    Need to set Diagnostic Reference Level (DRL) for locations for all diagnostic procedures in local as compared to National. The review of DRL's should compare local with national or referenced averages and a note made of any significant variances to these averages and the justification for it. To survey and asses radiation doses to patient and reduce the redundancy in patient imaging to maintain DRLs

  4. Establishment of local Diagnostic Reference Levels (DRLs) for ...

    African Journals Online (AJOL)

    Diagnostic reference levels (DRLs) is an essential optimization tool in radiography and radiological sciences. The objective of the study is to establish DRL for radiography examinations in north eastern Nigeria. A Prospective cross- sectional study conducted in two university teaching hospitals in north eastern Nigeria.

  5. Method of evaluation of diagnostics reference levels in computerized tomography

    International Nuclear Information System (INIS)

    Vega, Walter Flores

    1999-04-01

    Computerized tomography is a complex technique with several selectable exposition parameters delivering high doses to the patient. In this work it was developed a simple methodology to evaluate diagnostic reference levels in computerized tomography, using the concept of Multiple Scan Average Dose (MSAD), recently adopted by the Health Ministry. For evaluation of the MSAD, a dose distribution was obtained through a measured dose profile on the axial axis of a water phantom with thermoluminescence dosemeters, TLD-100, for different exam technique. The MSAD was evaluated hrough two distinct methods. First, it was evaluated by the integration of the dose profile of a single slice and, second, obtained by the integration on central slice of the profile of several slices. The latter is in of accordance with the ionization chamber method, suggesting to be the most practical method of dose evaluation to be applied in the diagnostic reference level assessment routine for CT, using TLDs. (author)

  6. Application of diagnostic reference levels in medical practice

    Energy Technology Data Exchange (ETDEWEB)

    Bourguignon, Michel [Faculty of Medicine of Paris, Deputy Director General, Nuclear Safety Authority (ASN), Paris (France)

    2006-07-01

    Diagnosis reference levels (D.R.L.) are defined in the Council Directive 97/43 EURATOM as 'Dose levels in medical radio diagnosis practices or in the case of radiopharmaceuticals, levels of activity, for typical examinations for groups of standards-sized patients or standards phantoms for broadly defined types of equipment. These levels are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied'. Thus D.R.L. apply only to diagnostic procedures and does not apply to radiotherapy. Radiation protection of patients is based on the application of 2 major radiation protection principles, justification and optimization. The justification principle must be respected first because the best way to protect the patient is not to carry a useless test. Radiation protection of the patient is a continuous process and local dose indicator values in the good range should not prevent the radiologist or nuclear medicine physician to continue to optimize their practice. (N.C.)

  7. Application of diagnostic reference levels in medical practice

    International Nuclear Information System (INIS)

    Bourguignon, Michel

    2006-01-01

    Diagnosis reference levels (D.R.L.) are defined in the Council Directive 97/43 EURATOM as 'Dose levels in medical radio diagnosis practices or in the case of radiopharmaceuticals, levels of activity, for typical examinations for groups of standards-sized patients or standards phantoms for broadly defined types of equipment. These levels are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied'. Thus D.R.L. apply only to diagnostic procedures and does not apply to radiotherapy. Radiation protection of patients is based on the application of 2 major radiation protection principles, justification and optimization. The justification principle must be respected first because the best way to protect the patient is not to carry a useless test. Radiation protection of the patient is a continuous process and local dose indicator values in the good range should not prevent the radiologist or nuclear medicine physician to continue to optimize their practice. (N.C.)

  8. Diagnostic reference levels in digital mammography: a systematic review

    International Nuclear Information System (INIS)

    Suleiman, Moayyad E.; Brennan, Patrick C.; McEntee, Mark F.

    2015-01-01

    This study aims to review the literature on existing diagnostic reference levels (DRLs) in digital mammography and methodologies for establishing them. To this end, a systematic search through Medline, Cinahl, Web of Science, Scopus and Google scholar was conducted using search terms extracted from three terms: DRLs, digital mammography and breast screen. The search resulted in 1539 articles of which 22 were included after a screening process. Relevant data from the included studies were summarised and analysed. Differences were found in the methods utilised to establish DRLs including test subjects types, protocols followed, conversion factors employed, breast compressed thicknesses and percentile values adopted. These differences complicate comparison of DRLs among countries; hence, an internationally accepted protocol would be valuable so that international comparisons can be made. (authors)

  9. Evolution of diagnostic reference levels in Spanish intraoral radiology

    International Nuclear Information System (INIS)

    Alcaraz, M.; Velasco, F.; Martinez-Beneyto, Y.; Alcaraz-Saura, M.; Velasco, E.; Achel, G. D.; Canteras, M.

    2008-01-01

    A total of 16 175 official reports of quality assurance on dental radiodiagnostic surgeries from 16 Spanish autonomous regions compiled during 2002-09 were studied to determine the evolution of diagnostic reference levels (DRLs) for obtaining a diagnostic image in the normal conditions of clinical practice in Spanish dental clinics. A DRL of 3.1 mGy was set in 2009, which represents a 35.4 % decrease compared with the dose determined in 2002 (4.8 mGy). During the same period, the mean dose fell by only 17.2 %. The DRL recommended by the European Union in 2004 for intraoral radiology is 4 mGy, and this study shows that 83.4 % of the installations used a dose below this. Of the installations using indirect or direct digital systems 1.1 and 1.2 %, respectively, used doses higher than those recommended, while 14.2 % of those using radiographic film exceeded this limit. (authors)

  10. Fluoroscopy in paediatric fractures - Setting a local diagnostic reference level

    International Nuclear Information System (INIS)

    Pillai, A.; McAuley, A.; McMurray, K.; Jain, M.

    2006-01-01

    Background: The ionizing radiations (Medical Exposure) Regulation 2000 has made it mandatory to establish diagnostic reference levels (DRLs) for all typical radiological examinations. Objectives: We attempt to provide dose data for some common fluoroscopic procedures used in orthopaedic trauma that may be used as the basis for setting DRLs for paediatric patients. Materials and methods: The dose area product (DAP) in 865 paediatric trauma examinations was analysed. Median DAP values and screening times for each procedure type along with quartile values for each range are presented. Results: In the upper limb, elbow examinations had maximum exposure with a median DAP value of 1.21 cGy cm 2 . Median DAP values for forearm and wrist examinations were 0.708 and 0.538 cGy cm 2 , respectively. In lower limb, tibia and fibula examinations had a median DAP value of 3.23 cGy cm 2 followed by ankle examinations with a median DAP of 3.10 cGy cm 2 . The rounded third quartile DAP value for each distribution can be used as a provisional DRL for the specific procedure type. (authors)

  11. Diagnostic reference levels in intraoral dental radiography in Korea

    International Nuclear Information System (INIS)

    Kim, Eun Kyung; Han, Won Jeong; Choi, Jin Woo; Jung, Yun Hoa; Yoon, Suk Ja; Lee, Jae Seo

    2012-01-01

    The objectives of this study were to survey the radiographic exposure parameters, to measure the patient doses for intraoral dental radiography nationwide, and thus to establish the diagnostic reference levels (DRLs) in intraoral dental X-ray examination in Korea. One hundred two intraoral dental radiographic machines from all regions of South Korea were selected for this study. Radiographic exposure parameters, size of hospital, type of image receptor system, installation duration of machine, and type of dental X-ray machine were documented. Patient entrance doses (PED) and dose-area products (DAP) were measured three times at the end of the exit cone of the X-ray unit with a DAP meter (DIAMENTOR M4-KDK, PTW, Freiburg, Germany) for adult mandibular molar intraoral dental radiography, and corrections were made for room temperature and pressure. Measured PED and DAP were averaged and compared according to the size of hospital, type of image receptor system, installation duration, and type of dental X-ray machine. The mean exposure parameters were 62.6 kVp, 7.9 mA, and 0.5 second for adult mandibular molar intraoral dental radiography. The mean patient dose was 2.11 mGy (PED) and 59.4 mGycm2 (DAP) and the third quartile one 3.07 mGy (PED) and 87.4 mGycm 2 (DAP). Doses at university dental hospitals were lower than those at dental clinics (p 2 (DAP) as the DRLs in adult mandibular molar intraoral dental radiography in Korea.

  12. Dosimetric methodology and reference system for diagnostic level X radiation

    International Nuclear Information System (INIS)

    Potiens, Maria da Penha Albuquerque

    1999-01-01

    Several methodologies for the calibration of diagnostic radiology instruments were developed and established at the Calibration Laboratory of IPEN. These established radiation qualities are recommended by international standards. The methods may be used in the calibration procedures of survey meters used in radiation protection measurements (scattered radiation), instruments used in direct beams (attenuated and non attenuated beams) and quality control instruments. A reference system was proposed using two identical ionization chambers developed at IPEN. They differ only by the collecting electrode material, one of aluminium and the other of graphite. The different energetic dependence of the chamber's response provided a ratio related to the tube potential. The variation of only 0.28%, from 14.3 to 111 keV, on the energetic dependence of the graphite electrode chamber, provided the possibility of air kerma rate determination in the studied radiation beams. (author)

  13. DEVELOPMENT OF DIAGNOSTIC REFERENCE LEVELS (DRL OF PATIENTS X-RAY EXPOSURE IN DIAGNOSTIC RADIOLOGY

    Directory of Open Access Journals (Sweden)

    A. V. Vodovatov

    2013-01-01

    Full Text Available We introduce a system of Diagnostic Reference Levels (DRLs for patients medical exposure for national health care practice implementation. DRLs are an effective way of the patient radiation protection through the optimization of the medical exposure. The paper discusses and compares different methods of determining the DRLs based on measured and/or calculated quantities of patient’s dose: dose area product (DAP, entrance surface dose (ESD and an effective dose. Distributions of different dose quantities in different Saint-Petersburg clinics are shown on the example of chest PA examinations. The results are compared with the data from other sources. Regional DRLs for Saint-Petersburg are proposed.

  14. French diagnostic reference levels in diagnostic radiology, computed tomography and nuclear medicine: 2004-2008 Review

    International Nuclear Information System (INIS)

    Roch, P.; Aubert, B.

    2013-01-01

    After 5 y of collecting data on diagnostic reference levels (DRLs), the Nuclear Safety and Radiation Protection French Inst. (IRSN) presents the analyses of this data. The analyses of the collected data for radiology, computed tomography (CT) and nuclear medicine allow IRSN to estimate the level of regulatory application by health professionals and the representativeness of current DRL in terms of relevant examinations, dosimetric quantities, numerical values and patient morphologies. Since 2004, the involvement of professionals has highly increased, especially in nuclear medicine, followed by CT and then by radiology. Analyses show some discordance between regulatory examinations and clinical practice. Some of the dosimetric quantities used for the DRL setting are insufficient or not relevant enough, and some numerical values should also be reviewed. On the basis of these findings, IRSN formulates recommendations to update regulatory DRL with current and relevant examination lists, dosimetric quantities and numerical values. (authors)

  15. Nordic working group for medical x-ray diagnostics: Diagnostic reference levels within xray diagnostics - experiences in the Nordic countries

    International Nuclear Information System (INIS)

    Leitz, W.; Groen, P.; Servomaa, A.; Einarsson, G.; Olerud, H.

    2003-01-01

    Medical x-ray diagnostics is one of the few applications of ionising radiation where people are irradiated on purpose. The strategy for radiation protection is also different compared to that in other areas that have the zero-alternative as its ultimate goal, meaning that no human beings at all are exposed in these practices. The focus in x-ray diagnostics concerning radiation protection is justification and optimisation. Optimisation implies that the examination is performed in such a way that the radiation dose is as small as possible without jeopardising the diagnostic security. X- ray diagnostics is a complex method where many technical parameters and methodology factors together are interacting in the determination of radiation dose and image quality. The optimisation process is not a simple and uncomplicated procedure, this difficulty is reflected in many international and national surveys showing a large spread of patient doses for one and the same type of examination. The concept diagnostic reference levels (DRL) has been introduced as a tool for reducing this wide distribution that is obviously indicating a lack of optimisation, and for cutting the highest radiation doses. In this presentation the concept for DRL and the experience gained in the Nordic countries with DRL are described. (orig.)

  16. Diagnostic Reference Levels in the 1990 and 1996 Recommendations of the ICRP (invited paper)

    International Nuclear Information System (INIS)

    Drexler, G.

    1998-01-01

    A review of and some comments on the paragraphs in the ICRP Publications 60 and 73 are presented, which are relevant to diagnostic reference doses. The content of the statements is traced back by approximately 50 years when ICRP's preoccupation with the future health and well-being of the population is reflected in guidance for characterisation of 'normal operational conditions'. The early ICRP levels of reference doses are compared with the values currently discussed to demonstrate the importance of diagnostic reference doses in the process of optimisation and to show the importance of a continuous review and update of these levels. (author)

  17. The need for national diagnostic reference levels: entrance surface dose measurement in intraoral radiography

    International Nuclear Information System (INIS)

    Mortazavi, S. M. J.; Shareghi, A.; Kavousi, A.; Ghiassi-Nejad, M.; Jafari-Zadeh, M.; Nazeri, F.; Mozdarani, H.

    2004-01-01

    Background: Intraoral radiographies are the most frequent X-ray examinations in humans. According to International Commission on Radiation Protection recommendations, the selection of a diagnostic reference level should be specific to a country or region. Critical organs such as thyroid gland are exposed to X-rays in intraoral radiography and these exposures should be kept as low as reasonably achievable. To assist the development of DRLs for intraoral radiography, a National Radiation Protection Department-sponsored pilot study was carried out. Materials and methods: thermoluminescent dosimetry is widely acknowledged to be the recommended method for measuring entrance surface doses. In this study, entrance surface doses was measured using LiF thermoluminescent dosimeters on the skin (either mandibular or maxillary arcs) of 40 patients. Three thermoluminescent dosimetry chips were placed on the skin of each patient. The doses were averaged for each radiography and mean entrance surface doses of all patients calculated. Results: the mean ±SD entrance surface dose at the center of the beam on the patient's skin in intraoral radiography was 1.173 ±0.606 mGy (ranged from 0.01 o 0.40 m Gy). The mean entrance surface doses for male and female patients were 1.380± 0.823, and 1.004± 0.258 respectively. No statistically significant difference was found between these means. Despite its necessity , in national level , there is no published data on the diagnostic reference levels for intraoral radiography. However, the results obtained in this study are lower than those reported by investigators in other countries. Conclusion: in IR Iran , due to lack of large scale studies, no diagnostic reference levels have been set for X-ray diagnostic procedures. Due to lack of national diagnostic reference levels, it is not possible to clarify whether in intraoral radiographies any dose reduction techniques are needed. We intend to perform similar nationwide studies to set the

  18. The establishment of local diagnostic reference levels for paediatric interventional cardiology

    International Nuclear Information System (INIS)

    McFadden, S.; Hughes, C.; D'Helft, C.I.; McGee, A.; Rainford, L.; Brennan, P.C.; McCrum-Gardner, E.; Winder, R.J.

    2013-01-01

    Background: There is a paucity of information worldwide on radiation exposure in paediatric interventional cardiology. At present Nationally established Diagnostic Reference Levels exist for adult interventional cardiology procedures in the UK but little data is available for paediatrics. In addition, interventional cardiology has been identified as one the highest contributors to medical exposure to ionising radiation and children are more radiosensitive than adults. Objective: This study sought to determine current radiation dose levels in paediatric interventional cardiology (IC) with a view to establishing local diagnostic reference levels (LDRL). Methods: Radiation dose and examination details were recorded for 354 paediatric patients examined by IC in a specialised paediatric centre in Europe. Radiation doses were recorded using a Dose Area Product meter along with examination details. Procedures were categorised as either diagnostic (A) or therapeutic (B). Data was further sub-divided into five age ranges; (1) newborn <1 year (2) 1 <5 years (3) 5 <10 years (4) 10 <15 years (5) 15 years and over. Proposed LDRL were calculated from the mean dose area product readings. Results: The mean patient age was 2.6 years (range 0.0 days–16 years) and weight was 14.9 kg (range 2.4–112 kg). LDRL for the five age groupings were calculated as 190, 421, 582, 1289 and 1776 cGycm² respectively. Conclusion: Local dose reference levels have been proposed for paediatric IC and can be used as a benchmark for other hospitals to compare against their own radiation doses

  19. Estimates of diagnostic reference levels for common radiographic x-ray examinations in some sudanese hospitals

    International Nuclear Information System (INIS)

    Awad, Ezdehar Mohammed Satti.

    2016-03-01

    The objective of this study were to estimate patient dose in some common diagnostic x-ray examinations in Sudan with the aim to propose national diagnostic reference levels (DRLs). Radiation doses were estimated for the patients in 23 public hospitals in different town in Sudan (Wad-Madani, Kasala, Atbara Al obaid, Al nhod, Khartoum). Entrance surface air kerma (ESAK) was estimated in a three steps protocol: First, x-ray unit output Y (d) was measured at a distance at a distance (d) for different peak tube voltages and tube loading (mAs). Next, incident air kerma (k) was calculated from Y (d) using inverse square law combined with patient exposure factors. ESAK was calculated from k using backscatter factor, B. Mean ESAK values were comparable to those reported in other countries and are below reference dose levels. The estimated mean ESAK values were: 0.4, 1.9, 1.8, 3.2, 2.4, 3.5, and 8.4 mGy for chests . The estimated mean ESAK values were 0.4, 1.9, 1.8, 3.2, 2.4, 3,5, and 8.4 mGy for chest PA, Skull AP/PA, Skull LAT, Abdomen Pelvis AP, Lumber Spine AP and Lumber Spine LAT examination respectively. The results are used for dose optimization and to propose national diagnostic reference levels. (Author)

  20. Preliminary Diagnostic Reference Levels of Adult CT at Aristide Ledantec National Hospital

    International Nuclear Information System (INIS)

    Diagne, M.; Gning, F.; Dieng, M. M.; Gueye, L.

    2015-01-01

    The number of Computed Tomography (CT) procedures performed in Senegal has widely increased as the CT is a powerful tool for the accurate and effective diagnosis. CT is a diagnostic imaging modality giving higher patient dose in comparison with other radiological procedures. The establishing of diagnostic reference levels (DRLs) is a way to optimize the radiation arising from CT procedures to as low as reasonable (ALARA) and to ensure good practice. Objective: The purpose of this study is to establish Local Diagnostic Reference Levels (LDRLs) at the University Hospital of Aristide LeDantec for CT examinations and to compare these values with the international Diagnostic Reference Levels (DRLs) to benchmark the local practice. Materials/Methods: This was a cross-sectional survey carried out in HALD between August 2014 and January 2015. Demographic data and acquisition parameters of 700 CT scan examinations performed on adult patients were collected from request forms and CT scan consoles. The values of CTDIw, CTDIvol and DLP were calculated using ImPACT (Imaging Performance and Assessment of Computed Tomography) software for Siemens Definition AS scanner of HALD. This was done by correlating the measurements from the National Radiological Protection Board (NRPB–R250) scanners with the effective dose calculated, using the CT–EXPO software. Data was analyzed using mean, range, 3rd quartile, as well as mean. Frequency tables and histogrammes were used to summarise the data. Results: The 3rd quartile doses in this study for head, chest, abdomen and pelvis were 89 mGy, 12 mGy, 16.5 mGy, and 15 mGy, respectively. These values were in good agreement with the values reported from the literature. (author)

  1. Regional Diagnostic Reference Levels and Collective Effective Doses from Computed Tomography (CT) Scanners in India

    International Nuclear Information System (INIS)

    Livingstone, R.S.; Dinakaran, P.M.

    2011-01-01

    Diagnostic examinations performed using computed tomography (CT) are on the increase, and the use of this modality needs to be monitored periodically. The aim of this study was to formulate regional diagnostic reference levels (DRLs) and assess collective effective doses from CT scanners in Tamil Nadu, India. In-site CT dose measurements were performed for 127 CT scanners in Tamil Nadu as a part of the Atomic Energy Regulatory Board (AERB) funded project for a period of two years. Regional DRLs were formulated at third quartile level for three CT protocols such as thorax, abdomen and pelvis and were found to be 557 mGy.cm, 521 mGy.cm and 294 mGy.cm, respectively. The collective effective dose in Tamil Nadu was found to be 14.93 man Sv per day. (author)

  2. A CONCEPTUAL FRAMEWORK FOR MANAGING RADIATION DOSE TO PATIENTS IN DIAGNOSTIC RADIOLOGY USING REFERENCE DOSE LEVELS.

    Science.gov (United States)

    Almén, Anja; Båth, Magnus

    2016-06-01

    The overall aim of the present work was to develop a conceptual framework for managing radiation dose in diagnostic radiology with the intention to support optimisation. An optimisation process was first derived. The framework for managing radiation dose, based on the derived optimisation process, was then outlined. The outset of the optimisation process is four stages: providing equipment, establishing methodology, performing examinations and ensuring quality. The optimisation process comprises a series of activities and actions at these stages. The current system of diagnostic reference levels is an activity in the last stage, ensuring quality. The system becomes a reactive activity only to a certain extent engaging the core activity in the radiology department, performing examinations. Three reference dose levels-possible, expected and established-were assigned to the three stages in the optimisation process, excluding ensuring quality. A reasonably achievable dose range is also derived, indicating an acceptable deviation from the established dose level. A reasonable radiation dose for a single patient is within this range. The suggested framework for managing radiation dose should be regarded as one part of the optimisation process. The optimisation process constitutes a variety of complementary activities, where managing radiation dose is only one part. This emphasises the need to take a holistic approach integrating the optimisation process in different clinical activities. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Diagnostic reference levels in intraoral radiology: From the laboratory to clinical practice

    International Nuclear Information System (INIS)

    Alcaraz, M.; Velasco, E.; Martinez-Beneyto, Y.; Velasco, F.; Parra, C.; Canteras, M.

    2010-01-01

    To determine the diagnostic reference levels (DRLs) for obtaining a diagnostic image in the normal conditions of clinical practice and to explain the differences between the levels found and the DRLs obtained in other experimental conditions, suggesting that there has been a reduction in the European Union (EU) recommended levels. A total of 2296 official reports on dental surgeries from 16 Spanish autonomous regions compiled during 2008 were studied. A mean DRL of 3.3 mGy was determined: 2.6 mGy for installations using direct digital systems, 3.4 mGy for those using indirect systems, 4.4 mGy for those using Ultra-speed film and 3.7 mGy for those using Insight. The DRLs found in this survey are below the EU recommended values but far above previously described values, possibly because all the different systems were considered and because values refer to those of the normal work conditions of clinical practice. (authors)

  4. A conceptual framework for managing radiation dose to patients in diagnostic radiology using reference dose levels

    International Nuclear Information System (INIS)

    Almen, Anja; Baath, Magnus

    2016-01-01

    The overall aim of the present work was to develop a conceptual framework for managing radiation dose in diagnostic radiology with the intention to support optimisation. An optimisation process was first derived. The framework for managing radiation dose, based on the derived optimisation process, was then outlined. The outset of the optimisation process is four stages: providing equipment, establishing methodology, performing examinations and ensuring quality. The optimisation process comprises a series of activities and actions at these stages. The current system of diagnostic reference levels is an activity in the last stage, ensuring quality. The system becomes a reactive activity only to a certain extent engaging the core activity in the radiology department, performing examinations. Three reference dose levels-possible, expected and established-were assigned to the three stages in the optimisation process, excluding ensuring quality. A reasonably achievable dose range is also derived, indicating an acceptable deviation from the established dose level. A reasonable radiation dose for a single patient is within this range. The suggested framework for managing radiation dose should be regarded as one part of the optimisation process. The optimisation process constitutes a variety of complementary activities, where managing radiation dose is only one part. This emphasises the need to take a holistic approach integrating the optimisation process in different clinical activities. (authors)

  5. Diagnostic Reference Levels for Patient Radiation Doses in Pelvis and Lumbar spine Radiography in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kwang Yong; Lee, Byung Young; Lee, Jung Eun; Lee, Hyun Koo; Jung, Seunbg Hwan; Kim, Byung Woo; Kim, Hyeog Ju; Kim, Dong Sup [Radiation Safety Division National Institute of Food and Drug Safety Evaluation, Seoul (Korea, Republic of)

    2009-12-15

    Pelvis and lumbar spine radiography, among various types of diagnostic radiography, include gonads of the human body and give patients high radiation dose. Nevertheless, diagnostic reference levels for patient radiation dose in pelvis and lumbar spine radiography has not yet been established in Korea. Therefore, the radiation dose that patients receive from pelvis and lumbar radiography is measured and the diagnostic reference level on patient radiation dose for the optimization of radiation protection of patients in pelvis and lumbar spine radiography was established. The conditions and diagnostic imaging information acquired during the time of the postero-anterior view of the pelvis and the postero-anterior and lateral view of the lumbar spine at 125 medical institutions throughout Korea are collected for analysis and the entrance surface dose received by patients is measured using a glass dosimeter. The diagnostic reference levels for patient radiation dose in pelvis and lumbar spine radiography to be recommended to the medical institutes is arranged by establishing the dose from the patient radiation dose that corresponds to the 3rd quartile values as the appropriate diagnostic reference level for patient radiation dose. According to the results of the assessment of diagnostic imaging information acquired from pelvis and lumbar spine radiography and the measurement of patient entrance surface dose taken at the 125 medical institutes throughout Korea, the tube voltage ranged between 60-97 kVp, with the average use being 75 kVp, and the tube current ranged between 8-123 mAs, with the average use being 30 mAs. In the posteroanterior and lateral views of lumbar spine radiography, the tube voltage of each view ranged between 65-100 kVp (average use: 78 kVp) and 70-109 kVp (average use: 87 kVp), respectively, and the tube current of each view ranged between 10-100 mAs(average use: 35 mAs) and between 8.9-300 mAs(average use: 64 mAs), respectively. The measurements of

  6. Diagnostic Reference Levels for Patient Radiation Doses in Pelvis and Lumbar spine Radiography in Korea

    International Nuclear Information System (INIS)

    Lee, Kwang Yong; Lee, Byung Young; Lee, Jung Eun; Lee, Hyun Koo; Jung, Seunbg Hwan; Kim, Byung Woo; Kim, Hyeog Ju; Kim, Dong Sup

    2009-01-01

    Pelvis and lumbar spine radiography, among various types of diagnostic radiography, include gonads of the human body and give patients high radiation dose. Nevertheless, diagnostic reference levels for patient radiation dose in pelvis and lumbar spine radiography has not yet been established in Korea. Therefore, the radiation dose that patients receive from pelvis and lumbar radiography is measured and the diagnostic reference level on patient radiation dose for the optimization of radiation protection of patients in pelvis and lumbar spine radiography was established. The conditions and diagnostic imaging information acquired during the time of the postero-anterior view of the pelvis and the postero-anterior and lateral view of the lumbar spine at 125 medical institutions throughout Korea are collected for analysis and the entrance surface dose received by patients is measured using a glass dosimeter. The diagnostic reference levels for patient radiation dose in pelvis and lumbar spine radiography to be recommended to the medical institutes is arranged by establishing the dose from the patient radiation dose that corresponds to the 3rd quartile values as the appropriate diagnostic reference level for patient radiation dose. According to the results of the assessment of diagnostic imaging information acquired from pelvis and lumbar spine radiography and the measurement of patient entrance surface dose taken at the 125 medical institutes throughout Korea, the tube voltage ranged between 60-97 kVp, with the average use being 75 kVp, and the tube current ranged between 8-123 mAs, with the average use being 30 mAs. In the posteroanterior and lateral views of lumbar spine radiography, the tube voltage of each view ranged between 65-100 kVp (average use: 78 kVp) and 70-109 kVp (average use: 87 kVp), respectively, and the tube current of each view ranged between 10-100 mAs(average use: 35 mAs) and between 8.9-300 mAs(average use: 64 mAs), respectively. The measurements of

  7. Local diagnostic reference levels at the Portuguese Institute of oncology francisco gentil of coimbra

    Energy Technology Data Exchange (ETDEWEB)

    Bras, S.; Sousa, M.C. de [Algarve Univ., LIP-Algarve, FCT (Portugal); Lopes, M.C. [IPOFG-CROC, S.A., Medical Physics Dept., Coimbra (Portugal)

    2006-07-01

    In the scope of medical radiological exposures and according to European recommendations and national legal requirements [14], the maximum responsible for an installation must assure the establishment of local dose levels for each type of radiological examination and also assure that they are available for the doctor who prescribes the examination. In the absence of national reference dose levels, the so called Local Diagnostic Reference Levels (L.D.R.L.) should be in agreement with the European Diagnostic Reference Levels published for the different types of medical exposures. The aim of this work was to establish a protocol of measurement for each type of more frequent examination, namely in conventional radiology, in CT and in mammography performed in our hospital. For each kind of examination the recommended dose descriptor was adopted and directly measured or derived from basic charge measurements. The patient sample corresponded in each case to at least a minimum of 10 standard-sized patients, as recommended, in order to obtain averages that constitute for each type of radiological examination the L.D.R.L. that could be compared with the European D.R.L.. The results obtained are in the large majority of the situations below the corresponding D.R.L.. Nevertheless we have identified some situations that deserve more attention.In conventional radiology all L.D.R.L. are below the reference levels. However we have detected some skull post anterior (skull P.A.) exposures where entrance skin doses exceeded the standard value. This may be due to equipment age problems but, as always, improvement of staff education will contribute to better practices and we hope that this work can contribute to this objective. In CT the L.D.R.L. that corresponds to single slice scan meet the standards whereas complete examinations described by dose length product (D.L.P.) values show a larger variation and also some situations where the reference level is exceeded. It is possible that

  8. Local diagnostic reference levels at the Portuguese Institute of oncology francisco gentil of coimbra

    International Nuclear Information System (INIS)

    Bras, S.; Sousa, M.C. de; Lopes, M.C.

    2006-01-01

    In the scope of medical radiological exposures and according to European recommendations and national legal requirements [14], the maximum responsible for an installation must assure the establishment of local dose levels for each type of radiological examination and also assure that they are available for the doctor who prescribes the examination. In the absence of national reference dose levels, the so called Local Diagnostic Reference Levels (L.D.R.L.) should be in agreement with the European Diagnostic Reference Levels published for the different types of medical exposures. The aim of this work was to establish a protocol of measurement for each type of more frequent examination, namely in conventional radiology, in CT and in mammography performed in our hospital. For each kind of examination the recommended dose descriptor was adopted and directly measured or derived from basic charge measurements. The patient sample corresponded in each case to at least a minimum of 10 standard-sized patients, as recommended, in order to obtain averages that constitute for each type of radiological examination the L.D.R.L. that could be compared with the European D.R.L.. The results obtained are in the large majority of the situations below the corresponding D.R.L.. Nevertheless we have identified some situations that deserve more attention.In conventional radiology all L.D.R.L. are below the reference levels. However we have detected some skull post anterior (skull P.A.) exposures where entrance skin doses exceeded the standard value. This may be due to equipment age problems but, as always, improvement of staff education will contribute to better practices and we hope that this work can contribute to this objective. In CT the L.D.R.L. that corresponds to single slice scan meet the standards whereas complete examinations described by dose length product (D.L.P.) values show a larger variation and also some situations where the reference level is exceeded. It is possible that

  9. Estimating the population dose from nuclear medicine examinations towards establishing diagnostic reference levels

    International Nuclear Information System (INIS)

    Niksirat, Fatemeh; Monfared, Ali Shabestani; Deevband, Mohammad Reza; Amiri, Mehrangiz; Gholami, Amir

    2016-01-01

    This study conducted a review on nuclear medicine (NM) services in Mazandaran Province with a view to establish adult diagnostic reference levels (DRLs) and provide updated data on population radiation exposure resulting from diagnostic NM procedures. The data were collected from all centers in all cities of Mazandaran Province in the North of Iran from March 2014 to February 2015. The 75 th percentile of the distribution and the average administered activity (AAA) were calculated and the average effective dose per examination, collective effective dose to the population and annual effective dose per capita were estimated using dose conversion factors. The gathered data were analyzed via SPSS (version 18) software using descriptive statistics. Based on the data of this study, the collective effective dose was 95.628 manSv, leading to a mean effective dose of 0.03 mSv per capita. It was also observed that the myocardial perfusion was the most common procedure (50%). The 75 th percentile of the distribution of administered activity (AA) represents the DRL. The AAA and the 75 th percentile of the distribution of AA are slightly higher than DRL of most European countries. Myocardial perfusion is responsible for most of the collective effective dose and it is better to establish national DRLs for myocardial perfusion and review some DRL values through the participation of NM specialists in the future

  10. A New Dual-purpose Quality Control Dosimetry Protocol for Diagnostic Reference-level Determination in Computed Tomography.

    Science.gov (United States)

    Sohrabi, Mehdi; Parsi, Masoumeh; Sina, Sedigheh

    2018-05-17

    A diagnostic reference level is an advisory dose level set by a regulatory authority in a country as an efficient criterion for protection of patients from unwanted medical exposure. In computed tomography, the direct dose measurement and data collection methods are commonly applied for determination of diagnostic reference levels. Recently, a new quality-control-based dose survey method was proposed by the authors to simplify the diagnostic reference-level determination using a retrospective quality control database usually available at a regulatory authority in a country. In line with such a development, a prospective dual-purpose quality control dosimetry protocol is proposed for determination of diagnostic reference levels in a country, which can be simply applied by quality control service providers. This new proposed method was applied to five computed tomography scanners in Shiraz, Iran, and diagnostic reference levels for head, abdomen/pelvis, sinus, chest, and lumbar spine examinations were determined. The results were compared to those obtained by the data collection and quality-control-based dose survey methods, carried out in parallel in this study, and were found to agree well within approximately 6%. This is highly acceptable for quality-control-based methods according to International Atomic Energy Agency tolerance levels (±20%).

  11. An approach to local diagnostic reference levels (DRL's) in the context of national and international DRL's

    International Nuclear Information System (INIS)

    Rogers, A.T.

    2001-01-01

    In recent years there has been a greater focus on the management of patient doses. This effort has been driven by the realisation of both the increasing magnitude of patient doses and their variation both intra- and inter-nationally. Legislators and guidance-issuing bodies have developed the idea of 'Diagnostic Reference Levels' (DRL's). In particular, the European Union, in their Council Directive 97/43/Euratom, required Member States to develop DRL's. The UK Government, when consolidating this EU Directive into UK legislation, extended the concept of DRL's from a national to an employer level. However, the methodologies used for development of national and international DRL's do not translate to a local level and hence a new approach is required. This paper describes one particular approach made by a UK hospital to introduce 'Local DRL's' in such a manner as to aid the optimisation process. This approach utilises a dose index, based on the local patient population, which is monitored for trends. Any trend in patient dose triggers an investigation linked to the clinical audit system within the Clinical Radiology Department. It is the audit cycle that ensures a continuing move towards an optimised situation. Additional triggers may be employed such as large patient dose variations. (author)

  12. SU-E-P-10: Establishment of Local Diagnostic Reference Levels of Routine Exam in Computed Tomography

    International Nuclear Information System (INIS)

    Yeh, M; Wang, Y; Weng, H

    2015-01-01

    Introduction National diagnostic reference levels (NDRLs) can be used as a reference dose of radiological examination can provide radiation dose as the basis of patient dose optimization. Local diagnostic reference levels (LDRLs) by periodically view and check doses, more efficiency to improve the way of examination. Therefore, the important first step is establishing a diagnostic reference level. Computed Tomography in Taiwan had been built up the radiation dose limit value,in addition, many studies report shows that CT scan contributed most of the radiation dose in different medical. Therefore, this study was mainly to let everyone understand DRL’s international status. For computed tomography in our hospital to establish diagnostic reference levels. Methods and Materials: There are two clinical CT scanners (a Toshiba Aquilion and a Siemens Sensation) were performed in this study. For CT examinations the basic recommended dosimetric quantity is the Computed Tomography Dose Index (CTDI). Each exam each different body part, we collect 10 patients at least. Carried out the routine examinations, and all exposure parameters have been collected and the corresponding CTDIv and DLP values have been determined. Results: The majority of patients (75%) were between 60–70 Kg of body weight. There are 25 examinations in this study. Table 1 shows the LDRL of each CT routine examination. Conclusions: Therefore, this study would like to let everyone know DRL’s international status, but also establishment of computed tomography of the local reference levels for our hospital, and providing radiation reference, as a basis for optimizing patient dose

  13. SU-E-P-10: Establishment of Local Diagnostic Reference Levels of Routine Exam in Computed Tomography

    Energy Technology Data Exchange (ETDEWEB)

    Yeh, M; Wang, Y; Weng, H [Chiayi Chang Gung Memorial Hospital of The C.G.M.F, Puzi City, Chiayi County, Taiwan (China)

    2015-06-15

    Introduction National diagnostic reference levels (NDRLs) can be used as a reference dose of radiological examination can provide radiation dose as the basis of patient dose optimization. Local diagnostic reference levels (LDRLs) by periodically view and check doses, more efficiency to improve the way of examination. Therefore, the important first step is establishing a diagnostic reference level. Computed Tomography in Taiwan had been built up the radiation dose limit value,in addition, many studies report shows that CT scan contributed most of the radiation dose in different medical. Therefore, this study was mainly to let everyone understand DRL’s international status. For computed tomography in our hospital to establish diagnostic reference levels. Methods and Materials: There are two clinical CT scanners (a Toshiba Aquilion and a Siemens Sensation) were performed in this study. For CT examinations the basic recommended dosimetric quantity is the Computed Tomography Dose Index (CTDI). Each exam each different body part, we collect 10 patients at least. Carried out the routine examinations, and all exposure parameters have been collected and the corresponding CTDIv and DLP values have been determined. Results: The majority of patients (75%) were between 60–70 Kg of body weight. There are 25 examinations in this study. Table 1 shows the LDRL of each CT routine examination. Conclusions: Therefore, this study would like to let everyone know DRL’s international status, but also establishment of computed tomography of the local reference levels for our hospital, and providing radiation reference, as a basis for optimizing patient dose.

  14. Developing patient-specific dose protocols for a CT scanner and exam using diagnostic reference levels

    International Nuclear Information System (INIS)

    Strauss, Keith J.

    2014-01-01

    The management of image quality and radiation dose during pediatric CT scanning is dependent on how well one manages the radiographic techniques as a function of the type of exam, type of CT scanner, and patient size. The CT scanner's display of expected CT dose index volume (CTDI vol ) after the projection scan provides the operator with a powerful tool prior to the patient scan to identify and manage appropriate CT techniques, provided the department has established appropriate diagnostic reference levels (DRLs). This paper provides a step-by-step process that allows the development of DRLs as a function of type of exam, of actual patient size and of the individual radiation output of each CT scanner in a department. Abdomen, pelvis, thorax and head scans are addressed. Patient sizes from newborns to large adults are discussed. The method addresses every CT scanner regardless of vendor, model or vintage. We cover adjustments to techniques to manage the impact of iterative reconstruction and provide a method to handle all available voltages other than 120 kV. This level of management of CT techniques is necessary to properly monitor radiation dose and image quality during pediatric CT scans. (orig.)

  15. Fluoroscopy-guided insertion of nasojejunal tubes in children - setting local diagnostic reference levels

    International Nuclear Information System (INIS)

    Vitta, Lavanya; Raghavan, Ashok; Sprigg, Alan; Morrell, Rachel

    2009-01-01

    Little is known about the radiation burden from fluoroscopy-guided insertions of nasojejunal tubes (NJTs) in children. There are no recommended or published standards of diagnostic reference levels (DRLs) available. To establish reference dose area product (DAP) levels for the fluoroscopy-guided insertion of nasojejunal tubes as a basis for setting DRLs for children. In addition, we wanted to assess our local practice and determine the success and complication rates associated with this procedure. Children who had NJT insertion procedures were identified retrospectively from the fluoroscopy database. The age of the child at the time of the procedure, DAP, screening time, outcome of the procedure, and any complications were recorded for each procedure. As the radiation dose depends on the size of the child, the children were assigned to three different age groups. The sample size, mean, median and third-quartile DAPs were calculated for each group. The third-quartile values were used to establish the DRLs. Of 186 procedures performed, 172 were successful on the first attempt. These were performed in a total of 43 children with 60% having multiple insertions over time. The third-quartile DAPs were as follows for each age group: 0-12 months, 2.6 cGy cm 2 ; 1-7 years, 2.45 cGy cm 2 ; >8 years, 14.6 cGy cm 2 . High DAP readings were obtained in the 0-12 months (n = 4) and >8 years (n = 2) age groups. No immediate complications were recorded. Fluoroscopy-guided insertion of NJTs is a highly successful procedure in a selected population of children and is associated with a low complication rate. The radiation dose per procedure is relatively low. (orig.)

  16. A study to establish international diagnostic reference levels for paediatric computed tomography

    International Nuclear Information System (INIS)

    Vassileva, J.; Rehani, M.; Kostova-Lefterova, D.; Al-Naemi, H.M.; Al Suwaidi, J.S.; Arandjic, D.; Bashier, E.H.O.; Kodlulovich Renha, S.; El-Nachef, L.; Aguilar, J.G.; Gershan, V.; Gershkevitsh, E.; Gruppetta, E.; Hustuc, A.; Jauhari, A.; Hassan Kharita, Mohammad; Khelassi-Toutaoui, N.; Khosravi, H.R.; Khoury, H.; Kralik, I.; Mahere, S.; Mazuoliene, J.; Mora, P.; Muhogora, W.; Muthuvelu, P.; Nikodemova, D.; Novak, L.; Pallewatte, A.; Pekarovic, D.; Shaaban, M.; Shelly, E.; Stepanyan, K.; Thelsy, N.; Visrutaratna, P.; Zaman, A.

    2015-01-01

    The article reports results from the largest international dose survey in paediatric computed tomography (CT) in 32 countries and proposes international diagnostic reference levels (DRLs) in terms of computed tomography dose index (CTDI vol ) and dose length product (DLP). It also assesses whether mean or median values of individual facilities should be used. A total of 6115 individual patient data were recorded among four age groups: <1 y, >1-5 y, >5-10 y and >10-15 y. CTDI w , CTDI vol and DLP from the CT console were recorded in dedicated forms together with patient data and technical parameters. Statistical analysis was performed, and international DRLs were established at rounded 75. percentile values of distribution of median values from all CT facilities. The study presents evidence in favour of using median rather than mean of patient dose indices as the representative of typical local dose in a facility, and for establishing DRLs as third quartile of median values. International DRLs were established for paediatric CT examinations for routine head, chest and abdomen in the four age groups. DRLs for CTDI vol are similar to the reference values from other published reports, with some differences for chest and abdomen CT. Higher variations were observed between DLP values, based on a survey of whole multi-phase exams. It may be noted that other studies in literature were based on single phase only. DRLs reported in this article can be used in countries without sufficient medical physics support to identify non-optimised practice. Recommendations to improve the accuracy and importance of future surveys are provided. (authors)

  17. Towards the definition of Institutional diagnostic reference levels in paediatric interventional cardiology procedures in Greece.

    Science.gov (United States)

    Kottou, S; Kollaros, N; Plemmenos, C; Mastorakou, I; Apostolopoulou, S C; Tsapaki, V

    2018-02-01

    This study aimed to evaluate paediatric radiation doses in a dedicated cardiology hospital, with the objective of characterising patterns in dose variation. The ultimate purpose was to define Local (Institutional) Diagnostic Reference Levels (LDRLs) for different types of paediatric cardiac interventional procedures (IC), according to patient age. From a total of 710 cases performed during three consecutive years, by operators with more than 15 years of experience, the age was noted in only 477 IC procedures. The median values obtained for Fluoroscopy Time (FT), Number of Frames (N) and Kerma Area Product (P KA ) by age range were 5.8 min, 1322 and 2.0 Gy.cm 2 for definition of LDRLs presents challenges mainly due to the multiple clinical and technical factors affecting the outcome. On the other hand the lack of paediatric IC DRLs makes the identification of good practices more difficult. A consensus is needed on IC procedures nomenclature and grouping in order to allow a common assessment and comparison of doses. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. Dose area product measurement for diagnostic reference levels and analysis of patient dose in dental radiography

    International Nuclear Information System (INIS)

    Han, S.; Lee, B.; Shin, G.; Choi, J.; Kim, J.; Park, C.; Park, H.; Lee, K.; Kim, Y.

    2008-01-01

    In this study, diagnostic reference levels (DRLs) were suggested and patient doses were analysed through the dose-area product value in dental radiography. In intraoral radiography, at three sites, i.e. molar, premolar and incisor on the maxilla and acquired third quartile values: 55.5, 46 and 36.5 mGy cm 2 , respectively, were measured. In panoramic, cephalo-metric and cone beam computed tomography, the values were 120.3, 146 and 3203 mGy cm 2 (16 x 18 cm), respectively. It has been shown that, in intraoral radiography, the patient dose changes proportionally to the value of mA s, but the change in extra-oral radiography in response to mA s could not be confirmed. The authors could confirm, however, the difference in dose according to the manufacturer in all dental radiography examinations, except for panoramic radiography. Depending on the size of hospital, there were some differences in patient dose in intraoral radiography, but no difference in patient dose in extra-oral radiography. (authors)

  19. Radiation safety concerns and diagnostic reference levels for computed tomography scanners in Tamil Nadu

    International Nuclear Information System (INIS)

    Livingstone, Roshan S.; Dinakaran, Paul M.

    2011-01-01

    Radiation safety in computed tomography (CT) scanners is of concern due its widespread use in the field of radiological imaging. This study intends to evaluate radiation doses imparted to patients undergoing thorax, abdomen and pelvic CT examinations and formulate regional diagnostic reference levels (DRL) in Tamil Nadu, South India. In-site CT dose measurement was performed in 127 CT scanners in Tamil Nadu for a period of 2 years as a part of the Atomic Energy Regulatory Board (AERB)-funded project. Out of the 127 CT scanners,13 were conventional; 53 single-slice helical scanners (SSHS); 44 multislice CT (MSCT) scanners; and 17 refurbished scanners. CT dose index (CTDI) was measured using a 32-cm polymethyl methacrylate (PMMA)-body phantom in each CT scanner. Dose length product (DLP) for different anatomical regions was generated using CTDI values. The regional DRLs for thorax, abdomen and pelvis examinations were 557, 521 and 294 mGy cm, respectively. The mean effective dose was estimated using the DLP values and was found to be 8.04, 6.69 and 4.79 mSv for thorax, abdomen and pelvic CT examinations, respectively. The establishment of DRLs in this study is the first step towards optimization of CT doses in the Indian context. (author)

  20. Patient doses in CT examinations in Switzerland: Implementation of national diagnostic reference levels

    International Nuclear Information System (INIS)

    Treier, R.; Aroua, A.; Verdun, F. R.; Samara, E.; Stuessi, A.; Trueb, P. R.

    2010-01-01

    Diagnostic reference levels (DRLs) were established for 21 indication-based CT examinations for adults in Switzerland. One hundred and seventy-nine of 225 computed tomography (CT) scanners operated in hospitals and private radiology institutes were audited on-site and patient doses were collected. For each CT scanner, a correction factor was calculated expressing the deviation of the measured weighted computed tomography dose index (CTDI) to the nominal weighted CTDI as displayed on the workstation. Patient doses were corrected by this factor providing a realistic basis for establishing national DRLs. Results showed large variations in doses between different radiology departments in Switzerland, especially for examinations of the petrous bone, pelvis, lower limbs and heart. This indicates that the concept of DRLs has not yet been correctly applied for CT examinations in clinical routine. A close collaboration of all stakeholders is mandatory to assure an effective radiation protection of patients. On-site audits will be intensified to further establish the concept of DRLs in Switzerland. (authors)

  1. Establishment of diagnostic reference levels for dental panoramic radiography in Greece

    International Nuclear Information System (INIS)

    Manousaridis, G.; Koukorava, C.; Hourdakis, C.J.; Kamenopoulou, V.; Yakoumakis, E.; Tsiklakis, K.

    2015-01-01

    The purpose of the present study was to present the national diagnostic reference levels (DRL) established for panoramic dental examinations in Greece. The establishment of DRL, as a tool for the optimisation of radiological procedures, is a requirement of national regulations. Measurements performed by the Greek Atomic Energy Commission on 90 panoramic systems have been used for the derivation of DRL values. DRL values have been proposed for exposure settings of different patient types (child, small adult and standard adult), both for film and digital imaging. The DRLs for different patient types are grouped in three categories: children, small adults (corresponding to female) and average adults (corresponding to male). Proposed DRLs for these groups are 2.2, 3.3 and 4.1 mGy, respectively. In order to investigate the correlation of DRLs with the available imaging modalities (CR, DR and film), this parameter was taken into account. DR imaging DRL is the lowest at 3.5 mGy, CR imaging the highest at 4.2 mGy and film imaging at 3.7 mGy. In order to facilitate comparison with other studies, kerma-width product values were calculated from K i , air and field size. (authors)

  2. Diagnostic reference levels and complexity indices in interventional radiology: a national programme

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz-Cruces, R.; Perez-Martinez, M.; Pastor-Vega, J.M.; Canete, S. [University of Malaga, School of Medicine, Malaga (Spain); Vano, E.; Fernandez-Soto, J.M.; Sanchez-Casanueva, R.; Gallego-Beuter, J.J. [Complutense University, San Carlos Hospital, Medical School, Madrid (Spain); Carrera-Magarino, F.; Moreno-Rodriguez, F.; Moreno-Sanchez, T. [Juan Ramon Jimenez University Hospital, Huelva (Spain); Soler-Cantos, M.M.; Canis-Lopez, M. [Reina Sofia University Hospital, Cordoba (Spain); Hernandez-Armas, J.; Diaz-Romero, F.J. [University Hospital of Canary Islands, Tenerife (Spain); Rosales-Espizua, F.; Lopez-Medina, A.; Gonzalez-de-Garay, M. [Basurto Hospital, Bilbao (Spain); Martin-Palanca, A. [Virgen de la Victoria University Hospital, Malaga (Spain); Gil-Agudo, A.; Zarca-Diaz, M.A.; Zapata-Jimenez, J.C. [General University Hospital, Ciudad Real (Spain); Parra-Osorio, V.; Munoz Ruiz-Canela, J.J.; Moreno-Saiz, C.; Galan-Montenegro, P. [Carlos Haya University Hospital, Malaga (Spain)

    2016-12-15

    To propose national diagnostic reference levels (DRLs) for interventional radiology and to evaluate the impact of the procedural complexity on patient doses. Eight interventional radiology units from Spanish hospitals were involved in this project. The participants agreed to undergo common quality control procedures for X-ray systems. Kerma area product (KAP) was collected from a sample of 1,649 procedures. A consensus document established the criteria to evaluate the complexity of seven types of procedures. DRLs were set as the 3rd quartile of KAP values. The KAP (3rd quartile) in Gy cm{sup 2} for the procedures included in the survey were: lower extremity arteriography (n = 784) 78; renal arteriography (n = 37) 107; transjugular hepatic biopsies (THB) (n = 30) 45; biliary drainage (BD) (n = 314) 30; uterine fibroid embolization (UFE) (n = 56) 214; colon endoprostheses (CE) (n = 31) 169; hepatic chemoembolization (HC) (n = 269) 303; femoropopliteal revascularization (FR) (n = 62) 119; and iliac stent (n = 66) 170. The complexity involved the increases in the following KAP factors from simple to complex procedures: THB x4; BD x13; UFE x3; CE x3; HC x5; FR x5 and IS x4. The evaluation of the procedure complexity in patient doses will allow the proper use of DRLs for the optimization of interventional radiology. (orig.)

  3. The impact of diagnostic reference levels on patient doses from X-ray examinations

    International Nuclear Information System (INIS)

    Leitz, W.; Almen, A.

    2008-01-01

    The aim of this study was to evaluate the effect of diagnostic reference levels (DRL). For this study patient doses for the years 1999 and 2006 were available. Patient doses on a national level for eleven specified X-ray examinations were assessed. For the conventional examinations DRL have been used after the first survey in 1999, for computed tomography no DRL were used and for mammography DRL have been used for more than 20 years. Whereas the patient doses for conventional examinations were 30% lower in 2006 compared to 1999 the doses remained essentially the same for computed tomography and mammography. The widths of the dose distributions had only slightly decreased for conventional examinations and remained the same for computed tomography and mammography. This study has shown that after implementation of DRL a considerable dose reduction can be expected. Practices exceeding DRL will perform remedial actions with the aim to reduce dose, as demonstrated for the conventional examinations. Despite the fact that practices for computed tomography could compare doses with others practices, in the absence of DRL no actions to reduce doses were performed. The margin for further dose reductions in mammography is small due to the long term use of DRL. The impact of DRL on patient doses is changing with time. When introduced large dose reductions can be expected. After long term use DRL will counteract the introduction of new technique with unjustified high patient doses. Despite the merits in terms of dose saving it must be recognized that DRL has its limits - it has to be amended with other radiological protection activities. Other means and measures have to be developed, for example by the authorities, in order to ensure that optimisation is continued even when the patient doses are below the DRL. (author)

  4. SU-E-I-33: Establishment of CT Diagnostic Reference Levels in Province Nova Scotia

    Energy Technology Data Exchange (ETDEWEB)

    Tonkopi, E; Abdolell, M; Duffy, S [Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (Canada)

    2015-06-15

    Purpose: To evaluate patient radiation dose from the most frequently performed CT examinations and to establish provincial diagnostic reference levels (DRLs) as a tool for protocol optimization. Methods: The study investigated the following CT examinations: head, chest, abdomen/pelvis, and chest/abdomen/pelvis (CAP). Dose data, volume CT dose index (CTDIvol) and dose-length product (DLP), were collected from 15 CT scanners installed during 2004–2014 in 11 hospital sites of Nova Scotia. All scanners had dose modulation options and multislice capability (16–128 detector rows). The sample for each protocol included 15 average size patients (70±20 kg). Provincial DRLs were calculated as the 75th percentile of patient dose distributions. The differences in dose between hospitals were evaluated with a single factor ANOVA statistical test. Generalized linear modeling was used to determine the factors associated with higher radiation dose. A sample of 36 abdominal studies performed on three different scanners was blinded and randomized for an assessment by an experienced radiologist who graded the imaging quality of anatomic structures. Results: Data for 900 patients were collected. The DRLs were proposed using CTDIvol (mGy) and DLP (mGy*cm) values for CT head (67 and 1049, respectively), chest (12 and 393), abdomen/pelvis (16 and 717), and CAP (14 and 1034). These DRLs were lower than the published national data except for the head CTDIvol. The differences between the means of the dose distributions from each scanner were statistically significant (p<0.05) for all examinations. A very weak correlation was found between the dose and the scanner age or the number of slices with Pearson’s correlation coefficients of 0.011–0.315. The blinded analysis of image quality demonstrated no clinically significant difference except for the noise category. Conclusion: Provincial DRLs were established for typical CT examinations. The variations in dose between the hospitals

  5. Use of the mini C-arm for wrist fractures - Establishing a diagnostic reference level

    International Nuclear Information System (INIS)

    Love, G. J.; Pillai, A.; Gibson, S.

    2008-01-01

    The establishment of diagnostic reference levels (DRLs) for all typical radiological examinations became mandatory following the implementation of the Ionising Radiations (Medical Exposure) Regulations Act 2000. At present, there are no national dosage guidelines in the UK regarding use of fluoroscopy in orthopaedic trauma. The increasing popularity of the mini C-arm image intensifier amongst surgeons has led to concerns regarding use of ionizing radiation by personnel who have not been trained in radiation protection. It is therefore essential to have formal protocols for use of the mini C-arm to comply with the law and to maintain safe clinical practice. It is attempted to provide dose data for wrist fracture manipulations that may be used as a basis for setting a DRL for this procedure. Screening times were recorded for 80 wrist manipulations in a fracture clinic setting using a mini C-arm image intensifier. A DRL was set using the third quartile value for screening time. The median screening time for wrist fractures was 20 s with a range from 1 to 177 s. The third quartile value for screening time was 34 s. This value can be used as a provisional DRL for wrist fracture manipulations. The DRL is a quantitative guide for the optimisation of radiological protection. IR(ME)R 2000 states that if it is consistently exceeded by an individual operator or a piece of equipment, investigation and remedial action must be taken. We recommend that trauma units establish their own local DRLs for common procedures as made mandatory by legislation. (authors)

  6. Establishment of local diagnostic reference levels for quality control in intraoral radiography.

    Science.gov (United States)

    Izawa, Maki; Harata, Yasuo; Shiba, Noriyoshi; Koizumi, Nobuhide; Ozawa, Tomonori; Takahashi, Nobutoshi; Okumura, Yasuhiko

    2017-01-01

    To investigate the dosage and imaging conditions for patients undergoing intraoral radiography at Meikai University Hospital and establish assurance and quality control data. Tube voltage, exposure time, and air kinetic energy released per unit mass (air kerma) of three intraoral radiography units were measured. To calculate the patient entrance dose (PED) for each radiograph using Insight film, we extracted data for 1063 patients from their exposure records. The PED was compared with the diagnostic reference level (DRL) from the European Commission and the UK. The tube voltage of the three units was maintained at 60 ± 2 kV. Differences in exposure time were less than 1.7 % for all units. The air kerma rates were well maintained within a 4.2 % error. Based on the patient data, there were no significant differences in the mean exposure times for males and females for all anatomical sites. The mean PED ranged from 1.09 ± 0.31 mGy for the mandibular incisors to 2.42 ± 0.33 mGy for the maxillary molars. The mean PED at the mandibular molars using InSight film was 1.59 ± 0.20 mGy, being less than the recommended value based on the DRL for intraoral radiography in the UK. We concluded that radiographic conditions at the hospital have been properly maintained. This basic quality control data may assist other dental radiation facilities to reduce patient dosage.

  7. Diagnostic reference levels for X-ray investigations in pain management units in Belgium

    International Nuclear Information System (INIS)

    Lichtherte, S.; Le Polain de Waroux, B.

    2008-01-01

    X-rays are commonly used in pain treatment centres where infiltrative techniques are performed. Although X-rays are useful in increasing the precision of infiltrative techniques, their use puts patients and staff at risk of radiation exposure. As a result, medical staff now have to obtain a certificate of training on the use of X-rays before being allowed to use X-rays in practice. This analysis was based on 373 detailed registrations of procedure-related parameters in the six centres that participated in this study between January 2009 and July 2009. Examinations chosen for inclusion in this study were the most commonly performed fluoroscopic imaging-guided procedures in a pain management unit: epidural (cervical/lumbar), facet joint nerve blocks (cervical/lumbar) and trans-foraminal (cervical/lumbar). The sample size, the dose-area product (DAP) range for whole population, the mean and the third quartile DAP corrected for patient size (DAP corr ), the screening time range, the mean and the third quartile screening time are presented. The proposed DRLs for epidural, facet joint nerve blocks and trans-foraminal are 0.5, 2.5 and 3 Gy cm 2 for DAP values and 12, 60 and 50 s for screening times, respectively. In the absence of national diagnostic reference levels (DRLs) for pain management fluoroscopic procedures, these DAP and screening time values provide a possible way of establishing provisional DRLs for local use. The values for each examination type could be used as a baseline against which to monitor the effectiveness of dose reduction strategies as part of the optimisation process that is the goal of any quality control and patient dose monitoring system. (authors)

  8. Establishment of institutional diagnostic reference level for computed tomography with automated dose-tracking software.

    Science.gov (United States)

    Liang, Chong R; Chen, Priscilla X H; Kapur, Jeevesh; Ong, Michael K L; Quek, Swee T; Kapur, Subhash C

    2017-06-01

    The aim of this study was to establish institutional diagnostic reference levels (DRLs) by summarising doses collected across the five computed tomography (CT) system in our institution. CT dose data of 15940 patients were collected retrospectively from May 2015 to October 2015 in five institutional scanners. The mean, 75th percentile and 90th percentile of the dose spread were calculated according to anatomic region. The common CT examinations such as head, chest, combined abdomen/pelvis (A/P), and combined chest/abdomen/pelvis (C/A/P) were reviewed. Distribution of CT dose index (CTDIvol), dose-length product (DLP) and effective dose (ED) were extracted from the data for single-phasic and multiphasic examinations. The institutional DRL for our CT units were established as mean (50th percentile) of CTDIvol (mGy), DLP (mGy.cm) and ED (mSv) for single and multiphasic studies using the dose-tracking software. In single phasic examination, Head: (49.0 mGy), (978.0 mGy.cm), (2.4 mSv) respectively; Chest: (6.0 mGy), (254.0 mGy.cm), (4.9 mSv) respectively; CT A/P (10.0 mGy), (514.0 mGy.cm), (8.9 mSv) respectively; CT C/A/P (10.0 mGy), (674.0 mGy.cm), (11.8 mSv) respectively. In multiphasic studies: Head (45.0 mGy), (1822.0 mGy.cm), (5.0 mSv) respectively; Chest (8.0 mGy), (577.0 mGy.cm), (10.0 mSv) respectively; CT A/P: (10.0 mGy), (1153.0 mGy.cm), (20.2 mSv) respectively; CT C/A/P: (11.0 mGy), (1090.0 mGy.cm), (19.2 mSv) respectively. The reported metrics offer a variety of information that institutions can use for quality improvement activities. The variations in dose between scanners suggest a large potential for optimisation of radiation dose. © 2017 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

  9. Determination of diagnostic reference levels in general radiography in Latin America

    International Nuclear Information System (INIS)

    Blanco, S.; Mora, P.; Almonte, N.; Benavente, T.; Benson, N.; Blanco, D.; Cardenas, J.; Gomez, Y. D.; Edding, O.; Escobar, C.; Fonseca, M.; Gamarra, M.; Aguilar, J. G.; Khoury, H. J.; Quintero, A. R.; Zuniga, N. R.; Zaire, E.; Nader, A.

    2013-01-01

    The International Atomic Energy Agency (IAEA) through the International Action Plan on Radiation Protection of Patients and the International Commission on Radiological Protection have for some time carried out important efforts to assure that in the medical applications of the ionising radiations, the optimisation of radiological protection of patients is fundamental, to such a point that the IAEA includes it directly as a requirement for these practices (in its International Basic Safety Standards for Protection against Ionising Radiation and for the Safety of Radiation Sources (BSS)-GSR Part 1, 2011). For this reason, among the objectives of Regional Project RLA/9/057 and Regional Project RLA/9/067, the intention was to establish the dose references in conventional radiology for Latin America, for the purposes of determining whether these doses comply with the requirements of the BSS and to tend to improve practices, in order to minimise the dose received by the patients. (authors)

  10. Establishment of national diagnostic reference level for renal doses in nuclear medicine departments at Khartoum-Sudan

    International Nuclear Information System (INIS)

    Alameen, Suhaib; Hamid, Alhadi; Rushdi, M. A. H.

    2016-01-01

    In this work we established a diagnostic reference level (DRL) for patient dose focusing on the investigation of activity to the kidneys during(99mTc-DTPA) kidney scan, selected two department nuclear medicine in main hospitals in Khartoum state. The DRLs is an investigational level used to identify unusually high radiation doses for common diagnostic medical in Nuclear Medicine procedures and suggested action levels above which a facility should review its methods and determine if acceptable image quality can be achieved at lower doses. The high specific activity of 99mTc makes it suitable as a first pass agent, for multiple or sequential studies, 99mTc diethylenetriaminepentaacetic acid (DTPA) is preferred to 99mTc-pertechnetate. Patients who had been prepared for the kidney scan 99mTc- DTPA were divided to three groups. The first group received dose less than 5 mCi, are represent (27.03%) from all patients, second group received dose 5 to 5.5 mCi are represent(66.67%) and the third group received dose from 5.6 to 6.2 mCi are represent (6.31%) from all patients 99mTc-DTPA. And according to the IAEA recommendation for adult doses(5-10mCi) this study show that about 93.1% of the sample examines by dose less than 5.5 mCi. The results presented will serve as a baseline data needed for deriving reference doses for renal examinations for nuclear medicine departments in Sudan.(Author)

  11. Local diagnostic reference levels, approaches and compare the values in the South Bohemia Region in view of radiation protection inspector

    International Nuclear Information System (INIS)

    Zemanova, E.

    2014-01-01

    This paper compares the value of local diagnostic reference levels(the LDRL)in health facilities of the South Bohemia Region. The work is motivated by questions of licensees, who would like to know their position in terms of the LDRL compared to other workplaces. Also by the activity of the inspector who can identify the problematic workplaces, where is necessary to increase attention to optimization, exposure, or justification. In connection with the ongoing internal audits in licensee workplaces the information about the status of the LDRL among others is current, motivating licensee to changes, optimization and verification of compliance with the recommendation of the National radiological standard of Ministry of Health (author)

  12. A comparison of the suitability of patient dosimetry methods for establishing diagnostic dose reference levels and optimisation strategies

    International Nuclear Information System (INIS)

    Gfirtner, Hans; Moores, B. Michael; Stieve, Friedrich E.

    2008-01-01

    For 50 adult patients referred for chest radiography, air kerma at the diaphragm KD, dose area product and entrance skin dose were measured. The air kerma at the diaphragm and the dose area product were determined using Diamentor M4KDK(PTW) which allows measuring air kerma and dose area product simultaneously. For the measurement of entrance skin dose TLDs are used. A 50% variation in dose, incident dose as well as entrance skin dose, was registered for the same patient thickness. The recommendation of ICRP to perform the measurements for DRLs at 'representative patients' and that of the CEC to use 'standard-sized patients' seem to make little sense in the case of chest radiography. It could be demonstrated, that the dose area product is the least appropriate dose quantity for patient measurements and to define dose reference levels. For some radiological examinations like chest, pelvis and lumbar spine the dose area product is even sex dependent. Incident dose and entrance surface dose are of equal quality for patient dose measurements in diagnostic radiography. (author)

  13. Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and patient weight values

    Energy Technology Data Exchange (ETDEWEB)

    Ubeda, Carlos, E-mail: cubeda@uta.cl [Medical Technology Department, Radiological Sciences Center, Health Sciences Faculty, Tarapaca University, Arica 1000000 (Chile); Miranda, Patricia [Hemodynamic Department, Cardiovascular Service, Luis Calvo Mackenna Hospital, Santiago 7500539 (Chile); Vano, Eliseo [Radiology Department, Faculty of Medicine, Complutense University and IdIS, San Carlos Hospital, Madrid 28040 (Spain)

    2015-02-15

    Purpose: To present the results of a patient dose evaluation program in pediatric cardiology and propose local diagnostic reference levels (DRLs) for different types of procedure and age range, in addition to suggesting approaches to correlate patient dose values with patient weight. This study was the first conducted in Latin America for pediatric interventional cardiology under the auspices of the International Atomic Energy Agency. Methods: Over three years, the following data regarding demographic and patient dose values were collected: age, gender, weight, height, number of cine series, total number of cine frames, fluoroscopy time (FT), and two dosimetric quantities, dose-area product (DAP) and cumulative dose (CD), at the patient entrance reference point. The third quartile values for FT, DAP, CD, number of cine series, and the DAP/body weight ratio were proposed as the set of quantities to use as local DRLs. Results: Five hundred and seventeen patients were divided into four age groups. Sample sizes by age group were 120 for <1 yr; 213 for 1 to <5 yr; 82 for 5 to <10 yr; and 102 for 10 to <16 yr. The third quartile values obtained for DAP by diagnostic and therapeutic procedures and age range were 1.17 and 1.11 Gy cm{sup 2} for <1 yr; 1.74 and 1.90 Gy cm{sup 2} for 1 to <5 yr; 2.83 and 3.22 Gy cm{sup 2} for 5 to <10 yr; and 7.34 and 8.68 Gy cm{sup 2} for 10 to <16 yr, respectively. The third quartile value obtained for the DAP/body weight ratio for the full sample of procedures was 0.17 (Gy cm{sup 2}/kg) for diagnostic and therapeutic procedures. Conclusions: The data presented in this paper are an initial attempt at establishing local DRLs in pediatric interventional cardiology, from a large sample of procedures for the standard age bands used in Europe, complemented with the values of the ratio between DAP and patient weight. This permits a rough estimate of DRLs for different patient weights and the refining of these values for the age bands when there

  14. Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and patient weight values

    International Nuclear Information System (INIS)

    Ubeda, Carlos; Miranda, Patricia; Vano, Eliseo

    2015-01-01

    Purpose: To present the results of a patient dose evaluation program in pediatric cardiology and propose local diagnostic reference levels (DRLs) for different types of procedure and age range, in addition to suggesting approaches to correlate patient dose values with patient weight. This study was the first conducted in Latin America for pediatric interventional cardiology under the auspices of the International Atomic Energy Agency. Methods: Over three years, the following data regarding demographic and patient dose values were collected: age, gender, weight, height, number of cine series, total number of cine frames, fluoroscopy time (FT), and two dosimetric quantities, dose-area product (DAP) and cumulative dose (CD), at the patient entrance reference point. The third quartile values for FT, DAP, CD, number of cine series, and the DAP/body weight ratio were proposed as the set of quantities to use as local DRLs. Results: Five hundred and seventeen patients were divided into four age groups. Sample sizes by age group were 120 for <1 yr; 213 for 1 to <5 yr; 82 for 5 to <10 yr; and 102 for 10 to <16 yr. The third quartile values obtained for DAP by diagnostic and therapeutic procedures and age range were 1.17 and 1.11 Gy cm 2 for <1 yr; 1.74 and 1.90 Gy cm 2 for 1 to <5 yr; 2.83 and 3.22 Gy cm 2 for 5 to <10 yr; and 7.34 and 8.68 Gy cm 2 for 10 to <16 yr, respectively. The third quartile value obtained for the DAP/body weight ratio for the full sample of procedures was 0.17 (Gy cm 2 /kg) for diagnostic and therapeutic procedures. Conclusions: The data presented in this paper are an initial attempt at establishing local DRLs in pediatric interventional cardiology, from a large sample of procedures for the standard age bands used in Europe, complemented with the values of the ratio between DAP and patient weight. This permits a rough estimate of DRLs for different patient weights and the refining of these values for the age bands when there may be large differences

  15. Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and patient weight values.

    Science.gov (United States)

    Ubeda, Carlos; Miranda, Patricia; Vano, Eliseo

    2015-02-01

    To present the results of a patient dose evaluation program in pediatric cardiology and propose local diagnostic reference levels (DRLs) for different types of procedure and age range, in addition to suggesting approaches to correlate patient dose values with patient weight. This study was the first conducted in Latin America for pediatric interventional cardiology under the auspices of the International Atomic Energy Agency. Over three years, the following data regarding demographic and patient dose values were collected: age, gender, weight, height, number of cine series, total number of cine frames, fluoroscopy time (FT), and two dosimetric quantities, dose-area product (DAP) and cumulative dose (CD), at the patient entrance reference point. The third quartile values for FT, DAP, CD, number of cine series, and the DAP/body weight ratio were proposed as the set of quantities to use as local DRLs. Five hundred and seventeen patients were divided into four age groups. Sample sizes by age group were 120 for bands used in Europe, complemented with the values of the ratio between DAP and patient weight. This permits a rough estimate of DRLs for different patient weights and the refining of these values for the age bands when there may be large differences in child size. These DRLs were obtained at the largest pediatric hospital in Chile, with an active optimization program, and could be used by other hospitals in the Latin America region to compare their current patient dose values and determine whether corrective action is appropriate. © 2015 American Association of Physicists in Medicine.

  16. Analysis of data relative to the update of diagnostic reference levels in radiology and nuclear medicine. 2011-2012 review

    International Nuclear Information System (INIS)

    2014-01-01

    Applying the Order of 24 October 2011 on diagnostic reference levels, departments of radiology and nuclear medicine must send a sample of 'patient' dosimetric data to the IRSN each year. The results of the analysis of dosimetric data performed between the 1 January 2011 and the 31 December 2012 presented in this report should enable the authority to define the needs for updating regulations. Professional involvement in DRLs improved globally over the 2011-2012 period but is heterogeneous according to the imaging area considered. The participation of conventional radiology professionals is still low, with less than 30% against over 75% in CT and 85% in nuclear medicine. Data collection in pediatrics, considering all the fields of medical imaging, remains extremely limited. This shows almost no dose assessment for children by imaging departments, and has the effect of not allowing authorities to provide professionals with DRLs representative of pediatric practices. The analysis of radiology doses and nuclear medicine administered activities by IRSN shows an overall decrease of statistical indicators on which DRLs are indexed. These results lead to proposals for updating reference values for a large number of examinations. In addition to the analysis of data collected for examinations currently mentioned in regulatory texts, IRSN recommends to update DRLs in a more general way by changing the strategy for collecting and updating pediatric DRLs, by including interventional radiology - specialty in which the radiation protection presents a major challenge - by introducing a more ambitious indicator than the 75. percentile in conventional radiology and nuclear medicine - the 25. percentile statistical indicator, and by taking into account new technologies inducing additional exposures to the patient as CT-scan associated with the PET. (authors)

  17. Evidence of dose saving in routine CT practice using iterative reconstruction derived from a national diagnostic reference level survey.

    Science.gov (United States)

    Thomas, P; Hayton, A; Beveridge, T; Marks, P; Wallace, A

    2015-09-01

    To assess the influence and significance of the use of iterative reconstruction (IR) algorithms on patient dose in CT in Australia. We examined survey data submitted to the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) National Diagnostic Reference Level Service (NDRLS) during 2013 and 2014. We compared median survey dose metrics with categorization by scan region and use of IR. The use of IR results in a reduction in volume CT dose index of between 17% and 44% and a reduction in dose-length product of between 14% and 34% depending on the specific scan region. The reduction was highly significant (p sum test) for all six scan regions included in the NDRLS. Overall, 69% (806/1167) of surveys included in the analysis used IR. The use of IR in CT is achieving dose savings of 20-30% in routine practice in Australia. IR appears to be widely used by participants in the ARPANSA NDRLS with approximately 70% of surveys submitted employing this technique. This study examines the impact of the use of IR on patient dose in CT on a national scale.

  18. Diagnostic reference levels for common computed tomography (CT) examinations: results from the first Nigerian nationwide dose survey.

    Science.gov (United States)

    Ekpo, Ernest U; Adejoh, Thomas; Akwo, Judith D; Emeka, Owujekwe C; Modu, Ali A; Abba, Mohammed; Adesina, Kudirat A; Omiyi, David O; Chiegwu, Uche H

    2018-01-29

    To explore doses from common adult computed tomography (CT) examinations and propose national diagnostic reference levels (nDRLs) for Nigeria. This retrospective study was approved by the Nnamdi Azikiwe University and University Teaching Hospital Institutional Review Boards (IRB: NAUTH/CS/66/Vol8/84) and involved dose surveys of adult CT examinations across the six geographical regions of Nigeria and Abuja from January 2016 to August 2017. Dose data of adult head, chest and abdomen/pelvis CT examinations were extracted from patient folders. The median, 75th and 25th percentile CT dose index volume (CTDI vol ) and dose-length-product (DLP) were computed for each of these procedures. Effective doses (E) for these examinations were estimated using the k conversion factor as described in the ICRP publication 103 (E DLP  =  k × DLP ). The proposed 75th percentile CTDI vol for head, chest, and abdomen/pelvis are 61 mGy, 17 mGy, and 20 mGy, respectively. The corresponding DLPs are 1310 mGy.cm, 735 mGy.cm, and 1486 mGy.cm respectively. The effective doses were 2.75 mSv (head), 10.29 mSv (chest), and 22.29 mSv (abdomen/pelvis). Findings demonstrate wide dose variations within and across centres in Nigeria. The results also show CTDI vol comparable to international standards, but considerably higher DLP and effective doses.

  19. Sci-Thur PM – Colourful Interactions: Highlights 07: Canadian Computed Tomography Survey: National Diagnostic Reference Levels

    Energy Technology Data Exchange (ETDEWEB)

    Wardlaw, Graeme M; Martel, Narine [Consumer & Clinical Radiation Protection Bureau / Health Canada (Canada)

    2016-08-15

    Purpose: The Canadian Computed (CT) Tomography Survey sought to collect CT technology and dose index data (CTDI and DLP) at the national level in order to establish national diagnostic reference levels (DRLs) for seven common CT examinations of standard-sized adults and pediatric patients. Methods: A single survey booklet (consisting of four sections) was mailed to and completed for each participating CT scanner. Survey sections collected data on (i) General facility and scanner information, (ii) routine protocols (as available), (iii) individual patient data (as applied) and (iv) manual CTDI measurements. Results: Dose index (CTDIvol and DLP) and associated patient data from 24 280 individual patient exam sequences was analyzed for seven common CT examinations performed in Canada: Adult Head, Chest, Abdomen/Pelvis, and Chest/Abdomen/Pelvis, and Pediatric Head, Chest, and Abdomen. Pediatric examination data was sub-divided into three age ranges: 0–3, 3–7 and 7–13 years. DRLs (75th percentile of dose index distributions) were found for all thirteen groups. Further analysis also permitted segmentation of examination data into 8 sub-groups, whose dose index data was displayed along with group histograms – showing relative contribution of axial vs. helical, contrast use (C+ vs. C-), and application of fixed current vs. dose reduction (DR) – 75th percentiles of DR sub-groups were, in almost all cases, lower than whole group (examination) DRLs. Conclusions: The analysis and summaries presented in the pending survey report can serve to aid local CT imaging optimization efforts within Canada and also contribute further to international efforts in radiation protection of patients.

  20. Analysis of data relative to the update of diagnostic reference levels in radiology and nuclear medicine. 2013-2015 review

    International Nuclear Information System (INIS)

    2016-11-01

    Applying the Order of 24 October 2011 on diagnostic reference levels, departments of radiology and nuclear medicine must send a sample of 'patient' dosimetric data to the IRSN each year. The results of the analysis of dosimetric data performed between the 1 January 2013 and the 31 December 2015 presented in this report should enable the authority to define the needs for updating regulation. This assessment takes place in a national and international context particularly rich and active since the last years. More than 20 years after the official introduction of the DRL concept by ICRP and the first regulation requirements at a European level, the good and the bad sides of the DRLs systems implemented by several countries, including France, has shown the necessity of complementary actions regarding some specific practices (pediatrics, interventional radiology). On one hand, from a national point of view, the current collection and analysis system is highly efficient for evaluation of practices in France and for DRL update ability. On the other hand, as an optimization implementation tool, regarding the lack of professionals involvement, the current system should not be considered as fully effective in radiology. However, when the professionals carry out DRL data collection and analysis, optimization actions are implemented for nearly all the cases. During the 2013-2015 period, professionals involvement in DRLs globally improved but is heterogeneous according to the imaging area considered. The participation of conventional radiology professionals is still low, with less than 30% against about 80% in CT and more than 85% in nuclear medicine. From a dosimetric point of view, the national analysis shows an overall decrease of statistical indicators in radiology, computed tomography and nuclear medicine on which DRLs are indexed. These results lead to proposals for updating reference values for a large number of examinations. In addition to the analysis of data collected

  1. MO-FG-CAMPUS-IeP1-03: Establishment of Provincial Diagnostic Reference Levels in Pediatric Imaging

    International Nuclear Information System (INIS)

    Tonkopi, E; O’Brien, K

    2016-01-01

    Purpose: To establish provincial diagnostic reference levels (DRLs) in pediatric general radiography and computed tomography (CT) as a tool for the optimization of exposure parameters. Methods: Patient dose survey was conducted in the only pediatric hospital in the province of Nova Scotia. The DRLs were established as the 75th percentile of patient dose distributions in different age groups. For routine radiography projections the DRLs were determined in terms of entrance surface dose (ESD) calculated from the radiation output measurements and the tube current-exposure time product (mAs) recorded for each examination. Patient thickness was measured by the technologist during the examination. The CR and DR systems, employing respectively a fixed technique and phototiming, were evaluated separately; a two-tailed Student’s t-test was used to determine the significance of differences between the means of dose distributions. The CT studies included routine head, chest, abdomen/pelvis, and chest/abdomen/pelvis. The volume CT dose index (CTDIvol) and dose-length product (DLP) values were extracted retrospectively from PACS. The correction factors based on the effective diameter of the patient were applied to the CT dosimetry metrics based on the standard phantoms. Results: The provincial DRLs were established in the following age groups: newborn, 1, 5, 10, and 15 year olds. In general radiography the DR systems demonstrated slightly lower dose than the CR for all views, however the differences were not statistically significant (p > 0.05) for all examinations. In CT the provincial DRLs were lower than the published data, except for head DLPs in all age categories. This might be due to the small patient sample size in the survey. Future work will include additional CT data collection over an extended period of time. Conclusion: Provincial DRLs were established in the dedicated children’s hospital to provide guidance for the other facilities in examinations of pediatric

  2. Quality assurance in CT: implementation of the updated national diagnostic reference levels using an automated CT dose monitoring system.

    Science.gov (United States)

    Appel, E; Kröpil, P; Bethge, O T; Aissa, J; Thomas, C; Antoch, G; Boos, J

    2018-03-20

    To evaluate the implementation of the updated computed tomography (CT) diagnostic reference levels (DRLs) from the German Federal Office for Radiation Protection into clinical routine using an automatic CT dose monitoring system. CT radiation exposure was analysed before and after implementing the updated national DRLs into routine clinical work in 2016. After the implementation process, institutional CT protocols were mapped to the anatomical regions for which DRLs were provided. Systematically, protocols that exceeded the thresholds were optimised and analysed in detail. The CT radiation output parameters analysed were volumetric CT dose index (CTDIvol) and dose-length product (DLP). Three radiologists evaluated subjective image quality using a three-point Likert scale. The study included 94,258 CT series (from 27,103 CT examinations) in adult patients performed in 2016. When averaged over all body regions with available DRL, institutional CTDIvol/DLP values were always below the DRLs (65.2±32.9%/67.3±41.5% initially; 59.4±32%/60.5±39.9% after optimisation). Values exceeding the national DRLs were found for pelvis (n=268; CTDIvol 107.7±65.7%/DLP 106.3±79.3%), lumbar spine (n=91; 160.8±74.7%/175.2±104.1%), and facial bones (n=527; 108±39%/152.7±75.7%). After optimisation, CTDIvol and DLP were 87.9±73%/87.8±80.8% for the pelvis, 67.8±33.2%/74.5±50.6% for the lumbar spine and 95.1±45.8%/133.3±74.6% for the viscerocranium. An automatic CT dose monitoring system enabled not only comprehensive monitoring of a DRL implementation process but can also help to optimise radiation exposure. Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  3. MO-FG-CAMPUS-IeP1-03: Establishment of Provincial Diagnostic Reference Levels in Pediatric Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Tonkopi, E [Dalhousie University (Canada); Queen Elizabeth II Health Sciences Ctr (Canada); O’Brien, K [Dalhousie University (Canada); IWK Health Centre, Halifax, NS (Canada)

    2016-06-15

    Purpose: To establish provincial diagnostic reference levels (DRLs) in pediatric general radiography and computed tomography (CT) as a tool for the optimization of exposure parameters. Methods: Patient dose survey was conducted in the only pediatric hospital in the province of Nova Scotia. The DRLs were established as the 75th percentile of patient dose distributions in different age groups. For routine radiography projections the DRLs were determined in terms of entrance surface dose (ESD) calculated from the radiation output measurements and the tube current-exposure time product (mAs) recorded for each examination. Patient thickness was measured by the technologist during the examination. The CR and DR systems, employing respectively a fixed technique and phototiming, were evaluated separately; a two-tailed Student’s t-test was used to determine the significance of differences between the means of dose distributions. The CT studies included routine head, chest, abdomen/pelvis, and chest/abdomen/pelvis. The volume CT dose index (CTDIvol) and dose-length product (DLP) values were extracted retrospectively from PACS. The correction factors based on the effective diameter of the patient were applied to the CT dosimetry metrics based on the standard phantoms. Results: The provincial DRLs were established in the following age groups: newborn, 1, 5, 10, and 15 year olds. In general radiography the DR systems demonstrated slightly lower dose than the CR for all views, however the differences were not statistically significant (p > 0.05) for all examinations. In CT the provincial DRLs were lower than the published data, except for head DLPs in all age categories. This might be due to the small patient sample size in the survey. Future work will include additional CT data collection over an extended period of time. Conclusion: Provincial DRLs were established in the dedicated children’s hospital to provide guidance for the other facilities in examinations of pediatric

  4. The role and impact of reference doses on diagnostic radiology, how to use them at the national level?

    International Nuclear Information System (INIS)

    Nikodemova, D.; Horvathova, M.; Karkus, R.

    2003-01-01

    Results of patient dose audits reported in this paper for several types of examinations and various technical units have shown the importance of applications of reference dose levels in radiological practice. On the basis of national surveys slightly lower or higher standard dose reference levels (DRL) values could be justified. Continuing revision of DRL values and their extension to other types of radiographic and fluoroscopic examinations is needed

  5. Computed Tomography (CT) radiation dose in children: A survey to propose regional diagnostic reference levels in Greater Accra-Ghana

    International Nuclear Information System (INIS)

    Addo, Patience

    2016-07-01

    The aim of this work was to assess the doses delivered to paediatric patients during computed tomography (CT) examinations of the head, chest and abdomen, and establishing regional diagnostic reference levels (RDRLs) for four age groups. The patient data, technique parameters and dose descriptors collected include: age, sex, tube voltage, tube current, rotation time, slice thickness, scan length, volume CT dose index (CTDI_v_o_l) and dose length product (DLP). Currently, paediatric CT examinations account for 11% of radiation exposure. For the paediatric age groups; < 1 year, (1-5 years), (6-10 years) and (11-15 years), the proposed RDRLs for head in terms of CTDI_v_o_l are (28, 38, 48 and 86 mGy) and in terms of DLP; (395, 487, 601, 1614 mGy cm) respectively. For Chest examinations, proposed RDRLs in terms of CTDI_v_o_l are (1 and 5 mGy) and in terms of DLP; (18 and 110 mGy cm) for age groups; < 1 year and (1-5 years) respectively. For Abdomino-pelvic examinations, proposed RDRLs in terms of CTDI_v_o_l are (3, 3 and 10 mGy) and in terms of DLP; (71, 120 and 494 mGy cm) for age groups; < 1 year, (1-5 years) and (6-10 years) respectively. For abdomen examinations, proposed RDRLs in terms of CTDI_v_o_l are (3, 5 and 5 mGy) and in terms of DLP; (83, 124 and 233 mGy cm) for age groups; < 1 year, (1-5 years) and (11-15 years) respectively. RDRLs have been proposed for CTDI_v_o_l and DLP for head, chest, abdomen and Abdomino-pelvic paediatric CT examinations in this study. An optimisation is required for 11-15 years age group for the DLP values which was higher than their corresponding international DRLs. For an effective optimization of patient protection a trade-off between image quality and patients doses studies should be investigated. (au)

  6. Method of evaluation of diagnostics reference levels in computerized tomography; Metodo de avaliacao de niveis de referencia de radiodiagnostico em tomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Vega, Walter Flores

    1999-04-01

    Computerized tomography is a complex technique with several selectable exposition parameters delivering high doses to the patient. In this work it was developed a simple methodology to evaluate diagnostic reference levels in computerized tomography, using the concept of Multiple Scan Average Dose (MSAD), recently adopted by the Health Ministry. For evaluation of the MSAD, a dose distribution was obtained through a measured dose profile on the axial axis of a water phantom with thermoluminescence dosemeters, TLD-100, for different exam technique. The MSAD was evaluated hrough two distinct methods. First, it was evaluated by the integration of the dose profile of a single slice and, second, obtained by the integration on central slice of the profile of several slices. The latter is in of accordance with the ionization chamber method, suggesting to be the most practical method of dose evaluation to be applied in the diagnostic reference level assessment routine for CT, using TLDs. (author)

  7. Reference handbook: Level detectors

    International Nuclear Information System (INIS)

    1990-01-01

    The purpose of this handbook is to provide Rocky Flats personnel with the information necessary to understand level measurement and detection. Upon completion of this handbook you should be able to do the following: List three reasons for measuring level. Describe the basic operating principles of the sight glass. Demonstrate proper techniques for reading a sight glass. Describe the basic operating principles of a float level detector. Describe the basic operating principles of a bubbler level indicating system. Explain the differences between a wet and dry reference leg indicating system, and describe how each functions. This handbook is designed for use by experienced Rocky Flats operators to reinforce and improve their current knowledge level, and by entry-level operators to ensure that they possess a minimum level of fundamental knowledge. Level Detectors is applicable to many job classifications and can be used as a reference for classroom work or for self-study. Although this reference handbook is by no means all-encompassing, you will gain enough information about this subject area to assist you in contributing to the safe operation of Rocky Flats Plant

  8. Patient dose measurement in common medical X-ray examinations and propose the first local dose reference levels to diagnostic radiology in Iran

    Science.gov (United States)

    Rasuli, Behrouz; Tabari Juybari, Raheleh; Forouzi, Meysam; Ghorbani, Mohammad

    2017-09-01

    Introduction: The main purpose of this study was to investigate patient dose in pelvic and abdomen x-ray examinations. This work also provided the LDRLs (local diagnostic reference levels) in Khuzestan region, southwest of Iran to help establish the NDRLs (national diagnostic reference levels). Methods: Patient doses were assessed from patient's anatomical data and exposure parameters based on the IAEA indirect dosimetry method. With regard to this method, exposure parameters such as tube output, kVp, mAs, FFD and patient anatomical data were used for calculating ESD (entrance skin dose) of patients. This study was conducted on 250 standard patients (50% men and 50% women) at eight high-patient-load imaging centers. Results: The results indicate that mean ESDs for the both pelvic and abdomen examinations were lower than the IAEA and EC reference levels, 2.3 and 3.7 mGy, respectively. Mean applied kVps were 67 and 70 and mean FFDs were 103 and 109, respectively. Tube loadings obtained in this study for pelvic examination were lower than all the corresponding values in the reviewed literature. Likewise, the average annual patient load across all hospitals were more than 37000 patients, i.e. more than 100 patients a day. Conclusions: The authors recommend that DRLs (diagnostic reference levels) obtained in this region, which are the first available data, can be used as local DRLs for pelvic and abdomen procedures. This work also provides that on-the-job training programs for staffs and close cross collaboration between physicists and physicians should be strongly considered.

  9. Patient dose audit of the most frequent radiographic examinations and the proposed local diagnostic reference levels in southwestern Nigeria: Imperative for dose optimisation

    Directory of Open Access Journals (Sweden)

    N.N. Jibiri

    2016-07-01

    Full Text Available Diagnostic reference levels (DRLs is a veritable tool for dose optimisation and patient protection in diagnostic radiology. However, it is essential to have information on the local situation especially in a large hospital with several units or a cluster of healthcare centres within a geographical region with several X-ray units. In the present study, entrance surface doses (ESDs were measured in twelve (12 healthcare centres consisting of 15 radiological units using thermoluminescent dosimeters (TLDs. Seven radiological procedures such as; chest PA, abdomen AP, pelvis AP, lumbar spine AP, skull AP, knee AP, and hand AP frequently carried out in Nigeria were included in the study, and their local diagnostic reference levels (LDRLs were determined. The values of the determined LDRLs were compared with established NDRLs in UK, US, Slovenia, Italy and Brazil. The LDRLs determined in the two groups (healthcare centres studied ranged from 1.78 to 3.01, 2.71 to 2.84, 2.11 to 3.79, 3.93 to 8.79, 1.06 to 1.73 and 1.10 to 1.44 mGy for chest PA, pelvis AP, lumbar spine AP, skull AP, knee AP and hand AP respectively. Large variations were found among the X-ray units studied even within the same centre. Entrance surface doses obtained in pelvis AP and lumbar spine AP in both GROUP A and were found to be lower than the NRPB-HPA 2010 review for UK, while in all other five examinations, value of the measured entrance surface dose (ESD are higher than the doses reported in the UK review. The relative higher doses found in the study are attributable to higher tube load (mAs used and indicative of the need for dose optimisation in Nigerian radiological practice.

  10. ENRAF gauge reference level calculations

    Energy Technology Data Exchange (ETDEWEB)

    Huber, J.H., Fluor Daniel Hanford

    1997-02-06

    This document describes the method for calculating reference levels for Enraf Series 854 Level Detectors as installed in the tank farms. The reference level calculation for each installed level gauge is contained herein.

  11. A comparison of mean glandular dose diagnostic reference levels within the all-digital irish national breast screening programme and the Irish symptomatic breast services

    International Nuclear Information System (INIS)

    O'Leary, D.; Rainford, L.

    2013-01-01

    Data on image quality, compression and radiation dose were collected from symptomatic breast units within the Republic of Ireland. Quantitative and qualitative data were analysed using SPSS. Recommendations of mean glandular dose (MGD) diagnostic reference levels were made at various levels for film-screen and full field digital mammography units to match levels published worldwide. MGDs received by symptomatic breast patients within Ireland are higher than those received in the all-digital Irish Breast Screening service; 55-65 mm breast: 1.75 mGy (screening) vs. 2.4 mGy (symptomatic) at the 95. percentile; various reasons are proposed for the differences. MGDs achieved in the screening service may be lower because of the exacting requirements for radiographer training, characteristics of the patients and equipment quality assurance levels. More precise imaging guidelines, standards and training of symptomatic radiographers performing mammography are suggested to remediate MGDs delivered to the breasts of Irish women attending the symptomatic breast services. (authors)

  12. The establishment of local diagnostic reference levels in endoscopic retrograde cholangiopancreatography: a practical tool for the optimisation and for quality assurance management

    International Nuclear Information System (INIS)

    Saukko, E.; Henner, A.; Nieminen, M.T.; Ahonen, S.-M.

    2017-01-01

    Fluoroscopic procedures are an area of special concern in relation to radiation protection. The aim of this study was to describe the current level of patient radiation doses in endoscopic retrograde cholangiopancreatography (ERCP) collected from a single centre, as well as to establish and review local diagnostic reference levels (DRLs) in ERCP. A total of 100 patients' radiation doses in ERCP were recorded, and the third-quartile method was adopted to establish local DRLs for ERCP. The mean dose area product (DAP) was 2.05 Gy cm 2 , fluoroscopy time (FT) 1.7 min and the number of images was 3. The proposed local DRLs for ERCP were 3.00 Gy cm 2 and 3.0 min. Local DRLs were reviewed in a sample of 25 patients 5 y after they had been established. In reviewing data, the averages of DAP and FT were below the local DRLs. Local DRLs help in the optimisation process of fluoroscopic procedures and guides to a good clinical practice. (authors)

  13. SU-E-P-08: Establishment of Local Diagnostic Reference Levels of Routine Abdomen Exam in Computed Tomography According to Body Weight

    International Nuclear Information System (INIS)

    Wang, H; Wang, Y; Weng, H

    2015-01-01

    Purpose: The national diagnostic reference levels (NDRLs) is an efficient, concise and powerful standard for optimizing radiation protection of a patient. However, for each hospital the dose-reducing potential of focusing on establishment of local DRLs (LDRLs). A lot of study reported that Computed tomography exam contributed majority radiation dose in different medical modalities, therefore, routine abdomen CT exam was choose in initial pilot study in our study. Besides the mAs of routine abdomen CT exam was decided automatic exposure control by linear attenuation is relate to body shape of patient. In this study we would like to establish the local diagnostic reference levels of routine abdomen exam in computed tomography according to body weight of patient. Methods and Materials: There are two clinical CT scanners (a Toshiba Aquilion and a Siemens Sensation) were performed in this study. For CT examinations the basic recommended dosimetric quantity is the Computed Tomography Dose Index (CTDI). The patient sample involved 82 adult patients of both sexes and divided into three groups by their body weight (50–60 kg, 60–70 kg, 70–80 kg).Carried out the routine abdomen examinations, and all exposure parameters have been collected and the corresponding CTDIv and DLP values have been determined. The average values were compared with the European DRLs. Results: The majority of patients (75%) were between 50–70 Kg of body weight, the numbers of patient in each group of weight were 40–50:7; 50–60:29; 60–70:33; 70–80:13. The LDRLs in each group were 10.81mGy, 14.46mGy, 20.27mGy and 21.04mGy, respectively. The DLP were 477mGy, 630mGy, 887mGy and 959mGy, respectively. No matter which group the LDRLs were lower than European DRLs. Conclusions: We would like to state that this was a pioneer work in local hospital in Chiayi. We hope that this may lead the way to further developments in Taiwan

  14. SU-E-P-08: Establishment of Local Diagnostic Reference Levels of Routine Abdomen Exam in Computed Tomography According to Body Weight

    Energy Technology Data Exchange (ETDEWEB)

    Wang, H; Wang, Y; Weng, H [Chiayi Chang Gung Memorial Hospital of The C.G.M.F, Puzi City, Chiayi County, Taiwan (China)

    2015-06-15

    Purpose: The national diagnostic reference levels (NDRLs) is an efficient, concise and powerful standard for optimizing radiation protection of a patient. However, for each hospital the dose-reducing potential of focusing on establishment of local DRLs (LDRLs). A lot of study reported that Computed tomography exam contributed majority radiation dose in different medical modalities, therefore, routine abdomen CT exam was choose in initial pilot study in our study. Besides the mAs of routine abdomen CT exam was decided automatic exposure control by linear attenuation is relate to body shape of patient. In this study we would like to establish the local diagnostic reference levels of routine abdomen exam in computed tomography according to body weight of patient. Methods and Materials: There are two clinical CT scanners (a Toshiba Aquilion and a Siemens Sensation) were performed in this study. For CT examinations the basic recommended dosimetric quantity is the Computed Tomography Dose Index (CTDI). The patient sample involved 82 adult patients of both sexes and divided into three groups by their body weight (50–60 kg, 60–70 kg, 70–80 kg).Carried out the routine abdomen examinations, and all exposure parameters have been collected and the corresponding CTDIv and DLP values have been determined. The average values were compared with the European DRLs. Results: The majority of patients (75%) were between 50–70 Kg of body weight, the numbers of patient in each group of weight were 40–50:7; 50–60:29; 60–70:33; 70–80:13. The LDRLs in each group were 10.81mGy, 14.46mGy, 20.27mGy and 21.04mGy, respectively. The DLP were 477mGy, 630mGy, 887mGy and 959mGy, respectively. No matter which group the LDRLs were lower than European DRLs. Conclusions: We would like to state that this was a pioneer work in local hospital in Chiayi. We hope that this may lead the way to further developments in Taiwan.

  15. Sci-Fri AM: MRI and Diagnostic Imaging - 02: Quality Improvement: Diagnostic Reference Levels for Interior Health CT exams – L-Spine, Chest/Abdomen/pelvis, Abdomen/Pelvis, Head

    International Nuclear Information System (INIS)

    Bjarnason, Thorarin

    2016-01-01

    Diagnostic Reference Levels are used to optimize patient dose and image quality in the clinical setting. It is assumed that the majority of exams are of diagnostic quality, or the radiologists would request protocol adjustments. By investigating the dose indicator distributions from all scanners, the upper DRL can be set to the 75th percentile of the distribution and a lower DRL can be set to the 10th percentile. Scanners using doses consistently outside the upper/lower DRL range can be adjusted accordingly. 11 CT scanners, all contributing to the American College of Radiology Dose Index Registry (ACR DIR) were used in this study. Dose indicator data were compiled from the ACR DIR data and local DRLs established. Scanners with median doses outside the upper/lower DRL were followed-up with. Using effective dose and exam volumes, collective dose was determined before and after protocol adjustments to evaluate the effect of this quality improvement effort. The quality initiative is complete for L-spine and Chest/Abdomen/Pelvis exams and only initial surveys were completed for Head and Abdomen/Pelvis examsg. Median Scanner Dose reductions were 8.8 and 4.9 % for L-spine and Chest/Abdomen/Pelvis exams, respectively, resulting with collective dose reductions of 0.7 and 3.2 person•Sv/yr. Follow-up is ongoing for Abdomen/Pelvis and Head exams.

  16. Sci-Fri AM: MRI and Diagnostic Imaging - 02: Quality Improvement: Diagnostic Reference Levels for Interior Health CT exams – L-Spine, Chest/Abdomen/pelvis, Abdomen/Pelvis, Head

    Energy Technology Data Exchange (ETDEWEB)

    Bjarnason, Thorarin [Diagnostic Imaging / Interior Health, Mathematics, Statistics, Physics & Computer Science / UBCO (Canada); Radiology / UBC (Canada)

    2016-08-15

    Diagnostic Reference Levels are used to optimize patient dose and image quality in the clinical setting. It is assumed that the majority of exams are of diagnostic quality, or the radiologists would request protocol adjustments. By investigating the dose indicator distributions from all scanners, the upper DRL can be set to the 75th percentile of the distribution and a lower DRL can be set to the 10th percentile. Scanners using doses consistently outside the upper/lower DRL range can be adjusted accordingly. 11 CT scanners, all contributing to the American College of Radiology Dose Index Registry (ACR DIR) were used in this study. Dose indicator data were compiled from the ACR DIR data and local DRLs established. Scanners with median doses outside the upper/lower DRL were followed-up with. Using effective dose and exam volumes, collective dose was determined before and after protocol adjustments to evaluate the effect of this quality improvement effort. The quality initiative is complete for L-spine and Chest/Abdomen/Pelvis exams and only initial surveys were completed for Head and Abdomen/Pelvis examsg. Median Scanner Dose reductions were 8.8 and 4.9 % for L-spine and Chest/Abdomen/Pelvis exams, respectively, resulting with collective dose reductions of 0.7 and 3.2 person•Sv/yr. Follow-up is ongoing for Abdomen/Pelvis and Head exams.

  17. Nationwide survey of radiation exposure during pediatric computed tomography examinations and proposal of age-based diagnostic reference levels for Japan

    International Nuclear Information System (INIS)

    Takei, Yasutaka; Miyazaki, Osamu; Matsubara, Kosuke; Koshida, Kichiro; Shimada, Yoshiya; Akahane, Keiichi; Muramatsu, Yoshihisa; Fujii, Keisuke; Suzuki, Shoichi

    2016-01-01

    Diagnostic reference levels (DRLs) have not been established in Japan. To propose DRLs for CT of the head, chest and abdomen for three pediatric age groups. We sent a nationwide questionnaire by post to 339 facilities. Questions focused on pediatric CT technology, exposure parameters, CT protocols, and radiation doses for age groups <1 year, 1-5 years, and 6-10 years. For the three age groups in the 196 facilities that responded, the 75th percentile values of volume CT dose index based on a 16-cm phantom (CTDI vol 16 [mGy]) for head, chest and abdominal CT were for infants 39.1, 11.1 and 12.0, respectively; for 1-to 5-year-olds 46.9, 14.3 and 16.7, respectively; and for 6-to 10-year-olds 67.7, 15.0 and 17.0, respectively. The corresponding dose-length products (DLP 16 [mGy·cm]) for head, chest and abdominal CT were for infants 526.1, 209.1 and 261.5, respectively; for 1-to 5-year-olds 665.5, 296.0 and 430.8, respectively; and for 6-to 10-year-olds 847.9, 413.0 and 532.2, respectively. The majority of CTDI vol 16 and DLP 16 values for the head were higher than DRLs reported from other countries. For risk reduction, it is necessary to establish DRLs for pediatric CT in Japan. (orig.)

  18. Local diagnostic reference level based on size-specific dose estimates: Assessment of pediatric abdominal/pelvic computed tomography at a Japanese national children's hospital

    Energy Technology Data Exchange (ETDEWEB)

    Imai, Rumi; Miyazaki, Osamu; Kurosawa, Hideo; Nosaka, Shunsuke [National Center for Child Health and Development, Department of Radiology, Setagaya-ku, Tokyo (Japan); Horiuchi, Tetsuya [Osaka University, Department of Medical Physics and Engineering, Division of Medical Technology and Science, Course of Health Science, Graduate School of Medicine, Suita, Osaka (Japan)

    2015-03-01

    A child's body size is not accurately reflected by volume CT dose index (CTDI{sub vol}) and dose-length product (DLP). Size-specific dose estimation (SSDE) was introduced recently as a new index of radiation dose. However, it has not yet been established as a diagnostic reference level (DRL). To calculate the SSDE of abdominal/pelvic CT and compare the SSDE with CTDI{sub vol}. To calculate the DRLs of CTDI{sub vol} and SSDE. Our hypotheses are: SSDE values will be greater than CTDI{sub vol}, and our DRL will be smaller than the known DRLs of other countries. The CTDI{sub vol} and DLP of 117 children who underwent abdominal/pelvic CT were collected retrospectively. The SSDE was calculated from the sum of the lateral and anteroposterior diameters. The relationships between body weight and effective diameter and between effective diameter and CTDI{sub vol}/SSDE were compared. Further, the local DRL was compared with the DRLs of other countries. Body weight and effective diameter and effective diameter and SSDE were positively correlated. In children ages 1, 5 and 10 years, the SSDE is closer to the exposure dose of CTDI{sub vol} for the 16-cm phantom, while in children ages 15 years, the SSDE falls between CTDI{sub vol} for the 16-cm phantom and that for the 32-cm phantom. The local DRL was lower than those of other countries. With SSDE, the radiation dose increased with increasing body weight. Since SSDE takes body size into account, it proved to be a useful indicator for estimating the exposure dose. (orig.)

  19. Nationwide survey of radiation exposure during pediatric computed tomography examinations and proposal of age-based diagnostic reference levels for Japan

    Energy Technology Data Exchange (ETDEWEB)

    Takei, Yasutaka [Kanazawa University, Department of Quantum Medical Technology, Division of Health Sciences, Graduate School of Medical Science, Kanazawa, Ishikawa (Japan); Miyazaki, Osamu [National Center for Child Health and Development, Department of Radiology, Tokyo (Japan); Matsubara, Kosuke; Koshida, Kichiro [Kanazawa University, Department of Quantum Medical Technology, Faculty of Health Sciences, Ishikawa (Japan); Shimada, Yoshiya; Akahane, Keiichi [National Institute of Radiological Sciences, Medical Exposure Research Project, Chiba (Japan); Muramatsu, Yoshihisa [National Cancer Center Hospital East, Department of Radiology, Chiba (Japan); Fujii, Keisuke [Nagoya University, Radiological Technology, Graduate School of Medicine, Aichi (Japan); Suzuki, Shoichi [Fujita Health University, Faculty of Radiological Technology, School of Health Sciences, Aichi (Japan)

    2016-02-15

    Diagnostic reference levels (DRLs) have not been established in Japan. To propose DRLs for CT of the head, chest and abdomen for three pediatric age groups. We sent a nationwide questionnaire by post to 339 facilities. Questions focused on pediatric CT technology, exposure parameters, CT protocols, and radiation doses for age groups <1 year, 1-5 years, and 6-10 years. For the three age groups in the 196 facilities that responded, the 75th percentile values of volume CT dose index based on a 16-cm phantom (CTDI{sub vol} 16 [mGy]) for head, chest and abdominal CT were for infants 39.1, 11.1 and 12.0, respectively; for 1-to 5-year-olds 46.9, 14.3 and 16.7, respectively; and for 6-to 10-year-olds 67.7, 15.0 and 17.0, respectively. The corresponding dose-length products (DLP 16 [mGy·cm]) for head, chest and abdominal CT were for infants 526.1, 209.1 and 261.5, respectively; for 1-to 5-year-olds 665.5, 296.0 and 430.8, respectively; and for 6-to 10-year-olds 847.9, 413.0 and 532.2, respectively. The majority of CTDI{sub vol} 16 and DLP 16 values for the head were higher than DRLs reported from other countries. For risk reduction, it is necessary to establish DRLs for pediatric CT in Japan. (orig.)

  20. Patient Dose During Carotid Artery Stenting With Embolic-Protection Devices: Evaluation With Radiochromic Films and Related Diagnostic Reference Levels According to Factors Influencing the Procedure

    International Nuclear Information System (INIS)

    D’Ercole, Loredana; Quaretti, Pietro; Cionfoli, Nicola; Klersy, Catherine; Bocchiola, Milena; Rodolico, Giuseppe; Azzaretti, Andrea; Lisciandro, Francesco; Cascella, Tommaso; Zappoli Thyrion, Federico

    2013-01-01

    To measure the maximum entrance skin dose (MESD) on patients undergoing carotid artery stenting (CAS) using embolic-protection devices, to analyze the dependence of dose and exposure parameters on anatomical, clinical, and technical factors affecting the procedure complexity, to obtain some local diagnostic reference levels (DRLs), and to evaluate whether overcoming DRLs is related to procedure complexity. MESD were evaluated with radiochromic films in 31 patients (mean age 72 ± 7 years). Five of 33 (15 %) procedures used proximal EPD, and 28 of 33 (85 %) procedures used distal EPD. Local DRLs were derived from the recorded exposure parameters in 93 patients (65 men and 28 women, mean age 73 ± 9 years) undergoing 96 CAS with proximal (33 %) or distal (67 %) EPD. Four bilateral lesions were included. MESD values (mean 0.96 ± 0.42 Gy) were FR ) were 269 Gy cm 2 , 28 minutes, and 251, respectively. Only simultaneous bilateral treatment was associated with KAP (odds ratio [OR] 10.14, 95 % confidence interval [CI] 1–102.7, p FR overexposures (OR 10.8, 95 % CI 1.1–109.5, p FR overexposure (OR 2.8, 95 % CI 1.1–7.4, p = 0.040). At multivariable analysis, stenosis ≥ 90 % (OR 2.8, 95 % CI 1.1–7.4, p = 0.040) and bilateral treatment (OR 10.8, 95 % CI 1.1–109.5, p = 0.027) were associated with overexposure for two or more parameters. Skin doses are not problematic in CAS with EPD because these procedures rarely lead to doses >2 Gy.

  1. Cloud-based CT dose monitoring using the DICOM-structured report. Fully automated analysis in regard to national diagnostic reference levels

    International Nuclear Information System (INIS)

    Boos, J.; Rubbert, C.; Heusch, P.; Lanzman, R.S.; Aissa, J.; Antoch, G.; Kroepil, P.

    2016-01-01

    To implement automated CT dose data monitoring using the DICOM-Structured Report (DICOM-SR) in order to monitor dose-related CT data in regard to national diagnostic reference levels (DRLs). Materials and Methods: We used a novel in-house co-developed software tool based on the DICOM-SR to automatically monitor dose-related data from CT examinations. The DICOM-SR for each CT examination performed between 09/2011 and 03/2015 was automatically anonymized and sent from the CT scanners to a cloud server. Data was automatically analyzed in accordance with body region, patient age and corresponding DRL for volumetric computed tomography dose index (CTDI vol ) and dose length product (DLP). Results: Data of 36 523 examinations (131 527 scan series) performed on three different CT scanners and one PET/CT were analyzed. The overall mean CTDI vol and DLP were 51.3 % and 52.8 % of the national DRLs, respectively. CTDI vol and DLP reached 43.8 % and 43.1 % for abdominal CT (n = 10 590), 66.6 % and 69.6 % for cranial CT (n = 16 098) and 37.8 % and 44.0 % for chest CT (n = 10 387) of the compared national DRLs, respectively. Overall, the CTDI vol exceeded national DRLs in 1.9 % of the examinations, while the DLP exceeded national DRLs in 2.9 % of the examinations. Between different CT protocols of the same body region, radiation exposure varied up to 50 % of the DRLs. Conclusion: The implemented cloud-based CT dose monitoring based on the DICOM-SR enables automated benchmarking in regard to national DRLs. Overall the local dose exposure from CT reached approximately 50 % of these DRLs indicating that DRL actualization as well as protocol-specific DRLs are desirable. The cloud-based approach enables multi-center dose monitoring and offers great potential to further optimize radiation exposure in radiological departments.

  2. Patient Dose During Carotid Artery Stenting With Embolic-Protection Devices: Evaluation With Radiochromic Films and Related Diagnostic Reference Levels According to Factors Influencing the Procedure

    Energy Technology Data Exchange (ETDEWEB)

    D' Ercole, Loredana, E-mail: l.dercole@smatteo.pv.it [Fondazione IRCCS Policlinico San Matteo, Department of Medical Physics (Italy); Quaretti, Pietro; Cionfoli, Nicola [Fondazione IRCCS Policlinico San Matteo, Department of Radiology (Italy); Klersy, Catherine [Fondazione IRCCS Policlinico San Matteo, Biometry and Clinical Epidemiology Service, Research Department, (Italy); Bocchiola, Milena [Fondazione IRCCS Policlinico San Matteo, Department of Medical Physics (Italy); Rodolico, Giuseppe; Azzaretti, Andrea [Fondazione IRCCS Policlinico San Matteo, Department of Radiology (Italy); Lisciandro, Francesco [Fondazione IRCCS Policlinico San Matteo, Department of Medical Physics (Italy); Cascella, Tommaso; Zappoli Thyrion, Federico [Fondazione IRCCS Policlinico San Matteo, Department of Radiology (Italy)

    2013-04-15

    To measure the maximum entrance skin dose (MESD) on patients undergoing carotid artery stenting (CAS) using embolic-protection devices, to analyze the dependence of dose and exposure parameters on anatomical, clinical, and technical factors affecting the procedure complexity, to obtain some local diagnostic reference levels (DRLs), and to evaluate whether overcoming DRLs is related to procedure complexity. MESD were evaluated with radiochromic films in 31 patients (mean age 72 {+-} 7 years). Five of 33 (15 %) procedures used proximal EPD, and 28 of 33 (85 %) procedures used distal EPD. Local DRLs were derived from the recorded exposure parameters in 93 patients (65 men and 28 women, mean age 73 {+-} 9 years) undergoing 96 CAS with proximal (33 %) or distal (67 %) EPD. Four bilateral lesions were included. MESD values (mean 0.96 {+-} 0.42 Gy) were <2 Gy without relevant dependence on procedure complexity. Local DRL values for kerma area product (KAP), fluoroscopy time (FT), and number of frames (N{sub FR}) were 269 Gy cm{sup 2}, 28 minutes, and 251, respectively. Only simultaneous bilateral treatment was associated with KAP (odds ratio [OR] 10.14, 95 % confidence interval [CI] 1-102.7, p < 0.05) and N{sub FR} overexposures (OR 10.8, 95 % CI 1.1-109.5, p < 0.05). Type I aortic arch decreased the risk of FT overexposure (OR 0.4, 95 % CI 0.1-0.9, p = 0.042), and stenosis {>=} 90 % increased the risk of N{sub FR} overexposure (OR 2.8, 95 % CI 1.1-7.4, p = 0.040). At multivariable analysis, stenosis {>=} 90 % (OR 2.8, 95 % CI 1.1-7.4, p = 0.040) and bilateral treatment (OR 10.8, 95 % CI 1.1-109.5, p = 0.027) were associated with overexposure for two or more parameters. Skin doses are not problematic in CAS with EPD because these procedures rarely lead to doses >2 Gy.

  3. Guidance levels for diagnostic radiology in Romania

    International Nuclear Information System (INIS)

    Iacob, O.; Diaconescu, C.

    2002-01-01

    Over two decades surveys of radiological practice in Romania have demonstrated wide variations in patient dose levels between different hospitals. Local and national investigations revealed poor performances as well as of radiological equipment, darkroom procedure or technology of investigation. Hitherto, the annual collective effective dose to the population of Romania from diagnostic medical exposures attained a value of 13,820 manSv. Since the annual frequencies of radiological examinations remain unchanged over last ten years, this value is mostly attributed to the individual dose levels in different X-ray procedures. Notwithstanding the huge benefits to patients, the reduction of unnecessary exposures and individual doses are our principal concern and the establishment of national reference dose levels should solve this problem. British experience demonstrated that reference doses are a practical tool in this purpose and the adoption of national reference dose values indicated an overall improvement in patient exposure. Even the local of reference dose values proved a useful way to achieve patient dose reduction. In meantime the optimization of patient protection, each X-ray examination should be conducted with lowest necessary dose to achieve the clinical aim. This paper presents the first approach to establish local reference dose levels for some diagnostic examinations based on the measurements made in six (from the eighth of Eastern territory of Romania) districts, invited to cooperate in this end

  4. Diagnostic reference levels for paediatric computed tomography ...

    African Journals Online (AJOL)

    SA Journal of Radiology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 19, No 2 (2015) >. Log in or Register to get access to full text downloads.

  5. A reference guide to quality assurance for diagnostic radiography

    International Nuclear Information System (INIS)

    1986-01-01

    The College of Radiographers, through its Professional and Technical Committee, set up a small Working Party to compile a list of references which would help radiographers to become experts at Quality Assurance in Diagnostic Imaging departments. The list is not comprehensive, but includes references which the Working Party have experience of and have found useful. The references provided should aid in the objectives of:- 1. determining acceptable standards of new equipment; 2. making comparisons during use with accepted base line performance; 3. establishing loss of cost effectiveness and the need for replacement. (author)

  6. Swiss National Reference Levels in Fluoroscopy

    International Nuclear Information System (INIS)

    Aroua, A.; Baechler, S.; Verdun, F.R.; Rickli, H.; Trueb, Ph.R.; Vock, P.

    2006-01-01

    A nationwide survey was launched in Switzerland in order to investigate the use of fluoroscopy and to establish national reference levels (R.L.) for dose-intensive procedures particularly in interventional radiology. The 2-year investigation covered 5 radiology and 9 cardiology departments in public hospitals and private clinics, and focused on twelve types of examinations: six diagnostic and six interventional. The performance of the fluoroscopy units used in these health-care centres (image quality and dose) was assessed extensively and 1000 examinations were registered. Information on the fluoroscopy time (T), the number of frames (N), the dose-area product (D.A.P.), the difficulty of the case, the age, gender, height and weight of the patient, as well as the experience of the practitioner was provided. The whole set of data was used in relative values (to the mean values for each type of examination) to establish the distributions of T, N and the D.A.P.. From these distributions a set of R.L. values was deduced for the types of examinations investigated using the 3.-quartile method. The R.L. values found are compared to the data published in the literature. (authors)

  7. Radiation levels in nuclear diagnostic examinations

    International Nuclear Information System (INIS)

    Vermeulen, A.M.T.I.

    1987-01-01

    To estimate the risks for a pregnant radiological worker, radiation level measurements are executed for common nuclear diagnostic techniques. These measurements are combined with the time which the radiologic worker is present during the performance of the diagnostic techniques. It is concluded that a radiologic worker is receiving less than 5 mSv during pregnancy. This is the case with in vivo determination in a department of nuclear medicine with common diagnostic techniques. Reduction of radiation doses during pregnancy is possible by reduction of heart function examinations, skeletal examinations and brain scans. 1 figure; 13 tabs

  8. Reference levels at diagnosis (NRD) for explorations in TC of the university Hospital Donostia

    International Nuclear Information System (INIS)

    Iriondo Igerabide, U.; Puertolas Hernandez, J. R.; Masso Odriozola, A.; Alonso Espinaco, M. t.; Pino Leon, C.; Lozano Flores, F. J.; Larretxea Etxarri, R.

    2013-01-01

    The objective of this work is the establishment of diagnostic reference levels in TC, for the anatomical regions, in the University Hospital Donostia, in order to reduce the dose to patients and without prejudice to the required diagnosis. (Author)

  9. Reference materials for molecular diagnostics: Current achievements and future strategies.

    Science.gov (United States)

    Jing, Rongrong; Wang, Huimin; Ju, Shaoqing; Cui, Ming

    2018-06-01

    Molecular diagnoses have become more widespread in many areas of laboratory medicine where qualitative or quantitative approaches are used to detect nucleic acids. The increasing number of assay methods and the targets for molecular diagnostics contribute to variability in the test results among clinical laboratories. Thus, reference materials (RMs) are required to enhance the comparability of results. This review focuses on the definition of RMs as well as the production and characteristics of higher order RMs from different organizations and their future strategies. We describe the recent progress in RMs, including the definition of RMs by the Joint Committee for Guides in Metrology, as well as the production and characteristics of higher order RMs by international official bodies. There is an urgent need for RMs in nucleic acid testing, especially higher order RMs. To advance the harmonization and standardization of clinical nucleic acid detection, cooperation between the above organizations is proposed and different approaches to higher order RMs development are also needed. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  10. Diagnostic reference activities for nuclear medicine in Australia and New Zealand

    International Nuclear Information System (INIS)

    Towson, J.E.; Smart, R.C.

    2001-01-01

    Nuclear medicine centres in Australia and New Zealand were surveyed in 1998 on behalf of the Australian and New Zealand Society of Nuclear Medicine (ANZSNM) and the Australasian Radiation Protection Society (ARPS) in order to establish diagnostic reference levels. A survey form was mailed to all centres, requesting information on the usual radiopharmaceutical activity administered to a standard adult patient and how the activity is calculated for children. The overall response rate was 89.5%. Data was obtained for 80 imaging procedures and 17 non-imaging tracer studies. For the 68 procedures for which data was available from 10 or more centres, the Most Common Activity and the Reference Activity were found from the mode and 75 th percentile of the distribution of activities. A follow-up survey of the 8 hospital centres specialising in pediatric nuclear medicine in Australia was conducted in 1999-2000. Data on the maximum and minimum administered activities (A max and A min ) was obtained for 43 pediatric imaging procedures. A max values were significantly less than the Reference Activities determined for adults. The median values of A max and A min are recommended as Pediatric Reference Activities. The effective dose from the Reference Activities was calculated for adults (male and female) and children. The survey results are available on the ANZSNM and ARPS web sites at http://www.anzsnm.org.au and http://www.arps.org.au. (author)

  11. Establishment of dose reference levels for mammography in Greece

    International Nuclear Information System (INIS)

    Kalathaki, M.; Hourdakis, C.J.; Economides, S.; Tritakis, P.; Manousaridis, G.; Kalyvas, N.; Simantirakis, G.; Kipouros, P.; Kamenopoulou, V.

    2006-01-01

    Full text of publication follows: Diagnostic Reference Levels (D.R.L.) are dose levels established in medical practices for typical x-ray examinations concerning groups of standard size patients or standard phantoms and broadly defined types of equipment. When good and normal practice is performed, these levels are not expected to be exceeded. This work is an attempt to establish for the first time the D.R.L. for mammography in Greece. At present, there are 402 mammographic systems in clinical use all over the country. This study that lasted 3 years (2000-2003), includes 117 of these systems, 85% of which are installed in private and 15% in public sector countrywide. Measurements of entrance surface dose (E.S.D.) were performed as a part of the regular inspections performed by the Licensing and Inspections Department of Greek Atomic Energy Commission on the basis of the laboratories licensing procedure. Moreover, the entire performance of the mammographic units was assessed by quantitative and qualitative measurements of specific parameters. In order to establish the national D.R.L., a standard phantom was used during the quality control of the mammographic units and E.S.D. measurements were performed based on the clinical practice of each laboratory. The D.R.L. for this type of examination was established according to the 75. percentile of the E.S.D. curve and found equal to 7 mGy per single view. The comparison of this value with the one reported by the European Commission (10 mGy per view), indicates that the D.R.L. for mammography is lower in Greece. However, the primary concern of a mammographic examination is to keep breast dose as low as reasonably achievable while providing images with the maximum amount of diagnostic information. The quality of the produced images was therefore assessed for all systems examined, regardless of meeting or exceeding the quality criteria reference surface entrance dose. The results showed that the average total score of the

  12. The establishment and use of dose reference levels in general paediatric radiology

    International Nuclear Information System (INIS)

    Marsden, P.J.; Hardwick, J.; Mencik, C.; McLaren, C.; Young, C.; Mashford, P.

    2001-01-01

    Diagnostic reference levels for general paediatric radiology have been established in terms of delivered exposure parameters rather than skin dose or dose-area product. With supporting measurements from equipment quality assurance and assumptions of standard patient sizes it was possible to derive reference levels in terms of entrance surface dose. This allowed comparison to be made with other published data. The reference levels for common examinations are presented for different age bands. There is a notable variation with patient age for some examinations which is not apparent in other published data. (author)

  13. Prevalence of Autism Spectrum Disorder in Children Referred for Diagnostic Autism Evaluation.

    Science.gov (United States)

    Monteiro, Sonia A; Spinks-Franklin, Adiaha; Treadwell-Deering, Diane; Berry, Leandra; Sellers-Vinson, Sherry; Smith, Eboni; Proud, Monica; Voigt, Robert G

    2015-12-01

    Increased public awareness of autism spectrum disorders (ASD) and routine screening in primary care have contributed to increased requests for diagnostic ASD evaluations. However, given the scarcity of subspecialty autism diagnostic resources, overreferral of children suspected of having ASD may be contributing to long waiting lists at tertiary care autism centers and delaying diagnosis for those children who truly have ASD. To determine whether children are being excessively referred to ASD-specific diagnostic clinics, our objective was to determine the prevalence of true ASD diagnoses in children referred for diagnostic ASD evaluation. Charts of all patients referred to a regional autism center between April 2011 and August 2012 for suspicion of a possible ASD were retrospectively reviewed and demographic and clinical diagnoses abstracted. Only 214 of 348 patients evaluated (61%) received an ASD diagnosis. Thus, concerns about autism are not confirmed by an ASD diagnosis in a significant number of children. © The Author(s) 2015.

  14. Dose management for X-ray and CT. Systematic comparison of exposition values from two institutes to diagnostic reference levels and use of results for optimisation of exposition; Dosismanagement fuer konventionelles Roentgen und CT. Systematischer Vergleich der Expositionswerte zweier radiologischer Institute mit den diagnostischen Referenzwerten und Verwendung der Ergebnisse zur Optimierung der Strahlenexposition bei diagnostischen Untersuchungen

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, S.; Alejandre-Lafont, E.; Krombach, G.A. [University Hospital Giessen (Germany). Dept. of Radiology; Schmidt, T. [University Hospital Giessen (Germany). Dept. of Neuroradiology; Gizewski, E.R. [University Hospital Innsbruck (Austria). Dept. of Neuroradiology; Fiebich, M. [University of Applied Sciences, Giessen (Germany). Inst. of Medical Physics and Radiation Protection

    2014-08-15

    Purpose: In 2 institutions exposure values were evaluated and compared with the 2010 updated diagnostic reference levels (DRL) and possibilities for decreasing the dose assessed. Materials and Methods: Mean exposure values obtained during a 3-month period were calculated for all modalities (X-ray: imaging plate system and digital detector; dual-source 64- and 16- slice spiral CT) as well as examination types were compared to old diagnostic reference levels in addition to DRLs introduced in 2010. Then 10 examinations of all modalities and types were accompanied by a medical physicist and optimized stepwise if necessary. Results: The mean values of X-ray examinations were above DRL. All accompanied examinations were beyond DRL except lateral lumbar spine (LSP) and lateral thoracic X-ray, which were elevated due to statistical outliers from morbidly obese patients or patients with metallic implants. For a-p LSP tube voltage was increased. While image quality was maintained, dose area product (DAP) was reduced by 50% to 123 ±61 cGy.cm{sup 2} for LSP a-p and 30% for lateral LSP to 229 ± 116 cGy.cm{sup 2}. For CT examinations, dose was below DRL. Accompanied examinations of the lumbar spine performed on a 16-slice spiral CT demonstrated a result 68% above DRL with dose length product (DLP) of 840 ± 252 cGy . cm. For optimization, pitch and tube voltage were stepwise increased and DLP reduced below DRL. Conclusion: Systematic analysis of our internal exposure values on the occasion of adaptation of DRL is crucial for prompt detection of exceeded values independently from assessment by the responsible authority and initiation of proper measures for decreasing exposure dose. Hereby active dose management is attained. (orig.)

  15. The level of diagnostic assessment in severe asthma

    DEFF Research Database (Denmark)

    von Bulow, Anna; Backer, Vibeke; Bodtger, Uffe

    2017-01-01

    INTRODUCTION: Systematic assessment of patients with severe asthma is pivotal to decide which patients are eligible to new biological therapies. However, the level of diagnostic work-up in patients with severe asthma is only poorly investigated. AIMS & OBJECTIVES: To describe the diagnostic work-...

  16. Determination of carbon-14 in environmental level, solid reference materials

    Energy Technology Data Exchange (ETDEWEB)

    Blowers, Paul, E-mail: paul.blowers@cefas.co.uk [Cefas Lowestoft Laboratory, Pakefield Road, Lowestoft, Suffolk, NR33 0HT (United Kingdom); Caborn, Jane, E-mail: jane.a.caborn@nnl.co.uk [NNL, Springfields, Salwick, Preston, Lancashire, PR4 0XJ (United Kingdom); Dell, Tony [Veterinary Laboratories Agency, New Haw, Addlestone, Surrey, KT15 3NB (United Kingdom); Gingell, Terry [DSTL, Radiation Protection Services, Crescent Road, Alverstoke, Gosport, Hants, PO12 2DL (United Kingdom); Harms, Arvic [National Physical Laboratory, Hampton Road, Teddington, Middlesex, TW11 0LW (United Kingdom); Long, Stephanie [Radiological Protection Institute of Ireland, 3 Clonskeagh Square, Clonskeagh Road, Dublin 14, Ireland (United Kingdom); Sleep, Darren [Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster, LA1 4AP (United Kingdom); Stewart, Charlie [UKAEA (Waste Management Group), Chemical Support Services, D1310/14, Dounreay, Thurso, Caithness, KW14 7TZ (United Kingdom); Walker, Jill [Radiocarbon Dating, The Old Stables, East Lockinge, Wantage, Oxon OX12 8QY (United Kingdom); Warwick, Phil E. [GAU-Radioanalytical, National Oceanography Centre Southampton, European Way, Southampton, SO14 3ZH (United Kingdom)

    2011-10-15

    An intercomparison exercise to determine the {sup 14}C activity concentrations in a range of solid, environmental level materials was conducted between laboratories in the UK. IAEA reference materials, C2, C6 and C7, and an in-house laboratory QA material were dispatched in 2006 to ten laboratories comprising of members of the Analyst Informal Working Group (AIWG) and one other invited party. The laboratories performed the determinations using a number of techniques, and using the results each one was evaluated in terms of levels of precision, sensitivity and limits of detection. The results of the study show that all techniques are capable of successfully analysing {sup 14}C in environmental level materials, however, a shortage of certified environmental reference materials exists. The suitability of the IAEA reference materials and other material for use as reference materials was also assessed.

  17. Determination of carbon-14 in environmental level, solid reference materials

    International Nuclear Information System (INIS)

    Blowers, Paul; Caborn, Jane; Dell, Tony; Gingell, Terry; Harms, Arvic; Long, Stephanie; Sleep, Darren; Stewart, Charlie; Walker, Jill; Warwick, Phil E.

    2011-01-01

    An intercomparison exercise to determine the 14 C activity concentrations in a range of solid, environmental level materials was conducted between laboratories in the UK. IAEA reference materials, C2, C6 and C7, and an in-house laboratory QA material were dispatched in 2006 to ten laboratories comprising of members of the Analyst Informal Working Group (AIWG) and one other invited party. The laboratories performed the determinations using a number of techniques, and using the results each one was evaluated in terms of levels of precision, sensitivity and limits of detection. The results of the study show that all techniques are capable of successfully analysing 14 C in environmental level materials, however, a shortage of certified environmental reference materials exists. The suitability of the IAEA reference materials and other material for use as reference materials was also assessed.

  18. Diagnostic radiography dose and guidance levels

    International Nuclear Information System (INIS)

    Cuadros, M.; Augusto, A.

    2001-01-01

    This work shows a study done on conventional radiodiagnostic equipment. The evaluation was implemented throughout different areas of Bolivia, covering not only single equipment radiographs used in the cities, but also the ones used in rural areas. There have been more than 90 equipment pieces evaluated of which the dose received by a patient for a given exam has been considered an essential element. For this purpose two types of examinations have been selected, these being considered the more frequent. Not only the dose aspect was taken into consideration but the technique used as well. These elements that support very important information have been related to orientative levels. (author)

  19. Reference hearing threshold levels for short duration signals

    DEFF Research Database (Denmark)

    Poulsen, Torben; Legarth, Søren Vase

    2008-01-01

    for the determination of reference hearing threshold levels. The results are given as peak-to-peak equivalent threshold sound pressure levels (peETSPL). The results are in good agreement with other sparse results from literature and are part of the basis for the ISO 389-6 standard from 2007....

  20. Practical considerations in the development and application of reference levels

    International Nuclear Information System (INIS)

    Selby, J. M.; Kennedy, W. E. Jr.; Swinth, K. L.; Gilbert, R. O.; Soldat, J. K.

    1988-05-01

    Radiological exposures to the public during an accident that releases radioactive materials to the environment occur initially through the air pathway, secondly through a water pathway, and finally, through the food chain. From these exposure pathways, reference levels of radionuclides must be applied to limit public radiation doses. Such reference levels are difficult to develop and apply, particularly if the contaminants are transuranic elements such as plutonium. The reference level must be related to a resultant theoretical dose to the public through generic calculations. However, to permit rapid decisions after an accident, the reference levels need to be related to conditions or media in the environment that can be directly measured. They must also be tied to specific countermeasures such as sheltering, evacuation, or interdiction of drinking water or food supplies. This paper discusses the practical considerations in the development and application of reference levels for transuranic in the environment and the present capability to rapidly detect and quantify their concentrations following accidental contamination events. 16 refs., 3 tabs

  1. Patient dose measurements in fluoroscopic examinations, aiming to the establishment of reference levels in Brazil

    International Nuclear Information System (INIS)

    Canevaro, L.; Drexler, G.

    2001-01-01

    This work was performed to investigate the actual exposure levels of the patients submitted to fluoroscopic procedures in diagnostic radiology. The data will be useful for a baseline in the establishment of local reference levels for fluoroscopic procedures, as recommended by the European Commission and IAEA. At present time there are no internationally accepted definitions for references levels for fluoroscopic complex procedures. Dose-area product (DAP) meters were employed in a pilot survey expressing the radiation exposures in terms of this quantity. This class of instrumentation has not yet been employed in Brazil. Parameters recorded were radiographic technique, fluoroscopy time, number of images, fluoroscopic and radiographic field sizes and DAPs. For fluoroscopy practice, a reference parameters set is recommended, instead of one diagnostic reference level. High patient exposures were found, calling for joined actions of health authorities, physicians, medical physicists, technicians and manufacturers. Monitoring of patient exposure, optimizing the radiation protection and establishing quantitative assessments of the exposition to the population in Brazil in this kind of procedure is important. (author)

  2. An N+3 Technology Level Reference Propulsion System

    Science.gov (United States)

    Jones, Scott M.; Haller, William J.; Tong, Michael To-Hing

    2017-01-01

    An N+3 technology level engine, suitable as a propulsion system for an advanced single-aisle transport, was developed as a reference cycle for use in technology assessment and decision-making efforts. This reference engine serves three main purposes: it provides thermodynamic quantities at each major engine station, it provides overall propulsion system performance data for vehicle designers to use in their analyses, and it can be used for comparison against other proposed N+3 technology-level propulsion systems on an equal basis. This reference cycle is meant to represent the expected capability of gas turbine engines in the N+3 timeframe given reasonable extrapolations of technology improvements and the ability to take full advantage of those improvements.

  3. Diagnostics

    DEFF Research Database (Denmark)

    Donné, A.J.H.; Costley, A.E.; Barnsley, R.

    2007-01-01

    of the measurements—time and spatial resolutions, etc—will in some cases be more stringent. Many of the measurements will be used in the real time control of the plasma driving a requirement for very high reliability in the systems (diagnostics) that provide the measurements. The implementation of diagnostic systems...... on ITER is a substantial challenge. Because of the harsh environment (high levels of neutron and gamma fluxes, neutron heating, particle bombardment) diagnostic system selection and design has to cope with a range of phenomena not previously encountered in diagnostic design. Extensive design and R......&D is needed to prepare the systems. In some cases the environmental difficulties are so severe that new diagnostic techniques are required. The starting point in the development of diagnostics for ITER is to define the measurement requirements and develop their justification. It is necessary to include all...

  4. Establishing a reference range for triiodothyronine levels in preterm infants.

    Science.gov (United States)

    Oh, Ki Won; Koo, Mi Sung; Park, Hye Won; Chung, Mi Lim; Kim, Min-ho; Lim, Gina

    2014-10-01

    Thyroid dysfunction affects clinical complications in preterm infants and older children. However, thyroid hormone replacement in preterm infants has no proven benefits, possibly owing to the lack of an appropriate reference range for thyroid hormone levels. We aimed to establish a reference range for triiodothyronine (T3) levels at 1-month postnatal age (PNA) in preterm infants. This retrospective study included preterm infants born at a tertiary referral neonatal center at gestational age (GA)<35 weeks with no apparent thyroid dysfunction, for 6 consecutive years, with follow-up from PNA 2 weeks to 16 weeks. Using thyroid function tests (TFT), the relationships between T3 levels and thyrotropin (TSH) and free thyroxine (fT4) levels, birth weight, GA, postmenstrual age (PMA), and PNA were examined. The conversion trend for fT4 to T3 was analyzed using the T3/fT4 ratio. Overall, 464 TFTs from 266 infants were analyzed, after excluding 65 infants with thyroid dysfunction. T3 levels increased with fT4 levels, birth weight, GA, PMA, and PNA but not with TSH levels. The T3/fT4 ratio also increased with GA, PNA, and PMA. The average T3 level at 1 month PNA was 72.56 ± 27.83 ng/dL, with significant stratifications by GA. Relatively low T3 and fT4 levels in preterm infants were considered normal, with T3 levels and conversion trends increasing with GA, PMA, and PNA. Further studies are required to confirm the role of the present reference range in thyroid hormone replacement therapy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Reference levels for assays in opened installations of industrial radiography

    International Nuclear Information System (INIS)

    Leocadio, Joao C.; Tauhata, Luiz; Crispim, Verginia R.

    2001-01-01

    This work had as objectives to analyze the facilities open of industrial x-ray to obtain the distribution of doses in the operators and present proposed for the reference levels. The results of the monitoring revealed an improvement of the radiation protection conditions in the facilities and that the risk of potential exposure was reduced. The advantage of the proposed reference levels is that the supervisors would enlarge the frequency of audits in the facilities opened to accomplish the investigations and interventions.The facilities open with 'bunkers' presented distributions with 95% of the doses below 0,2 mSv and the distributions of the facilities with cordoned area they had 75% of the doses below 0,4 mSv. (author)

  6. Diagnostic reference activities for nuclear medicine procedures in Australia and New Zealand

    International Nuclear Information System (INIS)

    Smart, R.C.; Towson, J.E.

    2000-01-01

    In July 1998 a survey of diagnostic nuclear medicine procedures in Australia and New Zealand was undertaken on behalf of the Australian and New Zealand Society of Nuclear Medicine (ANZSNM) and the Australasian Radiation Protection Society (ARPS) in order to establish diagnostic reference activities. A total of 96 responses were received representing 154 practices, comprising 45 public hospital departments, 21 private hospital departments, 87 private practices and 1 unspecified practice. The survey requested the usual activities administered for a standard adult, the method used to determine the activity for children and the minimum activities used for paediatric patients. Data was obtained for 80 different imaging procedures and for 17 non-imaging tracer studies. For those procedures for which information was available from 10 or more practices, 68 in total, the reference activity was calculated as the 75th percentile of the distribution of activities. The Most Common Activity, the Reference Activity, together with the effective dose in both male and female patients, is tabulated for all these procedures. Copyright (2000) Australasian Radiation Protection Society Inc

  7. Manifestations, acquisition and diagnostic categories of dental fear in a self-referred population.

    Science.gov (United States)

    Moore, R; Brødsgaard, I; Birn, H

    1991-01-01

    This study aimed to clarify how manifestations and acquisition relate to diagnostic categories of dental fear in a population of self-referred dental fear patients, since diagnostic criteria specifically related to dental fear have not been validated. DSM III-R diagnostic criteria for phobias were used to compare with four existing dental fear diagnostic categories, referred to as the Seattle system. Subjects were 208 persons with dental fear who were telephone interviewed, of whom a subsample of 155 responded to a mailed Dental Anxiety Scale (DAS), State-Trait Anxiety Inventory and a modified FSS-II Geer Fear Scale (GFS). Personal interviews and a Dental Beliefs Scale of perceived trust and social interaction with dentists were also used to evaluate a subsample of 80 patients selected by sex and high dental fear. Results showed that the majority of the 80 patients (66%), suffered from social embarrassment about their dental fear problem and their inability to do something about it. The largest cause of their fear (84%) was reported to be traumatic dental experiences, especially in childhood (70%). A minority of patients (16%) could not isolate traumatic experiences and had a history of general fearfulness or anxiety. Analysis of GFS data for the 155 subjects showed that fear of snakes and injuries were highest among women; heights and injections among men. Fear of blood was rarely reported. Spearman correlations between GFS individual items and DAS scores indicated functional independence between dental fear and common fears such as blood, injections and enclosures in most cases. Only in specific types of dental fear did these results support Rachman and Lopatka's contention that fears are thought to summate.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Reference levels in PTCA as a function of procedure complexity

    International Nuclear Information System (INIS)

    Peterzol, A.; Quai, E.; Padovani, R.; Bernardi, G.; Kotre, C. J.; Dowling, A.

    2005-01-01

    The multicentre assessment of a procedure complexity index (CI) for the introduction of reference levels (RLs) in percutaneous transluminal coronary angio-plasties (PTCA) is presented here. PTCAs were investigated based on methodology proposed by Bernardi et al. Multiple linear stepwise regression analysis, including clinical, anatomical and technical factors, was performed to obtain fluoroscopy time predictors. Based on these regression coefficients, a scoring system was defined and CI obtained. CI was used to classify dose values into three groups: low, medium and high complexity procedures, since there was good correlation (r = 0.41; P 2 , and 12, 20 and 27 min for fluoroscopy time, for the three CI groups. (authors)

  9. Integrating Nursing Diagnostic Concepts into the Medical Entities Dictionary Using the ISO Reference Terminology Model for Nursing Diagnosis

    OpenAIRE

    Hwang, Jee-In; Cimino, James J.; Bakken, Suzanne

    2003-01-01

    Objective: The purposes of the study were (1) to evaluate the usefulness of the International Standards Organization (ISO) Reference Terminology Model for Nursing Diagnoses as a terminology model for defining nursing diagnostic concepts in the Medical Entities Dictionary (MED) and (2) to create the additional hierarchical structures required for integration of nursing diagnostic concepts into the MED.

  10. Exploring the utility of narrative analysis in diagnostic decision making: picture-bound reference, elaboration, and fetal alcohol spectrum disorders.

    Science.gov (United States)

    Thorne, John C; Coggins, Truman E; Carmichael Olson, Heather; Astley, Susan J

    2007-04-01

    To evaluate classification accuracy and clinical feasibility of a narrative analysis tool for identifying children with a fetal alcohol spectrum disorder (FASD). Picture-elicited narratives generated by 16 age-matched pairs of school-aged children (FASD vs. typical development [TD]) were coded for semantic elaboration and reference strategy by judges who were unaware of age, gender, and group membership of the participants. Receiver operating characteristic (ROC) curves were used to examine the classification accuracy of the resulting set of narrative measures for making 2 classifications: (a) for the 16 children diagnosed with FASD, low performance (n = 7) versus average performance (n = 9) on a standardized expressive language task and (b) FASD (n = 16) versus TD (n = 16). Combining the rates of semantic elaboration and pragmatically inappropriate reference perfectly matched a classification based on performance on the standardized language task. More importantly, the rate of ambiguous nominal reference was highly accurate in classifying children with an FASD regardless of their performance on the standardized language task (area under the ROC curve = .863, confidence interval = .736-.991). Results support further study of the diagnostic utility of narrative analysis using discourse level measures of elaboration and children's strategic use of reference.

  11. Patient radiation doses and reference levels in pediatric interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Habib Geryes, Bouchra; Lachaux, Julie; Boddaert, Nathalie; Brunelle, Francis [Hopital Universitaire Necker Enfants Malades, Department of Paediatric Radiology, Paris (France); Bak, Adeline; Ozanne, Augustin; Saliou, Guillaume [Hopital Bicetre, Hopitaux Universitaires Paris-Sud, Department of Neuroradiology, Le Kremlin Bicetre (France); Naggara, Olivier [Hopital Universitaire Necker Enfants Malades, Department of Paediatric Radiology, Paris (France); Centre Hospitalier Sainte-Anne, Universite Paris Descartes Sorbonne Paris Cite, Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasculaire, Paris (France); Centre Hospitalier Sainte-Anne, Department of Neuroradiology, Universite Paris Descartes, Sorbonne Paris Cite, INSERM UMR894, Paris (France)

    2017-09-15

    To describe, in a multicentric paediatric population, reference levels (RLs) for three interventional radiological procedures. From January 2012 to March 2015, children scheduled for an interventional radiological procedure in two French tertiary centres were retrospectively included and divided into four groups according to age: children younger than 2 years (A1), aged 2-7 years (A5), 8-12 years (A10) and 13-18 years (A15). Three procedures were identified: cerebral digital subtraction angiography (DSA), brain arteriovenous malformation (bAVM) embolization, and head and neck superficial vascular malformation (SVM) percutaneous sclerotherapy. Demographic and dosimetric data, including dose area product (DAP), were collected. 550 procedures were included. For DSA (162 procedures), the proposed RL values in DAP were 4, 18, 12 and 32 Gy.cm{sup 2} in groups A1, A5, A10 and A15, respectively. For bAVM embolization (258 procedures), values were 33, 70, 105 and 88 Gy.cm{sup 2} in groups A1, A5, A10 and A15, respectively. For SVM sclerotherapy (130 procedures), values were 350, 790, 490 and 248 mGy.cm{sup 2} in groups A1, A5, A10 and A15, respectively. Consecutive data were available to permit a proposal of reference levels for three major paediatric interventional radiology procedures. (orig.)

  12. On detecting reference level of acrolein content in children's blood

    Directory of Open Access Journals (Sweden)

    T.S. Ulanova

    2017-03-01

    Full Text Available The article gives the results of complex chemical-analytical and clinical-laboratory research in course of which biological media of children living in Perm region were examined. To study impacts exerted by exogenous acrolein we examined 156 children in 2014–2016, aged 5–10, attending pre-school facilities and schools, and living in Perm region. As we conducted this research we detected average annual acrolein concentration in atmosphere on the examined territory; this concentration was equal to 0.000024 mg/m3, and it was 1.2 times higher than reference acrolein concentration in the air for chronic inhalation exposure. Average group acrolein concentration in children's blood was 1.2 times authentically higher (р3.96, p≤0.05. We used increased content of delta-aminolevulinic acid in urine as a limiting marker for effects occurring at chronic inhalation exposure to acrolein. Basing on the results of the performed examination we recommend concentration equal to 0.10 mgr/dm 3 as a reference level of acrolein content in blood at chronic inhalation exposure.

  13. Profile of usage of a reference diagnostic service on oral pathology: a 10-year evaluation.

    Science.gov (United States)

    Oliveira e Silva, Karla Rachel; Siqueira, Ana Luísa Lara; Caldeira, Patrícia Carlos; de Abreu, Mauro Henrique Nogueira Guimarães; de Aguiar, Maria Cássia Ferreira

    2014-12-20

    Despite the professional and academic relevance of the Brazilian oral pathology diagnostic laboratories, no information about their usage profile is available in the English literature. The objective of the present study is to report data about the histopathological and immunohistochemical exams performed in a Brazilian regional reference laboratory of oral pathology, as well as its main users. Information about all histopathological exams performed between 2002 and 2012 was retrieved from the files of the Oral and Maxillofacial Pathology Service of the School of Dentistry of Universidade Federal de Minas Gerais. Data collected included: 1) requestor of exam; 2) diagnosis classification; and 3) immunohistochemical tests. Descriptive statistical analyses were done. 13,522 histopathological exams were performed, mean 1,229/year. The Public Health System of the city of Belo Horizonte was the main requestor of exams (77.13%), followed by private professionals (19.26%), and other cities (2.03%). Most lesions were considered benign (12,599/ 93.17%), with 854 malignant lesions (6.32%). 469 immunohistochemical tests were performed; 324 (69.08%) were from benign diagnosis, and 145 (30.92%) from malignant diagnosis. The most used antibodies were against S100, vimentin, smooth muscle actin, actin muscle specific HHF-35, and pan-cytokeratin AE1/AE3. Public Health System is the major user of the diagnostic service on oral pathology in our institution. Most diagnoses were of benign lesions, although many malignant lesions were detected. Immunohistochemistry was particularly important in solving challenging cases.

  14. Provincial practice: adopting the new reference levels for Radon

    International Nuclear Information System (INIS)

    Kennedy, Christine; Johnson, Darryl

    2008-01-01

    Full text: In June 2007 new reference levels for radon gas were announced from Health Canada. These new levels brought new attention to the issue of radon gas exposure in the Province of Newfoundland and Labrador. Research in radon gas exposure has a long history in the fluorspar mines of the Burin Peninsula, indeed, occupational data from the 1950 's and 60 's had been included in Darby et al. large scale occupational meta analyses. Radon was also implicated in a royal commission of occupational mining hazards in Newfoundland in 1968. Although, the occupational exposures of miners have been well documented, very little is known about population exposures in indoor spaces. Geological maps are currently being composed for national areas, but data for this province is not yet published. Information about mining tailings used in construction materials or as fill is very poor (unlike the data known for uranium mining tailings in Ontario and Manitoba). The challenges of estimating radon exposures for the province are myriad and these are explored here in this narrative study of how new information has to be generated, and then incorporated into new environmental public health policies for a population. The process by which new scientific information informs public health policy is described in this study of radon in Newfoundland and Labrador. Anticipated regulations for new buildings are discussed. (author)

  15. Diagnostic value of different adherence measures using electronic monitoring and virologic failure as reference standards.

    Science.gov (United States)

    Deschamps, Ann E; De Geest, Sabina; Vandamme, Anne-Mieke; Bobbaers, Herman; Peetermans, Willy E; Van Wijngaerden, Eric

    2008-09-01

    Nonadherence to antiretroviral therapy is a substantial problem in HIV and jeopardizes the success of treatment. Accurate measurement of nonadherence is therefore imperative for good clinical management but no gold standard has been agreed on yet. In a single-center prospective study nonadherence was assessed by electronic monitoring: percentage of doses missed and drug holidays and by three self reports: (1) a visual analogue scale (VAS): percentage of overall doses taken; (2) the Swiss HIV Cohort Study Adherence Questionnaire (SHCS-AQ): percentage of overall doses missed and drug holidays and (3) the European HIV Treatment Questionnaire (EHTQ): percentage of doses missed and drug holidays for each antiretroviral drug separately. Virologic failure prospectively assessed during 1 year, and electronic monitoring were used as reference standards. Using virologic failure as reference standard, the best results were for (1) the SHCS-AQ after electronic monitoring (sensitivity, 87.5%; specificity, 78.6%); (2) electronic monitoring (sensitivity, 75%; specificity, 85.6%), and (3) the VAS combined with the SHCS-AQ before electronic monitoring (sensitivity, 87.5%; specificity, 58.6%). The sensitivity of the complex EHTQ was less than 50%. Asking simple questions about doses taken or missed is more sensitive than complex questioning about each drug separately. Combining the VAS with the SHCS-AQ seems a feasible nonadherence measure for daily clinical practice. Self-reports perform better after electronic monitoring: their diagnostic value could be lower when given independently.

  16. Adaptive Reference Levels in a Level-Crossing Analog-to-Digital Converter

    Directory of Open Access Journals (Sweden)

    Andrew C. Singer

    2008-11-01

    Full Text Available Level-crossing analog-to-digital converters (LC ADCs have been considered in the literature and have been shown to efficiently sample certain classes of signals. One important aspect of their implementation is the placement of reference levels in the converter. The levels need to be appropriately located within the input dynamic range, in order to obtain samples efficiently. In this paper, we study optimization of the performance of such an LC ADC by providing several sequential algorithms that adaptively update the ADC reference levels. The accompanying performance analysis and simulation results show that as the signal length grows, the performance of the sequential algorithms asymptotically approaches that of the best choice that could only have been chosen in hindsight within a family of possible schemes.

  17. Nordic Guidance Levels for Patient Doses in Diagnostic Radiology

    International Nuclear Information System (INIS)

    Saxebol, G.; Olerud, H.M.; Hjardemaal, O.; Leitz, W.; Servomaa, A.; Walderhaug, T.

    1998-01-01

    Within the framework of Nordic authoritative cooperation in radiation protection and nuclear safety, recommendations have been prepared dealing with dose constraints in diagnostic radiology. A working group with participants from all the Nordic countries has met and discussed possible implementations of the ICRP dose constraint for medical radiology. Dose constraints, expressed as guidance levels, were specified for six different radiological examinations, i.e. chest, pelvis, lumbar spine, urography, barium meal and enema in units of kerma-area product and entrance surface dose. The recommendations are described in report No 5 in the series 'Report on Nordic Radiation Protection Cooperation'. Examples of dose distributions and factors affecting the patient dose are described in the report. (author)

  18. Diagnostic Value of Procalcitonin Levels in Acute Mesenteric Ischemia

    Directory of Open Access Journals (Sweden)

    Yunus Karaca

    2015-09-01

    Full Text Available Background: Acute mesenteric ischemia (AMI is a potentially fatal disease. Difficulties in diagnosis make it essential to find early biomarkers. Aims: This study investigated the diagnostic value of procalcitonin (PCT levels in AMI. Study Design: Animal experimentation. Methods: Rats were divided into six groups of six animals each. In the experimental group, an experimental ischemia model was established by clamping the superior mesenteric artery from the aortic outflow tract. Blood and tissue specimens were collected from rats in the experimental mesenteric ischemia model at 30 min and 2 and 6 h, and these were compared with specimens from the respective control groups. PCT levels were compared at 30 min and 2 and 6 h. Results: PCT levels were 185.3 pg/mL in the control group and 219.3 pg/mL in the study group, 199.6 pg/mL in the control group and 243.9 pg/mL in the study group, and 201.9 pg/mL in the control group and 286.9 pg/mL in the study group, respectively, at 30 minute, 2 and 6 hours. Significant differences were determined between 6-h control group and ischemia group PCT levels (p=0.005. Conclusion: The absence of a significant increase in PCT levels in the early period, while a significant difference was detected in the later period (6 h, shows that PCT levels rise late in mesenteric ischemia and can be a marker in the late period.

  19. Bayesian modeling and inference for diagnostic accuracy and probability of disease based on multiple diagnostic biomarkers with and without a perfect reference standard.

    Science.gov (United States)

    Jafarzadeh, S Reza; Johnson, Wesley O; Gardner, Ian A

    2016-03-15

    The area under the receiver operating characteristic (ROC) curve (AUC) is used as a performance metric for quantitative tests. Although multiple biomarkers may be available for diagnostic or screening purposes, diagnostic accuracy is often assessed individually rather than in combination. In this paper, we consider the interesting problem of combining multiple biomarkers for use in a single diagnostic criterion with the goal of improving the diagnostic accuracy above that of an individual biomarker. The diagnostic criterion created from multiple biomarkers is based on the predictive probability of disease, conditional on given multiple biomarker outcomes. If the computed predictive probability exceeds a specified cutoff, the corresponding subject is allocated as 'diseased'. This defines a standard diagnostic criterion that has its own ROC curve, namely, the combined ROC (cROC). The AUC metric for cROC, namely, the combined AUC (cAUC), is used to compare the predictive criterion based on multiple biomarkers to one based on fewer biomarkers. A multivariate random-effects model is proposed for modeling multiple normally distributed dependent scores. Bayesian methods for estimating ROC curves and corresponding (marginal) AUCs are developed when a perfect reference standard is not available. In addition, cAUCs are computed to compare the accuracy of different combinations of biomarkers for diagnosis. The methods are evaluated using simulations and are applied to data for Johne's disease (paratuberculosis) in cattle. Copyright © 2015 John Wiley & Sons, Ltd.

  20. Diagnostic accuracy of routine blood examinations and CSF lactate level for post-neurosurgical bacterial meningitis

    Directory of Open Access Journals (Sweden)

    Yang Zhang

    2017-06-01

    Conclusions: The PBM diagnostic accuracy of routine blood examinations was relatively low, whereas the accuracy of CSF lactate level was high. Some variables that are involved in the incidence of PBM can also affect the diagnostic accuracy for PBM. Taking into account the effects of these variables significantly improves the diagnostic accuracies of routine blood examinations and CSF lactate level.

  1. A Meta-Analysis of Typhoid Diagnostic Accuracy Studies: A Recommendation to Adopt a Standardized Composite Reference.

    Directory of Open Access Journals (Sweden)

    Helen L Storey

    Full Text Available Novel typhoid diagnostics currently under development have the potential to improve clinical care, surveillance, and the disease burden estimates that support vaccine introduction. Blood culture is most often used as the reference method to evaluate the accuracy of new typhoid tests; however, it is recognized to be an imperfect gold standard. If no single gold standard test exists, use of a composite reference standard (CRS can improve estimation of diagnostic accuracy. Numerous studies have used a CRS to evaluate new typhoid diagnostics; however, there is no consensus on an appropriate CRS. In order to evaluate existing tests for use as a reference test or inclusion in a CRS, we performed a systematic review of the typhoid literature to include all index/reference test combinations observed. We described the landscape of comparisons performed, showed results of a meta-analysis on the accuracy of the more common combinations, and evaluated sources of variability based on study quality. This wide-ranging meta-analysis suggests that no single test has sufficiently good performance but some existing diagnostics may be useful as part of a CRS. Additionally, based on findings from the meta-analysis and a constructed numerical example demonstrating the use of CRS, we proposed necessary criteria and potential components of a typhoid CRS to guide future recommendations. Agreement and adoption by all investigators of a standardized CRS is requisite, and would improve comparison of new diagnostics across independent studies, leading to the identification of a better reference test and improved confidence in prevalence estimates.

  2. Serum Inhibin B and follicle-stimulating hormone levels as tools in the evaluation of infertile men: significance of adequate reference values from proven fertile men

    DEFF Research Database (Denmark)

    Andersson, A.-M.; Petersen, Jørgen Holm; Jørgensen, N.

    2004-01-01

    Inhibin B and FSH levels in 289 idiopathic infertile men were compared with reference materials consisting of 303 proven fertile men (reference group 1) and 307 healthy men from the general population with unknown fertility status (reference group 2). The diagnostic power of these two serum markers...... of spermatogenesis was evaluated by the use of receiver operating characteristic plot analysis, and an example of how both markers can be used simultaneously in a bivariate reference chart is presented. Inhibin B levels were significantly lower and FSH levels were significantly higher in the infertile men, compared...

  3. Establishment of multi-slice computed tomography (MSCT) reference level in Johor, Malaysia

    Science.gov (United States)

    Karim, M. K. A.; Hashim, S.; Bakar, K. A.; Muhammad, H.; Sabarudin, A.; Ang, W. C.; Bahruddin, N. A.

    2016-03-01

    Radiation doses from computed tomography (CT) are the highest and most hazardous compared to other imaging modalities. This study aimed to evaluate radiation dose in Johor, Malaysia to patients during computed tomography examinations of the brain, chest and abdomen and to establish the local diagnostic reference levels (DRLs) as are present with the current, state- of-art, multi-slice CT scanners. Survey forms were sent to five centres performing CT to obtain data regarding acquisition parameters as well as the dose information from CT consoles. CT- EXPO (Version 2.3.1, Germany) was used to validate the dose information. The proposed DRLs were indicated by rounding the third quartiles of whole dose distributions where mean values of CTDIw (mGy), CTDIvol (mGy) and DLP (mGy.cm) were comparable with other reference levels; 63, 63, and 1015 respectively for CT Brain; 15, 14, and 450 respectively for CT thorax and 16, 17, and 590 respectively for CT abdomen. The study revealed that the CT practice and dose output were revolutionised, and must keep up with the pace of introductory technology. We suggest that CTDIvol should be included in current national DRLs, as modern CTs are configured with a higher number of detectors and are independent of pitch factors.

  4. Establishment of multi-slice computed tomography (MSCT) reference level in Johor, Malaysia

    International Nuclear Information System (INIS)

    Karim, M K A; Hashim, S; Ang, W C; Bahruddin, N A; Bakar, K A; Muhammad, H; Sabarudin, A

    2016-01-01

    Radiation doses from computed tomography (CT) are the highest and most hazardous compared to other imaging modalities. This study aimed to evaluate radiation dose in Johor, Malaysia to patients during computed tomography examinations of the brain, chest and abdomen and to establish the local diagnostic reference levels (DRLs) as are present with the current, state- of-art, multi-slice CT scanners. Survey forms were sent to five centres performing CT to obtain data regarding acquisition parameters as well as the dose information from CT consoles. CT- EXPO (Version 2.3.1, Germany) was used to validate the dose information. The proposed DRLs were indicated by rounding the third quartiles of whole dose distributions where mean values of CTDI w (mGy), CTDI vol (mGy) and DLP (mGy.cm) were comparable with other reference levels; 63, 63, and 1015 respectively for CT Brain; 15, 14, and 450 respectively for CT thorax and 16, 17, and 590 respectively for CT abdomen. The study revealed that the CT practice and dose output were revolutionised, and must keep up with the pace of introductory technology. We suggest that CTDI vol should be included in current national DRLs, as modern CTs are configured with a higher number of detectors and are independent of pitch factors. (paper)

  5. Dose evaluation and establishment of reference levels in activity for nuclear medicine

    International Nuclear Information System (INIS)

    Ribeiro, Julio Cesar de Souza

    2017-01-01

    The International Commission on Radiation Protection (ICRP) has emphasized the importance of accurately determining the mean dose levels, or administered activity, received by the patients for each medical procedure that uses ionizing radiation. However, the number of bibliographic references addressing the need to know and optimize these levels is insufficient, or rather limited, which may lead to non-standardizes techniques, a lack of exposures control, and also the increase of associated radiological risks of these procedures. In this context, a software in Visual Basic® of Microsoft© language was developed whose function is to elaborate a method of obtaining the Reference Levels in Activity (RLA) for nuclear medicine patients by determining the third quartile of the examinations carried out. The program also allows obtaining absorbed dose values in critical organs based on patient specificities as age, sex and Body Mass Index (BMI) in order to evaluate the risk involved in each procedure. The main nuclear medicine diagnostic procedures were evaluated through the database of two public hospitals and a private clinic, obtaining the NRAs of each facility, where the software was validated by comparison with the traditionally accepted calculation methods. Due to the results obtained in each installation, in addition to NRA determination, gaps in treatment capacities and unjustified dose variations for the same procedure were identified, indicating the need for optimization. Thus, the developed program is able to provide the estimated values of effective and absorbed doses involved in each procedure, for each patient, providing reference values for nuclear medicine field, not available in the national scenario so far. (author)

  6. Reference dose levels for dental periapical radiography in Chonnam Province

    International Nuclear Information System (INIS)

    Han, Mi Ra; Kang, Byung Cheol; Yoon, Suk Ja; Lee, Jae Seo; Kim, Young Hee

    2009-01-01

    To establish reference doses of periapical radiography in Chonnam Province, Korea. The target-skin distances were measured for dental patient's 1235 exposures including 345 mandibular molar areas. Each periapical radiation exposure was simulated with exactly the same patients exposure parameters and the simulated radiation doses were measured utilizing Mult-O-Meter (Unfors Instruments, Billadal, Sweden). The measurements were done in 44 dental clinics with 49 dental x-ray sets in Chonnam Province for one or two weeks at each dental clinic during year 2006. The third quartile patient surface doses were 2.8 mGy for overall periapical exposures and 3.2 mGy for periapical mandibular molar exposures. The third quartile patient surface doses in Chonnam Province can be used as a guide to accepted clinical practice to reduce patient radiation exposure for the surveyed reference doses were below the recommended dental periapical radiography dose of 7 mGy by IAEA.

  7. Reference dose levels for dental periapical radiography in Chonnam Province

    Energy Technology Data Exchange (ETDEWEB)

    Han, Mi Ra; Kang, Byung Cheol; Yoon, Suk Ja [Department of Oral and Maxillofacial Radiology, College of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju (Korea, Republic of); Lee, Jae Seo [Department of Oral and Maxillofacial Radiology, Chonnan National University Hospital, Gwangju (Korea, Republic of); Kim, Young Hee [Department of Oral and Maxillofacial Radiology, Hallym University Sacred Heart Hospital, Chuncheon (Korea, Republic of)

    2009-12-15

    To establish reference doses of periapical radiography in Chonnam Province, Korea. The target-skin distances were measured for dental patient's 1235 exposures including 345 mandibular molar areas. Each periapical radiation exposure was simulated with exactly the same patients exposure parameters and the simulated radiation doses were measured utilizing Mult-O-Meter (Unfors Instruments, Billadal, Sweden). The measurements were done in 44 dental clinics with 49 dental x-ray sets in Chonnam Province for one or two weeks at each dental clinic during year 2006. The third quartile patient surface doses were 2.8 mGy for overall periapical exposures and 3.2 mGy for periapical mandibular molar exposures. The third quartile patient surface doses in Chonnam Province can be used as a guide to accepted clinical practice to reduce patient radiation exposure for the surveyed reference doses were below the recommended dental periapical radiography dose of 7 mGy by IAEA.

  8. Pregnancy and variations of carbohydrate-deficient transferrin levels measured by the candidate reference HPLC method.

    Science.gov (United States)

    Bianchi, Vincenza; Ivaldi, Alessandra; Raspagni, Alessia; Arfini, Carlo; Vidali, Matteo

    2011-01-01

    Contrasting data are available on the diagnostic accuracy of carbohydrate-deficient transferrin (CDT) during pregnancy. These differences may depend in part on how CDT was evaluated and expressed. Here, we report on variations of CDT levels in pregnant women using the high performance liquid chromatography (HPLC) candidate reference method. Alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, mean corpuscular volume, serum transferrin, urine and serum ethyl glucuronide and CDT were measured in 64 women, self-reporting as non-alcohol abusers (age: median 34, IQR: 28-38), at different stages of normal pregnancy (gestational weeks: median 28, IQR: 8-33). CDT was expressed as percentage of disialotransferrin to total transferrin (%CDT). Transferrin was associated with both %CDT (r = 0.66; P pregnancy trimester (first trimester: mean 1.01% (SD 0.19); second trimester: 1.30% (SD 0.14); third trimester: 1.53% (SD 0.22); ANOVA P pregnancy trimesters (P pregnancy and CDT could be more complex. The diagnostic accuracy of CDT for detecting alcohol abuse in a legal context may be limited in pregnant women and the effect of gestational age should be considered.

  9. Integrating nursing diagnostic concepts into the medical entities dictionary using the ISO Reference Terminology Model for Nursing Diagnosis.

    Science.gov (United States)

    Hwang, Jee-In; Cimino, James J; Bakken, Suzanne

    2003-01-01

    The purposes of the study were (1) to evaluate the usefulness of the International Standards Organization (ISO) Reference Terminology Model for Nursing Diagnoses as a terminology model for defining nursing diagnostic concepts in the Medical Entities Dictionary (MED) and (2) to create the additional hierarchical structures required for integration of nursing diagnostic concepts into the MED. The authors dissected nursing diagnostic terms from two source terminologies (Home Health Care Classification and the Omaha System) into the semantic categories of the ISO model. Consistent with the ISO model, they selected Focus and Judgment as required semantic categories for creating intensional definitions of nursing diagnostic concepts in the MED. Because the MED does not include Focus and Judgment hierarchies, the authors developed them to define the nursing diagnostic concepts. The ISO model was sufficient for dissecting the source terminologies into atomic terms. The authors identified 162 unique focus concepts from the 266 nursing diagnosis terms for inclusion in the Focus hierarchy. For the Judgment hierarchy, the authors precoordinated Judgment and Potentiality instead of using Potentiality as a qualifier of Judgment as in the ISO model. Impairment and Alteration were the most frequently occurring judgments. Nursing care represents a large proportion of health care activities; thus, it is vital that terms used by nurses are integrated into concept-oriented terminologies that provide broad coverage for the domain of health care. This study supports the utility of the ISO Reference Terminology Model for Nursing Diagnoses as a facilitator for the integration process.

  10. Reference dose levels for dental panoramic radiography in Anyang City

    International Nuclear Information System (INIS)

    Han, Mi Ra; Kang, Byung Cheol; Yoon, Suk Ja; Lee, Jae Seo; Kim, Young Hee

    2009-01-01

    To measure dose-width product (DWP) values used for dental panoramic radiography in Anyang city, Korea. Thirty-six panoramic dental radiographic sets (17 analogue panoramic sets and 19 digital panoramic sets) in 36 dental clinics in Anyang city were included in the study. Each patient's panoramic exposure parameters were simulated and the panoramic radiation doses were measured at the secondary collimator using a Mult-O-Meter (Unfors Instruments, Billdal, Sweden) at each dental clinic during 2006. The third quartile DWP was determined from 310 surface dose measurements on adult. The third quartile DWP for adult panoramic radiograph was 106.7 mGy mm. For analogue and digital panoramic radiograph, 3/4 DWP were 116.8 mGy mm and 72 mGy mm respectively. The overall third quartile DWP of panoramic radiography was 106.7 mGy mm. The measured 3/4 DWPs were higher than the 3/4 DWP of 65 mGy mm recommended by NRPB. Dentists who are operating above the reference dose should lower their panoramic exposure doses below the recommended reference value by changing the exposure parameters and/or their panoramic equipment.

  11. Diffusion-weighted MRI in prostatic lesions: Diagnostic performance of normalized ADC using normal peripheral prostatic zone as a reference

    Directory of Open Access Journals (Sweden)

    Tamer F. Taha Ali

    2018-03-01

    Full Text Available Aim of study: Evaluate the potential value of the normal peripheral zone as a reference organ to normalize prostatic lesion apparent diffusion coefficient (ADC to improve its evaluation of prostatic lesions. Patients and methods: This prospective study included 38 patients with clinical suspicion of cancer prostate (increased PSA levels (>4 ng/ml, hard prostate in digital rectal examination and who are scheduled to undergo a TRUS-guided biopsy. Conventional and DW-MRI was done and ADC was calculated. The normalized ADC value was calculated by dividing the ADC of lesion by ADC of reference site (healthy peripheral zone. DWI-MRI results were compared to the results of biopsy. Comparison of ADCs and nADCs of benign and malignant lesions was done. Receiver operating characteristics (ROC curve analysis was done. Results: The patients were classified by histopathology into non-malignant group (16 patients and malignant group (22 patients. Significant negative correlation between ADC and normalized ADC (nADC and malignancy was detected. There was no significant difference between the mean ADC of peripheral health prostatic zones (PZ between benign and malignant cases (2.221 ± 0.356 versus 1.99 ± 0.538x10−3 mm2/sec, p = 0.144.There was significant difference between the mean ADC and mean nADC in benign and malignant lesions (1.049 ± 0.217 versus 0.659 ± 0.221x10−3 mm2/sec, p < 0.001 and (0.475 ± 0.055 versus 0.328 ± 0.044, p < 0.001 respectively.There was significant higher diagnostic performance of nADC than ADC with ADC Cut-off value 0.75 × 10−3 mm2/sec and nADC cut-off value 0.39 could significantly differentiate between benign and malignant lesion with sensitivity, specificity, PPV,NPV of 86.36,75,82.61 and 80% respectively, p < 0.0001 for ADC and 95.45, 93.75, 95.45 and 93.75%, p < 0.0001 for nADC. Conclusion: diagnostic performance of nADC using normal peripheral zone is higher than

  12. Decreased plasma prorenin levels in primary aldosteronism: potential diagnostic implications.

    Science.gov (United States)

    Berge, Constance; Courand, Pierre-Yves; Harbaoui, Brahim; Paget, Vinciane; Khettab, Fouad; Bricca, Giampiero; Fauvel, Jean-Pierre; Lantelme, Pierre

    2015-01-01

    Primary aldosteronism could exert a negative feedback on prorenin secretion, of possibly different magnitude, whether it is related to an aldosterone-producing adenoma (APA) or an idiopathic hyperaldosteronism (IHA). The objectives of this study were to evaluate the level of prorenin in three subgroups: APA, IHA, and essential hypertension; and the performance of the aldosterone-to-prorenin ratio (APR) for the diagnosis of an APA. Seven hundred and forty-six hypertensive patients with a standardized work-up, including a prorenin measurement, were considered. Ninety-six patients without neutral treatment and 38 patients with other forms of secondary hypertension were excluded. APA and IHA were categorized according to computed tomography scan, adrenal venous sampling, pathological analysis and improvement of hypertension after surgery. Thirty-five patients had a diagnosis of APA, 57 of IHA and 504 of essential hypertension. Prorenin was lower in APA and IHA than in essential hypertension (32.9, 40.4 and 50.3  pg/ml, respectively; P < 0.001). APR was higher in patients with APA and IHA than in those with essential hypertension (24.0, 11.8, and 4.0  pmol/l per pg/ml, respectively; P < 0.001). The APR was more discriminant than the aldosterone-to-renin ratio to identify APA compared to IHA (area under the receiver operating curve at 0.750 and 0.639, respectively; P = 0.04). The optimal cut-off values were 22  pmol/l per pg/ml for APR (sensitivity 57.0%, specificity 93.0%) and 440  pmol/l per pg/ml for aldosterone-to-renin ratio (sensitivity 54.3%, specificity 82.5%). Primary aldosteronism and particularly its most caricatural form, that is APA, seems associated with a lower level of prorenin than essential hypertension. The APR could be included in the diagnostic strategy of APA.

  13. Revised and new national reference values for X-ray diagnostic examinations per 2010

    International Nuclear Information System (INIS)

    2010-01-01

    NRPA has revised the national reference values given in the Guide 5b and established reference values for 10 new investigations. The revision / creation is based on new national dose distributions obtained in the period 2006-2009. Reference values are effective from 27 April 2010. (AG)

  14. Tomosynthesis for the early detection of pulmonary emphysema: diagnostic performance compared with chest radiography, using multidetector computed tomography as reference

    International Nuclear Information System (INIS)

    Yamada, Yoshitake; Jinzaki, Masahiro; Hashimoto, Masahiro; Shiomi, Eisuke; Kuribayashi, Sachio; Abe, Takayuki; Ogawa, Kenji

    2013-01-01

    To compare the diagnostic performance of tomosynthesis with that of chest radiography for the detection of pulmonary emphysema, using multidetector computed tomography (MDCT) as reference. Forty-eight patients with and 63 without pulmonary emphysema underwent chest MDCT, tomosynthesis and radiography on the same day. Two blinded radiologists independently evaluated the tomosynthesis images and radiographs for the presence of pulmonary emphysema. Axial and coronal MDCT images served as the reference standard and the percentage lung volume with attenuation values of -950 HU or lower (LAA -950 ) was evaluated to determine the extent of emphysema. Receiver-operating characteristic (ROC) analysis and generalised estimating equations model were used. ROC analysis revealed significantly better performance (P -950 . The diagnostic performance of tomosynthesis was significantly superior to that of radiography for the detection of pulmonary emphysema. In both tomosynthesis and radiography, the sensitivity was affected by the LAA -950 . (orig.)

  15. Diagnostic value of MRS-quantified brain tissue lactate level in identifying children with mitochondrial disorders

    Energy Technology Data Exchange (ETDEWEB)

    Lunsing, Roelineke J.; Strating, Kim [University Medical Centre Groningen, University of Groningen, Department of Child Neurology, Groningen (Netherlands); Koning, Tom J. de [University Medical Centre Groningen, University of Groningen, Department of Pediatric Metabolic Diseases, Groningen (Netherlands); Sijens, Paul E. [University Medical Centre Groningen, University of Groningen, Department of Radiology, Groningen (Netherlands)

    2017-03-15

    Magnetic resonance spectroscopy (MRS) of children with or without neurometabolic disease is used for the first time for quantitative assessment of brain tissue lactate signals, to elaborate on previous suggestions of MRS-detected lactate as a marker of mitochondrial disease. Multivoxel MRS of a transverse plane of brain tissue cranial to the ventricles was performed in 88 children suspected of having neurometabolic disease, divided into 'definite' (n = 17, ≥1 major criteria), 'probable' (n = 10, ≥2 minor criteria), 'possible' (n = 17, 1 minor criterion) and 'unlikely' mitochondrial disease (n = 44, none of the criteria). Lactate levels, expressed in standardized arbitrary units or relative to creatine, were derived from summed signals from all voxels. Ten 'unlikely' children with a normal neurological exam served as the MRS reference subgroup. For 61 of 88 children, CSF lactate values were obtained. MRS lactate level (>12 arbitrary units) and the lactate-to-creatine ratio (L/Cr >0.22) differed significantly between the definite and the unlikely group (p = 0.015 and p = 0.001, respectively). MRS L/Cr also differentiated between the probable and the MRS reference subgroup (p = 0.03). No significant group differences were found for CSF lactate. MRS-quantified brain tissue lactate levels can serve as diagnostic marker for identifying mitochondrial disease in children. (orig.)

  16. Diagnostic value of MRS-quantified brain tissue lactate level in identifying children with mitochondrial disorders

    International Nuclear Information System (INIS)

    Lunsing, Roelineke J.; Strating, Kim; Koning, Tom J. de; Sijens, Paul E.

    2017-01-01

    Magnetic resonance spectroscopy (MRS) of children with or without neurometabolic disease is used for the first time for quantitative assessment of brain tissue lactate signals, to elaborate on previous suggestions of MRS-detected lactate as a marker of mitochondrial disease. Multivoxel MRS of a transverse plane of brain tissue cranial to the ventricles was performed in 88 children suspected of having neurometabolic disease, divided into 'definite' (n = 17, ≥1 major criteria), 'probable' (n = 10, ≥2 minor criteria), 'possible' (n = 17, 1 minor criterion) and 'unlikely' mitochondrial disease (n = 44, none of the criteria). Lactate levels, expressed in standardized arbitrary units or relative to creatine, were derived from summed signals from all voxels. Ten 'unlikely' children with a normal neurological exam served as the MRS reference subgroup. For 61 of 88 children, CSF lactate values were obtained. MRS lactate level (>12 arbitrary units) and the lactate-to-creatine ratio (L/Cr >0.22) differed significantly between the definite and the unlikely group (p = 0.015 and p = 0.001, respectively). MRS L/Cr also differentiated between the probable and the MRS reference subgroup (p = 0.03). No significant group differences were found for CSF lactate. MRS-quantified brain tissue lactate levels can serve as diagnostic marker for identifying mitochondrial disease in children. (orig.)

  17. Diagnostic performance of dental students in identifying mandibular condyle fractures by panoramic radiography and the usefulness of reference images

    International Nuclear Information System (INIS)

    Cho, Bong Hae

    2011-01-01

    The purpose of this study was to evaluate the diagnostic performance of dental students in detection of mandibular condyle fractures and the effectiveness of reference panoramic images. Forty-six undergraduates evaluated 25 panoramic radiographs for condylar fractures and the data were analyzed through receiver operating characteristic (ROC) analysis. After a month, they were divided into two homogeneous groups based on the first results and re-evaluated the images with (group A) or without (group B) reference images. Eight reference images included indications showing either typical condylar fractures or anatomic structures which could be confused with fractures. Paired t-test was used for statistical analysis of the difference between the first and the second evaluations for each group, and student's t-test was used between the two groups in the second evaluation. The intra- and inter-observer agreements were evaluated with Kappa statistics. Intra- and inter-observer agreements were substantial (k=0.66) and moderate (k=0.53), respectively. The area under the ROC curve (Az) in the first evaluation was 0.802. In the second evaluation, it was increased to 0.823 for group A and 0.814 for group B. The difference between the first and second evaluations for group A was statistically significant (p<0.05), however there was no statistically significant difference between the two groups in the second evaluation. Providing reference images to less experienced clinicians would be a good way to improve the diagnostic ability in detecting condylar fracture.

  18. Derived reference levels for prenatal exposure in a radiological emergency

    International Nuclear Information System (INIS)

    Nuccetelli, C.; Risica, S.; Rogani, A.

    2002-01-01

    After the Chernobyl accident many countries renewed their radiological emergency plans, also considering the possibility of over boundary accidents. This has been set out by the 96/29/Euratom Directive (Council Directive, 1996), which states that E ach Member State shall ensure that account is taken of the fact that radiological emergencies may occur in connection with practices on or outside its territory and affect it . Moreover, after September 11, 2001, the need to prepare emergency plans for possible terroristic attacks became evident and these plans are now being worked out in many countries for intervention in case of biological, chemical and/or radiological risk. In the event of radiological emergency, all decisions to be taken are based on possible doses to critical groups (European Commission, 1997), which are the population groups most at risk. These critical groups are, in most cases, infants or children, given that dose coefficients for these age groups are generally higher than for adults. However, a new ICRP Recommendation (ICRP, 2001) has recently been published that gives dose coefficients for embryo/foetus due to intake by the mother, by inhalation or ingestion, of 31 radionuclides. Also as a result of the revaluation in the last years of the possible health effects of prenatal exposure to ionising radiation (see e.g. the review in P. Fattibene et al., 1999), the consequences for the embryo/foetus of a possible radiological emergency connected to a nuclear plant and to possible dispersion of Depleted Uranium (DU) in the environment are analysed and discussed in this paper. For the former type of accident, Derived Intervention Levels (DILs) are calculated for prenatal exposure due to acute inhalation by the mother (female member of the public) and an assessment is performed of ingestion doses for the offspring resulting from consumption of foodstuffs by the mother of which 10% of the annual consumption is contaminated at the maximum levels

  19. Development of a low-level radon reference chamber; Entwicklung einer Low-Level-Radon-Referenzkammer

    Energy Technology Data Exchange (ETDEWEB)

    Linzmaier, Diana

    2013-01-04

    The naturally occurring, radioactive noble gas radon-222 exists worldwide in different activity concentrations in the air. During the decay of radon-222, decay products are generated which are electrically charged and attach to aerosols in the air. Together with the aerosols, the radon is inhaled and exhaled by humans. While the radon is nearly completely exhaled, ca. 20 % of the inhaled aerosols remain in the lungs in one breath cycle. Due to ionizing radiation, in a chain of events, lung cancer might occur. Consequently, radon and its decay products are according to the current findings the second leading cause of lung cancer. At the workplace and in the home measurements of radon activity concentration are performed to determine the radiation exposition of humans. All measurement devices for the determination of radon activity concentration are calibrated above 1000 Bq/m{sup 3}, even though the mean value of the present investigation in Germany shows only 50 Bq/m{sup 3}. For the calibration of measurement devices in the range below 1000 Bq/m{sup 3} over a long time period, the generation of a stable reference atmosphere is presented in this work. Due to a long term calibration (t>5 days) of the measurement devices, smaller uncertainties result for the calibration factor. For the calibration procedure, a so-called low-level radon reference chamber was set up and started operation. The generation of a stable reference atmosphere is effected by means of emanation sources which consist of a radium-226 activity standard. On the basis of {gamma}-spectrometry, the effective emanation coefficient ofthe emanation sources is determined. The traceability of the activity concentration in the reference volume is realized via the activity ofthe radium-226, the emanation coefficient and the volume. With the emanation sources produced, stable reference atmospheres within the range of 150 Bq/m{sup 3} to 1900 Bq/m{sup 3} are achieved. For the realization, maintenance and

  20. Diagnostic accuracy of direct ophthalmoscopy for detection of diabetic retinopathy using fundus photographs as a reference standard.

    Science.gov (United States)

    Ahsan, Shahid; Basit, Abdul; Ahmed, Kazi Rumana; Ali, Liaquat; Shaheen, Fariha; Ulhaque, Muhammad Saif; Fawwad, Asher

    2014-01-01

    To determine the diagnostic accuracy of direct ophthalmoscopy for the presence and severity of diabetic retinopathy (DR) using fundus photographs as a reference standard. Patients with type 2 diabetes attending the outpatient department (OPD) of a tertiary care diabetes center, from October 2009 to March 2010 were recruited in the study after obtaining signed informed consent. Patients with type 1 diabetes and gestational diabetes or having eye problems were excluded. After checking visual acuity, direct ophthalmoscopy of each eye was done by diabetologist, followed by photography of two fields of retina by fundus camera. DR was graded by a retinal specialist, according to International Diabetic Retinopathy Disease Severity Scale. According to severity, patients with DR were grouped into non-sight threatening diabetic retinopathy (NSTDR) and sight threatening diabetic retinopathy (STDR). Sensitivity and specificity of direct ophthalmoscopy for detection of any retinopathy, NSTDR and STDR was calculated. A total of 728 eyes were examined by direct ophthalmoscopy as well as fundus photography. Sensitivity (95% CI) of direct ophthalmoscopy for any retinopathy, NSTDR and STDR was found to be 55.67% (50.58-60.78), 37.63% (32.67-42.59) and 68.25% (63.48-73.02) respectively. Whereas, specificity of direct ophthalmoscopy was found to be 76.78% (72.45-81.11), 71.27% (CI: 66.63-75.91) and 90.0% (86.93-93.07) for any retinopathy, NSTDR and STDR respectively. The sensitivity and specificity of direct ophthalmoscopy performed by the diabetologist for the presence and severity of DR was lower compared to the recommended level of sensitivity and specificity of a screening test of DR. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  1. Dose reference levels in Spanish intraoral dental radiology: stabilisation of the incorporation of digital systems in dental clinical practices

    International Nuclear Information System (INIS)

    Alcaraz, M.; Velasco, F.; Olivares, A.; Velasco, E.; Canteras, M.

    2016-01-01

    A total of 34 044 official quality assurance reports in dental radiodiagnostic surgery from 16 regions of Spain, compiled from 2002 to 2014, were studied in order to determine the progress of diagnostic reference levels (DRLs) for obtaining diagnostic images under normal conditions for clinical practice in Spanish dental clinics. A DRL of 2.8 mGy was set in 2014, which represents a 41.7 % decrease compared with that of 2002 (4.8 mGy). Over the same time period, the mean dose fell by 55.2 %. However, over the last 3 y, the stabilisation of the mean dose administered to patients has been observed with only a 6.7 % reduction in DRLs, which corresponds to the stabilisation of dental radiodiagnostic surgery on replacing the use of radiographic film with digital imaging systems. (authors)

  2. Forget the Desk Job: Current Roles and Responsibilities in Entry-Level Reference Job Advertisements

    Science.gov (United States)

    Detmering, Robert; Sproles, Claudene

    2012-01-01

    This study examines the evolving roles and responsibilities of entry-level academic reference positions, as stated in recent job advertisements posted on the American Library Association's JobLIST Web site and other sources. Findings from a content analysis of these advertisements indicate that current entry-level reference positions in academic…

  3. Diagnostic accuracy of routine blood examinations and CSF lactate level for post-neurosurgical bacterial meningitis.

    Science.gov (United States)

    Zhang, Yang; Xiao, Xiong; Zhang, Junting; Gao, Zhixian; Ji, Nan; Zhang, Liwei

    2017-06-01

    To evaluate the diagnostic accuracy of routine blood examinations and Cerebrospinal Fluid (CSF) lactate level for Post-neurosurgical Bacterial Meningitis (PBM) at a large sample-size of post-neurosurgical patients. The diagnostic accuracies of routine blood examinations and CSF lactate level to distinguish between PAM and PBM were evaluated with the values of the Area Under the Curve of the Receiver Operating Characteristic (AUC -ROC ) by retrospectively analyzing the datasets of post-neurosurgical patients in the clinical information databases. The diagnostic accuracy of routine blood examinations was relatively low (AUC -ROC CSF lactate level achieved rather high diagnostic accuracy (AUC -ROC =0.891; CI 95%, 0.852-0.922). The variables of patient age, operation duration, surgical diagnosis and postoperative days (the interval days between the neurosurgery and examinations) were shown to affect the diagnostic accuracy of these examinations. The variables were integrated with routine blood examinations and CSF lactate level by Fisher discriminant analysis to improve their diagnostic accuracy. As a result, the diagnostic accuracy of blood examinations and CSF lactate level was significantly improved with an AUC -ROC value=0.760 (CI 95%, 0.737-0.782) and 0.921 (CI 95%, 0.887-0.948) respectively. The PBM diagnostic accuracy of routine blood examinations was relatively low, whereas the accuracy of CSF lactate level was high. Some variables that are involved in the incidence of PBM can also affect the diagnostic accuracy for PBM. Taking into account the effects of these variables significantly improves the diagnostic accuracies of routine blood examinations and CSF lactate level. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Diagnostic performance of dental students in identifying mandibular condyle fractures by panoramic radiography and the usefulness of reference images

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Bong Hae [School of Dentistry, Pusan National University, Pusan (Korea, Republic of)

    2011-06-15

    The purpose of this study was to evaluate the diagnostic performance of dental students in detection of mandibular condyle fractures and the effectiveness of reference panoramic images. Forty-six undergraduates evaluated 25 panoramic radiographs for condylar fractures and the data were analyzed through receiver operating characteristic (ROC) analysis. After a month, they were divided into two homogeneous groups based on the first results and re-evaluated the images with (group A) or without (group B) reference images. Eight reference images included indications showing either typical condylar fractures or anatomic structures which could be confused with fractures. Paired t-test was used for statistical analysis of the difference between the first and the second evaluations for each group, and student's t-test was used between the two groups in the second evaluation. The intra- and inter-observer agreements were evaluated with Kappa statistics. Intra- and inter-observer agreements were substantial (k=0.66) and moderate (k=0.53), respectively. The area under the ROC curve (Az) in the first evaluation was 0.802. In the second evaluation, it was increased to 0.823 for group A and 0.814 for group B. The difference between the first and second evaluations for group A was statistically significant (p<0.05), however there was no statistically significant difference between the two groups in the second evaluation. Providing reference images to less experienced clinicians would be a good way to improve the diagnostic ability in detecting condylar fracture.

  5. Lung cancer: Diagnostic procedures and therapeutic management, with special reference to radiotherapy

    International Nuclear Information System (INIS)

    Scarantino, C.W.

    1985-01-01

    This book on lung cancer provides a good overview of this very common cause of death in both men and women. The eight chapters in this book review a number of aspects of the disease including epidemiology, pathology, diagnostic workup, and treatment by radiation and chemotherapy. The two introductory chapters provide a summary of the epidemiology of this disease and an approach to each individual patient. Included are chapters on the many methods of treating lung cancer and the results of clinical trials as well as a brief discussion given to surgical treatment. A chapter on clinical research is directed primarily at ideas relating to chemotherapy. This brief book provides an overview of the many aspects involved in diagnosing and treating lung cancer

  6. Evaluation of serological diagnostic tests for typhoid fever in Papua New Guinea using a composite reference standard.

    Science.gov (United States)

    Siba, Valentine; Horwood, Paul F; Vanuga, Kilagi; Wapling, Johanna; Sehuko, Rebecca; Siba, Peter M; Greenhill, Andrew R

    2012-11-01

    Typhoid fever remains a major global health problem. A major impediment to improving outcomes is the lack of appropriate diagnostic tools, which have not significantly improved in low-income settings for 100 years. We evaluated two commercially available rapid diagnostic tests (Tubex and TyphiDot), a prototype (TyphiRapid TR-02), and the commonly used single-serum Widal test in a previously reported high-burden area of Papua New Guinea. Samples were collected from 530 outpatients with axillary temperatures of ≥37.5°C, and analysis was conducted on all malaria-negative samples (n = 500). A composite reference standard of blood culture and PCR was used, by which 47 participants (9.4%) were considered typhoid fever positive. The sensitivity and specificity of the Tubex (51.1% and 88.3%, respectively) and TyphiDot (70.0% and 80.1%, respectively) tests were not high enough to warrant their ongoing use in this setting; however, the sensitivity and specificity for the TR-02 prototype were promising (89.4% and 85.0%, respectively). An axillary temperature of ≥38.5°C correlated with typhoid fever (P = 0.014). With an appropriate diagnostic test, conducting typhoid fever diagnosis only on patients with high-grade fever could dramatically decrease the costs associated with diagnosis while having no detrimental impact on the ability to accurately diagnose the illness.

  7. Plasma levels and diagnostic utility of VEGF, MMP-2 and TIMP-2 in the diagnostics of breast cancer patients.

    Science.gov (United States)

    Ławicki, Sławomir; Zajkowska, Monika; Głażewska, Edyta Katarzyna; Będkowska, Grażyna Ewa; Szmitkowski, Maciej

    2017-03-01

    We investigated plasma levels and diagnostic utility of vascular endothelial growth factor VEGF, matrix metalloproteinase-2 (MMP-2) and tissue inhibitors of metalloproteinase-2 (TIMP-2) in comparison to cancer antigen 15-3 (CA 15-3). Plasma levels of tested parameters were determined using enzyme-linked immunosorbent assay (ELISA) while CA 15-3 with chemiluminescent microparticle immunoassay (CMIA). The plasma levels of VEGF, TIMP-2 showed significantly higher than CA 15-3 values of the diagnostic sensitivity, the predictive values of positive and negative test results (PPV, NPV) and the area under the receiver-operating characteristics (ROC) curve (AUC) in early stages of breast cancer (BC). The combined use of the tested parameters with CA 15-3 resulted in the increase in sensitivity, NPV and AUC, especially in the combination with VEGF (83%; 72%; 0.888) and TIMP-2 (83%; 72%; 0.894). The highest values were obtained for combination of all three parameters (93%; 85%; 0.923). These findings suggest the usefulness of the tested parameters in the diagnosis of BC, especially VEGF and TIMP-2 with CA 15-3 in early stages of BC, which could be a new diagnostic panel.

  8. Tomosynthesis for the early detection of pulmonary emphysema: diagnostic performance compared with chest radiography, using multidetector computed tomography as reference

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Yoshitake [Keio University School of Medicine, Department of Diagnostic Radiology, Tokyo (Japan); Nippon Koukan Hospital, Department of Radiology, Kawasaki-shi, Kanagawa (Japan); Jinzaki, Masahiro; Hashimoto, Masahiro; Shiomi, Eisuke; Kuribayashi, Sachio [Keio University School of Medicine, Department of Diagnostic Radiology, Tokyo (Japan); Abe, Takayuki [Keio University School of Medicine, Center for Clinical Research, Tokyo (Japan); Ogawa, Kenji [Nippon Koukan Hospital, Department of Radiology, Kawasaki-shi, Kanagawa (Japan)

    2013-08-15

    To compare the diagnostic performance of tomosynthesis with that of chest radiography for the detection of pulmonary emphysema, using multidetector computed tomography (MDCT) as reference. Forty-eight patients with and 63 without pulmonary emphysema underwent chest MDCT, tomosynthesis and radiography on the same day. Two blinded radiologists independently evaluated the tomosynthesis images and radiographs for the presence of pulmonary emphysema. Axial and coronal MDCT images served as the reference standard and the percentage lung volume with attenuation values of -950 HU or lower (LAA{sub -950}) was evaluated to determine the extent of emphysema. Receiver-operating characteristic (ROC) analysis and generalised estimating equations model were used. ROC analysis revealed significantly better performance (P < 0.0001) of tomosynthesis than radiography for the detection of pulmonary emphysema. The average sensitivity, specificity, positive predictive value and negative predictive value of tomosynthesis were 0.875, 0.968, 0.955 and 0.910, respectively, whereas the values for radiography were 0.479, 0.913, 0.815 and 0.697, respectively. For both tomosynthesis and radiography, the sensitivity increased with increasing LAA{sub -950}. The diagnostic performance of tomosynthesis was significantly superior to that of radiography for the detection of pulmonary emphysema. In both tomosynthesis and radiography, the sensitivity was affected by the LAA{sub -950}. (orig.)

  9. Tomosynthesis for the early detection of pulmonary emphysema: diagnostic performance compared with chest radiography, using multidetector computed tomography as reference.

    Science.gov (United States)

    Yamada, Yoshitake; Jinzaki, Masahiro; Hashimoto, Masahiro; Shiomi, Eisuke; Abe, Takayuki; Kuribayashi, Sachio; Ogawa, Kenji

    2013-08-01

    To compare the diagnostic performance of tomosynthesis with that of chest radiography for the detection of pulmonary emphysema, using multidetector computed tomography (MDCT) as reference. Forty-eight patients with and 63 without pulmonary emphysema underwent chest MDCT, tomosynthesis and radiography on the same day. Two blinded radiologists independently evaluated the tomosynthesis images and radiographs for the presence of pulmonary emphysema. Axial and coronal MDCT images served as the reference standard and the percentage lung volume with attenuation values of -950 HU or lower (LAA-950) was evaluated to determine the extent of emphysema. Receiver-operating characteristic (ROC) analysis and generalised estimating equations model were used. ROC analysis revealed significantly better performance (P pulmonary emphysema. The average sensitivity, specificity, positive predictive value and negative predictive value of tomosynthesis were 0.875, 0.968, 0.955 and 0.910, respectively, whereas the values for radiography were 0.479, 0.913, 0.815 and 0.697, respectively. For both tomosynthesis and radiography, the sensitivity increased with increasing LAA-950. The diagnostic performance of tomosynthesis was significantly superior to that of radiography for the detection of pulmonary emphysema. In both tomosynthesis and radiography, the sensitivity was affected by the LAA-950. • Tomosynthesis showed significantly better diagnostic performance for pulmonary emphysema than radiography. • Interobserver agreement for tomosynthesis was significantly higher than that for radiography. • Sensitivity increased with increasing LAA -950 in both tomosynthesis and radiography. • Tomosynthesis imparts a similar radiation dose to two projection chest radiography. • Radiation dose and cost of tomosynthesis are lower than those of MDCT.

  10. Histopathological diagnostic discrepancies in soft tissue tumours referred to a specialist centre: reassessment in the era of ancillary molecular diagnosis.

    Science.gov (United States)

    Thway, Khin; Wang, Jayson; Mubako, Taka; Fisher, Cyril

    2014-01-01

    Introduction. Soft tissue tumour pathology is a highly specialised area of surgical pathology, but soft tissue neoplasms can occur at virtually all sites and are therefore encountered by a wide population of surgical pathologists. Potential sarcomas require referral to specialist centres for review by pathologists who see a large number of soft tissue lesions and where appropriate ancillary investigations can be performed. We have previously assessed the types of diagnostic discrepancies between referring and final diagnosis for soft tissue lesions referred to our tertiary centre. We now reaudit this 6 years later, assessing changes in discrepancy patterns, particularly in relation to the now widespread use of ancillary molecular diagnostic techniques which were not prevalent in our original study. Materials and Methods. We compared the sarcoma unit's histopathology reports with referring reports on 348 specimens from 286 patients with suspected or proven soft tissue tumours in a one-year period. Results. Diagnostic agreement was seen in 250 cases (71.8%), with 57 (16.4%) major and 41 (11.8%) minor discrepancies. There were 23 cases of benign/malignant discrepancies (23.5% of all discrepancies). 50 ancillary molecular tests were performed, 33 for aiding diagnosis and 17 mutational analyses for gastrointestinal stromal tumour to guide therapy. Findings from ancillary techniques contributed to 3 major and 4 minor discrepancies. While the results were broadly similar to those of the previous study, there was an increase in frequency of major discrepancies. Conclusion. Six years following our previous study and notably now in an era of widespread ancillary molecular diagnosis, the overall discrepancy rate between referral and tertiary centre diagnosis remains similar, but there is an increase in frequency of major discrepancies likely to alter patient management. A possible reason for the increase in major discrepancies is the increasing lack of exposure to soft tissue

  11. Environmental Perception as a Diagnostic Probe of Environmental Complexity Levels

    Science.gov (United States)

    Freitas, Mirlaine R.; Macedo, Renato L. G.; Freitas, Matheus P.; Nunes, Cleiton A.; Venturin, Nelson

    2015-01-01

    Purpose: Educational methods to diagnose and improve the level of environmental conception are required. The present work reports a methodology based on studies about the environmental perception of a university public, divided into general students and those related to the forest sciences, who are involved with disciplines and researches related…

  12. Hearing Tests on Mobile Devices: Evaluation of the Reference Sound Level by Means of Biological Calibration.

    Science.gov (United States)

    Masalski, Marcin; Kipiński, Lech; Grysiński, Tomasz; Kręcicki, Tomasz

    2016-05-30

    Hearing tests carried out in home setting by means of mobile devices require previous calibration of the reference sound level. Mobile devices with bundled headphones create a possibility of applying the predefined level for a particular model as an alternative to calibrating each device separately. The objective of this study was to determine the reference sound level for sets composed of a mobile device and bundled headphones. Reference sound levels for Android-based mobile devices were determined using an open access mobile phone app by means of biological calibration, that is, in relation to the normal-hearing threshold. The examinations were conducted in 2 groups: an uncontrolled and a controlled one. In the uncontrolled group, the fully automated self-measurements were carried out in home conditions by 18- to 35-year-old subjects, without prior hearing problems, recruited online. Calibration was conducted as a preliminary step in preparation for further examination. In the controlled group, audiologist-assisted examinations were performed in a sound booth, on normal-hearing subjects verified through pure-tone audiometry, recruited offline from among the workers and patients of the clinic. In both the groups, the reference sound levels were determined on a subject's mobile device using the Bekesy audiometry. The reference sound levels were compared between the groups. Intramodel and intermodel analyses were carried out as well. In the uncontrolled group, 8988 calibrations were conducted on 8620 different devices representing 2040 models. In the controlled group, 158 calibrations (test and retest) were conducted on 79 devices representing 50 models. Result analysis was performed for 10 most frequently used models in both the groups. The difference in reference sound levels between uncontrolled and controlled groups was 1.50 dB (SD 4.42). The mean SD of the reference sound level determined for devices within the same model was 4.03 dB (95% CI 3

  13. Smoking affects diagnostic salivary periodontal disease biomarker levels in adolescents.

    Science.gov (United States)

    Heikkinen, Anna Maria; Sorsa, Timo; Pitkäniemi, Janne; Tervahartiala, Taina; Kari, Kirsti; Broms, Ulla; Koskenvuo, Markku; Meurman, Jukka H

    2010-09-01

    The effects of smoking on periodontal biomarkers in adolescents are unknown. This study investigates matrix metalloproteinase (MMP)-8 and polymorphonuclear leukocyte elastase levels in saliva together with periodontal health indices accounting for body mass index and smoking in a birth cohort from Finland. The oral health of boys (n = 258) and girls (n = 243) aged 15 to 16 years was examined clinically. Health habits were assessed by questionnaire. Saliva samples were collected and analyzed by immunofluorometric and peptide assays for MMP-8 levels and polymorphonuclear leukocyte elastase activities, and investigated statistically with the background factors. Median MMP-8 values of male smokers were 112.03 microg/l compared to 176.89 microg/l of non-smokers (P = 0.05). For female smokers corresponding values were 170.88 microg/l versus 177.92 microg/l in non-smokers (not statistically significant). Elastase values in male smokers were 5.88 x 10(-3) Delta OD(405)/h versus 11.0 x 10(-3) Delta OD(405)/h in non-smokers (P = 0.02), and in female smokers 9.16 x 10(-3) Delta OD(405)/h versus 10.88 x 10(-3) Delta OD(405)/h in non-smokers (P = 0.72). The effect was strengthened by high pack-years of smoking (MMP-8, P = 0.04; elastase, P = 0.01). Both biomarkers increased with gingival bleeding. However, statistically significant associations were observed with bleeding on probing and MMP-8 (P = 0.04); MMP-8 was suggestively associated with probing depth (P = 0.09) in non-smoking boys. In smokers with calculus, MMP-8 increased after adjusting with body mass index (P = 0.03). No corresponding differences were seen in girls. Smoking significantly decreased both biomarkers studied. Compared to girls, boys seem to have enhanced susceptibility for periodontitis as reflected in salivary MMP-8 values.

  14. Adrenal Vein Catecholamine Levels and Ratios: Reference Intervals Derived from Patients with Primary Aldosteronism.

    Science.gov (United States)

    Sze, Candy W C; O'Toole, Samuel Matthew; Tirador, Roger Kent; Akker, Scott A; Matson, Matthew; Perry, Leslie; Druce, Maralyn Rose; Dekkers, Tanja; Deinum, Jaap; Lenders, Jacques W M; Eisenhofer, Graeme; Drake, William Martyn

    2017-06-01

    Phaeochromocytoma localisation is generally reliably achieved with modern imaging techniques, particularly in sporadic cases. On occasion, however, there can be diagnostic doubt due to the presence of bilateral adrenal abnormalities, particularly in patients with mutations in genes predisposing them to the development of multiple phaeochromocytomas. In such cases, surgical intervention is ideally limited to large or functional lesions due to the long-term consequences associated with hypoadrenalism. Adrenal venous sampling (AVS) for catecholamines has been used in this situation to guide surgery, although there are few data available to support diagnostic thresholds. Retrospective analyses of AVS results from 2 centres were carried out. A total of 172 patients (88 men, 84 women) underwent AVS under cosyntropin stimulation for the diagnosis of established primary aldosteronism (PA) with measurement of adrenal and peripheral venous cortisol, aldosterone and catecholamines. Six patients (3 men, 3 women) with phaeochromocytoma underwent AVS for diagnostic purposes with subsequent histological confirmation. Reference intervals for the adrenal venous norepinephrine to epinephrine ratio were created from the PA group. Using the 97.5th centile (1.21 on the left, 1.04 on the right), the false negative rate in the phaeochromocytoma group was 0%. In conclusion, this study describes the largest dataset of adrenal venous catecholamine measurements and provides reference intervals in patients without phaeochromocytoma. This strengthens the certainty with which conclusions related to adrenal venous sampling for catecholamines can be drawn, acknowledging the procedure is not part of the routine diagnostic workup and is an adjunct for use only in difficult clinical cases. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Investigation of reference levels and radiation dose associated with abdominal EVAR (endovascular aneurysm repair) procedures across several European Centres

    Energy Technology Data Exchange (ETDEWEB)

    Tuthill, E.; Rainford, L. [University College Dublin, Diagnostic Imaging, School of Medicine, Dublin (Ireland); O' Hora, L.; O' Donohoe, M. [Mater Misericordiae University Hospital, Dublin (Ireland); Panci, S. [San Giovanni di Dio Hospital, Florence (Italy); Gilligan, P.; Fox, E. [Mater Private Hospital, Dublin (Ireland); Campion, D. [Mauriziano-Umberto Hospital, Turin (Italy); Trenti, R. [Policlinico S. Orsola-Malpighi, Bologna (Italy); Catania, D. [AITRI, Association of Italian Interventional Radiographers, Milan (Italy)

    2017-11-15

    Endovascular aneurysm repair (EVAR) is considered the treatment of choice for abdominal aortic aneurysms with suitable anatomy. In order to improve radiation safety, European Directive (2013/59) requires member states to implement diagnostic reference levels (DRLs) in radio-diagnostic and interventional procedures. This study aimed to determine local DRLs for EVAR across five European centres and identify an interim European DRL, which currently remains unestablished. Retrospective data was collected for 180 standard EVARs performed between January 2014 and July 2015 from five specialist centres in Ireland (n=2) and Italy (n=3). Data capture included: air kerma-area product (P{sub KA}), total air kerma at the reference point (K{sub a,r}), fluoroscopic time (FT), number of acquisitions, frame rate of acquisition, type of acquisition, patient height, weight, and gender. The mean values for each site A, B, C, D, and E were: P{sub KA}s of 4343 ± 994 μGym{sup 2}, 18,200 ± 2141 μGym{sup 2}, 11,423 ± 1390 μGym{sup 2}, 7796 ± 704 μGym{sup 2}, 31,897 ± 5798 μGym{sup 2}; FTs of 816 ± 92 s, 950 ± 150 s, 708 ± 70 s, 972 ± 61 s, 827 ± 118 s; and number of acquisitions of 6.72 ± 0.56, 10.38 ± 1.54, 4.74 ± 0.19, 5.64 ± 0.36, 7.28 ± 0.65, respectively. The overall pooled 75th percentile P{sub KA} was 15,849 μGym{sup 2}. Local reference levels were identified. The pooled data has been used to establish an interim European DRL for EVAR procedures. (orig.)

  16. Computized analysis of diagnostic level in breast diseases and frequency of their clinicoroentgenological symptoms

    International Nuclear Information System (INIS)

    Babij, Ya.S.; Krakhmaleva, L.P.; Shumakov, A.G.

    1988-01-01

    A standardized chart with a list of clinicoroentgenological symptoms of the most frequent mammary gland diseases is developed. The data of computer analysis of the diagnostics level and the frequency of clinicoroentgenological symptoms of different diseases of the mammary gland are given. The data obtained can be used for conventional and computer diagnostics of mammary gland diseases, as well as as a basis for the further study of semiotics of different pathological processes in the mammary gland. 22 refs

  17. Low-level lasers alter mRNA levels from traditional reference genes used in breast cancer cells

    Science.gov (United States)

    Teixeira, A. F.; Canuto, K. S.; Rodrigues, J. A.; Fonseca, A. S.; Mencalha, A. L.

    2017-07-01

    Cancer is among the leading causes of mortality worldwide, increasing the importance of treatment development. Low-level lasers are used in several diseases, but some concerns remains on cancers. Reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) is a technique used to understand cellular behavior through quantification of mRNA levels. Output data from target genes are commonly relative to a reference that cannot vary according to treatment. This study evaluated reference genes levels from MDA-MB-231 cells exposed to red or infrared lasers at different fluences. Cultures were exposed to red and infrared lasers, incubated (4 h, 37 °C), total RNA was extracted and cDNA synthesis was performed to evaluate mRNA levels from ACTB, GUSB and TRFC genes by RT-qPCR. Specific amplification was verified by melting curves and agarose gel electrophoresis. RefFinder enabled data analysis by geNorm, NormFinder and BestKeeper. Specific amplifications were obtained and, although mRNA levels from ACTB, GUSB or TRFC genes presented no significant variation through traditional statistical analysis, Excel-based tools revealed that the use of these reference genes are dependent of laser characteristics. Our data showed that exposure to low-level red and infrared lasers at different fluences alter the mRNA levels from ACTB, GUSB and TRFC in MDA-MB-231 cells.

  18. Feasibility and diagnostic power of transthoracic coronary Doppler for coronary flow velocity reserve in patients referred for myocardial perfusion imaging

    Directory of Open Access Journals (Sweden)

    Nylander Eva

    2008-03-01

    Full Text Available Abstract Background Myocardial perfusion imaging (MPI, using single photon emission computed tomography (SPECT is a validated method for detecting coronary artery disease. Transthoracic Doppler echocardiography (TTDE of flow at rest and during adenosine provocation has previously been evaluated in selected patient groups. We therefore wanted to compare the diagnostic ability of TTDE in the left anterior descending coronary artery (LAD to that of MPI in an unselected population of patients with chest pain referred for MPI. Our hypothesis was that TTDE with high accuracy would identify healthy individuals and exclude them from the need for further studies, enabling invasive investigations to be reserved for patients with a high probability of disease. Methods Sixty-nine patients, 44 men and 25 women, age 61 ± 10 years (range 35–82, with a clinical suspicion of stress induced myocardial ischemia, were investigated. TTDE was performed at rest and during adenosine stress for myocardial scintigraphy. Results We found that coronary flow velocity reserve (CFVR determined from diastolic measurements separated normal from abnormal MPI findings with statistical significance. TTDE identified coronary artery disease, defined from MPI, as reversible ischemia and/or permanent defect, with a sensitivity of 60% and a specificity of 79%. The positive predictive value was 43% and the negative predictive value was 88%. There was an overlap between groups which could be due to abnormal endothelial function in patients with normal myocardial perfusion having either hypertension or diabetes. Conclusion TTDE is an attractive non-invasive method to evaluate chest pain without the use of isotopes, but the diagnostic power is strongly dependent on the population investigated. Even in our heterogeneous clinical cardiac population, we found that CFVR>2 in the LAD excluded significant coronary artery disease detected by MPI.

  19. Comparing climate and cost impacts of reference levels for reducing emissions from deforestation

    Energy Technology Data Exchange (ETDEWEB)

    Busch, Jonah [Center for Applied Biodiversity Science, Conservation International, 2011 Crystal Drive, Suite 500, Arlington, VA (United States); Strassburg, Bernardo [Center for Social and Economic Research on the Global Environment, University of East Anglia, Norwich NR4 7TJ (United Kingdom); Cattaneo, Andrea [Woods Hole Research Center, 149 Woods Hole Road, Falmouth, MA 02540-1644 (United States); Lubowski, Ruben [Environmental Defense Fund, 1875 Connecticut Avenue NW, Washington, DC (United States); Bruner, Aaron; Rice, Richard; Boltz, Frederick [Conservation International, 2011 Crystal Drive, Suite 500, Arlington, VA (United States); Creed, Anna; Ashton, Ralph, E-mail: jbusch@conservation.or [Terrestrial Carbon Group, 900 17th Street NW, Suite 700, Washington, DC (United States)

    2009-10-15

    The climate benefit and economic cost of an international mechanism for reducing emissions from deforestation and degradation (REDD) will depend on the design of reference levels for crediting emission reductions. We compare the impacts of six proposed reference level designs on emission reduction levels and on cost per emission reduction using a stylized partial equilibrium model (the open source impacts of REDD incentives spreadsheet; OSIRIS). The model explicitly incorporates national incentives to participate in an international REDD mechanism as well as international leakage of deforestation emissions. Our results show that a REDD mechanism can provide cost-efficient climate change mitigation benefits under a broad range of reference level designs. We find that the most effective reference level designs balance incentives to reduce historically high deforestation emissions with incentives to maintain historically low deforestation emissions. Estimates of emission reductions under REDD depend critically on the degree to which demand for tropical frontier agriculture generates leakage. This underscores the potential importance to REDD of complementary strategies to supply agricultural needs outside of the forest frontier.

  20. Comparing climate and cost impacts of reference levels for reducing emissions from deforestation

    International Nuclear Information System (INIS)

    Busch, Jonah; Strassburg, Bernardo; Cattaneo, Andrea; Lubowski, Ruben; Bruner, Aaron; Rice, Richard; Boltz, Frederick; Creed, Anna; Ashton, Ralph

    2009-01-01

    The climate benefit and economic cost of an international mechanism for reducing emissions from deforestation and degradation (REDD) will depend on the design of reference levels for crediting emission reductions. We compare the impacts of six proposed reference level designs on emission reduction levels and on cost per emission reduction using a stylized partial equilibrium model (the open source impacts of REDD incentives spreadsheet; OSIRIS). The model explicitly incorporates national incentives to participate in an international REDD mechanism as well as international leakage of deforestation emissions. Our results show that a REDD mechanism can provide cost-efficient climate change mitigation benefits under a broad range of reference level designs. We find that the most effective reference level designs balance incentives to reduce historically high deforestation emissions with incentives to maintain historically low deforestation emissions. Estimates of emission reductions under REDD depend critically on the degree to which demand for tropical frontier agriculture generates leakage. This underscores the potential importance to REDD of complementary strategies to supply agricultural needs outside of the forest frontier.

  1. [Diagnostic value of baseline serum luteinizing hormone level for central precocious puberty in girls].

    Science.gov (United States)

    Ou-Yang, Li-Xue; Yang, Fan

    2017-07-01

    To evaluate the diagnostic value of baseline serum luteinizing hormone (LH) level for central precocious puberty (CPP) in girls. A total of 279 girls with precocious puberty were subjected to assessment of growth and development, bone age determination, baseline LH test, and follicle-stimulating hormone (FSH) test, gonadotropin-releasing hormone stimulation test, and other related examinations. Of the 279 patients, 175 were diagnosed with CPP and 104 with premature thelarche (PT). The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of baseline LH and FSH levels and their peak levels for CPP, and the correlation between the baseline LH level and the peak LH level was analyzed. The CPP group had significantly higher bone age, baseline LH and FSH levels, peak LH and FSH levels, and ratio of peak LH level to peak FSH level than the PT group (Pbaseline LH level and peak LH level had good diagnostic values for CPP. Among the three bone age subgroups in the CPP group (7.0-9.0 years, 9.0-11.0 years, and >11.0 years), baseline LH level showed the best diagnostic value in the >11.0 years subgroup, with the largest area under the ROC curve. At a baseline LH level of 0.45 IU/L, the Youden index reached the peak value, and the sensitivity and specificity were 66.7% and 80% respectively, for the diagnosis of CPP. At a peak LH level of 9.935 IU/L, the Youden index reached the peak value, and the sensitivity and specificity were 74.8% and 100% respectively, for the diagnosis of CPP. The baseline LH level was positively correlated with the peak LH level (r=0.440, PBaseline LH level can be used as an primary screening index for the diagnosis of CPP. It has a certain diagnostic value for CPP at different bone ages, and may be used as a monitoring index during the treatment and follow-uP.

  2. Referent 3D tumor model at cellular level in radionuclide therapy

    International Nuclear Information System (INIS)

    Spaic, R.; Ilic, R.D.; Petrovic, B.J.

    2002-01-01

    Aim Conventional internal dosimetry has a lot of limitations because of tumor dose nonuniformity. The best approach for absorbed dose at cellular level for different tumors in radionuclide therapy calculation is Monte Carlo method. The purpose of this study is to introduce referent tumor 3D model at cellular level for Monte Carlo simulation study in radionuclide therapy. Material and Methods The moment when tumor is detectable and when same therapy can start is time period in which referent 3D tumor model at cellular level was defined. In accordance with tumor growth rate at that moment he was a sphere with same radius (10 000 μm). In that tumor there are cells or cluster of cells, which are randomly distributed spheres. Distribution of cells/cluster of cells can be calculated from histology data but it was assumed that this distribution is normal with the same mean value and standard deviation (100±50 mm). Second parameter, which was selected to define referent tumor, is volume density of cells (30%). In this referent tumor there are no necroses. Stroma is defined as space between spheres with same concentration of materials as in spheres. Results: Referent tumor defined on this way have about 2,2 10 5 cells or cluster of cells random distributed. Using this referent 3D tumor model and for same concentration of radionuclides (1:100) and energy of beta emitters (1000 keV) which are homogeneously distributed in labeled cells absorbed dose for all cells was calculated. Simulations are done using FOTELP Monte Carlo code, which is modified for this purposes. Results of absorbed dose in cells are given in numerical values (1D distribution) and as the images (2D or 3D distributions). Conclusion Geometrical module for Monte Carlo simulation study can be standardized by introducing referent 3D tumor model at cellular level. This referent 3D tumor model gives most realistic presentation of different tumors at the moment of their detectability. Referent 3D tumor model at

  3. Patient grouping for dose surveys and establishment of diagnostic reference levels in paediatric computed tomography

    International Nuclear Information System (INIS)

    Vassileva, J.; Rehani, M.

    2015-01-01

    There has been confusion in literature on whether paediatric patients should be grouped according to age, weight or other parameters when dealing with dose surveys. The present work aims to suggest a pragmatic approach to achieve reasonable accuracy for performing patient dose surveys in countries with limited resources. The analysis is based on a subset of data collected within the IAEA survey of paediatric computed tomography (CT) doses, involving 82 CT facilities from 32 countries in Asia, Europe, Africa and Latin America. Data for 6115 patients were collected, in 34.5 % of which data for weight were available. The present study suggests that using four age groups, <1, >1-5, >5-10 and >10-15 y, is realistic and pragmatic for dose surveys in less resource countries and for the establishment of DRLs. To ensure relevant accuracy of results, data for >30 patients in a particular age group should be collected if patient weight is not known. If a smaller sample is used, patient weight should be recorded and the median weight in the sample should be within 5-10 % from the median weight of the sample for which the DRLs were established. Comparison of results from different surveys should always be performed with caution, taking into consideration the way of grouping of paediatric patients. Dose results can be corrected for differences in patient weight/age group. (authors)

  4. Discussion on Implementation of ICRP Recommendations Concerning Reference Levels and Optimisation

    International Nuclear Information System (INIS)

    2013-02-01

    International Commission on Radiological Protection (ICRP) Publication 103, 'The 2007 Recommendations of the International Commission on Radiological Protection', issued in 2007, defines emergency exposure situations as unexpected situations that may require the implementation of urgent protective actions and perhaps longer term protective actions. The ICRP continues to recommend optimisation and the use of reference levels to ensure an adequate degree of protection in regard to exposure to ionising radiation in emergency exposure situations. Reference levels represent the level of dose or risk above which it is judged to be inappropriate to plan to allow exposures to occur and for which protective actions should therefore be planned and optimised. National authorities are responsible for establishing reference levels. The Expert Group on the Implementation of New International Recommendations for Emergency Exposure Situations (EGIRES) performed a survey to analyse the established processes for optimisation of the protection strategy for emergency exposure situations and for practical implementation of the reference level concept in several member states of the Nuclear Energy Agency (NEA). The EGIRES collected information on several national optimisation strategy definitions, on optimisation of protection for different protective actions, and also on optimisation of urgent protective actions. In addition, national criteria for setting reference levels, their use, and relevant processes, including specific triggers and dosimetric quantifies in setting reference levels, are focus points that the EGIRES also evaluated. The analysis of national responses to this 2011 survey shows many differences in the interpretation and application of the established processes and suggests that most countries are still in the early stages of implementing these processes. Since 2011, national authorities have continued their study of the ICRP recommendations to incorporate them into

  5. The use of reference image criteria in X-ray diagnostics: an application for the optimisation of lumbar spine radiographs

    International Nuclear Information System (INIS)

    Almen, A.; Tingberg, A.; Mattsson, S.; Besjakov, J.

    2004-01-01

    To ensure that sufficient image quality is obtained in diagnostic radiology, the image quality of clinical radiographs has to be evaluated. We present two methods herein for evaluating antero-posterior (AP) radiographs of the lumbar spine. One was using image criteria, including six anatomical details (absolute method). In the other, the visibility of anatomical details relative to a reference radiograph was evaluated (visual grading analysis). In total, 14 technique groups were evaluated. The technique groups differed in tube voltage and detector system characteristics. Six different gradients of the H and D curves were simulated. The visual grading analysis showed larger differences in image quality compared with the absolute method. The influence on the image quality due to a variation in tube voltage was easier to detect than the influence on the image quality from the detector characteristics. The visibility of the anatomical details was significantly dependent on the location in the spine. The visual grading analysis was found to be the preferable evaluation method in studies such as the present; however, it is necessary to guide and train the observer before the evaluation is performed. (orig.)

  6. Establishment of standard x-ray qualities to be used in diagnostic level at SSDLs

    International Nuclear Information System (INIS)

    A-Aziz, R.O.

    2007-08-01

    The objective of the present work is to modify x-ray machine (used by the secondary standard dosimetry laboratory in Sudan) to produce x-ray qualities suitable for the calibration at diagnostic level. It based on experimental evaluations. The importance of this study appears in development of protocols to calibrate the instruments used in diagnostic radiology in by good response of the instruments and low cost. In particular, the half value layer (HVL) values for the following qualities 40, 60, 80, 100, 120 and 150 were determined using various attenuation layers. Ionization chamber was used to determine the free air kerma rate at a distance of 100 cm from the x-ray generator. The obtained HVL values were compared with standard values of diagnostic levels. It was observed that the HVL of the present x-ray machine in most qualities are smaller than the standard ones. An approved method (described in the standard IEC 61267) was applied to determine the amount of additional filtration required to meet the standard values. The results show that the available cupper layers were not suitable for this purpose as most of the x-ray was absorbed in the material. Aluminum layers, on the other hand , show good performances to reduce the beams to the desired levels. The amount of additional filtration (from aluminum layers) needed in order to establish standard x-ray qualities to be used in diagnostic level were determined.(Author)

  7. An Evaluation of Serum Procalcitonin and C-Reactive Protein Levels as Diagnostic and Prognostic Biomarkers of Severe Sepsis

    Directory of Open Access Journals (Sweden)

    Szederjesi Janos

    2015-10-01

    Full Text Available Background: Recommendations have been made, following the multicenter Surviving Sepsis Campaign study, to standardize the definition of severe sepsis with reference to several parameters such as haemodynamic stability, acid-base balance, bilirubin, creatinine, International Normalized Ratio (INR, urine output and pulmonary functional value of the ratio between arterial oxigen partial pressure and inspiratory oxigen concentration. Procalcitonin (PCT is considered to be a gold standard biomarker for the inflammatory response, and recent studies have shown that it may help to discover whether a seriously ill person is developing sepsis. C-reactive protein (CRP is also used as a marker of inflammation in the body, as its blood levels increase if there is any inflammation in the body. The aim of this study was to evaluate serum procalcitonin and C-reactive protein levels as diagnostic and prognostic biomarkers of severe sepsis.

  8. Strengthening the diagnostic capacity to detect Bio Safety Level 3 organisms in unusual respiratory viral outbreaks.

    Science.gov (United States)

    van Asten, Liselotte; van der Lubben, Mariken; van den Wijngaard, Cees; van Pelt, Wilfrid; Verheij, Robert; Jacobi, Andre; Overduin, Pieter; Meijer, Adam; Luijt, Dirk; Claas, Eric; Hermans, Mirjam; Melchers, Willem; Rossen, John; Schuurman, Rob; Wolffs, Petra; Boucher, Charles; Bouchier, Charles; Schirm, Jurjen; Kroes, Louis; Leenders, Sander; Galama, Joep; Peeters, Marcel; van Loon, Anton; Stobberingh, Ellen; Schutten, Martin; Koopmans, Marion

    2009-07-01

    Experience with a highly pathogenic avian influenza outbreak in the Netherlands (2003) illustrated that the diagnostic demand for respiratory viruses at different biosafety levels (including BSL3), can increase unexpectedly and dramatically. We describe the measures taken since, aimed at strengthening national laboratory surge capacity and improving preparedness for dealing with diagnostic demand during outbreaks of (emerging) respiratory virus infections, including pandemic influenza virus. Academic and peripheral medical-microbiological laboratories collaborated to determine minimal laboratory requirements for the identification of viruses in the early stages of a pandemic or a large outbreak of avian influenza virus. Next, an enhanced collaborative national network of outbreak assistance laboratories (OAL) was set up. An inventory was made of the maximum diagnostic throughput that this network can deliver in a period of intensified demand. For an estimate of the potential magnitude of this surge demand, historical counts were calculated from hospital- and physician-based registries of patients presenting with respiratory symptoms. Number of respiratory physician-visits ranged from 140,000 to 615,000 per month and hospitalizations ranged from 3000 to 11,500 per month. The established OAL-network provides rapid diagnostic response with agreed quality requirements and a maximum throughput capacity of 1275 samples/day (38,000 per month), assuming other routine diagnostic work needs to be maintained. Thus surge demand for diagnostics for hospitalized cases (if not distinguishable from other respiratory illness) could be handled by the OAL network. Assessing etiology of community acquired acute respiratory infection however, may rapidly exceed the capacity of the network. Therefore algorithms are needed for triaging for laboratory diagnostics; currently this is not addressed in pandemic preparedness plans.

  9. Radon reference levels and priority areas considering optimisation and avertable lung cancers

    International Nuclear Information System (INIS)

    Bochicchio, F.; Venoso, G.; Antignani, S.; Carpentieri, C.

    2017-01-01

    Protection from radon exposure in workplaces and dwellings, as included in the latest relevant international regulations and recommendations, is based on the new concept of 'reference level' whose meaning is significantly different from that of previous 'action level' concept. In fact, whereas remedial actions had to be considered only for radon concentrations above the action level, actions to optimise radon exposure are requested with priority above reference level but optimisation should be applied also for radon concentrations below reference level. Similar considerations can be applied to the usually called 'Rn-prone' areas, which are here proposed to be regulated as 'priority' areas. The main implication of these new challenging concepts is a substantial increase of avertable lung cancer deaths, as it will be shown using Italian data. Some practical examples of possible policy actions fitting an approach based on these new concepts will also be given, which could be useful for the implementation of the Council Directive 2013/59/Euratom. (authors)

  10. Arterial blood gas reference values for sea level and an altitude of 1,400 meters.

    Science.gov (United States)

    Crapo, R O; Jensen, R L; Hegewald, M; Tashkin, D P

    1999-11-01

    Blood gas measurements were collected on healthy lifetime nonsmokers at sea level (n = 96) and at an altitude of 1,400 meters (n = 243) to establish reference equations. At each study site, arterial blood samples were analyzed in duplicate on two separate blood gas analyzers and CO-oximeters. Arterial blood gas variables included Pa(O(2)), Pa(CO(2)), pH, and calculated alveolar-arterial PO(2) difference (AaPO(2)). CO-oximeter variables were Hb, COHb, MetHb, and Sa(O(2)). Subjects were 18 to 81 yr of age with 166 male and 173 female. Outlier data were excluded from multiple regression analysis, and reference equations were fitted to the data in two ways: (1) best fit using linear, squared, and cross-product terms; (2) simple equations, including only the variables that explained at least 3% of the variance. Two sets of equations were created: (1) using only the sea level data and (2) using the combined data with barometric pressure as an independent variable. Comparisons with earlier studies revealed small but significant differences; the decline in Pa(O(2)) with age at each altitude was consistent with most previous studies. At sea level, the equation that included barometric pressure predicted Pa(O(2)) slightly better than the sea level specific equation. The inclusion of barometric pressure in the equations allows better prediction of blood gas reference values at sea level and at altitudes as high as 1,400 meters.

  11. Development of diagnostic test instruments to reveal level student conception in kinematic and dynamics

    Science.gov (United States)

    Handhika, J.; Cari, C.; Suparmi, A.; Sunarno, W.; Purwandari, P.

    2018-03-01

    The purpose of this research was to develop a diagnostic test instrument to reveal students' conceptions in kinematics and dynamics. The diagnostic test was developed based on the content indicator the concept of (1) displacement and distance, (2) instantaneous and average velocity, (3) zero and constant acceleration, (4) gravitational acceleration (5) Newton's first Law, (6) and Newton's third Law. The diagnostic test development model includes: Diagnostic test requirement analysis, formulating test-making objectives, developing tests, checking the validity of the content and the performance of reliability, and application of tests. The Content Validation Index (CVI) results in the category are highly relevant, with a value of 0.85. Three questions get negative Content Validation Ratio CVR) (-0.6), after revised distractors and clarify visual presentation; the CVR become 1 (highly relevant). This test was applied, obtained 16 valid test items, with Cronbach Alpha value of 0.80. It can conclude that diagnostic test can be used to reveal the level of students conception in kinematics and dynamics.

  12. Advice concerning the advantages of a reference incinerator for low-level and intermediate-level radioactive waste processing

    International Nuclear Information System (INIS)

    Luyten, G.B.

    1985-05-01

    In this report, an inventory is presented of new incinerators and flue gas filters used in low and intermediate-level radioactive waste combustion. It is argued that a 'reference equipment' for the combustion of solid and liquid low- and intermediate-level wastes best meets existing Dutch radiation protection standards. A cost-benefit analysis of such an equipment is given including annual costs of investment, capital and exploration. A separate combustion process of organic liquids and carrions is considered finally. (G.J.P.)

  13. Serum Glutamine Levels as a Potential Diagnostic Biomarker in Sepsis following Surgery for Peritonitis.

    Science.gov (United States)

    Yang, Chun-Ju; Huang, Ting-Shuo; Lee, Tung-Liang; Yang, Kang-Chung; Yuan, Shin-Sheng; Lu, Ruey-Hwa; Hsieh, Chung-Ho; Shyu, Yu-Chiau

    2017-12-31

    Few diagnostic biomarkers for sepsis after emergency peritonitis surgery are available to clinicians, and, thus, it is important to develop new biomarkers for patients undergoing this procedure. We investigated whether serum glutamine and selenium levels could be diagnostic biomarkers of sepsis in individuals recovering from emergency peritonitis surgery. From February 2012 to March 2013, patients who had peritonitis diagnosed at the emergency department and underwent emergency surgery were screened for eligibility. Serum glutamine and selenium levels were obtained at pre-operative, post-operative and recovery time points. The average level of pre-operation serum glutamine was significantly different from that on the recovery day (0.317 ± 0.168 vs. 0.532 ± 0.155 mM, P peritonitis. We recommend including glutamine as a biomarker for sepsis severity assessment in addition to the commonly used clinical indicators.

  14. The Influence of the Terrestrial Reference Frame on Studies of Sea Level Change

    Science.gov (United States)

    Nerem, R. S.; Bar-Sever, Y. E.; Haines, B. J.; Desai, S.; Heflin, M. B.

    2015-12-01

    The terrestrial reference frame (TRF) provides the foundation for the accurate monitoring of sea level using both ground-based (tide gauges) and space-based (satellite altimetry) techniques. For the latter, tide gauges are also used to monitor drifts in the satellite instruments over time. The accuracy of the terrestrial reference frame (TRF) is thus a critical component for both types of sea level measurements. The TRF is central to the formation of geocentric sea-surface height (SSH) measurements from satellite altimeter data. The computed satellite orbits are linked to a particular TRF via the assumed locations of the ground-based tracking systems. The manner in which TRF errors are expressed in the orbit solution (and thus SSH) is not straightforward, and depends on the models of the forces underlying the satellite's motion. We discuss this relationship, and provide examples of the systematic TRF-induced errors in the altimeter derived sea-level record. The TRF is also crucial to the interpretation of tide-gauge measurements, as it enables the separation of vertical land motion from volumetric changes in the water level. TRF errors affect tide gauge measurements through GNSS estimates of the vertical land motion at each tide gauge. This talk will discuss the current accuracy of the TRF and how errors in the TRF impact both satellite altimeter and tide gauge sea level measurements. We will also discuss simulations of how the proposed Geodetic Reference Antenna in SPace (GRASP) satellite mission could reduce these errors and revolutionize how reference frames are computed in general.

  15. Reference dose levels for dental panoramic radiography in Gwangju (South Korea)

    International Nuclear Information System (INIS)

    Lee, J. S.; Kim, Y. H.; Yoon, S. J.; Kang, B. C.

    2010-01-01

    This study assessed the reference dose levels for dental panoramic radiography in Gwangju city (South Korea) based on the dose width product (DWP) and compared them with those already established elsewhere. A total of 44 panoramic dental radiographic sets (36 digital and 8 analogue panoramic sets) in 41 dental clinics in Gwangju city were chosen. The third quartile DWP was determined from 429 surface dose measurements of the adult surface dose in panoramic dental radiography. The third quartile DWP for panoramic radiography was 60.1 mGy mm. The proposed DWP reference levels of 60.1 mGy mm were less than or equal to those previously reported in other countries, such as Italy and UK, and acceptable for panoramic radiography in Gwangju (KR). (authors)

  16. Correlation electron cyclotron emission diagnostic and improved calculation of turbulent temperature fluctuation levels on ASDEX Upgrade

    Science.gov (United States)

    Creely, A. J.; Freethy, S. J.; Burke, W. M.; Conway, G. D.; Leccacorvi, R.; Parkin, W. C.; Terry, D. R.; White, A. E.

    2018-05-01

    A newly upgraded correlation electron cyclotron emission (CECE) diagnostic has been installed on the ASDEX Upgrade tokamak and has begun to perform experimental measurements of electron temperature fluctuations. CECE diagnostics measure small amplitude electron temperature fluctuations by correlating closely spaced heterodyne radiometer channels. This upgrade expanded the system from six channels to thirty, allowing simultaneous measurement of fluctuation level radial profiles without repeat discharges, as well as opening up the possibility of measuring radial turbulent correlation lengths. Newly refined statistical techniques have been developed in order to accurately analyze the fluctuation data collected from the CECE system. This paper presents the hardware upgrades for this system and the analysis techniques used to interpret the raw data, as well as measurements of fluctuation spectra and fluctuation level radial profiles.

  17. Microbiopsy a first-level diagnostic test to rule out oral dysplasia or carcinoma in general dental practice.

    Science.gov (United States)

    Pentenero, M; Val, M; Rosso, S; Gandolfo, S

    2018-03-01

    Diagnostic delay in oral oncology could be improved if general dentists had a reliable and easy-to-use first-level diagnostic test to rule out the presence of oral dysplasia or carcinoma. Microbiopsy has been proved to have high sensitivity and high negative predictive value in a clinical setting characterized by high prevalence of disease. Moreover, it has been proved to be easily performed by general dentists. This study aimed to determine the negative predictive value of microbiopsy in routine dental practice: a clinical setting characterized by low prevalence of disease. Within the frame of a previous study, general dentists from the Metropolitan Area of Turin performed microbiopsy for each oral mucosal lesion detected during their practice. The clinical outcome of 129 lesions negative at microbiopsy was checked by a query performed through the database of the Piedmont Cancer Registry, covering the population of the Metropolitan Area of Turin, with particular reference to cancer involving the mouth (ICD-10:C03-06). This allowed us to define "true negative" cases and to calculate the negative predictive value of microbiopsy. In a mean follow-up of 7.5 years (range 7-9 years), with a dropout rate of 7.7%, no case of tumour involving the mouth was observed, thus revealing a negative predictive value approaching 100%. Microbiopsy represents an easy-to-use and reliable first-level test able to aid general dentists to select patients requiring an oral medicine assessment in a short time and definitely to avoid diagnostic delay in oncologically relevant oral mucosal lesions. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved.

  18. Reference hearing threshold levels for chirp signals delivered by an ER-3A insert earphone

    DEFF Research Database (Denmark)

    Gøtsche-Rasmussen, Kristian; Poulsen, Torben; Elberling, Claus

    2012-01-01

    back from a Tucker Davies Technologies System II, and a Matlab program controlled the test setup. The results are specified in dB peak-to-peak equivalent threshold sound pressure levels (dB peETSPL). Study sample: The test group consisted of 25 otologically-normal young adults (age 18–25 years......Objective: To establish reference hearing threshold levels for chirps and frequency-specific chirps. Design: Hearing thresholds were determined monaurally for broad-band chirps and octave-band chirps using the Etymotic Research, ER-3A insert earphone. The chirps were presented using two repetition...

  19. Age-specific reference values for serum FSH and estradiol levels throughout the reproductive period.

    Science.gov (United States)

    Grisendi, Valentina; Spada, Elena; Argento, Cindy; Plebani, Maddalena; Milani, Silvano; Seracchioli, Renato; Volpe, Annibale; La Marca, Antonio

    2014-06-01

    High serum day 3 FSH levels are associated with poor ovarian reserve and reduced fertility, but the interpretation of FSH values according to age is still not univocal. The purpose of this study was to determine age-dependent reference values in women with regular menstrual cycles and FSH as a guide for specialists. The study was performed at the Department of Mother-Infant of a University-based tertiary care centre. One-hundred ninety-two healthy normal menstruating women were recruited for the study. All patients attended the department on menstrual cycle day 3 for a blood sample for FSH and estradiol determination. A linear relationship between FSH or estradiol serum levels and age was observed. The FSH level increased by 0.11 IU for every year of age (1 IU for every 9 years of age). The values of FSH and estradiol corresponding to the 5th, 25th, 50th, 75th, 95th centiles for any specific age have been calculated. Serum FSH levels need to be interpreted according to age-dependent reference values. Serum FSH levels on 95th centile for any age may represent a warning sign for reduced ovarian reserve.

  20. Reference design and operations for deep borehole disposal of high-level radioactive waste

    International Nuclear Information System (INIS)

    Herrick, Courtney Grant; Brady, Patrick Vane; Pye, Steven; Arnold, Bill Walter; Finger, John Travis; Bauer, Stephen J.

    2011-01-01

    A reference design and operational procedures for the disposal of high-level radioactive waste in deep boreholes have been developed and documented. The design and operations are feasible with currently available technology and meet existing safety and anticipated regulatory requirements. Objectives of the reference design include providing a baseline for more detailed technical analyses of system performance and serving as a basis for comparing design alternatives. Numerous factors suggest that deep borehole disposal of high-level radioactive waste is inherently safe. Several lines of evidence indicate that groundwater at depths of several kilometers in continental crystalline basement rocks has long residence times and low velocity. High salinity fluids have limited potential for vertical flow because of density stratification and prevent colloidal transport of radionuclides. Geochemically reducing conditions in the deep subsurface limit the solubility and enhance the retardation of key radionuclides. A non-technical advantage that the deep borehole concept may offer over a repository concept is that of facilitating incremental construction and loading at multiple perhaps regional locations. The disposal borehole would be drilled to a depth of 5,000 m using a telescoping design and would be logged and tested prior to waste emplacement. Waste canisters would be constructed of carbon steel, sealed by welds, and connected into canister strings with high-strength connections. Waste canister strings of about 200 m length would be emplaced in the lower 2,000 m of the fully cased borehole and be separated by bridge and cement plugs. Sealing of the upper part of the borehole would be done with a series of compacted bentonite seals, cement plugs, cement seals, cement plus crushed rock backfill, and bridge plugs. Elements of the reference design meet technical requirements defined in the study. Testing and operational safety assurance requirements are also defined. Overall

  1. Reference design and operations for deep borehole disposal of high-level radioactive waste.

    Energy Technology Data Exchange (ETDEWEB)

    Herrick, Courtney Grant; Brady, Patrick Vane; Pye, Steven; Arnold, Bill Walter; Finger, John Travis; Bauer, Stephen J.

    2011-10-01

    A reference design and operational procedures for the disposal of high-level radioactive waste in deep boreholes have been developed and documented. The design and operations are feasible with currently available technology and meet existing safety and anticipated regulatory requirements. Objectives of the reference design include providing a baseline for more detailed technical analyses of system performance and serving as a basis for comparing design alternatives. Numerous factors suggest that deep borehole disposal of high-level radioactive waste is inherently safe. Several lines of evidence indicate that groundwater at depths of several kilometers in continental crystalline basement rocks has long residence times and low velocity. High salinity fluids have limited potential for vertical flow because of density stratification and prevent colloidal transport of radionuclides. Geochemically reducing conditions in the deep subsurface limit the solubility and enhance the retardation of key radionuclides. A non-technical advantage that the deep borehole concept may offer over a repository concept is that of facilitating incremental construction and loading at multiple perhaps regional locations. The disposal borehole would be drilled to a depth of 5,000 m using a telescoping design and would be logged and tested prior to waste emplacement. Waste canisters would be constructed of carbon steel, sealed by welds, and connected into canister strings with high-strength connections. Waste canister strings of about 200 m length would be emplaced in the lower 2,000 m of the fully cased borehole and be separated by bridge and cement plugs. Sealing of the upper part of the borehole would be done with a series of compacted bentonite seals, cement plugs, cement seals, cement plus crushed rock backfill, and bridge plugs. Elements of the reference design meet technical requirements defined in the study. Testing and operational safety assurance requirements are also defined. Overall

  2. Diagnostic serum vitamin D level is not a reliable prognostic factor for resectable breast cancer.

    Science.gov (United States)

    Mizrak Kaya, Dilsa; Ozturk, Bengi; Kubilay, Pinar; Onur, Handan; Utkan, Gungor; Cay Senler, Filiz; Alkan, Ali; Yerlikaya, Halis; Koksoy, Elif B; Karci, Ebru; Demirkazik, Ahmet; Akbulut, Hakan; Icli, Fikri

    2018-05-09

    There are inconsistent results about the effects of vitamin D level on breast cancer prognosis. We aimed to investigate the effect of vitamin D levels on the prognosis of resectable breast cancer in a patient group with highly different clothing styles. A total of 186 breast cancer patients were enrolled in the study. Vitamin D level was sufficient, insufficient and deficient in 17.2, 52.2 and 30.6% of patients, respectively. There was a significant relationship between clothing style and serum 25 (OH) D levels. We could not establish any relation between vitamin D level and tumor characteristics or survival. Vitamin D supplementation can be more important than diagnostic serum vitamin D level on prognosis of breast cancer.

  3. Mapping of radio frequency electromagnetic field exposure levels in outdoor environment and comparing with reference levels for general public health.

    Science.gov (United States)

    Cansiz, Mustafa; Abbasov, Teymuraz; Kurt, M Bahattin; Celik, A Recai

    2018-03-01

    In this study, radio frequency electromagnetic field exposure levels were measured on the main streets in the city center of Diyarbakır, Turkey. Measured electric field levels were plotted on satellite imagery of Diyarbakır and were compared with exposure guidelines published by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). Exposure measurements were performed in dense urban, urban and suburban areas each day for 7 consecutive days. The measurement system consisted of high precision and portable spectrum analyzer, three-axis electric field antenna, connection cable and a laptop which was used to record the measurement samples as a data logger. The highest exposure levels were detected for two places, which are called Diclekent and Batıkent. It was observed that the highest instantaneous electric field strength value for Batıkent was 7.18 V/m and for Diclekent was 5.81 V/m. It was statistically determined that the main contributor band to the total exposure levels was Universal Mobile Telecommunications System band. Finally, it was concluded that all measured exposure levels were lower than the reference levels recommended by ICNIRP for general public health.

  4. Dose limits, constraints, reference levels. What does it mean for radiation protection?

    International Nuclear Information System (INIS)

    Breckow, J.

    2016-01-01

    The established concept of radiation protection with its basic principles justification, optimization, and limitation has proved its value and is going to be continued. In its deeper meaning, however, the concept is rather subtle and complex. Furthermore, in some aspects there remain some breaches or inconsistencies. This is just true for the terms dose limit, reference lever, and constraint that are tightly associated with the radiation protection principles. In order to guarantee the ability of radiation protection in whole extent, the subtle differences of meaning have to be communicated. There is a permanent need to defend the conceptual function of these terms against deliberate or undeliberate misinterpretations. Reference levels are definitely not the same as dose limits and they may not be misused as such. Any attempt to misinterpret fundamental radiation protection principles for selfish purposes should discouraged vigorously.

  5. DIAGNOSTICS OF LEVELS OF FORMATION OF FUTURE MUSIC TEACHERS’ ART REFLECTION

    Directory of Open Access Journals (Sweden)

    Zhang Jingjing

    2016-11-01

    Full Text Available Features of diagnostics of levels of formation of art reflection are justified in the article. Four levels of future music teachers’ art reflection are defined. These levels are based on the research measures of desire to master art reflection; the degree of understanding the nature and characteristics of art reflection; measures of the emotional involvement into art reflection; degree of possession of the necessary skills for art reflection; formation of professionalism in music and performing activities. They are initial, satisfactory, sufficient and optimal. The importance of formation of future music teachers’ art reflection is considered as the basis for professional development, self-regulation on the acquisition of implementing art knowledge. The formation of art reflection requires the creation and implementation of specific methods of diagnostics of future music teachers’ art reflection. The article is dedicated to the problem of developing and testing diagnostic methods of formation of future music teachers’ art reflection. While writing the article there methods of analysis, synthesis, method of systematization of the material, the principles of objectivity and scientific character are being used. Diagnostics and analysis of the levels of future music teachers’ art reflection shows that the vast majority of students have art reflection at a satisfactory level (67.24%. 22.41% of students are found to have the initial level of formation of art reflection. Only 10.34% of students are found to have the sufficient level of art reflection. There are no students having the optimal level of art reflection. The author concluded that educational and behavior tasks, which the future music teachers have, are identified while testing the features of formation of future music teachers’ art reflection. They cause picking out the most appropriate areas and focus on the most prospective and effective methods of formation in the course of

  6. A comparison and cross-reference of commercial low-level radioactive waste acceptance criteria

    International Nuclear Information System (INIS)

    Kerr, T.A.

    1997-04-01

    This document, prepared by the National Low-Level Waste Management Program at the Idaho National Engineering and Environmental Laboratory, is a comparison and cross-reference of commercial low-level radioactive waste acceptance criteria. Many of these are draft or preliminary criteria as well as implemented criteria at operating low-level radioactive waste management facilities. Waste acceptance criteria from the following entities are included: US Nuclear Regulatory Commission, South Carolina, Washington, Utah, Nevada, California, illinois, Texas, North Carolina, Nebraska, Pennsylvania, New York, and the Midwest Compact Region. Criteria in the matrix include the following: physical form, chemical form, liquid limits, void space in packages, concentration averaging, types of packaging, chelating agents, solidification media, stability requirements, sorptive media, gas, oil, biological waste, pyrophorics, source material, special nuclear material, package dimensions, incinerator ash, dewatered resin, transuranics, and mixed waste. Each criterion in the matrix is cross-referenced to its source document so that exact requirements can be determined

  7. Diagnostic accuracy at several reduced radiation dose levels for CT imaging in the diagnosis of appendicitis

    Science.gov (United States)

    Zhang, Di; Khatonabadi, Maryam; Kim, Hyun; Jude, Matilda; Zaragoza, Edward; Lee, Margaret; Patel, Maitraya; Poon, Cheryce; Douek, Michael; Andrews-Tang, Denise; Doepke, Laura; McNitt-Gray, Shawn; Cagnon, Chris; DeMarco, John; McNitt-Gray, Michael

    2012-03-01

    Purpose: While several studies have investigated the tradeoffs between radiation dose and image quality (noise) in CT imaging, the purpose of this study was to take this analysis a step further by investigating the tradeoffs between patient radiation dose (including organ dose) and diagnostic accuracy in diagnosis of appendicitis using CT. Methods: This study was IRB approved and utilized data from 20 patients who underwent clinical CT exams for indications of appendicitis. Medical record review established true diagnosis of appendicitis, with 10 positives and 10 negatives. A validated software tool used raw projection data from each scan to create simulated images at lower dose levels (70%, 50%, 30%, 20% of original). An observer study was performed with 6 radiologists reviewing each case at each dose level in random order over several sessions. Readers assessed image quality and provided confidence in their diagnosis of appendicitis, each on a 5 point scale. Liver doses at each case and each dose level were estimated using Monte Carlo simulation based methods. Results: Overall diagnostic accuracy varies across dose levels: 92%, 93%, 91%, 90% and 90% across the 100%, 70%, 50%, 30% and 20% dose levels respectively. And it is 93%, 95%, 88%, 90% and 90% across the 13.5-22mGy, 9.6-13.5mGy, 6.4-9.6mGy, 4-6.4mGy, and 2-4mGy liver dose ranges respectively. Only 4 out of 600 observations were rated "unacceptable" for image quality. Conclusion: The results from this pilot study indicate that the diagnostic accuracy does not change dramatically even at significantly reduced radiation dose.

  8. Age- and Gender-Specific Reference Intervals for Fasting Blood Glucose and Lipid Levels in School Children Measured With Abbott Architect c8000 Chemistry Analyzer.

    Science.gov (United States)

    Tamimi, Waleed; Albanyan, Esam; Altwaijri, Yasmin; Tamim, Hani; Alhussein, Fahad

    2012-04-01

    Reference intervals for pubertal characteristics are influenced by genetic, geographic, dietary and socioeconomic factors. Therefore, the aim of this study was to establish age-specific reference intervals of glucose and lipid levels among local school children. This was cross-sectional study, conducted among Saudi school children. Fasting blood samples were collected from 2149 children, 1138 (53%) boys and 1011 (47%) girls, aged 6 to 18 years old. Samples were analyzed on the Architect c8000 Chemistry System (Abbott Diagnostics, USA) for glucose, cholesterol, triglycerides, HDL and LDL. Reference intervals were established by nonparametric methods between the 2.5th and 97.5th percentiles. Significant differences were observed between boys and girls for cholesterol and triglycerides levels in all age groups (P glucose levels except at age 12 to 13 years. Saudi children have comparable serum cholesterol levels than their Western counterparts. This may reflect changing dietary habits and increasing affluence in Saudi Arabia. Increased lipid screening is anticipated, and these reference intervals will aid in the early assessment of cardiovascular and diabetes risk in Saudi pediatric populations.

  9. Technology, Safety and Costs of Decommissioning a Reference Low-Level Waste Burial Ground. Appendices

    International Nuclear Information System (INIS)

    None

    1980-01-01

    Safety and cost information are developed for the conceptual decommissioning of commercial low-level waste (LLW) burial grounds. Two generic burial grounds, one located on an arid western site and the other located on a humid eastern site, are used as reference facilities for the study. The two burial grounds are assumed to have the same site capacity for waste, the same radioactive waste inventory, and similar trench characteristics and operating procedures. The climate, geology. and hydrology of the two sites are chosen to be typical of real western and eastern sites. Volume 2 (Appendices) contains the detailed analyses and data needed to support the results given in Volume 1.

  10. Technology, Safety and Costs of Decommissioning a Reference Low-Level Waste Burial Ground. Main Report

    International Nuclear Information System (INIS)

    Murphy, E. S.; Holter, G. M.

    1980-01-01

    Safety and cost information are developed for the conceptual decommissioning of commercial low-level waste (LLW) burial grounds. Two generic burial grounds, one located on an arid western site and the other located on a humid eastern site, are used as reference facilities for the study. The two burial grounds are assumed to have the same site capacity for waste, the same radioactive waste inventory, and similar trench characteristics and operating procedures. The climate, geology. and hydrology of the two sites are chosen to be typical of real western and eastern sites. Volume 1 (Main Report) contains background information and study results in summary form.

  11. Technology, Safety and Costs of Decommissioning a Reference Low-Level Waste Burial Ground. Main Report

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, E. S.; Holter, G. M.

    1980-06-01

    Safety and cost information are developed for the conceptual decommissioning of commercial low-level waste (LLW) burial grounds. Two generic burial grounds, one located on an arid western site and the other located on a humid eastern site, are used as reference facilities for the study. The two burial grounds are assumed to have the same site capacity for waste, the same radioactive waste inventory, and similar trench characteristics and operating procedures. The climate, geology. and hydrology of the two sites are chosen to be typical of real western and eastern sites. Volume 1 (Main Report) contains background information and study results in summary form.

  12. Children's level of word knowledge predicts their exclusion of familiar objects as referents of novel words

    Directory of Open Access Journals (Sweden)

    Susanne eGrassmann

    2015-08-01

    Full Text Available When children are learning a novel object label, they tend to exclude as possible referents familiar objects for which they already have a name. In the current study, we wanted to know if children would behave in this same way regardless of how well they knew the name of potential referent objects, specifically, whether they could only comprehend it or they could both comprehend and produce it. Sixty-six monolingual German-speaking 2-, 3-, and 4-year-old children participated in two experimental sessions. In one session the familiar objects were chosen such that their labels were in the children's productive vocabularies, and in the other session the familiar objects were chosen such that their labels were only in the children's receptive vocabularies. Results indicated that children at all three ages were more likely to exclude a familiar object as the potential referent of the novel word if they could comprehend and produce its name rather than comprehend its name only. Indeed, level of word knowledge as operationalized in this way was a better predictor than was age. These results are discussed in the context of current theories of word learning by exclusion.

  13. Diagnostic reference range of κ/λ free light chain ratio to screen for Bence Jones proteinuria is not significantly influenced by GFR.

    Science.gov (United States)

    Schmidt-Hieltjes, Yvonne; Elshof, Clemens; Roovers, Lian; Ruinemans-Koerts, Janneke

    2016-05-01

    The aim of our study was to analyse whether the κ/λ free light chain ratio reference range for screening for Bence Jones proteinuria should be dependent on the estimated glomerular filtration rate (eGFR). The serum κ/λ free light chain ratio, eGFR, serum M-protein and Bence Jones protein were measured in 544 patients for whom Bence Jones protein analysis was ordered. In the population of patients without Bence Jones proteinuria or a M-protein (n = 402), there is no gradual increase in κ/λ free light chain ratio with diminishing eGFR. The κ/λ free light chain ratio in this group was 0.56-1.86 (95% interval). With this diagnostic reference range of the κ/λ ratio, 105 of the 110 patients with Bence Jones protein could be identified correctly. Only five patients with Bence Jones proteinuria (free light chain ratio was measured without the presence of Bence Jones proteinuria. A κ/λ free light chain ratio in serum can be used safely and efficiently to select urine samples which should be analysed for Bence Jones proteinuria with an electrophoresis/immunofixation technique. Using this diagnostic reference range, the number of urine samples which should be analysed by electrophoresis/immunofixation could be reduced by 74%. The diagnostic reference interval can be determined best in a group of patients for whom Bence Jones analysis is indicated. For calculation of this reference range, the eGFR value does not need to be taken into account. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Determination of Natural Levels of Radionuclides in Proposed Mushroom Reference Material (A Proficiency Test Exercise)

    International Nuclear Information System (INIS)

    Waheed, S.; Rahman, A.; Siddique, N.; Ahmad, S.; Zaidi, J.H.

    2006-08-01

    A proficiency test (PT) was organized within the framework of international Atomic Energy Agency (IAEA) project INT/1/054, entitled 'Preparation' of Reference Materials and Organization of Proficiency Test Rounds'. This exercise served to estimate the proficiency of the analytical laboratories from participating countries. This report presents the results of the proficiency test exercise on the proposed Mushroom Reference Material for the determination of natural levels of radionuclides. Laboratories from 6 different countries submitted data on the following three radionuclides: /sup 134/Cs, /sup 137/Cs, /sup 40/K. Results for /sup 134/Cs, 137/sup 137/Cs, and /sup 40/K in the mushroom reference material were reported by three or more participating laboratories and could be subjected to statistical evaluation. The original data of these raionuclides was subjected to a computer program 'Histo Vession 2.1' provided by IAEA. The four outlier tests i.e. Dixon, Grubbs, Skewness and Kurtosis were applied to the data sets. All values for these three radionuclides were accepted by the software. Consensus (overall) mean value, absolute standard deviation, relative standard deviation, standard error, median and range of values for these three radionuclides have been are obtained (at significance level 0.05). the consensus mean values and confidence intervals are given./sup 134/Cs: 4.4 Bq/kg (3.4-5.3 Bq/kg) /sup 137/Cs: 2899 Bq/kg (2740-3058 Bq/kg) /sup 40/K: 1136 Bq/kg (1046-1226 Bq/kg). (author)

  15. Exhaled nitric oxide levels in asthma: Personal best versus reference values.

    Science.gov (United States)

    Smith, Andrew D; Cowan, Jan O; Taylor, D Robin

    2009-10-01

    Factors affecting the fraction of nitric oxide in exhaled air (FE(NO)) are multiple. Interpreting values when assessing airways disease may be problematic. Clinically optimum levels have not been defined. We aimed to establish the relationship between predicted values for FE(NO) obtained from equations by Olin et al, Travers et al, and Dressel et al, and normalized levels after oral prednisone. We also compared postprednisone FE(NO) levels with those obtained during optimized treatment with inhaled fluticasone. Data were obtained before and after a trial of oral prednisone (30mg/d for 14 days), and also from a previously published study in which patients had their dose of inhaled corticosteroid adjusted using either FE(NO) or symptoms/lung function to optimize treatment. Seventy-three patients completed the study. The geometric mean FE(NO) after prednisone (17.7 parts per billion [ppb]; 95% CI, 15.5-20.2) was significantly lower than mean FE(NO) at the optimized fluticasone dose (20.2 ppb; 95% CI, 17.1-23.8; P=.04) and at loss of control (27.6 ppb; 95% CI, 22.8-33.4; P values of Olin et al (16.8 ppb, 95% CI, 16.0-17.5; P=.44), but were significantly lower than values of Travers et al (predicted, 21.5 ppb; 95% CI, 20.9-22.2; P=.005) and Dressel et al (predicted, 27.8 ppb; 95% CI, 26.7-28.9; P values from the reference equation by Olin et al. However, at optimized doses of inhaled corticosteroid, although FE(NO) levels were higher than predicted, asthma was well controlled. Targeting FE(NO) on reference values is not justified.

  16. 23 CFR Appendix A to Part 772 - National Reference Energy Mean Emission Levels as a Function of Speed

    Science.gov (United States)

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false National Reference Energy Mean Emission Levels as a Function of Speed A Appendix A to Part 772 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF... NOISE Pt. 772, App. A Appendix A to Part 772—National Reference Energy Mean Emission Levels as a...

  17. Third-person Diagnostic Interview on the Cognitive Insight Level of Psychotic Patients with an Insight at the Denial Level.

    Science.gov (United States)

    Mehdizadeh, Mahsa; Rezaei, Omid

    2016-01-01

    According to the previous findings, the third-person technique improved the clinical insight of psychotic patients, therefore the present study aims to examine the effect of a third-person interview compared to a first-person interview on the level of cognitive insight of psychotic patients with an insight at the denial level. In this study, using interviews and questionnaires, a total number of 44 patients of Razi Psychiatric Educational and Treatment Center with an insight at the denial level being assessed using diagnostic interviews were divided randomly into two groups. Then, the two groups of patients' cognitive insights were evaluated using Beck Cognitive Insight Scale. The findings indicated that in psychotic patients with an insight at the denial level, the third-person technique of interview compared to the first-person had little effect on the improvement of overall cognitive insight and its components, including self-reflection and self-assurance; however, this effect was not strong enough to make a significant difference between the two groups of patients. According to the study findings, we can conclude that the third-person interview compared to the first-person interview has no effect on the improvement of the cognitive insight of psychotic patients with an insight at the denial level. This finding is consistent with the previous studies indicating that although the theory of mind has some correlations with the clinical insight of patients, it has no effect on their cognitive insight.

  18. Recommended aerobic fitness level for metabolic health in children and adolescents: a study of diagnostic accuracy

    DEFF Research Database (Denmark)

    Adegboye, Amanda Ra; Anderssen, Sigmund A; Froberg, Karsten

    2011-01-01

    Objective To define the optimal cut-off for low aerobic fitness and to evaluate its accuracy to predict clustering of risk factors for cardiovascular disease in children and adolescents. Design Study of diagnostic accuracy using a cross-sectional database. Setting European Youth Heart Study...... would be expected by chance (AUC >0.5) for all cut-offs. Conclusions Aerobic fitness is easy to measure, and is an accurate tool for screening children with clustering of cardiovascular risk factors. Promoting physical activity in children with aerobic fitness level lower than the suggested cut...

  19. DIAGNOSTIC VALUE OF GALECTIN-3 LEVEL IN PATIENTS WITH CHRONIC HEART FAILURE AND TYPE 2 DIABETES

    Directory of Open Access Journals (Sweden)

    A. A. Snetkova

    2015-09-01

    Full Text Available Currently, a greater emphasis is placed on the search for additional biomarkers of chronic heart failure (CHF. Galectin-3, a marker of fibrosis and inflammation, has shown himself as a biomarker of CHF in many studies, but the dynamics of its levels in patients with concomitant diabetes mellitus (DM type 2 is not well-studied.Aim. To identify diagnostic significance of galectin-3 plasma level evaluation and its correlations with echocardiographic criteria for patients with CHF and DM type 2.Material and methods. The study included 33 patients with ischemic CHF (all patients had a history of myocardial infarction and DM type 2. The patients were divided into two groups according to the left ventricle (LV ejection fraction (EF: a group with CHF and preserved ejection fraction (PEF (EF≥50% and with CHF and reduced ejection fraction (EF<50%. Patients underwent clinical laboratory tests and Doppler echocardiography; moreover, the levels of brain natriuretic peptide (BNP and galeсtin-3 were measured.Results. The mean level of galectin-3 in blood plasma in the group with CHF and PEF was significantly higher than in the group with CHF and reduced EF (p=0.007. In the group with CHF and PEF a positive correlation between the level of galectin-3 and diastolic LV function E/E' was found (r=0.620, p=0.01. A significant correlation between galectin-3 level and LV systolic function was stated in the group with reduced EF (r=0.53; p<0.05, while in the group with PEF, the correlation was not significant (p=0.225. In the group of patients with reduced EF a negative correlation between galectin-3 and the volume of left atrium was revealed (r=-0.53; p<0.05.Conclusion. Galectin-3 can be used as a diagnostic biomarker primarily in patients with CHF and PEF.

  20. Development of a concept for radiation patients exposure assessment during dental X-ray examinations and statistical data acquisition for the determination of a diagnostic reference value

    International Nuclear Information System (INIS)

    Kueppers, C.; Sering, M.; Poppe, B.; Poplawski, A.; Looe, H.K.; Beyer, D.; Pfaffenberger, A.; Chofor, N.; Eenboom, F.

    2012-01-01

    The research project on the development a concept for radiation patients exposure assessment during dental X-ray examinations and statistical data acquisition for the determination of a diagnostic reference value includes the following issues: Fundamental facts: dental X-ray examination techniques, dose relevant factors and characteristics during X-ray examinations, radiation exposed organs during dental X-ray examinations, dose assessment based on phantoms. Materials and methodologies of the project: TLD measurements using the phantom, calculation of the effective dose during dental X-ray examinations, properties and settings of the reference facilities for the determination of radiation exposure, selection of dental offices, dosimetric measurements, data acquisition and statistical evaluation. Results of dosimetric examinations: results of dosimetric measurements at reference facilities, results of dosimetric measurements in dental offices. Discussion of the concept for the determination of the radiation exposure during dental X-ray examinations.

  1. Napsin A levels in epithelial lining fluid as a diagnostic biomarker of primary lung adenocarcinoma.

    Science.gov (United States)

    Uchida, Akifumi; Samukawa, Takuya; Kumamoto, Tomohiro; Ohshige, Masahiro; Hatanaka, Kazuhito; Nakamura, Yoshihiro; Mizuno, Keiko; Higashimoto, Ikkou; Sato, Masami; Inoue, Hiromasa

    2017-12-12

    It is crucial to develop novel diagnostic approaches for determining if peripheral lung nodules are malignant, as such nodules are frequently detected due to the increased use of chest computed tomography scans. To this end, we evaluated levels of napsin A in epithelial lining fluid (ELF), since napsin A has been reported to be an immunohistochemical biomarker for histological diagnosis of primary lung adenocarcinoma. In consecutive patients with indeterminate peripheral lung nodules, ELF samples were obtained using a bronchoscopic microsampling (BMS) technique. The levels of napsin A and carcinoembryonic antigen (CEA) in ELF at the nodule site were compared with those at the contralateral site. A final diagnosis of primary lung adenocarcinoma was established by surgical resection. We performed BMS in 43 consecutive patients. Among patients with primary lung adenocarcinoma, the napsin A levels in ELF at the nodule site were markedly higher than those at the contralateral site, while there were no significant differences in CEA levels. Furthermore, in 18 patients who were undiagnosed by bronchoscopy and finally diagnosed by surgery, the napsin A levels in ELF at the nodule site were identically significantly higher than those at the contralateral site. In patients with non-adenocarcinoma, there were no differences in napsin A levels in ELF. The area under the receiver operator characteristic curve for identifying primary lung adenocarcinoma was 0.840 for napsin A and 0.542 for CEA. Evaluation of napsin A levels in ELF may be useful for distinguishing primary lung adenocarcinoma.

  2. Diagnostic work-up of 449 consecutive girls who were referred to be evaluated for precocious puberty

    DEFF Research Database (Denmark)

    Mogensen, Signe Sloth; Aksglaede, Lise; Mouritsen, Annette

    2011-01-01

    A decrease in age at pubertal onset has been observed internationally. The aim of this study was to describe a large cohort of Caucasian girls referred with signs of early puberty according to etiology and compare biochemical characteristics.......A decrease in age at pubertal onset has been observed internationally. The aim of this study was to describe a large cohort of Caucasian girls referred with signs of early puberty according to etiology and compare biochemical characteristics....

  3. Low-level radioactive waste technology: a selected, annotated bibliography. [416 references

    Energy Technology Data Exchange (ETDEWEB)

    Fore, C.S.; Carrier, R.F.; Brewster, R.H.; Hyder, L.K.; Barnes, K.A.

    1981-10-01

    This annotated bibliography of 416 references represents the third in a series to be published by the Hazardous Materials Information Center containing scientific, technical, economic, and regulatory information relevant to low-level radioactive waste technology. The bibliography focuses on disposal site, environmental transport, and waste treatment studies as well as general reviews on the subject. The publication covers both domestic and foreign literature for the period 1951 to 1981. Major chapters selected are Chemical and Physical Aspects; Container Design and Performance; Disposal Site; Environmental Transport; General Studies and Reviews; Geology, Hydrology, and Site Resources; Regulatory and Economic Aspects; Social Aspects; Transportation Technology; Waste Production; and Waste Treatment. Entries in each of the chapters are further classified as a field study, laboratory study, theoretical study, or general overview involving one or more of these research areas.

  4. 1-GWh diurnal load-leveling superconducting magnetic energy storage system reference design

    International Nuclear Information System (INIS)

    Hassenzahl, W.V.; Rogers, J.D.

    1979-01-01

    A point reference design has been completed for a 1-GWh Superconducting Magnetic Energy Storage system. The system is for electric utility dirunal load leveling; however, such a device will function to meet much faster power demands including dynamic stabilization. The study has explored several concepts of design not previously considered in the same detail as treated here. Because the study is for a point design, optimization in all respects is not complete. The study examines aspects of the coil design; superconductor supported off of the dewar shell; the dewar shell, its configuration and stresses; the underground excavation and related construction for holding the superconducting coil and its dewar; the helium refrigeration system; the electrical converter system; the vacuum system; the guard coil; and the costs. The report is a condensation of the more comprehensive study which is in the process of being printed

  5. Nanosecond-level time synchronization of AERA using a beacon reference transmitter and commercial airplanes

    Directory of Open Access Journals (Sweden)

    Huege Tim

    2017-01-01

    Full Text Available Radio detection of cosmic-ray air showers requires time synchronization of detectors on a nanosecond level, especially for advanced reconstruction algorithms based on the wavefront curvature and for interferometric analysis approaches. At the Auger Engineering Radio Array, the distributed, autonomous detector stations are time-synchronized via the Global Positioning System which, however, does not provide sufficient timing accuracy. We thus employ a dedicated beacon reference transmitter to correct for eventby-event clock drifts in our offline data analysis. In an independent cross-check of this “beacon correction” using radio pulses emitted by commercial airplanes, we have shown that the combined timing accuracy of the two methods is better than 2 nanoseconds.

  6. Alanine dosimetry at NPL - the development of a mailed reference dosimetry service at radiotherapy dose levels

    International Nuclear Information System (INIS)

    Sharpe, P.H.G.; Sephton, J.P.

    1999-01-01

    In this paper we describe the work that has been carried out at National Physical Laboratory (NPL) to develop a mailed alanine reference dosimetry service for radiotherapy dose levels. The service is based on alanine/paraffin wax dosimeters produced at NPL. Using a data analysis technique based on spectrum fitting, it has been possible to achieve a precision of dose measurement better than ±0.05 Gy (1σ). A phantom set has been developed for use in high energy photon beams, which enables simultaneous irradiation of alanine dosimeters and ionisation chambers in a well defined geometry. Studies in photon beams of energies between 60 Co and 20 MeV have shown no significant energy dependence (<1%) for alanine relative to dose determination using a graphite calorimeter. Work is underway to extend the service to electron beams, and preliminary results are presented on the direct calibration of alanine in electron beams using a graphite calorimeter. (author)

  7. Nanosecond-level time synchronization of AERA using a beacon reference transmitter and commercial airplanes

    Science.gov (United States)

    Huege, Tim

    2017-03-01

    Radio detection of cosmic-ray air showers requires time synchronization of detectors on a nanosecond level, especially for advanced reconstruction algorithms based on the wavefront curvature and for interferometric analysis approaches. At the Auger Engineering Radio Array, the distributed, autonomous detector stations are time-synchronized via the Global Positioning System which, however, does not provide sufficient timing accuracy. We thus employ a dedicated beacon reference transmitter to correct for eventby-event clock drifts in our offline data analysis. In an independent cross-check of this "beacon correction" using radio pulses emitted by commercial airplanes, we have shown that the combined timing accuracy of the two methods is better than 2 nanoseconds.

  8. Radioactivity reference levels in ceramics tiles as building materials for different countries

    International Nuclear Information System (INIS)

    Ortiz, Josefina; Ballesteros, Luisa; Serradell, Vicente

    2008-01-01

    Measurements campaigns of ceramic tiles and raw materials used in them, shows that natural radionuclides of uranium ( 238 U) and thorium ( 232 Th) series, together with the radioactive isotope of potassium ( 40 K ), are presents. Uranium series contain radium, which decays to radon ( 222 Rn), an inert gas that can be released from materials and inhaled by individuals. Limits of 226 Ra concentrations are established by different countries in order to control Radon levels (200 Bq.m -3 in European Union). Potassium -40 and others gamma emitters of 226 Ra and 232 Th descendent, can cause an external dose. Therefore, with the purpose that individual doses due to building materials doesn't exceed a certain level recommendations or regulations have been established. A maximum value of 1 mSv.y -1 is recommended in European Union. In practice an easy way to avoid ceramic tiles provide doses to individuals over the reference level is to introduce an index, depending on activities concentrations of 226 Ra, 232 Th and 40 K, defined so that the dose limits due, exclusively, to building materials, will never be exceeded. These limits and indexes present differences between countries. In this paper indexes are compared and differences are discussed. (author)

  9. Diagnostic Utility of Pleural Fluid Adenosine Deaminase Level in Tuberculousis Pleural Effusion

    International Nuclear Information System (INIS)

    Suleman, A.; Abbasi, M. A.; Anwar, S. A.; Kamal, M.; Khan, H.

    2016-01-01

    Background: Early diagnosis and management of tuberculosis is essential for decreasing the disease burden. Pakistan is one of the few countries of world with a very high burden of tuberculosis. Many diagnostic tests are available for detection of tuberculosis but each is fraught with certain limitations of its own. Methods: This study was a cross sectional validation study that sought to determine the validity of pleural fluid adenosine deaminase levels for diagnosis of tuberculous pleural effusion. Results: A total of 160 patients with exudative lymphocytic pleural effusions were enrolled in this study. The mean pleural fluid ADA level was 52.18±1.98 U/L. The mean pleural fluid ADA level in patients diagnosed to have tuberculosis on pleural biopsy/histopathology was higher as compared to patients who did not have tuberculous pleural effusion 52.16±2.4 U/L vs 38.6±3.14 U/L. The difference was found to be statistically significant between the two groups (p<0.05). The sensitivity, specificity, ppv and npv of pleural fluid ADA level were 88.88 percent, 77.04 percent, 86.28 percent and 81.04 percent respectively. Conclusion: Despite wide variations in the reported sensitivity and specificity of pleural fluid ADA level, it can be used as a surrogate for pleural biopsy when the latter is not feasible. (author)

  10. Cerebrospinal fluid adenosine deaminase levels as a diagnostic marker in tuberculous meningitis in adult Nepalese patients

    Directory of Open Access Journals (Sweden)

    Anil Chander

    2013-02-01

    Full Text Available Objective: To study the cerebrospinal fluid (CSF adenosine deaminase (ADA levels in tuberculous meningitis (TBM and non-TBM -viral meningitis cases and to determine its diagnostic significance as a biochemical marker of TBM infection.Methods: The study population comprised two different patient groups. TBM - group I - 28 cases and non-TBM-viral meningitis - 22 cases. These were enrolled consecutively in the study and CSF specimens were collected from them. ADA estimation was carried out by spectrophotometry.Results: ADA levels (mean依 SD in the TBM and non-TBM groups were 16.46依6.24 U/L and 5.13依2.96 U/L, respectively (highly significant P10 IU/L, the test showed a good sensitivity of 82.14% (95% CI 64.41-92.12 and a high specificity of 90.91% (95% CI 72.19-97.47. Positive and negative predictive value and positive and negative likelihood ratios and accuracy of the test in TBM cases were 92% (95% CI 75.03-97.77, 80% (95% CI 60.86-91.13, 9.03 (95% CI 2.38- 34.25, 0.19 (95% CI 0.09-0.44 and 86%, respectively.Conclusion: CSF ADA levels are elevated in the TBM cases as compared to the non-TBM - viral meningitis cases with a good sensitivity and a high specificity. It is a simple and inexpensive diagnostic adjunctive test in the rapid and early diagnosis of TBM.

  11. A Terrestrial Reference Frame realised on the observation level using a GPS-LEO satellite constellation

    Science.gov (United States)

    Koenig, Daniel

    2018-02-01

    Applying a one-step integrated process, i.e. by simultaneously processing all data and determining all satellite orbits involved, a Terrestrial Reference Frame (TRF) consisting of a geometric as well as a dynamic part has been determined at the observation level using the EPOS-OC software of Deutsches GeoForschungsZentrum. The satellite systems involved comprise the Global Positioning System (GPS) as well as the twin GRACE spacecrafts. Applying a novel approach, the inherent datum defect has been overcome empirically. In order not to rely on theoretical assumptions this is done by carrying out the TRF estimation based on simulated observations and using the associated satellite orbits as background truth. The datum defect is identified here as the total of all three translations as well as the rotation about the z-axis of the ground station network leading to a rank-deficient estimation problem. To rectify this singularity, datum constraints comprising no-net translation (NNT) conditions in x, y, and z as well as a no-net rotation (NNR) condition about the z-axis are imposed. Thus minimally constrained, the TRF solution covers a time span of roughly a year with daily resolution. For the geometric part the focus is put on Helmert transformations between the a priori and the estimated sets of ground station positions, and the dynamic part is represented by gravity field coefficients of degree one and two. The results of a reference solution reveal the TRF parameters to be estimated reliably with high precision. Moreover, carrying out a comparable two-step approach using the same data and models leads to parameters and observational residuals of worse quality. A validation w.r.t. external sources shows the dynamic origin to coincide at a level of 5 mm or better in x and y, and mostly better than 15 mm in z. Comparing the derived GPS orbits to IGS final orbits as well as analysing the SLR residuals for the GRACE satellites reveals an orbit quality on the few cm level

  12. Adrenal Vein Catecholamine Levels and Ratios: Reference Intervals Derived from Patients with Primary Aldosteronism

    NARCIS (Netherlands)

    Sze, C.W.C.; O'Toole, S.M.; Tirador, R.K.; Akker, S.A; Matson, M.; Perry, L.; Druce, M.R.; Dekkers, T.; Deinum, J.; Lenders, J.W.M.; Eisenhofer, G.; Drake, W.M.

    2017-01-01

    Phaeochromocytoma localisation is generally reliably achieved with modern imaging techniques, particularly in sporadic cases. On occasion, however, there can be diagnostic doubt due to the presence of bilateral adrenal abnormalities, particularly in patients with mutations in genes predisposing them

  13. Diagnostic utility of daytime salivary melatonin levels in Smith-Magenis syndrome.

    Science.gov (United States)

    Chik, Constance L; Rollag, Mark D; Duncan, Wallace C; Smith, Ann C M

    2010-01-01

    An inverted circadian rhythm of melatonin (MT) likely contributes to the sleep disturbance in patients with Smith-Magenis syndrome (SMS). Plasma MT levels have documented this altered rhythm, but daytime levels of salivary MT has not been determined. Daytime measures of salivary MT might have utility in home/outpatient settings for assessing MT levels in undiagnosed patients with clinical features of SMS. The objective of this study was to determine the utility of daytime salivary MT as a diagnostic test in SMS. Thirty individuals with confirmed SMS [28 with del 17p11.2 and 2 with the retinoic acid induced 1 (RAI1) gene mutation] and five controls were studied. Single or serial daytime salivary MT levels were measured. The mean midday salivary MT level was 79.0 pg/ml in SMS patients, compared with 16.3 pg/ml in controls, with nine patients having values similar to controls. The median MT level in SMS patients was 49.0 pg/ml (first and third quartile values = 15.5 and 106.8 pg/ml). Twenty-six (90%) of 29 patients had at least one MT value >15.5 pg/ml, including 70 (78%) of 90 samples from patients with del 17p11.2 and one (20%) of five samples from the two patients with the RAI1 mutation. Neither the pattern of medication use nor age had an effect on daytime salivary MT levels. Although most SMS patients had elevated daytime salivary MT levels, multiple sampling appears necessary to distinguish patients with SMS from other conditions.

  14. Budd-Chiari syndrome and secondary nodular regenerative hyperplasia of the liver. Case report with special reference to diagnostic imaging

    International Nuclear Information System (INIS)

    Mutze, A.; Rueckert, R.; Rudolph, B.; Paris, S.; Podrabski, P.

    1993-01-01

    Nodular regenerative hyperplasia is a benign epithelial proliferation of the liver with unknown etiology. We observed a female patient with Budd-Chiari syndrome and secondary nodular regenerative hyperplasia of the liver over a period of five years. Patient history, diagnostic imaging (sonography, CT, MR imaging, angiography), and clinical course are demonstrated along with results of macroscopic and microscopic studies of explanted liver prior to liver transplantation. The patient presented with various predisposing factors in combination that favour the development of nodular regenerative hyperplasia. (orig.) [de

  15. Calibration methodology for instruments utilized in X radiation beams, diagnostic level

    Energy Technology Data Exchange (ETDEWEB)

    Penha, M. da; Potiens, A.; Caldas, L.V.E. [Instituto de Pesquisas Energeticas e Nucleares, Comissao Nacional de Energia Nuclear, Sao Paulo (Brazil)]. E-mail: mppalbu@ipen.br

    2004-07-01

    Methodologies for the calibration of diagnostic radiology instruments were established at the Calibration Laboratory of IPEN. The methods may be used in the calibration procedures of survey meters used in radiation protection measurements (scattered radiation), instruments used in direct beams (attenuated and non attenuated beams) and quality control instruments. The established qualities are recommended by the international standards IEC 1267 and ISO 4037-3. Two ionization chambers were used as reference systems, one with a volume of 30 cm{sup 3} for radiation protection measurements, and the other with a volume of 1 cm{sup 3} for direct beam measurements. Both are traceable to the German Primary Laboratory of Physikalisch-Technische Bundesanstalt (PTB). In the case of calibration of quality control instruments, a non-invasive method using the measurement of the spectrum endpoint was established with a portable gamma and X-ray Intertechnique spectrometer system. The methods were applied to survey meters (radiation protection measurements), ionization chambers (direct beam measurements) and k Vp meters (invasive and non-invasive instruments). (Author)

  16. Calibration methodology for instruments utilized in X radiation beams, diagnostic level

    International Nuclear Information System (INIS)

    Penha, M. da; Potiens, A.; Caldas, L.V.E.

    2004-01-01

    Methodologies for the calibration of diagnostic radiology instruments were established at the Calibration Laboratory of IPEN. The methods may be used in the calibration procedures of survey meters used in radiation protection measurements (scattered radiation), instruments used in direct beams (attenuated and non attenuated beams) and quality control instruments. The established qualities are recommended by the international standards IEC 1267 and ISO 4037-3. Two ionization chambers were used as reference systems, one with a volume of 30 cm 3 for radiation protection measurements, and the other with a volume of 1 cm 3 for direct beam measurements. Both are traceable to the German Primary Laboratory of Physikalisch-Technische Bundesanstalt (PTB). In the case of calibration of quality control instruments, a non-invasive method using the measurement of the spectrum endpoint was established with a portable gamma and X-ray Intertechnique spectrometer system. The methods were applied to survey meters (radiation protection measurements), ionization chambers (direct beam measurements) and k Vp meters (invasive and non-invasive instruments). (Author)

  17. When Students Doubt Their Teachers' Diagnostic Competence: Moderation in the Internal/External Frame of Reference Model

    Science.gov (United States)

    Zimmermann, Friederike; Möller, Jens; Köller, Olaf

    2018-01-01

    The internal/external frame of reference model (I/E model) posits that individuals' achievement-related self-concepts are formed through social comparisons (e.g., self vs. peers) within academic domains and dimensional comparisons (e.g., math vs. verbal) between distinct domains. A large body of research has supported the theorized pattern of…

  18. Testosterone, free testosterone, and free androgen index in women: Reference intervals, biological variation, and diagnostic value in polycystic ovary syndrome

    NARCIS (Netherlands)

    Bui, H.N.; Sluss, P.M.; Hayes, F.J.; Blincko, S.; Knol, D.L.; Blankenstein, M.A.; Heijboer, A.C.

    2015-01-01

    Objective: The objective of our study was to determine reference intervals and biologic variation for testosterone (T), free testosterone (fT), and free androgen index (FAI) in women with accurate methods and to test the discriminative value of these parameters in a polycystic ovary syndrome

  19. Exploring different forest definitions and their impact on developing REDD+ reference emission levels: A case study for Indonesia

    NARCIS (Netherlands)

    Romijn, J.E.; Ainembabazi, J.H.; Wijaya, A.; Herold, M.; Angelsen, A.; Verchot, L.; Murdiyarso, D.

    2013-01-01

    Developing countries participating in the mitigation mechanism of reducing emissions from deforestation and forest degradation and the role of conservation, sustainable management of forests and enhancement of forest carbon stocks (REDD+), need to determine a national forest reference emission level

  20. A Comparison of Salivary Steroid Levels during Diagnostic Tests for Adrenal Insufficiency

    Directory of Open Access Journals (Sweden)

    Michaela Dušková

    2016-01-01

    Full Text Available Numerous diagnostic tests are used to evaluate the hypothalamic-pituitary-adrenal axis (HPA axis. The gold standard is still considered the insulin tolerance test (ITT, but this test has many limitations. Current guidelines therefore recommend the Synacthen test first when an HPA axis insufficiency is suspected. However, the dose of Synacthen that is diagnostically most accurate and sensitive is still a matter of debate. We investigated 15 healthy men with mean/median age 27.4/26 (SD ±4.8 years, and mean/median BMI (body mass index 25.38/24.82 (SD ±3.2 kg/m2. All subjects underwent 4 dynamic tests of the HPA axis, specifically 1 μg, 10 μg, and 250 μg Synacthen (ACTH tests and an ITT. Salivary cortisol, cortisone, pregnenolone, and DHEA (dehydroepiandrosterone were analysed using liquid chromatography-tandem mass spectrometry. During the ITT maximum salivary cortisol levels over 12.5 nmol/l were found at 60 minutes. Maximum cortisol levels in all of the Synacthen tests were higher than this; however, demonstrating that sufficient stimulation of the adrenal glands was achieved. Cortisone reacted similarly as cortisol, i.e. we did not find any change in the ratio of cortisol to cortisone. Pregnenolone and DHEA were higher during the ITT, and their peaks preceded the cortisol peak. There was no increase of pregnenolone or DHEA in any of the Synacthen tests. We demonstrate that the 10 μg Synacthen dose is sufficient stimulus for testing the HPA axis and is also a safe and cost-effective alternative. This dose also largely eliminates both false negative and false positive results.

  1. Introducing carrying capacity-based normalisation in LCA: framework and development of references at midpoint level

    DEFF Research Database (Denmark)

    Bjørn, Anders; Hauschild, Michael Zwicky

    2015-01-01

    carrying capacity-based normalisation references. The purpose of this article is to present a framework for normalisation against carrying capacity-based references and to develop average normalisation references (NR) for Europe and the world for all those midpoint impact categories commonly included....... A literature review was carried out to identify scientifically sound thresholds for each impact category. Carrying capacities were then calculated from these thresholds and expressed in metrics identical to midpoint indicators giving priority to those recommended by ILCD. NR was expressed as the carrying...... ozone formation and soil quality were found to exceed carrying capacities several times.The developed carrying capacity-based normalisation references offer relevant supplementary reference information to the currently applied references based on society’s background interventions by supporting...

  2. Low-level lead exposure effects on spatial reference memory and working memory in rats

    Institute of Scientific and Technical Information of China (English)

    Xinhua Yang; Ping Zhou; Yonghui Li

    2009-01-01

    BACKGROUND: Studies have demonstrated that lead exposure can result in cognitive dysfunction and behavior disorders. However, lead exposure impairments vary under different experimental conditions.OBJECTIVE: To detect changes in spatial learning and memory following low-level lead exposure in rats, in Morris water maze test under the same experimental condition used to analyze lead exposure effects on various memory types and learning processes.DESIGN AND SETTING: The experiment was conducted at the Animal Laboratory, Institute of Psychology, Chinese Academy of Science between February 2005 and March 2006. One-way analysis of variance (ANOVA) and behavioral observations were performed.MATERIALS: Sixteen male, healthy, adult, Sprague Dawley rats were randomized into normal control and lead exposure groups (n = 8).METHODS: Rats in the normal control group were fed distilled water, and those in the lead exposure group were fed 250 mL of 0.05% lead acetate once per day. At day 28, all rats performed the Morris water maze test, consisting of four phases: space navigation, probe test, working memory test, and visual cue test.MAIN OUTCOME MEASURES: Place navigation in the Morris water maze was used to evaluate spatial learning and memory, probe trials for spatial reference memory, working memory test for spatial working memory, and visual cue test for non-spatial cognitive function. Perkin-Elmer Model 300 Atomic Absorption Spectrometer was utilized to determine blood lead levels in rats.RESULTS: (1) In the working memory test, the time to reach the platform remained unchanged between the control and lead exposure groups (F(1,1) = 0.007, P = 0.935). A visible decrease in escape latencies was observed in each group (P = 0.028). However, there was no significant difference between the two groups (F(1,1) = 1.869, P = 0.193). The working memory probe test demonstrated no change between the two groups in the time spent in the target quadrant during the working memory probe test

  3. Derivation of a reference dose and drinking water equivalent level for 1,2,3-trichloropropane.

    Science.gov (United States)

    Tardiff, Robert G; Carson, M Leigh

    2010-06-01

    In some US potable water supplies, 1,2,3-trichloropropane (TCP) has been present at ranges of non-detect to less than 100 ppb, resulting from past uses. In subchronic oral studies, TCP produced toxicity in kidneys, liver, and other tissues. TCP administered by corn oil gavage in chronic studies produced tumors at multiple sites in rats and mice; however, interpretation of these studies was impeded by substantial premature mortality. Drinking water equivalent levels (DWELs) were estimated for a lifetime of consumption by applying biologically-based safety/risk assessment approaches, including Monte Carlo techniques, and with consideration of kinetics and modes of action, to possibly replace default assumptions. Internationally recognized Frameworks for human relevance of animal data were employed to interpret the findings. Calculated were a reference dose (=39 microg/kg d) for non-cancer and Cancer Values (CV) (=10-14 microg/kg d) based on non-linear dose-response relationships for mutagenicity as a precursor of cancer. Lifetime Average Daily Intakes (LADI) are 3130 and 790-1120 microg/person-d for non-cancer and cancer, respectively. DWELs, estimated by applying a relative source contribution (RSC) of 50% to the LADIs, are 780 and 200-280 microg/L for non-cancer and cancer, respectively. These DWELs may inform establishment of formal/informal guidelines and standards to protect public health. Copyright 2010 Elsevier Ltd. All rights reserved.

  4. Establishment of computed tomography reference dose levels in Onassis Cardiac Surgery Center

    International Nuclear Information System (INIS)

    Tsapaki, V.; Kyrozi, E.; Syrigou, T.; Mastorakou, I.; Kottou, S.

    2001-01-01

    The purpose of the study was to apply European Commission (EC) Reference Dose Levels (RDL) in Computed Tomography (CT) examinations at Onassis Cardiac Surgery Center (OCSC). These are weighted CT Dose Index (CTDI w ) for a single slice and Dose-Length Product (DLP) for a complete examination. During the period 1998-1999, the total number of CT examinations, every type of CT examination, patient related data and technical parameters of the examinations were recorded. The most frequent examinations were chosen for investigation which were the head, chest, abdomen and pelvis. CTDI measurements were performed and CTDI w and DLP were calculated. Third Quartile values of CTDI w were chosen to be 43mGy for head, 8mGy for chest, and 22mGy for abdomen and pelvis examinations. Third quartile values of DLP were chosen to be 740mGycm for head, 370mGycm for chest, 490mGycm for abdomen and 420mGycm for pelvis examination. Results confirm that OCSC follows successfully the proposed RDL for the head, chest, abdomen and pelvis examinations in terms of radiation dose. (author)

  5. 1-GWh diurnal load-leveling Superconducting Magnetic Energy Storage system reference design

    International Nuclear Information System (INIS)

    Rogers, J.D.; Hassenzahl, W.V.; Schermer, R.I.

    1979-09-01

    A point reference design has been completed for a 1-GWh Superconducting Magnetic Energy Storage system. The system is for electric utility diurnal load-leveling but can also function to meet much faster power demands including dynamic stabilization. This study explores several concepts of design not previously considered in the same detail as treated here. Because the study is for a point design, optimization in all respects is not complete. This report examines aspects of the coil, the superconductor supported off of the dewar shell, the dewar shell, and its configuration and stresses, the underground excavation and construction for holding the superconducting coil and its dewar, the helium refrigeration system, the electrical converter system, the vacuum system, the guard coil, and the costs. This report is divided into two major portions. The first is a general treatment of the work and the second is seven detailed technical appendices issued as separate reports. The information presented on the aluminum stabilizer for the conductor, on the excavation, and on the converter is based upon industrial studies contracted for this work

  6. Reactor Emergency Action Level Monitor: Volume 2, REALM user's reference guide: Final report

    International Nuclear Information System (INIS)

    Touchton, R.A.

    1988-09-01

    A User Manual for the Reactor Emergency Action Level Monitor (REALM) expert system prototype is provided in this volume. REALM has been designed to provide expert assistance in the identification of a nuclear power plant emergency situation and the determination of its severity. REALM has been developed as an expert system which can provide sensor interpretation and situation assessment in a real-time processing environment. In its state of development at project completion, these capabilities are used in an off-line (i.e., stand-alone, desktop) fashion to provide emergency preparedness assistance in the areas of emergency classification training and emergency exercise scenario generation. REALM also serves a prototype and stepping-stone for the possible connection to the plant for on-line use. In order to distinguish the off-line system (now complete) from the on-line system (now moving from a research prototype to an installed system), the term ''REALM'' is used to indicate the on-line version, with users in the control room, technical support center, and the emergency operations facility, The off-line version is referred to as ''uREALM.''

  7. Dose evaluation and establishment of reference levels in activity for nuclear medicine; Avaliação de dose e estabelecimento de níveis de referência em atividade para a medicina nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Ribeiro, Julio Cesar de Souza

    2017-07-01

    The International Commission on Radiation Protection (ICRP) has emphasized the importance of accurately determining the mean dose levels, or administered activity, received by the patients for each medical procedure that uses ionizing radiation. However, the number of bibliographic references addressing the need to know and optimize these levels is insufficient, or rather limited, which may lead to non-standardizes techniques, a lack of exposures control, and also the increase of associated radiological risks of these procedures. In this context, a software in Visual Basic® of Microsoft© language was developed whose function is to elaborate a method of obtaining the Reference Levels in Activity (RLA) for nuclear medicine patients by determining the third quartile of the examinations carried out. The program also allows obtaining absorbed dose values in critical organs based on patient specificities as age, sex and Body Mass Index (BMI) in order to evaluate the risk involved in each procedure. The main nuclear medicine diagnostic procedures were evaluated through the database of two public hospitals and a private clinic, obtaining the NRAs of each facility, where the software was validated by comparison with the traditionally accepted calculation methods. Due to the results obtained in each installation, in addition to NRA determination, gaps in treatment capacities and unjustified dose variations for the same procedure were identified, indicating the need for optimization. Thus, the developed program is able to provide the estimated values of effective and absorbed doses involved in each procedure, for each patient, providing reference values for nuclear medicine field, not available in the national scenario so far. (author)

  8. The Development of Expertise in Radiology: In Chest Radiograph Interpretation, "Expert" Search Pattern May Predate "Expert" Levels of Diagnostic Accuracy for Pneumothorax Identification.

    Science.gov (United States)

    Kelly, Brendan S; Rainford, Louise A; Darcy, Sarah P; Kavanagh, Eoin C; Toomey, Rachel J

    2016-07-01

    Purpose To investigate the development of chest radiograph interpretation skill through medical training by measuring both diagnostic accuracy and eye movements during visual search. Materials and Methods An institutional exemption from full ethical review was granted for the study. Five consultant radiologists were deemed the reference expert group, and four radiology registrars, five senior house officers (SHOs), and six interns formed four clinician groups. Participants were shown 30 chest radiographs, 14 of which had a pneumothorax, and were asked to give their level of confidence as to whether a pneumothorax was present. Receiver operating characteristic (ROC) curve analysis was carried out on diagnostic decisions. Eye movements were recorded with a Tobii TX300 (Tobii Technology, Stockholm, Sweden) eye tracker. Four eye-tracking metrics were analyzed. Variables were compared to identify any differences between groups. All data were compared by using the Friedman nonparametric method. Results The average area under the ROC curve for the groups increased with experience (0.947 for consultants, 0.792 for registrars, 0.693 for SHOs, and 0.659 for interns; P = .009). A significant difference in diagnostic accuracy was found between consultants and registrars (P = .046). All four eye-tracking metrics decreased with experience, and there were significant differences between registrars and SHOs. Total reading time decreased with experience; it was significantly lower for registrars compared with SHOs (P = .046) and for SHOs compared with interns (P = .025). Conclusion Chest radiograph interpretation skill increased with experience, both in terms of diagnostic accuracy and visual search. The observed level of experience at which there was a significant difference was higher for diagnostic accuracy than for eye-tracking metrics. (©) RSNA, 2016 Online supplemental material is available for this article.

  9. Diagnostic value of frozen section study for thyroid nodules in patients referred to Shariati Hospital 1997-2000

    Directory of Open Access Journals (Sweden)

    "Shirzad M

    2001-11-01

    Full Text Available Frozen section is a useful method in the diagnosis of different malignancies including those of thyroid origin. However, there are still controversies about its application, sensitivity and specificity for thyroid neoplasm. In this study, diagnostic value of frozen section (FS was compared with permanent histopathologic and Fine Needle Aspiration (FNA. In this study, which was conducted in process research method, permanent sample, FNA, and frozen section results in 214 patients was compared. All of these 214 patients had been seeking medical evaluation for thyroid nodules between years 1997 and 1999 in Shariati hospital. All pathologic evaluations were performed by pathology staff of this hospital. Permanent pathology was considered as the gold standard; so the specificity, sensitivity and diagnostic precision of FNA and FS were evaluated on the basis of its results. We use Macnemar test for this purpose. The number of patients during this period were 214 (160 women and 54 men. Mean age of our patients was 42.3±5.4 and their age ranged between 12 to 84 years. Pathologic results revealed that 163 of the patients (76 percent had benign lesions, and 51 of them (24 percent had malignant lesions. Thyroid malignancies comparised papillary carcinoma (70 percent, follicular carcinoma (13.5 percent, papilofollicular carcinoma (6 percent, medulary carcinoma (6 percent, Hurtle cell carcinoma (4 percent and anaplastic carcinoma (5 percent. FNA was done in all of the patients before surgery and was able to determine the status of nodules in 150 patients. Sensitivity, specificity and precision of FNA in these 150 patients were 72, 96 and 90 percents respectively. When FNA was unable to determine the status of a nodule (64 remaining patients, FS was applied to do the job. A sensitivity of 36 percent, specificity of 85 percent and precision of 73 percent was found in this group of patients. Macnemar test showed that there is no significant difference between

  10. Farm-level risk factors for Fasciola hepatica infection in Danish dairy cattle as evaluated by two diagnostic methods

    DEFF Research Database (Denmark)

    Takeuchi-Storm, Nao; Denwood, Matthew; Hansen, Tina Vicky Alstrup

    2017-01-01

    ) as a tool for diagnosis in Danish dairy cattle farms was assessed. This case-control study aimed to identify farm-level risk factors for fasciolosis in Danish dairy farms (> 50 animals slaughtered in 2013) using two diagnostic methods: recordings of liver condemnation at slaughter, and farm-level Fasciola...

  11. Diagnostic Value of Serum Adenosine Deaminase (ADA) Level for Pulmonary Tuberculosis.

    Science.gov (United States)

    Salmanzadeh, Shokrollah; Tavakkol, Heshmatollah; Bavieh, Khalid; Alavi, Seyed Mohammad

    2015-03-01

    Diagnosis of tuberculosis (TB) is not always easy, thus employing methods with a short duration and acceptable sensitivity and specificity is necessary to diagnose TB. The aim of this study was to investigate the diagnostic value of serum adenosine deaminase (ADA) level for diagnosis of pulmonary tuberculosis. A total of 160 sex and age-matched subjects were included in this study, and were divided to four groups; forty patients with pulmonary tuberculosis (PTB) diagnosed based on the national TB program (NTP), forty patients with non-tuberculosis bacterial pneumonia, forty patients with lung cancer and forty people who were healthy in every respect. Serum adenosine deaminase activity in patients of each group was measured by the Giusti and Galanti calorimetry method using a commercial kit (Diazyme, USA). The ANOVA analysis was used to compare groups for quantitative variables. Mean serum ADA level in the PTB group was clearly higher than the mean serum ADA in the other three groups. Mean serum ADA was 26 IU/L in PTB patients, 19.48 IU/L in patients with pneumonia, 15.8 IU/L in patients with lung cancer, and 10.7 IU/L in the control group (P ADA in patients with PTB sensitivity and specificity was defined as 35% and 91%, respectively. Serum ADA activity with high specificity percentage may be a useful alternative test in restricted resource areas to rule out diagnosis of PTB. However, serum ADA activity is not a useful tool for TB diagnosis.

  12. Nuclear medicine diagnostic experience for 25 patients with parathyroid disease accompanied elevated serum PTH level

    International Nuclear Information System (INIS)

    Su Li; Huang Chenggang; Niu Wenqiang; Wu Liwen

    2010-01-01

    Objective: To explore nuclear medicine diagnostic method for parathyroid disease accompanied elevated serum parathyroid hormone (PTH) level. Methods: The images of 25 patients with parathyroid disease were obtained by SPECT 99 Tc m -MIBI double-phase parathyroid imaging and 99 Tc m -methylene diphosphonate ( 99 Tc m -MDP) whole-body static bone imaging. All subject were measured serum PTH, calcium, phosphorus and alkaline phosphatase. Results: (1) Serum PTH level increased to varying degrees in patients with primary hyperparathyroidism (PHPT), secondary hyperparathyroidism (SHPT). (2) PHPT and SHPT showed significant change before and after surgery (t=6.24 and t=6.85, P 99 Tc m -MIBI were above 90%. (4) Whole-body bone imaging results of SHPT patients showed complex and diverse caused by high background, increased uptakes mainly. 99 Tc m -MIBI dual-phase parathyroid imaging showed hyperparathyroidism in varying degree, up to 56% or more. Conclusion: Determination of serum PTH combined SPECT for parathyroid and whole-body bone imaging showed high clinical value in diagnosis and treatment of parathyroid disease. (authors)

  13. A file study of refugee children referred to specialized mental health care: from an individual diagnostic to an ecological perspective.

    Science.gov (United States)

    Villanueva O'Driscoll, Julia; Serneels, Geertrui; Imeraj, Lindita

    2017-11-01

    The past years have been characterized by a large refugee crisis across the globe. The exposure to preflight, flight, and resettlement stressors puts refugee children and their families at risk of developing emotional and behavioral disorders. A unique Western-based approach of mental health problems seems to be insufficient to address the complexity of interactions between individual vulnerabilities and more ecological surrounding systems. We looked into (1) the reasons for referral; and (2) the process diagnostic outcomes after ethnopsychiatric and psychological assessment. We conducted a thematic content analysis on 93 files of refugee children. The findings suggest that mental health care professionals need to hold into account the multiplicity and intertwining of ongoing challenges to the well-being of refugee children. The integration of a Western-based psychiatric assessment with a more ecologically based view can lead to a more culturally sensitive approach in refugee children and their families. This way, both under- and overdiagnosis of psychiatric disorders could be avoided to further optimalise mental health care in this population.

  14. Diagnostic value of the digital subtraction angiography of brain tumors. With special reference to the significance of tumor stains

    Energy Technology Data Exchange (ETDEWEB)

    Hirata, Yoshifumi; Matsukado, Yasuhiko; Takahashi, Mutsumasa

    1986-10-01

    Digital subtraction angiography (DSA) in 110 cases of brain tumors were studied in comparison with conventional angiography (CA). The dural sinuses and tumor stains of meningiomas, particularly tuberculum sellae meningioma, were better shown by intravenous DSA (IV-DSA) than by CA. IV-DSA clearly demonstrated bilateral carotid arteries and was able to rule out the coexistence of the intracranial aneurysm in 88 % of 32 cases with pituitary adenomas. Combination of IV-DSA and high resolution computed tomography has replaced CA to determine surgical indication of patients with pituitary adenomas. Intra-arterial DSA (IA-DSA) was diagnostic and well comparable to CA in identifying main cerebral vasculature over 1 mm in diameter. As to the small arteries under 1 mm and fine tumor vessels, IA-DSA provided less information or none at all. However, IA-DSA was superior to CA for visualization of tumor stains. Not only in most of meningiomas and hemangioblastomas, but in some astrocytomas and oligodendrogliomas, marked tumor stains were well demonstrated on DSA, and DSA provided surgical anatomy for neurosurgeons because of high contrast resolutions. Careful attention should be paid because tumor stains may overestimate tumor vascularity.

  15. CSF lactate level: a useful diagnostic tool to differentiate acute bacterial and viral meningitis.

    Science.gov (United States)

    Abro, Ali Hassan; Abdou, Ahmed Saheh; Ustadi, Abdulla M; Saleh, Ahmed Alhaj; Younis, Nadeem Javeed; Doleh, Wafa F

    2009-08-01

    To evaluate the potential role of CSF lactate level in the diagnosis of acute bacterial meningitis and in the differentiation between viral and bacterial meningitis. This was a hospital based observational study, conducted at Infectious Diseases Unit, Rashid Hospital Dubai, United Arab Emirates, from July 2004 to June 2007. The patients with clinical diagnosis of acute bacterial meningitis and who had CSF Gram stain/culture positive, CSF analysis suggestive of bacterial meningitis with negative Gram stain and culture but blood culture positive for bacteria and patients with clinical diagnosis suggestive of viral meningitis supported by CSF chemical analysis with negative Gram stain and culture as well as negative blood culture for bacteria were included in the study. CT scan brain was done for all patients before lumber puncture and CSF and blood samples were collected immediately after admission. CSF chemical analysis including lactate level was done on first spinal tap. The CSF lactate level was tested by Enzymatic Colorimetric method. A total 95 adult patients of acute meningitis (53 bacterial and 42 viral) fulfilled the inclusion criteria. Among 53 bacterial meningitis patients, Neisseria meningitides were isolated in 29 (54.7%), Strept. Pneumoniae in 18 (33.96%), Staph. Aureus in 2 (3.77%), Klebsiell Pneumoniae in 2 (3.77%), Strept. Agalactiae in 1 (1.8%) and E. Coli in 1 (1.8%). All the patients with bacterial meningitis had CSF lactate > 3.8 mmol/l except one, whereas none of the patients with viral meningitis had lactate level > 3.8 mmol/l. The mean CSF lactate level in bacterial meningitis cases amounted to 16.51 +/- 6.14 mmol/l, whereas it was significantly lower in viral group 2.36 +/- 0.6 mmol/l, p < .0001. CSF lactate level was significantly high in bacterial than viral meningitis and it can provide pertinent, rapid and reliable diagnostic information. Furthermore, CSF lactate level can also differentiate bacterial meningitis from viral one in a quick

  16. Diagnostic value of blood urea and bilirubin levels determination in patients with gastroduodenal zone diseases

    Directory of Open Access Journals (Sweden)

    I. B. Zhakun

    2017-12-01

    Full Text Available The study of relationships of urea and bilirubin blood levels in patients with Helicobacter pylori associated gastroduodenal pathology (HP-aGDP has the considerable relevance for clinicians, since these indicators represent the status and function of the gastroduodenal zone. The aim of this study was to estimate changes of bilirubin and urea blood levels in patients with HP-aGDP before and after treatment. Materials and methods. Our study has included 59 patients of the main group with different HP-aGDP and 40 patients of the control group with community-acquired pneumonia (CAP. Results. In patients with HP-aGDP the doubly severe reduction of urea concentration was observed in significantly greater number of patients, while half of the patients in the controls had an increase of its level by 10.4 %. The bilirubin concentration decrease was more pronounced (37.1 % vs. 3.5 % and significant (p < 0.05 in patients with HP-aGDP. Its rate depended on the dynamics of urea exactly in patients with HP-aGDP and it was more pronounced in case of urea reduction (p < 0.05. Thus, the revealed association of bilirubin and urea levels changes, namely their decrease owing to the treatment, was inherent only to patients with HP-aGDP unlike to the patients with CAD. We also determined the involvement of lipid, carbohydrate and protein metabolism, electrolytes, composition of blood in the processes of local and systemic inflammation caused by HP and its relationship with adaptive reactions, which generally depended on other individual characteristics of patients in the study group (age, duration of disease, ulcer size, etc.. Conclusions. The monitoring of urea and bilirubin blood levels in patients especially with HP-aGDP during the eradication has a specific diagnostic and prognostic value. The bilirubin level in such cases reflects the severity of cholestasis, inflammatory lesions of the duodenal mucosa, comorbid hepatobiliary disease, while the urea level

  17. Determination of dose to patient in different teams of TC and assessment with international reference levels

    International Nuclear Information System (INIS)

    Ruiz Morales, C.; Fernandez lara, A. A.; Buades Forner, M. J.; Tobarra Gonzalez, B. M.

    2013-01-01

    The increase in CT studies and the differences observed between the different equipment used in our hospital prompted us to determine the doses to patients in different studies and check the results obtained with the reference values published internationally. (Author)

  18. Automated System of Diagnostic Monitoring at Bureya HPP Hydraulic Engineering Installations: a New Level of Safety

    International Nuclear Information System (INIS)

    Musyurka, A. V.

    2016-01-01

    This article presents the design, hardware, and software solutions developed and placed in service for the automated system of diagnostic monitoring (ASDM) for hydraulic engineering installations at the Bureya HPP, and assuring a reliable process for monitoring hydraulic engineering installations. Project implementation represents a timely solution of problems addressed by the hydraulic engineering installation diagnostics section.

  19. Automated System of Diagnostic Monitoring at Bureya HPP Hydraulic Engineering Installations: a New Level of Safety

    Energy Technology Data Exchange (ETDEWEB)

    Musyurka, A. V., E-mail: musyurkaav@burges.rushydro.ru [Bureya HPP (a JSC RusGidro affiliate) (Russian Federation)

    2016-09-15

    This article presents the design, hardware, and software solutions developed and placed in service for the automated system of diagnostic monitoring (ASDM) for hydraulic engineering installations at the Bureya HPP, and assuring a reliable process for monitoring hydraulic engineering installations. Project implementation represents a timely solution of problems addressed by the hydraulic engineering installation diagnostics section.

  20. Basic Restriction and Reference Level in Anatomically-based Japanese Models for Low-Frequency Electric and Magnetic Field Exposures

    Science.gov (United States)

    Takano, Yukinori; Hirata, Akimasa; Fujiwara, Osamu

    Human exposed to electric and/or magnetic fields at low frequencies may cause direct effect such as nerve stimulation and excitation. Therefore, basic restriction is regulated in terms of induced current density in the ICNIRP guidelines and in-situ electric field in the IEEE standard. External electric or magnetic field which does not produce induced quantities exceeding the basic restriction is used as a reference level. The relationship between the basic restriction and reference level for low-frequency electric and magnetic fields has been investigated using European anatomic models, while limited for Japanese model, especially for electric field exposures. In addition, that relationship has not well been discussed. In the present study, we calculated the induced quantities in anatomic Japanese male and female models exposed to electric and magnetic fields at reference level. A quasi static finite-difference time-domain (FDTD) method was applied to analyze this problem. As a result, spatially averaged induced current density was found to be more sensitive to averaging algorithms than that of in-situ electric field. For electric and magnetic field exposure at the ICNIRP reference level, the maximum values of the induced current density for different averaging algorithm were smaller than the basic restriction for most cases. For exposures at the reference level in the IEEE standard, the maximum electric fields in the brain were larger than the basic restriction in the brain while smaller for the spinal cord and heart.

  1. Diagnostic value and timing of serum antichlamidial antibody level evaluation during infertility workup among infertile women in whom tubal factor was detected with diagnostic laparoscopy

    Directory of Open Access Journals (Sweden)

    Serkan Kahyaoğlu

    2012-03-01

    Full Text Available OBJECTIVES: With normal hysterosalpingography (HSG results, selecting suitable candidates for the laparoscopic treatment of probable pelvic adhesions following previous pelvic inflammatory disease, it would be wise to investigate serum antibody screening against chlamidia trachomatis. It is worth to evaluate whether it is useful to detect a negative antichlamidial antibody disease for cancelling laparoscopy for a while with abnormal HSG findings. These two subjects have been investigated in study. MATERIAL AND METHODS: For detecting diagnostic value of serum antichlamidial antibody, in our infertility clinic, postoperative blood samples of 80 patients who were hospitalized for diagnostic laparoscopy to investigate infertility ethiology between May 2004 and November 2005 have been tested with microelisa method for antichlamidial IgM and IgG antibodies. HSG films of the patients performed at least one year were evaluated. Venous blood was drawn from these patients during postoperative early period for studying serum IgM and IgG antibodies of chlamidia trachomatis and the results were compared with operative findings. RESULTS: According to the antichlamidial antibody levels 60 (75% patients have not been infected with chlamidia and 20 (25% patients have been infected previously. When the patients were divided to two groups; normal and abnormal; based on preoperative HSG films; 18 (30% of the 60 patients with abnormal HSG films and 2 (10% of the 20 patients with normal HSG films had positive antichlamidial antibody levels respectively. CONCLUSION: The relationship between chlamidia trachomatis infection and tubal infertility has been demonstrated among 85% of patients with positive antichlamidial antibody levels and 46.7% of patients with negative levels who had tubal passage defects detected during diagnostic laparoscopy.

  2. Diagnostic value of soluble CD163 serum levels in patients suspected of meningitis: comparison with CRP and procalcitonin

    DEFF Research Database (Denmark)

    Knudsen, Troels Bygum; Larsen, Klaus; Kristiansen, Thomas Birk

    2007-01-01

    CD163. However, sCD163 may be helpful in rapid identification of patients with systemic bacterial infection. If used as an adjunct to lumbar puncture, PCT and CRP had very high diagnostic accuracy for distinguishing between bacterial and viral infection in patients with spinal fluid pleocytosis. However......-operating characteristic AUCs (areas under curves). Patients were classified by 2 sets of diagnostic criteria into: A) purulent meningitis, serous meningitis or non-meningitis, and B) systemic bacterial infection, local bacterial infection or non-bacterial disease. An elevated serum level of sCD163 was the most specific......The aim of the study was to evaluate and compare the diagnostic value of sCD163 serum levels with CRP and PCT in meningitis and bacterial infection. An observational cohort study was conducted between February 2001 and February 2005. The study population comprised 55 patients suspected...

  3. Evaluation and management of patients referred to a tertiary-level ...

    African Journals Online (AJOL)

    has been associated with two-thirds of strokes and almost half of ischaemic heart ... individuals with hypertension were on treatment, and of these only ... There are few published data on the control of hypertension and ... We therefore conducted a prospective study of patients referred ..... A recent meta-analysis by Briasoulis.

  4. MLS/Aura Level 2 Diagnostics, Geophysical Parameter Grid V004

    Data.gov (United States)

    National Aeronautics and Space Administration — ML2DGG is the EOS Aura Microwave Limb Sounder (MLS) product containing geophysical diagnostic quantities pertaining directly to the standard geophysical data...

  5. Pilot-benchmarking of the WENRA safety reference levels for the spent fuel intermediate storage facility Ahaus

    International Nuclear Information System (INIS)

    Lorenz, Bernd; Roeder, Markus; Brandt, Klaus-Dieter

    2008-01-01

    Full text: The Western European Nuclear Regulator's Association (WENRA) has 2007 issued the draft of the 'Waste and Spent Fuel Storage Safety Reference Levels'. The objective of WENRA is to strive for a harmonized safety level of nuclear facilities within the European Community and these Reference Levels are a benchmark method to demonstrate the achieved level for the regulatory system and the implementation as well. Safety Reference Levels exist at the moment for Reactor Safety, Waste Storage and Decommissioning in different stages of development. ENISS, the European Nuclear Installations Safety Standards Initiative, a FORATOM based special organisation of nuclear operators, has discussed these Safety Reference Levels very intensively with WENRA and the agreement was to make a implementation benchmark-exercise for the storage facilities before the authorities finally agree on the Reference Levels. This benchmark was scheduled for the year 2008. Because of the special situation in Germany where a large number of storage facilities is in operation the German authorities felt that it would be useful to initiate a Pilot-Benchmark to get first results on the feasibility of the Reference Levels and the burden imposed to authorities and operators by these benchmark-exercises. GNS, a subsidiary company of the utilities, agreed to step into this process on a voluntary basis with its storage facility for spent fuel in Ahaus. The exercise was done in a very efficient way and in good co-operation between the authorities, local and federal, and the operator. The results in terms of safety assessments have been very satisfactory showing the high degree of safety. Although the facility was for the first time licensed already in 1987 the compliance with nearly all Reference Levels from 2007 could be demonstrated. It became also clear that newer facilities would fulfil the desired safety standard too. Nevertheless, in spite of the good results the exercise revealed some weak

  6. Standardized assessment to enhance the diagnostic value of prostate volume; Part II: Correlation with prostate-specific antigen levels

    NARCIS (Netherlands)

    Aarnink, R. G.; de la Rosette, J. J.; Huynen, A. L.; Giesen, R. J.; Debruyne, F. M.; Wijkstra, H.

    1996-01-01

    Standardized estimations of prostate volumes are used for interpretation of prostate specific antigen (PSA) levels. In 243 patients with clinically benign diagnosis, automated and reference prostate volumes and transition zone volumes are correlated to PSA levels. Besides, growth curves of PSA level

  7. Integrating Research-Informed Teaching within an Undergraduate Level 4 (Year 1) Diagnostic Radiography Curriculum: A Pilot Study

    Science.gov (United States)

    Higgins, Robert; Hogg, Peter; Robinson, Leslie

    2013-01-01

    This article discusses the piloting and evaluation of the Research-informed Teaching experience (RiTe) project. The aim of RiTe was to link teaching and learning with research within an undergraduate diagnostic radiography curriculum. A preliminary pilot study of RiTe was undertaken with a group of level 4 (year 1) volunteer BSc (Hons) diagnostic…

  8. Global Assessment of the SMAP Level-4 Soil Moisture Product Using Assimilation Diagnostics

    Science.gov (United States)

    Reichle, Rolf; Liu, Qing; De Lannoy, Gabrielle; Crow, Wade; Kimball, John; Koster, Randy; Ardizzone, Joe

    2018-01-01

    The Soil Moisture Active Passive (SMAP) mission Level-4 Soil Moisture (L4_SM) product provides 3-hourly, 9-km resolution, global estimates of surface (0-5 cm) and root-zone (0-100 cm) soil moisture and related land surface variables from 31 March 2015 to present with approx. 2.5-day latency. The ensemble-based L4_SM algorithm assimilates SMAP brightness temperature (Tb) observations into the Catchment land surface model. This study describes the spatially distributed L4_SM analysis and assesses the observation-minus-forecast (O-F) Tb residuals and the soil moisture and temperature analysis increments. Owing to the climatological rescaling of the Tb observations prior to assimilation, the analysis is essentially unbiased, with global mean values of approx. 0.37 K for the O-F Tb residuals and practically zero for the soil moisture and temperature increments. There are, however, modest regional (absolute) biases in the O-F residuals (under approx. 3 K), the soil moisture increments (under approx. 0.01 cu m/cu m), and the surface soil temperature increments (under approx. 1 K). Typical instantaneous values are approx. 6 K for O-F residuals, approx. 0.01 (approx. 0.003) cu m/cu m for surface (root-zone) soil moisture increments, and approx. 0.6 K for surface soil temperature increments. The O-F diagnostics indicate that the actual errors in the system are overestimated in deserts and densely vegetated regions and underestimated in agricultural regions and transition zones between dry and wet climates. The O-F auto-correlations suggest that the SMAP observations are used efficiently in western North America, the Sahel, and Australia, but not in many forested regions and the high northern latitudes. A case study in Australia demonstrates that assimilating SMAP observations successfully corrects short-term errors in the L4_SM rainfall forcing.

  9. Using Data Assimilation Diagnostics to Assess the SMAP Level-4 Soil Moisture Product

    Science.gov (United States)

    Reichle, Rolf; Liu, Qing; De Lannoy, Gabrielle; Crow, Wade; Kimball, John; Koster, Randy; Ardizzone, Joe

    2018-01-01

    The Soil Moisture Active Passive (SMAP) mission Level-4 Soil Moisture (L4_SM) product provides 3-hourly, 9-km resolution, global estimates of surface (0-5 cm) and root-zone (0-100 cm) soil moisture and related land surface variables from 31 March 2015 to present with approx.2.5-day latency. The ensemble-based L4_SM algorithm assimilates SMAP brightness temperature (Tb) observations into the Catchment land surface model. This study describes the spatially distributed L4_SM analysis and assesses the observation-minus-forecast (O-F) Tb residuals and the soil moisture and temperature analysis increments. Owing to the climatological rescaling of the Tb observations prior to assimilation, the analysis is essentially unbiased, with global mean values of approx. 0.37 K for the O-F Tb residuals and practically zero for the soil moisture and temperature increments. There are, however, modest regional (absolute) biases in the O-F residuals (under approx. 3 K), the soil moisture increments (under approx. 0.01 cu m/cu m), and the surface soil temperature increments (under approx. 1 K). Typical instantaneous values are approx. 6 K for O-F residuals, approx. 0.01 (approx. 0.003) cu m/cu m for surface (root-zone) soil moisture increments, and approx. 0.6 K for surface soil temperature increments. The O-F diagnostics indicate that the actual errors in the system are overestimated in deserts and densely vegetated regions and underestimated in agricultural regions and transition zones between dry and wet climates. The O-F auto-correlations suggest that the SMAP observations are used efficiently in western North America, the Sahel, and Australia, but not in many forested regions and the high northern latitudes. A case study in Australia demonstrates that assimilating SMAP observations successfully corrects short-term errors in the L4_SM rainfall forcing.

  10. Comparative evaluation of bivalent malaria rapid diagnostic tests versus traditional methods in field with special reference to heat stability testing in Central India.

    Directory of Open Access Journals (Sweden)

    Neeru Singh

    Full Text Available Malaria presents a diagnostic challenge in areas where both Plasmodium falciparum and P.vivax are co-endemic. Bivalent Rapid Diagnostic tests (RDTs showed promise as diagnostic tools for P.falciparum and P.vivax. To assist national malaria control programme in the selection of RDTs, commercially available seven malaria RDTs were evaluated in terms of their performance with special reference to heat stability.This study was undertaken in four forested districts of central India (July, 2011- March, 2012. All RDTs were tested simultaneously in field along with microscopy as gold standard. These RDTs were stored in their original packing at 25°C before transport to the field or they were stored at 35°C and 45°C upto 100 days for testing the performance of RDTs at high temperature. In all 2841 patients with fever were screened for malaria of which 26% were positive for P.falciparum, and 17% for P.vivax. The highest sensitivity of any RDT for P.falciparum was 98% (95% CI; 95.9-98.8 and lowest sensitivity was 76% (95% CI; 71.7-79.6. For P.vivax highest and lowest sensitivity for any RDT was 80% (95% CI; 94.9 - 83.9 and 20% (95% CI; 15.6-24.5 respectively. Heat stability experiments showed that most RDTs for P.falciparum showed high sensitivity at 45°C upto 90 days. While for P.vivax only two RDTs maintained good sensitivity upto day 90 when compared with RDTs kept at room temperature. Agreement between observers was excellent for positive and negative readings for both P.falciparum and P.vivax (Kappa >0.6-0.9.This is first field evaluation of RDTs regarding their temperature stability. Although RDTs are useful as diagnostic tool for P.falciparum and P.vivax even at high temperature, the quality of RDTs should be regulated and monitored more closely.

  11. Low and intermediate level waste in SFR-1. Reference Waste Inventory 2007

    Energy Technology Data Exchange (ETDEWEB)

    Almkvist, Lisa (Vattenfall Power Consultant AB, Stockholm (SE)); Gordon, Anna (Swedish Nuclear Fuel and Waste Management Co., Stockholm (SE))

    2007-11-15

    The objective with this report is to describe all the waste and the waste package that is expected to be deposited in SFR 1 at the time of closure. The report will form the basis for the release calculation in the safety analysis for SFR 1. Three different scenarios are explored in this report; the waste inventory is based on an estimated operational lifetime of the Swedish nuclear power plants of 50 and 60 years and that closure of the SFR 1 repository will take place in 2040 or 2050 respectively. The third scenario is where the repository is full (one part where the activity adds up to 1016 Bq and one part where the repository is considered full regarding volume). In the report, data about geometries, weights, materials, chemicals and radionuclide are given. No chemotoxic material has been identified in the waste. The inventory is estimated using the Prosit-interface which extracts information from the Triumf database. The inventory is based on so called 'waste types' and the waste types' 'reference waste package'. The reference waste package combined with a prognosis of the number of waste packages to be delivered to SFR 1 gives the final waste inventory for SFR 1. All reference waste packages are thoroughly described in the appendices of this report. The reference waste packages are as far as possible based on actual experiences and measurements. The radionuclide inventory is also based on actual measurements. The inventory is based on measurements of 60Co and 137Cs in waste packages and on measurements of 239Pu and 240Pu in reactor water. Other nuclides in the inventory are calculated with correlation factors

  12. Low and intermediate level waste in SFR-1. Reference waste inventory

    International Nuclear Information System (INIS)

    Riggare, P.; Johansson, Claes

    2001-06-01

    The objective with this report is to describe all the waste and the waste package that is expected to be deposited in SFR-1 at the time of closure. This report is a part of the SAFE project (Safety Assessment of Final Repository for Radioactive Operational Waste), i.e. the renewed safety assessment of SFR-1. The accounted waste inventory has been used as input to the release calculation that has been performed in the SAFE project. The waste inventory is based on an estimated operational lifetime of the Swedish nuclear power plants of 40 years and that closure of the SFR repository will happen in 2030. In the report, data about geometries, weights, materials, chemicals and radionuclide are given. No chemo toxic material has been identified in the waste. The inventory is based on so called waste types and the waste types reference waste package. The reference waste package combined with a prognosis of the number of waste packages to the year 2030 gives the final waste inventory for SFR-1. All reference waste packages are thoroughly described in the appendices of this report. The reference waste packages are as far as possible based on actual experiences and measurements. The radionuclide inventory is also based on actual measurements. The inventory is based on measurements of 60 Co and 137 Cs in waste packages and on measurements 239 Pu and 240 Pu in reactor water. Other nuclides in the inventory are calculated with correlation factors. In the SAFE project's prerequisites it was said that one realistic and one conservative (pessimistic) inventory should be produced. The conservative one should then be used for the release calculations. In this report one realistic and one conservative radionuclide inventory is presented. The conservative one adds up to 10 16 Bq. Regarding materials there is only one inventory given since it is not certain what is a conservative assumption

  13. Low and intermediate level waste in SFR-1. Reference Waste Inventory 2007

    International Nuclear Information System (INIS)

    Almkvist, Lisa; Gordon, Ann

    2007-11-01

    The objective with this report is to describe all the waste and the waste package that is expected to be deposited in SFR 1 at the time of closure. The report will form the basis for the release calculation in the safety analysis for SFR 1. Three different scenarios are explored in this report; the waste inventory is based on an estimated operational lifetime of the Swedish nuclear power plants of 50 and 60 years and that closure of the SFR 1 repository will take place in 2040 or 2050 respectively. The third scenario is where the repository is full (one part where the activity adds up to 1016 Bq and one part where the repository is considered full regarding volume). In the report, data about geometries, weights, materials, chemicals and radionuclide are given. No chemotoxic material has been identified in the waste. The inventory is estimated using the Prosit-interface which extracts information from the Triumf database. The inventory is based on so called 'waste types' and the waste types' 'reference waste package'. The reference waste package combined with a prognosis of the number of waste packages to be delivered to SFR 1 gives the final waste inventory for SFR 1. All reference waste packages are thoroughly described in the appendices of this report. The reference waste packages are as far as possible based on actual experiences and measurements. The radionuclide inventory is also based on actual measurements. The inventory is based on measurements of 60 Co and 137 Cs in waste packages and on measurements of 239 Pu and 240 Pu in reactor water. Other nuclides in the inventory are calculated with correlation factors

  14. Tails from previous exposures: a general problem in setting reference levels for the assessment of internal contamination

    International Nuclear Information System (INIS)

    Breuer, F.; Frittelli, L.

    1988-01-01

    Reference levels for retention and excretion are evaluated for routine and special monitoring following the intake of a fraction of ICRP annual limits (ALIs) or of a unit activity. Methodologies are also suggested for taking into account the contribution by previous intakes to excretion or retention

  15. Commentary Variations: Level of Verbalization, Personal Reference, and Phase Relations in Instructional Films on Perceptual-Motor Tasks. Technical Report.

    Science.gov (United States)

    Zuckerman, John V.

    In an experiment to determine the most efficient design for the commentary of an instructional film, special consideration was given to three variables concerned with the construction of commentaries: the level of verbalization (the amount of talk), the personal reference of the narrator, and the phase relationship between the commentary and the…

  16. Annual limits on intake for members of the public and derived reference levels of radionuclide concentrations in the environment

    International Nuclear Information System (INIS)

    Mason, G.C.

    1983-01-01

    A proposal is presented recommending the introduction in Australia of Annual Limits on Intake of radionuclides for members of the public and of corresponding reference levels of radionuclide concentrations in the environment. The proposal is related to recent recommendations of the International Commission on Radiological Protection and draft recommendations under consideration by the International Atomic Energy Agency

  17. Children and adults exposed to electromagnetic fields at the ICNIRP reference levels: Theoretical assessment of the induced peak temperature increase

    NARCIS (Netherlands)

    J. Bakker (Jan); M.M. Paulides (Maarten); E. Neufeld; A. Christ (A.); N. Kuster (Niels); G.C. van Rhoon (Gerard)

    2011-01-01

    textabstractTo avoid potentially adverse health effects of electromagnetic fields (EMF), the International Commission on Non-Ionizing Radiation Protection (ICNIRP) has defined EMF reference levels. Restrictions on induced whole-body-averaged specific absorption rate (SAR wb) are provided to keep the

  18. Clinical Diagnostic Utility of IP-10 and LAM Antigen Levels for the Diagnosis of Tuberculous Pleural Effusions in a High Burden Setting

    Science.gov (United States)

    Dheda, Keertan; Van-Zyl Smit, Richard N.; Sechi, Leonardo A.; Badri, Motasim; Meldau, Richard; Symons, Gregory; Khalfey, Hoosein; Carr, Igshaan; Maredza, Alice; Dawson, Rodney; Wainright, Helen; Whitelaw, Andrew; Bateman, Eric D.; Zumla, Alimuddin

    2009-01-01

    Background Current tools for the diagnosis of tuberculosis pleural effusions are sub-optimal. Data about the value of new diagnostic technologies are limited, particularly, in high burden settings. Preliminary case control studies have identified IFN-γ-inducible-10kDa protein (IP-10) as a promising diagnostic marker; however, its diagnostic utility in a day-to-day clinical setting is unclear. Detection of LAM antigen has not previously been evaluated in pleural fluid. Methods We investigated the comparative diagnostic utility of established (adenosine deaminase [ADA]), more recent (standardized nucleic-acid-amplification-test [NAAT]) and newer technologies (a standardized LAM mycobacterial antigen-detection assay and IP-10 levels) for the evaluation of pleural effusions in 78 consecutively recruited South African tuberculosis suspects. All consenting participants underwent pleural biopsy unless contra-indicated or refused. The reference standard comprised culture positivity for M. tuberculosis or histology suggestive of tuberculosis. Principal Findings Of 74 evaluable subjects 48, 7 and 19 had definite, probable and non-TB, respectively. IP-10 levels were significantly higher in TB vs non-TB participants (p<0.0001). The respective outcomes [sensitivity, specificity, PPV, NPV %] for the different diagnostic modalities were: ADA at the 30 IU/L cut-point [96; 69; 90; 85], NAAT [6; 93; 67; 28], IP-10 at the 28,170 pg/ml ROC-derived cut-point [80; 82; 91; 64], and IP-10 at the 4035 pg/ml cut-point [100; 53; 83; 100]. Thus IP-10, using the ROC-derived cut-point, missed ∼20% of TB cases and mis-diagnosed ∼20% of non-TB cases. By contrast, when a lower cut-point was used a negative test excluded TB. The NAAT had a poor sensitivity but high specificity. LAM antigen-detection was not diagnostically useful. Conclusion Although IP-10, like ADA, has sub-optimal specificity, it may be a clinically useful rule-out test for tuberculous pleural effusions. Larger multi

  19. Parallel implementation of multireference coupled-cluster theories based on the reference-level parallelism

    Energy Technology Data Exchange (ETDEWEB)

    Brabec, Jiri; Pittner, Jiri; van Dam, Hubertus JJ; Apra, Edoardo; Kowalski, Karol

    2012-02-01

    A novel algorithm for implementing general type of multireference coupled-cluster (MRCC) theory based on the Jeziorski-Monkhorst exponential Ansatz [B. Jeziorski, H.J. Monkhorst, Phys. Rev. A 24, 1668 (1981)] is introduced. The proposed algorithm utilizes processor groups to calculate the equations for the MRCC amplitudes. In the basic formulation each processor group constructs the equations related to a specific subset of references. By flexible choice of processor groups and subset of reference-specific sufficiency conditions designated to a given group one can assure optimum utilization of available computing resources. The performance of this algorithm is illustrated on the examples of the Brillouin-Wigner and Mukherjee MRCC methods with singles and doubles (BW-MRCCSD and Mk-MRCCSD). A significant improvement in scalability and in reduction of time to solution is reported with respect to recently reported parallel implementation of the BW-MRCCSD formalism [J.Brabec, H.J.J. van Dam, K. Kowalski, J. Pittner, Chem. Phys. Lett. 514, 347 (2011)].

  20. Diagnostic value of combined determination of serum CEA, CA72-4 and TSGF levels in patients with gastric cancer

    International Nuclear Information System (INIS)

    Wang Yuyi; Gu Yan

    2007-01-01

    Objective: To explore the diagnostic value of combined determination of serum CEA, CA72-4 and TSGF levels for gastric cancer. Methods: Serum CEA, CA72-4(with RIA) and TSGF (with biochemistry)levels were measured in 31 patients with gastric cancer and 35 controls. Results: As a single tumor marker for diagnosis, the sensitivity of CEA, CA72-4 and TSGF was 23. 0%, 38.0%, 48.0% respectively and the specificity was 23.0%, 38.0%, 48.0% respectively with combined detection of the three markers and assuming two or more markers positive as diagnostic, the sensitivity would be 67.0% and specificity would be 88.0%. Conclusion: Combined determination of serum CEA, CA72-4 and TSGF levels could promote the clinical usefulness for diagnosis of gastric cancer. (authors)

  1. Serum levels of interleukin-6 and interleukin-8 as diagnostic markers of acute pyelonephritis in children

    Directory of Open Access Journals (Sweden)

    Abolfazl Mahyar

    2013-05-01

    Full Text Available &lt;b&gt;Purpose:&lt;/b&gt; Early diagnosis and treatment of acute pyelonephritis in children is of special importance in order to prevent serious complications. This study was conducted to determine the diagnostic value of serum interleukin (IL-6 and IL-8 in children with acute pyelonephritis. &lt;b&gt;Methods:&lt;/b&gt; Eighty seven patients between 1 month to 12 years old with urinary tract infection (UTI were divided into 2 groups based on the result of 99m-technetium dimercapto-succinic acid (DMSA renal scan: acute pyelonephritis (n=37 and lower UTI (n=50 groups. White blood cell (WBC count, neutrophil (Neutl count, erythrocyte sedimentation rate (ESR, C-reactive protein (CRP concentration, platelet count, and serum IL-6 and IL-8 concentrations of both groups were measured and compared . &lt;b&gt;Results:&lt;/b&gt; There was a significant difference between two groups regarding WBC count, Neutl count, ESR, and CRP concentration (P&lt;0.05. In addition, the difference between the two groups regarding serum IL-6 and IL-8 concentrations was not significant (IL-6, 60 and 35.4 pg/mL and IL-8, 404 and 617 pg/mL, respectively. The sensitivity and specificity of serum IL-6 and IL-8 for diagnosis of acute pyelonephritis were 73%, 42% and 78%, 32%, respectively. Sensitivity, specificity, negative and positive predictive values of serum IL-6 and IL-8 were less than those of acute phase serum reactants such as CRP. &lt;b&gt;Conclusion:&lt;/b&gt; This study showed that there was no significant difference between acute pyelonephritis and lower UTI groups regarding serum IL-6 and IL-8 levels. Therefore, despite confirming results of previous studies, it seems that IL-6 and IL-8 are not suitable markers for differentiating between acute pyelonephritis and lower UTI.

  2. Survey of the diagnostic retooling process in national TB reference laboratories, with special focus on rapid speciation tests endorsed by WHO in 2007.

    Directory of Open Access Journals (Sweden)

    Sanne C van Kampen

    Full Text Available BACKGROUND: Successful integration of new diagnostics in national tuberculosis (TB control programs, also called 'retooling', is highly dependent on operational aspects related to test availability, accessibility and affordability. This survey aimed to find out whether recommendations to use new diagnostics lead to successful retooling in high TB endemic countries, using immunochromatographic tests (ICTs for TB culture speciation as a case study. ICTs are recommended to accurately confirm the presence of bacteria of the Mycobacterium tuberculosis complex in liquid culture isolates. METHODS AND FINDINGS: Questionnaires were sent to national TB reference laboratories (NRLs in 42 high TB endemic countries to address their access to information on ICT implementation, logistics related to availability, accessibility and affordability of ICTs, and testing algorithms. Results from 16 responding countries indicated that half of the NRLs were aware of the contents of WHO guidance documents on liquid culture and ICT implementation, as well as their eligibility for a negotiated pricing agreement for ICT procurement. No major issues with availability and accessibility of ICTs were raised. When asked about testing algorithms, ICTs were not used as stand-alone or first test for TB culture identification as recommended by WHO. CONCLUSIONS: The low response rate was a limitation of this survey and together with NRLs managers' unawareness of global guidance, suggests a lack of effective communication between partners of the global laboratory network and NRLs. TB tests could become more affordable to high TB endemic countries, if the possibility to negotiate lower prices for commercial products is communicated to them more successfully. NRLs need additional guidance to identify where available technologies can be most usefully implemented and in what order, taking into account long-term laboratory strategies.

  3. Diagnostic value of soluble CD163 serum levels in patients suspected of meningitis: comparison with CRP and procalcitonin

    DEFF Research Database (Denmark)

    Knudsen, Troels Bygum; Larsen, Klaus; Kristiansen, Thomas Birk

    2007-01-01

    The aim of the study was to evaluate and compare the diagnostic value of sCD163 serum levels with CRP and PCT in meningitis and bacterial infection. An observational cohort study was conducted between February 2001 and February 2005. The study population comprised 55 patients suspected of meningi......The aim of the study was to evaluate and compare the diagnostic value of sCD163 serum levels with CRP and PCT in meningitis and bacterial infection. An observational cohort study was conducted between February 2001 and February 2005. The study population comprised 55 patients suspected...... marker for distinguishing bacterial infection from non-bacterial disease (specificity 0.91; sensitivity 0.47). However, the overall diagnostic accuracy of CRP (AUC =0.91) and PCT (AUC =0.87) were superior (p... infection, the AUC of sCD163 (0.83) did not differ significantly from those of CRP or PCT. All markers had AUCs CRP and PCT had high diagnostic value and were superior as markers of bacterial infection compared to s...

  4. Research on maximum level noise contaminated of remote reference magnetotelluric measurements using synthesized data

    Science.gov (United States)

    Gang, Zhang; Fansong, Meng; Jianzhong, Wang; Mingtao, Ding

    2018-02-01

    Determining magnetotelluric impedance precisely and accurately is fundamental to valid inversion and geological interpretation. This study aims to determine the minimum value of signal-to-noise ratio (SNR) which maintains the effectiveness of remote reference technique. Results of standard time series simulation, addition of different Gaussian noises to obtain the different SNR time series, and analysis of the intermediate data, such as polarization direction, correlation coefficient, and impedance tensor, show that when the SNR value is larger than 23.5743, the polarization direction disorder at morphology and a smooth and accurate sounding carve value can be obtained. At this condition, the correlation coefficient value of nearly complete segments between the base and remote station is larger than 0.9, and impedance tensor Zxy presents only one aggregation, which meet the natural magnetotelluric signal characteristic.

  5. Goeckerman's therapy for psoriasis with special reference to serum pentraxin 3 level

    Energy Technology Data Exchange (ETDEWEB)

    Ctirad, A.; Lenka, B.; David, P.; Zdenek, F.; Kveta, H.; Karel, E.; Jan, K. [Charles University Prague, Hradec Kralove (Czech Republic). University Hospital

    2008-10-15

    Goeckerman's therapy (GT) of psoriasis is based on daily application of pharmacy grade coal tar on affected skin with subsequent exposure to UV light. Pentraxin 3 (PTX3) is a newly identified acute phase reactant with non redundant functions in innate immunity. PTX3 has been shown to be a reliable prognostic marker in patients with various inflammatory disorders including rheumatoid arthritis, vasculitis, and psoriasis. The aim of this study was to evaluate the influence of Goeckerman's therapy of psoriasis on levels of two pentraxins: long pentraxin PTX3 and C reactive protein in 49 patients with chronic plaque psoriasis. CRP was assessed by immunonephelometry on IMMAGE 800 (Beckman, USA). PTX3 was detected using sandwich ELISA detection set (Alexis Biochemicals, Switzerland). The serum levels of both parameters (expressed as average {+-} 1 SD) were significantly diminished after GT. The level of PTX3 dropped from 1.92 {+-} 0.72 ng/ml before GT to 1.66 {+-} 0.58 ng/ml after GT (P = 0.0396) and the level of CRP fell from 4.64 {+-} 3.93 mg/l to 1.66 {+-} 0.58 mg/l (P {lt} 0.0001). Comparing to healthy controls, the serum levels of both parameters before GT were significantly higher than those found in healthy blood donors and remained significantly increased after GT. Increased serum concentrations of pentraxin 3 and CRP are alleviated by GT in patients with psoriasis.

  6. Characteristics of complex regional pain syndrome in patients referred to a tertiary pain clinic by community physicians, assessed by the Budapest clinical diagnostic criteria.

    Science.gov (United States)

    Mailis-Gagnon, Angela; Lakha, Shehnaz Fatima; Allen, Matti D; Deshpande, Amol; Harden, Robert Norman

    2014-11-01

    The aim of this study was to describe the characteristics of patients referred with complex regional pain syndrome (CRPS) diagnosis to a tertiary care pain center. Descriptive chart review study of all patients referred by family physicians or community specialists as having CRPS (2006-2010). Data extraction included demographics, pain ratings, and diagnosis utilizing the Budapest CRPS criteria. The study population consisted of 54 subjects (male [M] =7, female [F] =47). Only 27.7% were classified as CRPS by the clinical expert. Four additional subjects carrying other diagnoses but found to have CRPS were added to the analysis. The non-CRPS group consisted of 39 subjects (M=8, F=31) and the CRPS group of 19 (M=2, F=17). CRPS patients were statistically significantly more likely to 1) have suffered a fracture; 2) report symptoms in each of the four symptom categories, as well as signs in three or four categories collectively; and 3) have allodynia/hyperalgesia alone or in combination (85/90%) as compared with the non-CRPS group (23/25%, respectively). The non-CRPS group was much more likely to report no symptoms or signs at all in the different symptom and sign categories. Of the 39 non-CRPS patients, 74% had other diagnosable entities (1/3 suffering from specific neuropathic pain conditions, e.g., radiculopathy, diabetic neuropathy, etc. and 2/3 from discreet musculoskeletal entities), while 18% were diagnosed with psychogenic pain disorders including conversion reaction associated with immobility or paralysis. Besides fulfilling the Budapest CRPS diagnostic criteria, the most important other factor for diagnosing CRPS is the exclusion of a neuropathic, musculoskeletal, or non-biomedical condition accounting for the presentation. Wiley Periodicals, Inc.

  7. Wavenumber selection based analysis in Raman spectroscopy improves skin cancer diagnostic specificity at high sensitivity levels (Conference Presentation)

    Science.gov (United States)

    Zhao, Jianhua; Zeng, Haishan; Kalia, Sunil; Lui, Harvey

    2017-02-01

    Background: Raman spectroscopy is a non-invasive optical technique which can measure molecular vibrational modes within tissue. A large-scale clinical study (n = 518) has demonstrated that real-time Raman spectroscopy could distinguish malignant from benign skin lesions with good diagnostic accuracy; this was validated by a follow-up independent study (n = 127). Objective: Most of the previous diagnostic algorithms have typically been based on analyzing the full band of the Raman spectra, either in the fingerprint or high wavenumber regions. Our objective in this presentation is to explore wavenumber selection based analysis in Raman spectroscopy for skin cancer diagnosis. Methods: A wavenumber selection algorithm was implemented using variably-sized wavenumber windows, which were determined by the correlation coefficient between wavenumbers. Wavenumber windows were chosen based on accumulated frequency from leave-one-out cross-validated stepwise regression or least and shrinkage selection operator (LASSO). The diagnostic algorithms were then generated from the selected wavenumber windows using multivariate statistical analyses, including principal component and general discriminant analysis (PC-GDA) and partial least squares (PLS). A total cohort of 645 confirmed lesions from 573 patients encompassing skin cancers, precancers and benign skin lesions were included. Lesion measurements were divided into training cohort (n = 518) and testing cohort (n = 127) according to the measurement time. Result: The area under the receiver operating characteristic curve (ROC) improved from 0.861-0.891 to 0.891-0.911 and the diagnostic specificity for sensitivity levels of 0.99-0.90 increased respectively from 0.17-0.65 to 0.20-0.75 by selecting specific wavenumber windows for analysis. Conclusion: Wavenumber selection based analysis in Raman spectroscopy improves skin cancer diagnostic specificity at high sensitivity levels.

  8. Reference range levels of polycyclic aromatic hydrocarbons in the US population by measurement of urinary monohydroxy metabolites

    International Nuclear Information System (INIS)

    Grainger, James; Huang, Wenlin; Patterson, Donald G.; Turner, Wayman E.; Pirkle, James; Caudill, Samuel P.; Wang, Richard Y.; Needham, Larry L.; Sampson, Eric J.

    2006-01-01

    We developed a gas chromatography isotope-dilution high-resolution mass spectrometry (GC/Id-HRMS) method for measuring 14 polycyclic aromatic hydrocarbon (PAH) metabolites representing seven parent PAHs in 3 mL of urine at low parts-per-trillion levels. PAH levels were determined in urine samples collected in 1999 and 2000 from approximately 2400 participants in the National Health and Nutrition Examination Survey, and, for the first time, reference range values were calculated for these metabolites in the US population. Using this GC/ID-HRMS method, we found detectable concentrations for monohydroxy metabolite isomers of fluorene, phenanthrene, fluoranthene, pyrene, and chrysene, benzo[c]phenanthrene, and benz[a]anthracene. Some monohydroxy metabolite isomers of benzo[c]phenanthrene, chrysene, and benz[a]anthracene exhibited low detection frequencies that did not allow for geometric mean calculations. Our study results enabled us to establish a reference range for the targeted PAHs in the general US population

  9. Speakeasy-3 reference manual. Level MU. IBM OS/VS version

    International Nuclear Information System (INIS)

    Cohen, S.; Pieper, S.C.

    1977-08-01

    Speakeasy is a computer language designed to provide access to information stored in a computer. Ease of use, natural notation, and built-in capabilities for growth are important features of Speakeasy. The language is based on the concepts of arrays and matrices, and processes these as entities; the need for many of the loops necessary in other programing languages is thus eliminated. It has a large vocabulary (over 500 words) of functions and commands in the areas of array manipulation, matrix algebra including eigenanalysis, special mathematical functions, numerical integration and differentiation, statistics, graphics, and character processing. It can be used either in batch mode or interactively. This book is the primary reference manual for the Speakeasy language and presents a nearly complete description of its capabilities. The chapters deal with the use of Speakeasy as a ''super desk calculator,'' the construction and editing of Speakeasy programs, the ability to communicate with other programing languages, the construction of user-written additions to the language, and various other facets of Speakeasy. In addition, a complete listing of the Help Library, which contains brief descriptions of each of the Speakeasy functions or commands, is included. This edition applies to the Mu release of Speakeasy-3, and describes the IBM OS/VS version. 18 figures

  10. Safety Study of the X-Ray Reference Laboratory for Radiation Protection Levels (IR-14D)

    International Nuclear Information System (INIS)

    Garcia, G.

    1999-01-01

    This report is a study about the safety of the X-ray reference laboratory that has been recently constructed in the building 2 of the CIEMAT. After a brief description of the apparatus, we present the method used to calculate the exposure and absorbed dose rates in the most characteristic points of the laboratory. This method takes into account the spectral distribution of the radiation beams as a function of the accelerating voltage. The built-up factors of the absorbent materials have been considered to calculate the transmission of the radiation beams through the filters and shielding. Scattered radiations has been introduced in the calculations by means of a semiempirical method. This model supposes that multiple scattering processes give an isotropic contribution to the reflected beams and the single scattered can be described in terms of the differential cross section of Klein-Nishina. The results of this study have been applied to determine the maximum dose equivalent that the personnel of the laboratory could receive in normal operation conditions. (Author) 5 refs

  11. Educational level and risk of colorectal cancer in EPIC with specific reference to tumor location

    NARCIS (Netherlands)

    Leufkens, Anke M.; van Duijnhoven, Fränzel J. B.; Boshuizen, Hendriek C.; Siersema, Peter D.; Kunst, Anton E.; Mouw, Traci; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Françoise; Morois, Sophie; Krogh, Vittorio; Tumino, Rosario; Panico, Salvatore; Polidoro, Silvia; Palli, Domenico; Kaaks, Rudolf; Teucher, Birgit; Pischon, Tobias; Trichopoulou, Antonia; Orfanos, Philippos; Goufa, Ioulia; Peeters, Petra H. M.; Skeie, Guri; Braaten, Tonje; Rodríguez, Laudina; Lujan-Barroso, Leila; Sánchez-Pérez, Maria-José; Navarro, Carmen; Barricarte, Aurelio; Zackrisson, Sophia; Almquist, Martin; Hallmans, Goran; Palmqvist, Richard; Tsilidis, Konstantinos K.; Khaw, Kay-Tee; Wareham, Nick; Gallo, Valentina; Jenab, Mazda; Riboli, Elio; Bueno-de-Mesquita, H. Bas

    2012-01-01

    Existing evidence is inconclusive on whether socioeconomic status (SES) and educational inequalities influence colorectal cancer (CRC) risk, and whether low or high SES/educational level is associated with developing CRC. The aim of our study was to investigate the relationship between educational

  12. Urbanist workshops between theory and practice: The importance of spatial and programme reference levels in the planning method

    OpenAIRE

    Gregor Čok

    2013-01-01

    One of the key characteristics of urban-architectural workshops as a soft planning method is above all the fact that the authors are free of burden of formal facts and reference levels of the local environment, which do not influence the concept and the working process. Within this framework, the workshop presents an opportunity for the creator to focus primarily on the core of the problem, and work creatively towards a substantiated professional solution. In addition to the basic ref...

  13. [Establishment of Reference Value of Hs-cTnT in Sichuan Region and Its Diagnostic Value in Patients with Chest Pain].

    Science.gov (United States)

    Guo, Ying; Du, Xiang-Yang; Huang, Hua-Lan; Wang, Wei-Qing; Nie, Xin; Li, Gui-Xing

    2017-11-01

    To establish the reference value of high sensitive cardiac troponin T (hs-cTnT) and the efficiency of reference value in the diagnosis of chest pain. Volunteers from eight independent communities in Chengdu,Sichuan were selected with detailed records of physical examination,electrocardiogram,ultrasound examination. The level of hs-cTnT for healthy volunteers was tested to determine ninety-ninth percentile references according to sex and ages. 2 249 patients with chest pain in the emergency department of Western China Hospital from July 2009 to July 2014 were enrolled to measure the efficiency of reference value for diagnosing acute myocardial infarction (AMI). There were 1 305 volunteers included finally. Among them,the mean hs-cTnT level of male was 4.3 (3.2-5.9) ng/L,which was significantly higher than that of female 3.0 (3.0-3.1) ng/L ( P value was less than 0.01. The 99th percentile values of male were 10.8 ng/L,15.4 ng/L and 19.7 ng/L for values of female were 4.6 ng/L,8.9 ng/L,18.8 ng/L,respectively. There was no difference in sensitivity and specificity between the value we figured out and manufactures provided (14.0 ng/L) for thosevalue did not show diversity ( P >0.05) but the specificity and positive predictive value showed significant difference (male: 0.67 vs. 0.56 and 0.83 vs. 0.79, P value of patients<60 yr. should be 14.0 ng/L,while 20.0 ng/L for those patients≥60 yr.

  14. The eye of the Barbary sheep or aoudad (Ammotragus lervia: Reference values for selected ophthalmic diagnostic tests, morphologic and biometric observations

    Directory of Open Access Journals (Sweden)

    G.A. Fornazari

    2016-06-01

    Full Text Available The purpose of this study was to describe the normal ocular anatomy and establish reference values for ophthalmic tests in the Barbary sheep or aoudad (Ammotragus lervia. Aoudad eyes are large and laterally positioned in the head with several specialized anatomic features attributed to evolutionary adaptations for grazing. Normal values for commonly used ophthalmic tests were established, Schirmer tear test (STT - 27.22 ± 3.6 mm/min; Predominant ocular surface bacterial microbiota - Staphylococcus sp.; Corneal esthesiometry- 1.3 ± 0.4 cm; Intraocular pressure by rebound tonometry- 19.47 ± 3.9 mmHg; Corneal thickness- 630.07 ± 20.67 μm, B-mode ultrasonography of the globe- axial eye globe length 29.94 ± 0.96 mm, anterior chamber depth 5.03 ± 0.17 mm, lens thickness 9.4 ± 0.33 mm, vitreous chamber depth 14.1 ± 0.53 mm; Corneal diameter- horizontal corneal diameter 25.05 ± 2.18 mm, vertical corneal diameter 17.95 ± 1.68 mm; Horizontal palpebral fissure length- 34.8 ± 3.12 mm. Knowledge of these normal anatomic variations, biometric findings and normal parameters for ocular diagnostic tests may assist veterinary ophthalmologists in the diagnosis of ocular diseases in this and other similar species.

  15. Children and adults exposed to electromagnetic fields at the ICNIRP reference levels: theoretical assessment of the induced peak temperature increase

    Energy Technology Data Exchange (ETDEWEB)

    Bakker, J F; Paulides, M M; Van Rhoon, G C [Erasmus MC-Daniel den Hoed Cancer Center, Department of Radiation Oncology, Section Hyperthermia, PO Box 5201, NL-3008 AE, Rotterdam (Netherlands); Neufeld, E; Christ, A; Kuster, N, E-mail: j.bakker@erasmusmc.nl [Foundation for Research on Information Technologies in Society (IT' IS) (Switzerland)

    2011-08-07

    To avoid potentially adverse health effects of electromagnetic fields (EMF), the International Commission on Non-Ionizing Radiation Protection (ICNIRP) has defined EMF reference levels. Restrictions on induced whole-body-averaged specific absorption rate (SAR{sub wb}) are provided to keep the whole-body temperature increase (T{sub body,incr}) under 1 deg. C during 30 min. Additional restrictions on the peak 10 g spatial-averaged SAR (SAR{sub 10g}) are provided to prevent excessive localized tissue heating. The objective of this study is to assess the localized peak temperature increase (T{sub incr,max}) in children upon exposure at the reference levels. Finite-difference time-domain modeling was used to calculate T{sub incr,max} in six children and two adults exposed to orthogonal plane-wave configurations. We performed a sensitivity study and Monte Carlo analysis to assess the uncertainty of the results. Considering the uncertainties in the model parameters, we found that a peak temperature increase as high as 1 deg. C can occur for worst-case scenarios at the ICNIRP reference levels. Since the guidelines are deduced from temperature increase, we used T{sub incr,max} as being a better metric to prevent excessive localized tissue heating instead of localized peak SAR. However, we note that the exposure time should also be considered in future guidelines. Hence, we advise defining limits on T{sub incr,max} for specified durations of exposure.

  16. Children and adults exposed to electromagnetic fields at the ICNIRP reference levels: theoretical assessment of the induced peak temperature increase.

    Science.gov (United States)

    Bakker, J F; Paulides, M M; Neufeld, E; Christ, A; Kuster, N; van Rhoon, G C

    2011-08-07

    To avoid potentially adverse health effects of electromagnetic fields (EMF), the International Commission on Non-Ionizing Radiation Protection (ICNIRP) has defined EMF reference levels. Restrictions on induced whole-body-averaged specific absorption rate (SAR(wb)) are provided to keep the whole-body temperature increase (T(body, incr)) under 1 °C during 30 min. Additional restrictions on the peak 10 g spatial-averaged SAR (SAR(10g)) are provided to prevent excessive localized tissue heating. The objective of this study is to assess the localized peak temperature increase (T(incr, max)) in children upon exposure at the reference levels. Finite-difference time-domain modeling was used to calculate T(incr, max) in six children and two adults exposed to orthogonal plane-wave configurations. We performed a sensitivity study and Monte Carlo analysis to assess the uncertainty of the results. Considering the uncertainties in the model parameters, we found that a peak temperature increase as high as 1 °C can occur for worst-case scenarios at the ICNIRP reference levels. Since the guidelines are deduced from temperature increase, we used T(incr, max) as being a better metric to prevent excessive localized tissue heating instead of localized peak SAR. However, we note that the exposure time should also be considered in future guidelines. Hence, we advise defining limits on T(incr, max) for specified durations of exposure.

  17. The diagnostic value of plasma N-terminal connective tissue growth factor levels in children with heart failure.

    Science.gov (United States)

    Li, Gang; Song, Xueqing; Xia, Jiyi; Li, Jing; Jia, Peng; Chen, Pengyuan; Zhao, Jian; Liu, Bin

    2017-01-01

    The aim of this study was to assess the diagnostic value of plasma N-terminal connective tissue growth factor in children with heart failure. Methods and results Plasma N-terminal connective tissue growth factor was determined in 61 children, including 41 children with heart failure, 20 children without heart failure, and 30 healthy volunteers. The correlations between plasma N-terminal connective tissue growth factor levels and clinical parameters were investigated. Moreover, the diagnostic value of N-terminal connective tissue growth factor levels was evaluated. Compared with healthy volunteers and children without heart failure, plasma N-terminal connective tissue growth factor levels were significantly elevated in those with heart failure (p0.05), but it obviously improved the ability of diagnosing heart failure in children, as demonstrated by the integrated discrimination improvement (6.2%, p=0.013) and net re-classification improvement (13.2%, p=0.017) indices. Plasma N-terminal connective tissue growth factor is a promising diagnostic biomarker for heart failure in children.

  18. [Personalizing the reference level: gold standard to evaluate the quality of service perceived].

    Science.gov (United States)

    Rodrigo-Rincón, I; Reyes-Pérez, M; Martínez-Lozano, M E

    2014-01-01

    To know the cutoff point at which in-house Nuclear Medicine Department (MND) customers consider that the quality of service is good (personalized cutoff). We conducted a survey of the professionals who had requested at least 5 tests to the Nuclear Medicine Department. A total of 71 doctors responded (response rate: 30%). A question was added to the questionnaire for the user to establish a cutoff point for which they would consider the quality of service as good. The quality non-conformities, areas of improvement and strong points of the six questions measuring the quality of service (Likert scale 0 to 10) were compared with two different thresholds: personalized cutoff and one proposed by the service itself a priori. Test statistics: binomial and Student's t-test for paired data. A cutoff value of 7 was proposed by the service as a reference while 68.1% of respondents suggested a cutoff above 7 points (mean 7.9 points). The 6 elements of perceived quality were considered strong points with the cutoff proposed by the MND, while there were 3 detected with the personalized threshold. Thirteen percent of the answers were nonconformities with the service cutoff versus 19.2% with the personalized one, the differences being statistically significant (difference 95% CI 6.44%:0,83-12.06). The final image of the perceived quality of an in-house customer is different when using the cutoff established by the Department versus the personalized cutoff given by the respondent. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  19. Two generators to produce SI-traceable reference gas mixtures for reactive compounds at atmospheric levels

    Science.gov (United States)

    Pascale, C.; Guillevic, M.; Ackermann, A.; Leuenberger, D.; Niederhauser, B.

    2017-12-01

    To answer the needs of air quality and climate monitoring networks, two new gas generators were developed and manufactured at METAS in order to dynamically generate SI-traceable reference gas mixtures for reactive compounds at atmospheric concentrations. The technical features of the transportable generators allow for the realization of such gas standards for reactive compounds (e.g. NO2, volatile organic compounds) in the nmol · mol-1 range (ReGaS2), and fluorinated gases in the pmol ṡ mol-1 range (ReGaS3). The generation method is based on permeation and dynamic dilution. The transportable generators have multiple individual permeation chambers allowing for the generation of mixtures containing up to five different compounds. This mixture is then diluted using mass flow controllers, thus making the production process adaptable to generate the required amount of substance fraction. All parts of ReGaS2 in contact with the gas mixture are coated to reduce adsorption/desorption processes. Each input parameter required to calculate the generated amount of substance fraction is calibrated with SI-primary standards. The stability and reproducibility of the generated amount of substance fractions were tested with NO2 for ReGaS2 and HFC-125 for ReGaS3. They demonstrate stability over 1-4 d better than 0.4% and 0.8%, respectively, and reproducibility better than 0.7% and 1%, respectively. Finally, the relative expanded uncertainty of the generated amount of substance fraction is smaller than 3% with the major contributions coming from the uncertainty of the permeation rate and/or of the purity of the matrix gas. These relative expanded uncertainties meet then the needs of the data quality objectives fixed by the World Meteorological Organization.

  20. Rational reference levels for Pacific Coast radioactive pollution studies supplied by samples from northern Baja California

    International Nuclear Information System (INIS)

    Folsom, T.R.

    1974-01-01

    Background levels of radioactivity in the marine environment along the Pacific Coast are at present extremely low. However, these certainly will rise along with the growth of coastal populations and with the increased use of nuclear energy. It would be desirable to anticipate where and how fast concentrations of artificial radioactivities may reach unacceptable levels in coastal water. Successful prediction of this sort requires knowing how the ocean responds, in given regions, to specific inputs. Fortunately, some of the fate of a large class of radioactive pollutants that must be faced in the future may be inferred from careful studies during the past 20 years of the behavior of certain constituents of nuclear fallout that have entered the ocean along the coasts of California and Baja California. (CH)

  1. Study and Analysis of a Natural Reference Frame Current Controller for a Multi-Level H-Bridge Power Converter

    DEFF Research Database (Denmark)

    Ciobotaru, Mihai; Iov, Florin; Zanchetta, P.

    2008-01-01

    will be needed in order to control the power flow and to ensure proper and secure operation of this future grid with an increased level of renewable power. These power converters must be able to provide intelligent power management as well as ancillary services. This paper presents an analysis of the natural...... reference frame controller, based on proportional-resonant (PR) technique, for a multi-level H-bridge power converter for Universal and Flexible Power Management in Future Electricity Network. The proposed method is tested in terms of harmonic content in the Point of Common Coupling (PCC), voltage...

  2. Diagnostic Performance of Serum IgG4 Levels in Patients With IgG4-Related Disease

    Science.gov (United States)

    Yu, Kuang-Hui; Chan, Tien-Ming; Tsai, Ping-Han; Chen, Ching-Hui; Chang, Pi-Yueh

    2015-01-01

    Abstract The aim of this study is to study the clinical features and diagnostic performance of IgG4 in Chinese populations with IgG4-related diseases (IgG4-RDs). The medical records of 2901 adult subjects who underwent serum IgG4 level tests conducted between December 2007 and May 2014 were reviewed. Serum concentrations of IgG4 were measured in 2901 cases, including 161 (5.6%) patients with IgG4-RD and 2740 (94.4%) patients without IgG4-RD (non-IgG4-RD group). The mean age of the IgG4-RD patients was 58.4 ± 16.1 years (range: 21–87), and 48 (29.8%) were women. The mean serum IgG4 level was significantly much higher in IgG4-RD patients than in non-IgG4-RD (1062.6 vs 104.3 mg/dL, P IgG4 >135 mg/dL, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio (LR)+, and LR− were 86%, 77%, 18%, 99%, 3.70, and 0.19, respectively. When the upper limit of normal was doubled for an IgG4 >270 mg/dL, the corresponding data were 75%, 94%, 43%, 98%, 12.79, and 0.26, respectively. For IgG4 >405 mg/dL (tripling the upper limit of normal), the corresponding data were 62%, 98%, 68%, 98%, 37.00, and 0.39, respectively. When calculated according to the manufacturer's package insert cutoff (>201 mg/dL) for the diagnosis of IgG4-RD, the corresponding sensitivity, specificity, PPV, NPV, LR+, and LR− were 80%, 89%, 29%, 99%, 7.00, and 0.23, respectively. For IgG4 >402 mg/dL (>2× the upper limit of the normal range), the corresponding data were 62%, 98%, 68%, 98%, 36.21, and 0.39, respectively. For IgG4 >603 mg/dL (>3× the upper limit of the normal range), the corresponding data were 50%, 99%, 84%, 97%, 90.77 and 0.51, respectively. The optimal cutoff value of serum IgG4 (measured by nephelometry using a Siemens BN ProSpec instrument and Siemens reagent) for the diagnosis of IgG4-RD was 248 mg/dL, the sensitivity and specificity were 77.6% and 92.8%, respectively. The present study demonstrated that 2 or

  3. Impact of low-level radiation with special reference to tritium in environment

    International Nuclear Information System (INIS)

    Bhatia, A.L.

    2005-01-01

    Radiation is invisible, but exists in various types, in the form of particles and/or energy bundles. The effects of low-level radiation seem very abstract since these can not be perceived by our sensory organs. The increase in natural background radiation from various inadvertent sources like tritium has the prospect of altering the entire scenario of billions of years' slow and steady biogenetic evolution. Mankind, by developing atomic technologies, is unleashing forces which it does understand but not beyond experimental findings. There is no wise sorcerer who can undo the damage we are causing. Tritium is a radioactive form of hydrogen that is produced in the reactor core. The released tritium replaces hydrogen in water. Tritium in water when gets ingested, causes continuos internal low-level beta radiation exposure over a long period. Proposed presentation will focus on the possible long term damage caused by its low-level exposure is dependent on the length of duration living tissue spends in the radiation field, not on the relative radiation field strength. As internal radiation pulses never stop, impact is continuous by the ambient radiation atmosphere. There is no chance to heal at the molecular level, except small chances of DNA repair since the organically bound tritium has greater severe influence with the slow turnover. Though the situation needs not be alarming with tritium, the studies on radiation damage on various parameters have given evidence of two compartments of radiation damage; the reparable or potentially lethal and the irreparable or lethal. With emerging new reports on the stochastic effects, those for which the probability, rather than the severity of an effect from tritium occurring as a function of dose also can not be ruled out. Biotoxicity of tritium in the form of induction of cancer, hereditary effects, teratogenesis and life shortening really needs an exhaustive investigation and warrants careful evaluation. However, a positive

  4. Discovery and validation of plasma-protein biomarker panels for the detection of colorectal cancer and advanced adenoma in a Danish collection of samples from patients referred for diagnostic colonoscopy

    DEFF Research Database (Denmark)

    Blume, John E.; Wilhelmsen, Michael; Benz, Ryan W.

    2016-01-01

    and utilization of such a resource is an important step in the development of blood-based biomarker tests for colorectal cancer.Methods: We have created a subject data and biological sample resource, Endoscopy II, which is based on 4698 individuals referred for diagnostic colonoscopy in Denmark between May 2010...

  5. Evaluation of alanine as a reference dosimeter for therapy level dose comparisons in megavoltage electron beams

    International Nuclear Information System (INIS)

    McEwen, Malcolm; Sharpe, Peter; Voros, Sandor

    2015-01-01

    When comparing absorbed dose standards from different laboratories (e.g. National Measurement Institutes, NMIs, for Key or Supplementary comparisons) it is rarely possible to carry out a direct comparison of primary standard instruments, and therefore some form of transfer detector is required. Historically, air-filled, unsealed ionization chambers have been used because of the long history of using these instruments, very good stability over many years, and ease of transport. However, the use of ion chambers for therapy-level comparisons is not without its problems. Findings from recent investigations suggest that ion chambers are prone to non-random variations, they are not completely robust to standard courier practices, and failure at any step in a comparison can render all measurements potentially useless. An alternative approach is to identify a transfer system that is insensitive to some of these concerns - effectively a dosimeter that is inexpensive, simple to use, robust, but with sufficient precision and of a size relevant to the disseminated quantity in question. The alanine dosimetry system has been successfully used in a number of situations as an audit dosimeter and therefore the purpose of this investigation was to determine whether alanine could also be used as the transfer detector for dosimetric comparisons, which require a lower value for the measurement uncertainty. A measurement protocol was developed for comparing primary standards of absorbed dose to water in high-energy electron beams using alanine pellets irradiated in a water-equivalent plastic phantom. A trial comparison has been carried out between three NMIs and has indicated that alanine is a suitable alternative to ion chambers, with the system used achieving a precision of 0.1%. Although the focus of the evaluation was on the performance of the dosimeter, the comparison results are encouraging, showing agreement at the level of the combined uncertainties (∼0.6%). Based on this

  6. Analysis of data relative to the update of diagnosis reference levels in radiology and nuclear medicine. Situation 2004-2006

    International Nuclear Information System (INIS)

    2008-01-01

    This report presents the results of the analysis of patients dosimetry data the radiology and nuclear medicine institutions have to transmit yearly to I.R.S.N. in application of the 12. february decree disposal relative to the diagnosis reference levels in radiology and nuclear medicine. The analysed dosimetry data concern the evaluations realised between the date of decree publication, the 16. march 2004 and 31. december 2006. The so considered results have to allow to the Nuclear Safety Authority to define the evolution needs of the regulation. Particularly, the analysis of delivered doses in radiology and the activities given in nuclear medicine lead to propositions on the possible update of reference values of some examination types. (N.C.)

  7. Diagnostic value of sputum adenosine deaminase (ADA) level in pulmonary tuberculosis.

    Science.gov (United States)

    Binesh, Fariba; Jalali, Hadi; Zare, Mohammad Reza; Behravan, Farhad; Tafti, Arefeh Dehghani; Behnaz, Fatemah; Tabatabaee, Mohammad; Shahcheraghi, Seyed Hossein

    2016-06-01

    Tuberculosis is still a considerable health problem in many countries. Rapid diagnosis of this disease is important, and adenosine deaminase (ADA) has been used as a diagnostic test. The aim of this study was to assess the diagnostic value of ADA in the sputum of patients with pulmonary tuberculosis. The current study included 40 patients with pulmonary tuberculosis (culture positive, smear ±) and 42 patients with non tuberculosis pulmonary diseases (culture negative). ADA was measured on all of the samples. The median value of ADA in non-tuberculosis patients was 2.94 (4.2) U/L and 4.01 (6.54) U/L in tuberculosis patients, but this difference was not statistically significant (p=0.100). The cut-off point of 3.1 U/L had a sensitivity of 61% and a specificity of 53%, the cut-off point of 2.81 U/L had a sensitivity of 64% and a specificity of 50% and the cut-off point of 2.78 U/L had a sensitivity of 65% and a specificity of 48%. The positive predictive values for cut-off points of 3.1, 2.81 and 2.78 U/L were 55.7%, 57.44% and 69.23%, respectively. The negative predictive values for the abovementioned cut-off points were 56.75%, 57.14% and 55.88%, respectively. Our results showed that sputum ADA test is neither specific nor sensitive. Because of its low sensitivity and specificity, determination of sputum ADA for the diagnosis of pulmonary tuberculosis is not recommended.

  8. Analysis of data related to the update of diagnosis reference levels in radiology and nuclear medicine. Assessment 2009-2010

    International Nuclear Information System (INIS)

    Roch, Patrice; Celier, David

    2012-10-01

    This report presents and comments the results of the analysis of 'patient' dosimetric data which radiology and nuclear medicine establishments had to transmit to the IRSN. The first part concerns conventional radiology and the analysis is made from a general point of view, and then by examination type (in the case of adults and of children). A synthesis of results since 2004 is proposed in terms of transmitted data, of data representativeness, of influence of detection technology on the delivered dose, of evolution of diagnosis reference level. With the same approach, the next parts address scanography examinations and nuclear medicine

  9. Analysis of data related to the updating of diagnosis reference levels in radiology and nuclear medicine. Assessment 2007-2008

    International Nuclear Information System (INIS)

    2010-01-01

    This report presents the results of the analysis of 'patient' dosimetric data which radiology and nuclear medicine establishments must supply every year to the IRSN (the French Radioprotection and Nuclear Safety Institute) according to a decree related to diagnosis reference levels in radiology and nuclear medicine. The analysed dosimetric data concern assessments performed during 2007 and 2008. For the different concerned practices (radiology, scanography, nuclear medicine), the report proposes a presentation and a discussion of global data, and then a presentation of data either for different types of examination on adults and on children, or for the different parts of the body

  10. Current levels of gonadal irradiation from a selection of routine diagnostic X-ray examinations in Great Britain

    International Nuclear Information System (INIS)

    Wall, B.F.; Fisher, E.S.; Shrimpton, P.C.; Rae, S.

    1980-07-01

    The gonadal doses from 13 types of diagnostic examination have been measured at 21 hospitals throughout the country in preparation for a new assessment of the genetically significant dose to the population of Great Britain from diagnostic radiology. Thermoluminescent dosemeters, consisting of lithium borate powder contained in adhesive polythene sachets, were used for the measurements. They were attached to patients to monitor the testes dose directly or the entrance skin dose at the level of the ovaries. Skin doses were converted to ovarian doses using factors obtained by measurements in an anthropomorphic phantom exposed to a range of typical diagnostic X-ray fields. The results indicate that for some types of examination there has been an increase and for others there has been a reduction in the mean gonadal dose delivered per examination since a similar survey was made 20 years ago. Individual gonadal doses for the same examination still ranged over 3 or 4 orders of magnitude throughout the country with distributions described by coefficients of variation that were no less than those found in the late 1950s. This large variability in patient exposure, together with the observation that examinations were satisfactorily conducted on children with a much higher degree of gonadal protection than that offered to young adults, indicates that many patients must be receiving doses that are unnecessarily high. (author)

  11. Farm-level risk factors for Fasciola hepatica infection in Danish dairy cattle as evaluated by two diagnostic methods

    DEFF Research Database (Denmark)

    Takeuchi-Storm, Nao; Denwood, Matthew; Hansen, Tina Vicky Alstrup

    2017-01-01

    ) as a tool for diagnosis in Danish dairy cattle farms was assessed. This case-control study aimed to identify farm-level risk factors for fasciolosis in Danish dairy farms (> 50 animals slaughtered in 2013) using two diagnostic methods: recordings of liver condemnation at slaughter, and farm-level Fasciola...... on wet pastures, dry cows grazing on wet pastures, herd size, breed and concurrent beef cattle production were identified as risk factors associated with being classified as a case farm. With the categorised BTM ELISA result as the response variable, heifers grazing on wet pastures, dry cows grazing...... on wet pastures, and purchase of cows were identified as risk factors. Within the case and control groups, 74.8 and 12.7% of farms were positive for fasciolosis on BTM ELISA, respectively. The differences are likely to be related to the detection limit of the farm-level prevalence by the BTM ELISA test...

  12. Reference datum level

    Digital Repository Service at National Institute of Oceanography (India)

    Pathak, M.C.; Kotnala, K.L.

    stream_size 5 stream_content_type text/plain stream_name Trg_Calculat_Water_Depth_Chart_Datum_1991_25.pdf.txt stream_source_info Trg_Calculat_Water_Depth_Chart_Datum_1991_25.pdf.txt Content-Encoding ISO-8859-1 Content-Type text.../plain; charset=ISO-8859-1 ...

  13. Study on the diagnostic value of plasma Adrenomedullin (AM) levels determination for differentiation of pulmonary cancer from pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Yu Hua; Sun Shuhong; Xu Shuhua; Zhu Wenru; Yu Hui

    2005-01-01

    Objective: To explore the relationship between plasma adrenomedullin (AM) levels and pulmonary cancer as well as the diagnostic value of AM levels determination for differentiation of pulmonary cancer from pulmonary tuberculosis. Methods: Plasma levels of AM in patients with pulmonary cancer (n=43), pulmonary tuberculosis (n=43) and 43 controls were determined with RIA. Results: Plasma levels of AM (98.46 ± 29.28 ng/ml) in patients with pulmonary cancer were significantly higher than those in patients with pulmonary tuberculosis (61.46 ± 19.57 ng/ml) as well as those in controls (40.22 ± 8.23 ng/ml) (both P<0.01). Levels in patients with small cell carcinoma were significantly lower than those in patients with adenocarcinoma and squamous cell carcinoma (both P<0.05). Positive correlation existed between the plasma levels of AM and the severity (grading 1 to 4) of the disease (P<0.05). Conclusion: Adrenomedullin could be regarded as a valuable plasma marker for differentiating lung cancer from tuberculosis. The plasma AM levels might be able to reflect the severity and predict the prognosis of the disease. Besides, high AM levels might suggest a tentative diagnosis of lung cancer in patients without pathologic evidence. (authors)

  14. Efficacy of a chairside diagnostic test kit for estimation of C-reactive protein levels in periodontal disease.

    Science.gov (United States)

    Nagarale, Girish; Ravindra, S; Thakur, Srinath; Setty, Swati

    2010-10-01

    C-reactive protein [CRP] levels increase to hundreds of mg/mL within hours following infection. Studies have shown that serum CRP levels were elevated in periodontal disease. However, in all the previous studies, CRP levels were measured by using high-sensitivity CRP assay kits with minimal detection limits of 0.1 to 3 mg/L, which was much below the normal value of 10 mg/L. These high-sensitivity CRP assays need a proper laboratory setup, and these methods cannot be used as a routine chair-side test in the dental office. The purpose of this study was to investigate the serum CRP levels in subjects with periodontal disease by using a rapid chair-side diagnostic test kit with a lower detection limit of 6 mg/L and to compare the CRP levels before and after periodontal therapy. A total of 45 systemically healthy subjects were selected for the study. Subjects were divided into three groups: group A: healthy controls, group B: gingivitis, group C: periodontitis. Serum levels of CRP were determined by using a latex slide agglutination method with commercially available kit with lower detection limit of 6 mg/L. CRP was negative in all the 15 subjects in groups A and B at baseline, 7th and 30th day. CRP was positive only in 2 subjects in Group C at baseline and 7th day. Estimation of serum CRP by using a rapid chair-side diagnostic test kit is not of any significance in subjects with periodontitis.

  15. L-carnitine plasma levels in dogs and cats. A diagnostic parameter?

    International Nuclear Information System (INIS)

    Fischer, J.

    1993-04-01

    The relation between levels of carnitine in plasma and lesions of organs should be demonstrated. 52 dogs and 58 cats examined in veterinary clinics for several reasons and routinely screened for blood chemistry also were analysed for free plasma carnitine by a radiocarbon method. Increased carnitine levels were observed in both species in case of heart, liver and kidney disorders. Additionally the influence of food intake on carnitine levels in dogs was studied. Postprandial changes were insignificant. Because of lack of information about carnitine levels in cats and changes with age plasma carnitine was determined in cats and kittens. The range of normal values was 8.2 to 24.2 μmol/l without any significance of age

  16. Diagnostic value of determination of serum pepsinogen and gastrin levels in patients with peptic ulcer

    International Nuclear Information System (INIS)

    Xiao Zhansen; Li Jingrong; Feng Jiandong; Wang Yuqiong; Fu Xiufeng; Zhang Lanfeng

    2005-01-01

    Objective: To investigate the clinical significance of changes of serum pepsinogen and gastrin levels in patients with gastric/duodenal ulcer. Methods: Serum pepsinogen I (PG I), pepsinogen II (PGII), gastrin levels and PG I/PG II ratio were determined with RIA in 100 controls, 61 patients with duodenal ulcer, 46 patients with gastric ulcer, 66 patients with gastric cancer and 101 patients with chronic gastritis. Results: In patients with peptic ulcer (gastric/duodenal), the serum levels of PG I, PG II and PG I/PG II ratio were significantly higher than those in controls (P<0.001); the serum gastrin levels were also significantly higher than those in controls and patients with chronic gastritis (P<0.001), but lower than those in patients with gastric cancer (P<0.001). Among patients with peptic ulcer, the serum PG I level and PG I/PG II ratio were significantly higher in patients with duodenal ulcer than those in patients with gastric ulcer (P<0.001). Conclusion: Excessive high serum levels of PG I, PG II, gastrin and PG I/PG II ratio were some of the high risk factors for peptic ulcer. Those were useful serum markers for diagnosis and follow-up of the disease. (authors)

  17. The diagnostic value of the lactate level in the vaginal fluid for determining the premature rupture of membranes

    International Nuclear Information System (INIS)

    Ahmadi, M.; Rafaei, F.; Nazari, N.

    2013-01-01

    Objectives:To determine the diagnostic value of the lactate concentration in vaginal secretions in determining the premature rupture of membranes. Subjects and Methods:One hundred 100 pregnant women with single pregnancy of gestational age 20--41 weeks were divided to two groups of 50 each. One group comprised of women with premature rupture of membranes, and the other (control group) of women with intact membranes. To verify the premature rupture of membranes in both groups, the speculum, fern, and nitrazine tests were done. Lactate Pro manual instrument was used to measure the lactate levels in vaginal fluid via enzymatic staining which was displayed on the instrument's liquid crystal display after 60 seconds. Descriptive analytic statistics and SPSS 17 software were used to analyze the data. Results The lactate concentration of 4.6 mM in the vaginal fluid was diagnostic for premature rupture of membranes. It had a sensitivity of 96%, specificity of 98.8%, accuracy of 97%, positive predictive value of 97.9%, and negative predictive value of 96%. Conclusions:Testing lactate levels in the vaginal fluid is an easy, rapid and reliable method for the diagnosis of premature rupture of membranes in pregnancy. (author)

  18. Component-Level Electronic-Assembly Repair (CLEAR) Spacecraft Circuit Diagnostics by Analog and Complex Signature Analysis

    Science.gov (United States)

    Oeftering, Richard C.; Wade, Raymond P.; Izadnegahdar, Alain

    2011-01-01

    The Component-Level Electronic-Assembly Repair (CLEAR) project at the NASA Glenn Research Center is aimed at developing technologies that will enable space-flight crews to perform in situ component-level repair of electronics on Moon and Mars outposts, where there is no existing infrastructure for logistics spares. These technologies must provide effective repair capabilities yet meet the payload and operational constraints of space facilities. Effective repair depends on a diagnostic capability that is versatile but easy to use by crew members that have limited training in electronics. CLEAR studied two techniques that involve extensive precharacterization of "known good" circuits to produce graphical signatures that provide an easy-to-use comparison method to quickly identify faulty components. Analog Signature Analysis (ASA) allows relatively rapid diagnostics of complex electronics by technicians with limited experience. Because of frequency limits and the growing dependence on broadband technologies, ASA must be augmented with other capabilities. To meet this challenge while preserving ease of use, CLEAR proposed an alternative called Complex Signature Analysis (CSA). Tests of ASA and CSA were used to compare capabilities and to determine if the techniques provided an overlapping or complementary capability. The results showed that the methods are complementary.

  19. Correlation between Serum Aldosterone Level and Hearing Condition of Elderly Patients Referred to Otolaryngology Services of Hamadan, Western Iran

    Directory of Open Access Journals (Sweden)

    Dr. Farhad Farahani

    2010-06-01

    Full Text Available Background and Aim: Recently, more attention was paid to the direct protective effect of aldosterone against hearing impairment in elderly patients. The aim of this study was determination of possible correlation between serum aldosterone level and hearing condition of elderly patients that referred to the Otolaryngology services of Hamadan in 2005-2006.Methods: In this case control study 54 (27 males,27 females persons above 60 years old were evaluated. They contained twenty eight cases with normal hearing and 26 cases with presbycusis. Persons with any abnormal biochemical finding or history of conditions that predispose them to the sensorineural hearing loss (SNHL were excluded. In both groups serum level of sodium, potassium and aldosterone were measured and hearing condition evaluated by puretone, speech and immitance audiometry.Results: Statistical relationship between serum aldostrone level and hearing condition, sex, configuration of audiogram and speech discrimination score (SDS were not significant. In addition, no significant relationship between sodium and potassium levels with hearing condition was found (p>0.05.Conclusion: This study could not confirm protective effect of aldostrone against presbycusis. This discrepancy may originate from epidemiologic differences, laboratory errors or small sample size.

  20. Cuban typical doses for 99mTc-DMSA renal gammagraphy studies: a methodology for the establishment of reference levels

    International Nuclear Information System (INIS)

    Diaz Barreto, M.; Varela Corona, C.; Lopez Bejerano, G.M.; Perea Diaz, M.; Paz Viera, J.E.

    2008-01-01

    Since a handful of years ago, international rules on Radiological Protection include the principle of optimization of given dose to patients, if this procedure doesn't lessen diagnosis quality, and the establishment of reference levels of activity. For these reasons, the Radiological Protection staff of Cuban Institute of Nephrology's Nuclear Medicine Service, where morpho functional renal studies are carried out, 70% on infants and young children, started a research on that way. Thus, because their biggest incidence, 99m Tc -DMSA renal gammagraphy studies were chosen, using a General Electric 400 AT Planar Gamma Camera. Studied sample was randomly selected, including adults (12 peoples) and children (23); divided into 4 groups, lessen given dose step by step. Other items were kept in mind in the research, such age, weight, time delayed between administrations and image getting, getting time of each view and total time of the study, as well as radiopharmaceuticals quality and Gamma Camera performance. Image quality was evaluated for each case, using both, objective and subjective criteria. Objective evaluation was done by using contrast/noise ratios and variance of the random noise. They were used to develop clustering and discriminant analysis over the independent variables to detect groups with differentiated image quality from the physical and mathematical point of view. Subjective evaluation was performed using the criteria of two expert observers who had no information about the activity levels used. They evaluated image quality separately, giving a good, regular or bad evaluation for each image. As a conclusion, we found that it is possible to reduce the given activities in 50% and thus, indirectly, to reduce doses for workers and for the public. Additionally, we propose a methodology for the establishment of reference levels for 99m Tc -DMSA renal gammagraphy studies in Cuba, both, for adults and paediatric patients. (author)

  1. Predictive value of Borrelia burgdorferi IgG antibody levels in patients referred to a tertiary Lyme centre.

    Science.gov (United States)

    Zwerink, M; Zomer, T P; van Kooten, B; Blaauw, G; van Bemmel, T; van Hees, B C; Vermeeren, Y M; Landman, G W

    2018-03-01

    A two-step testing strategy is recommended in serological testing for Lyme borreliosis; positive and indeterminate enzyme-linked immunosorbent assay (ELISA) results are confirmed with immunoblots. Several ELISAs quantify the concentration of antibodies tested, however, no recommendation exists for an upper cut-off value at which an IgG ELISA is sufficient and the immunoblot can be omitted. The study objective was to determine at which IgG antibody level an immunoblot does not have any additional predictive value compared to ELISA results. Data of adult patients who visited a tertiary Lyme centre between 2008 and 2014 were analysed. Both an ELISA (Enzygnost Lyme link VlsE IgG) and immunoblot (recomLine blot Borrelia) were performed. Clinical data were extracted from the patient's digital medical record. Positive predictive values (PPVs) for either previous or active infection with Borrelia burgdorferi s.l. were calculated for different cut-off ELISA IgG antibody levels where the immunoblot was regarded as reference test. In total, 1454 patients were included. According to the two-step test strategy, 486 (33%), 69 (5%) and 899 (62%) patients had positive, indeterminate and negative Borrelia IgG serology, respectively. At IgG levels of 500 IU/ml and higher, all immunoblots were positive, resulting in a 100% PPV (95% CI: 97.0-100). At IgG levels of 200 IU/ml and higher, the PPV was 99.3% (95% CI: 97.4-99.8). In conclusion, at IgG levels of 200 IU/ml and higher, an ELISA was sufficient to detect antibodies to Borrelia burgdorferi s.l. At those IgG levels, a confirmatory immunoblot may be omitted in patients referred to a tertiary Lyme centre. Before these results can be implemented in routine diagnosis of Lyme borreliosis, confirmation of the results is necessary in other patient populations and using other quantitative ELISAs and immunoblots. Copyright © 2017 Elsevier GmbH. All rights reserved.

  2. MERRA 2D IAU Ocean Surface Diagnostic, Single Level, Time Avg 1-hr (2/3x1/2L1) V5.2.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The MAT1NXOCN or tavg1_2d_ocn_Nx data product is the MERRA Data Assimilation System 2-Dimensional ocean surface single-level diagnostics that is time averaged...

  3. MERRA 2D IAU Ocean Surface Diagnostic, Single Level, Monthly Mean (2/3x1/2L1) V5.2.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The MATMNXOCN or tavgM_2d_ocn_Nx data product is the MERRA Data Assimilation System 2-Dimensional ocean surface single-level diagnostics that is monthly mean...

  4. MERRA 2D IAU Diagnostic, Single Level Meteorology, Diurnal (2/3x1/2L1) V5.2.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The MATUNXSLV or tavgU_2d_slv_Nx data product is the MERRA Data Assimilation System 2-Dimensional atmospheric single-level diagnostics that is time averaged...

  5. MERRA 2D IAU Ocean Surface Diagnostic, Single Level, Diurnal (2/3x1/2L1) V5.2.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The MATUNXOCN or tavgU_2d_ocn_Nx data product is the MERRA Data Assimilation System 2-Dimensional ocean surface single-level diagnostics that is monthly mean...

  6. MERRA 2D IAU Diagnostic, Single Level Meteorology, Time Average 1-hourly (2/3x1/2L1) V5.2.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The MAT1NXSLV or tavg1_2d_slv_Nx data product is the MERRA Data Assimilation System 2-Dimensional atmospheric single-level diagnostics that is time averaged...

  7. Colorado Upper-Division Electrostatics Diagnostic: A Conceptual Assessment for the Junior Level

    Science.gov (United States)

    Chasteen, Stephanie V.; Pepper, Rachel E.; Caballero, Marcos D.; Pollock, Steven J.; Perkins, Katherine K.

    2012-01-01

    As part of an effort to systematically improve our junior-level E&M I course, we have developed a tool to assess student conceptual learning of electrostatics at the upper division. Together with a group of physics faculty, we established a list of learning goals for the course that, with results from student observations and interviews,…

  8. Item level diagnostics and model - data fit in item response theory ...

    African Journals Online (AJOL)

    Item response theory (IRT) is a framework for modeling and analyzing item response data. Item-level modeling gives IRT advantages over classical test theory. The fit of an item score pattern to an item response theory (IRT) models is a necessary condition that must be assessed for further use of item and models that best fit ...

  9. Perturbational treatment of spin-orbit coupling for generally applicable high-level multi-reference methods

    Energy Technology Data Exchange (ETDEWEB)

    Mai, Sebastian; Marquetand, Philipp; González, Leticia [Institute of Theoretical Chemistry, University of Vienna, Währinger Str. 17, 1090 Vienna (Austria); Müller, Thomas, E-mail: th.mueller@fz-juelich.de [Institute for Advanced Simulation, Jülich Supercomputing Centre, Forschungszentrum Jülich, 52425 Jülich (Germany); Plasser, Felix [Interdisciplinary Center for Scientific Computing, University of Heidelberg, Im Neuenheimer Feld 368, 69120 Heidelberg (Germany); Lischka, Hans [Institute of Theoretical Chemistry, University of Vienna, Währinger Str. 17, 1090 Vienna (Austria); Department of Chemistry and Biochemistry, Texas Tech University, Lubbock, Texas 79409-1061 (United States)

    2014-08-21

    An efficient perturbational treatment of spin-orbit coupling within the framework of high-level multi-reference techniques has been implemented in the most recent version of the COLUMBUS quantum chemistry package, extending the existing fully variational two-component (2c) multi-reference configuration interaction singles and doubles (MRCISD) method. The proposed scheme follows related implementations of quasi-degenerate perturbation theory (QDPT) model space techniques. Our model space is built either from uncontracted, large-scale scalar relativistic MRCISD wavefunctions or based on the scalar-relativistic solutions of the linear-response-theory-based multi-configurational averaged quadratic coupled cluster method (LRT-MRAQCC). The latter approach allows for a consistent, approximatively size-consistent and size-extensive treatment of spin-orbit coupling. The approach is described in detail and compared to a number of related techniques. The inherent accuracy of the QDPT approach is validated by comparing cuts of the potential energy surfaces of acrolein and its S, Se, and Te analoga with the corresponding data obtained from matching fully variational spin-orbit MRCISD calculations. The conceptual availability of approximate analytic gradients with respect to geometrical displacements is an attractive feature of the 2c-QDPT-MRCISD and 2c-QDPT-LRT-MRAQCC methods for structure optimization and ab inito molecular dynamics simulations.

  10. Perturbational treatment of spin-orbit coupling for generally applicable high-level multi-reference methods

    International Nuclear Information System (INIS)

    Mai, Sebastian; Marquetand, Philipp; González, Leticia; Müller, Thomas; Plasser, Felix; Lischka, Hans

    2014-01-01

    An efficient perturbational treatment of spin-orbit coupling within the framework of high-level multi-reference techniques has been implemented in the most recent version of the COLUMBUS quantum chemistry package, extending the existing fully variational two-component (2c) multi-reference configuration interaction singles and doubles (MRCISD) method. The proposed scheme follows related implementations of quasi-degenerate perturbation theory (QDPT) model space techniques. Our model space is built either from uncontracted, large-scale scalar relativistic MRCISD wavefunctions or based on the scalar-relativistic solutions of the linear-response-theory-based multi-configurational averaged quadratic coupled cluster method (LRT-MRAQCC). The latter approach allows for a consistent, approximatively size-consistent and size-extensive treatment of spin-orbit coupling. The approach is described in detail and compared to a number of related techniques. The inherent accuracy of the QDPT approach is validated by comparing cuts of the potential energy surfaces of acrolein and its S, Se, and Te analoga with the corresponding data obtained from matching fully variational spin-orbit MRCISD calculations. The conceptual availability of approximate analytic gradients with respect to geometrical displacements is an attractive feature of the 2c-QDPT-MRCISD and 2c-QDPT-LRT-MRAQCC methods for structure optimization and ab inito molecular dynamics simulations

  11. Diagnostic Cut-Off Levels of Plasma Brain Natriuretic Peptide to Distinguish Left Ventricular Failure in Emergency Setting

    International Nuclear Information System (INIS)

    Hussain, A.; Afridi, F. I.; Lutfi, I. A.

    2014-01-01

    Objective: To determine the diagnostic cut-off values of brain natriuretic (BNP) peptide to establish left ventricular failure in patients presenting with dyspnoea in emergency department. Study Design: Descriptive study. Place and Duration of Study: Ziauddin University Hospital, Karachi, from July to December 2011. Methodology: BNP estimation was done on Axysm analyzer with kit provided by Abbott diagnostics, while the Doppler echocardiography was done on Toshiba style (UICW-660A) using 2.5 MHz and 5.0 MHz probes. Log transformation was done to normalize the original BNP values. A receiver operating curve was plotted to determine the diagnostic cut-off value of BNP which can be used to distinguish CHF from other causes of dyspnoea. Statistical analysis was performed by SPSS version 17. Results: A total of 92 patients presenting with dyspnoea in the emergency department were studied. There were 38/92 (41.3%) males and 54/92 (58.7%) females, and the average age of the study population was 64 A +- 14.1 years. These patients had BNP levels and Doppler echocardiography done. The average BNP was found to be 1117.78 A +- 1445.74 pg/ml. In log transformation, the average was found to be 2.72 A +- 0.58. BNP value of 531 pg/ml was found to be the cut off to distinguish between cardiogenic and non-cardiogenic causes of dyspnoea. Conclusion: BNP value of 531 pg/ml can distinguish CHF from other conditions as a cause of dyspnoea in emergency. (author)

  12. Intercomparison of ionization chambers in standard X-ray beams, at radiotherapy, diagnostic radiology and radioprotection levels

    International Nuclear Information System (INIS)

    Bessa, Ana Carolina Moreira de

    2007-01-01

    Since the calibration of radiation measurement instruments and the knowledge of their major characteristics are very important subjects, several different types of ionization chambers were inter compared in terms of their calibration coefficients and their energy dependence, in radiotherapy, diagnostic radiology and radioprotection standard beams. An intercomparison of radionuclide calibrators for nuclear medicine was performed, using three radionuclides: 67 Ga, 201 Tl and 99m Tc; the results obtained were all within the requirements of the national standard CNEN-NE-3.05. In order to complete the range of radiation qualities of the Calibration Laboratory of IPEN, standard radiation beam qualities, radiation protection and low energy radiation therapy levels, were established, according international recommendations. Three methodologies for the calibration of unsealed ionization chambers in X-ray beams were studied and compared. A set of Victoreen ionization chambers, specially designed for use in laboratorial intercomparisons, was submitted to characterization tests. The performance of these Victoreen ionization chambers showed that they are suitable for use in radioprotection beams, because the results obtained agree with international recommendations. However, these Victoreen ionization chambers can be used in radiotherapy and diagnostic radiology beams only with some considerations, since their performance in these beams, especially in relation to the energy dependence and stabilization time tests, did not agree with the international recommendations for dosimeters used in radiotherapy and diagnostic radiology beams. This work presents data on the performance of several types of ionization chambers in different X-ray beams, that may be useful for choosing the appropriate instrument for measurements in ionizing radiation beams. (author)

  13. Intercomparison of ionization chambers in standard X-ray beams, at radiotherapy, diagnostic radiology and radioprotection levels

    International Nuclear Information System (INIS)

    Bessa, Ana Carolina Moreira de

    2006-01-01

    Since the calibration of radiation measurement instruments and the knowledge of their major characteristics are very important subjects, several different types of ionization chambers were intercompared in terms of their calibration coefficients and their energy dependence, in radiotherapy, diagnostic radiology and radioprotection standard beams. An intercomparison of radionuclide calibrators for nuclear medicine was performed, using three radionuclides: 67 Ga, 201 Tl and 99m Tc; the results obtained were all within the requirements of the national standard CNEN-NE-3.05. In order to complete the range of radiation qualities of the Calibration Laboratory of IPEN, standard radiation beam qualities, radiation protection and low energy radiation therapy levels, were established, according international recommendations. Three methodologies for the calibration of unsealed ionization chambers in X-ray beams were studied and compared. A set of Victoreen ionization chambers, specially designed for use in laboratorial intercomparisons, was submitted to characterization tests. The performance of these Victoreen ionization chambers showed that they are suitable for use in radioprotection beams, because the results obtained agree with international recommendations. However, these Victoreen ionization chambers can be used in radiotherapy and diagnostic radiology beams only with some considerations, since their performance in these beams, especially in relation to the energy dependence and stabilization time tests, did not agree with the international recommendations for dosimeters used in radiotherapy and diagnostic radiology beams. This work presents data on the performance of several types of ionization chambers in different X-ray beams, that may be useful for choosing the appropriate instrument for measurements in ionizing radiation beams. (author)

  14. Study on the diagnostic values of changes of serum endometrium antibody (EMAb) and CA125 (CA125) levels in patients with endometriosis

    International Nuclear Information System (INIS)

    Yang Jingxiu; Shi Shaohong; Wang Yuping

    2005-01-01

    Objective: To explore the diagnostic values of changes of serum EMAb and CA125 levels in patients with endometriosis. Methods: Serum EMAb levels were measured with ELISA and CA125 levels with RIA in 54 patients with endometriosis and 35 controls. Results: Positive rate of serum EMAb was significantly higher in the patients with endometriosis than those in controls (P≤0.01). Serum CA125 levels were also significantly higher than those in controls (P<0.01). Conclusion: Combined detection of serum EMAb positive rate and CA125 levels was of diagnostic value in patients with endometriosis. (authors)

  15. Diagnostic Systems and Resources utilization of the ATLAS High Level Trigger

    CERN Document Server

    Sidoti, A; The ATLAS collaboration; Ospanov, R

    2010-01-01

    Since the LHC started colliding protons in December 2009, the ATLAS trigger has operated very successfully with a collision rate which has increased by several orders of magnitude. The trigger monitoring and data quality infrastructure was essential to this success. We describe the software tools used to monitor the trigger system performance and assess the overall quality of the trigger selection during collisions running. ATLAS has broad physics goals which require a large number of different active triggers due to complex event topology, requiring quite sophisticated software structures and concepts. The trigger of the ATLAS experiment is built as a three level system. The first level is realized in hardware while the high level triggers (HLT) are software based and run on large PC farms. The trigger reduces the bunch crossing rate of 40 MHz, at design, to an average event rate of about 200 Hz for storage. Since the ATLAS detector is a general purpose detector, the trigger must be sensitive to a large numb...

  16. Combined assessment of DYRK1A, BDNF and homocysteine levels as diagnostic marker for Alzheimer's disease.

    Science.gov (United States)

    Janel, N; Alexopoulos, P; Badel, A; Lamari, F; Camproux, A C; Lagarde, J; Simon, S; Feraudet-Tarisse, C; Lamourette, P; Arbones, M; Paul, J L; Dubois, B; Potier, M C; Sarazin, M; Delabar, J M

    2017-06-20

    Early identification of Alzheimer's disease (AD) risk factors would aid development of interventions to delay the onset of dementia, but current biomarkers are invasive and/or costly to assess. Validated plasma biomarkers would circumvent these challenges. We previously identified the kinase DYRK1A in plasma. To validate DYRK1A as a biomarker for AD diagnosis, we assessed the levels of DYRK1A and the related markers brain-derived neurotrophic factor (BDNF) and homocysteine in two unrelated AD patient cohorts with age-matched controls. Receiver-operating characteristic curves and logistic regression analyses showed that combined assessment of DYRK1A, BDNF and homocysteine has a sensitivity of 0.952, a specificity of 0.889 and an accuracy of 0.933 in testing for AD. The blood levels of these markers provide a diagnosis assessment profile. Combined assessment of these three markers outperforms most of the previous markers and could become a useful substitute to the current panel of AD biomarkers. These results associate a decreased level of DYRK1A with AD and challenge the use of DYRK1A inhibitors in peripheral tissues as treatment. These measures will be useful for diagnosis purposes.

  17. Carcinogenesis and low-level ionizing radiation with special reference to lung cancer and exposure to radon daughters

    Energy Technology Data Exchange (ETDEWEB)

    Fabrikant, J.I.

    1982-04-01

    Of the important health effects of ionizing radiation, three important late effects - carcinogenesis, teratogenesis and mutagenesis are of greatest concern. This is because any exposure, even at low levels, carries some risk of such deleterious effects. As the dose of radiation increases above very low levels, the risk of health effects increases. Cancer-induction is the most important late somatic effect of low-dose ionizing radiation. Solid cancers, rather than leukemia, are principal late effects in exposed individuals. Tissues vary greatly in their susceptibility to radiation carcinogenesis. The most frequently occurring radiation-induced cancers in man include, in decreasing order of susceptibility: the female breast, the thyroid gland, the blood-forming tissues, the lung, certain organs of the gastrointestinal tract, and the bones. A number of biological and physical factors affect the cancer risk, such as age, sex, life-style, LET, and RBE. Despite uncertainty about low-level radiation risks, regulatory and advisory bodies must set standards for exposure, and individuals need information to be able to make informed judgments for themselves. From the point of view of the policy maker, the overriding concern is the fact that small doses of radiation can cause people to have more cancers than would otherwise be expected. While concern for all radiation effects exists, our human experience is limited to cancer-induction in exposed populations. This discussion is limited to cancer risk estimation and decision-making in relation to the health effects on populations of exposure to low levels of ionizing radiation. Here, low-level radiation will refer to yearly whole-body doses up to 5 rems or 0.05 Sv, or to cumulative doses up to 50 rems or 0.5 Sv from low-LET radiation and from high-LET radiation. (ERB)

  18. Carcinogenesis and low-level ionizing radiation with special reference to lung cancer and exposure to radon daughters

    International Nuclear Information System (INIS)

    Fabrikant, J.I.

    1982-04-01

    Of the important health effects of ionizing radiation, three important late effects - carcinogenesis, teratogenesis and mutagenesis are of greatest concern. This is because any exposure, even at low levels, carries some risk of such deleterious effects. As the dose of radiation increases above very low levels, the risk of health effects increases. Cancer-induction is the most important late somatic effect of low-dose ionizing radiation. Solid cancers, rather than leukemia, are principal late effects in exposed individuals. Tissues vary greatly in their susceptibility to radiation carcinogenesis. The most frequently occurring radiation-induced cancers in man include, in decreasing order of susceptibility: the female breast, the thyroid gland, the blood-forming tissues, the lung, certain organs of the gastrointestinal tract, and the bones. A number of biological and physical factors affect the cancer risk, such as age, sex, life-style, LET, and RBE. Despite uncertainty about low-level radiation risks, regulatory and advisory bodies must set standards for exposure, and individuals need information to be able to make informed judgments for themselves. From the point of view of the policy maker, the overriding concern is the fact that small doses of radiation can cause people to have more cancers than would otherwise be expected. While concern for all radiation effects exists, our human experience is limited to cancer-induction in exposed populations. This discussion is limited to cancer risk estimation and decision-making in relation to the health effects on populations of exposure to low levels of ionizing radiation. Here, low-level radiation will refer to yearly whole-body doses up to 5 rems or 0.05 Sv, or to cumulative doses up to 50 rems or 0.5 Sv from low-LET radiation and from high-LET radiation

  19. Assessment of effectiveness of ultrasonography in diagnosis of acute appendicitis: Correlation with level of initial clinical diagnostic confidence

    International Nuclear Information System (INIS)

    Song, Soon Young; Koo, Ja Hong; Lee, Eun Ja; Lee, Jong In; Jung, Jin Ho; Kim, Jin Young; Oh, Hwa Eun; Moon, Won Jin; Kim, Sam Soo; Heon, Han

    2002-01-01

    To evaluate effectiveness of ultrasonography (US) in the diagnosis of acute appendicitis by comparing with initial level of clinical diagnostic confidence. Graded compression US of one hundred forty eight with clinically suspected of acute appendicitis were prospectively evaluated. General surgeons classified patients into three groups bases on the clinical probability before US examination: group 1 as cases with low probability ( 75%). Two radiologists performed US examination. Statistical significance of ultrasonographic results in each group was assessed. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of sonography for all patients were 91.3%, 97%, 97.3%, 90.4%, and 93.9% respectively. Those of group 1 were 100%, 95.5%, 84.6%, 100%, and 96.4%, and those of group 2, 95.8%, 100%, 100%, 95%, and 97.7% while those of group 3, 86.4%, 100%, 100%, 50%, and 88%. There was no statistical difference in each parameter among three groups. The accuracy and NPV in group 3 was significantly higher than those in groups with the low and intermediate probability (group 1 and 2). Ultrasonography in the diagnosis of acute appendicitis is an useful and reliable method, especially in case of low clinical diagnostic confidence.

  20. Diagnostics of the illuminance levels of building of EIE complying with the Standard INTECO

    International Nuclear Information System (INIS)

    Cubero Hernandez, Wargner

    2013-01-01

    An analysis detailed is performed in spaces comprising the Edificio de Ingenieria Electrica; the designs of lighting aforetime were made without use of standards or scientifically proven methods, could be that this building be the case. The Standard IESNA is considered both to perform the analysis, which has set the standard to perform the respective measurements of the areas indicated in the building. Also, the standard INTECO is used, this makes mention of the minimum values recommended that each space should have analyzed, and these values meet the visual needs that are necessary for visual comfort. The measurements are performed using the illuminance meter and where it was considered the proper distribution of luminaires; the simulation of the spaces without meet the minimum values established by the standard INTECO; tabulation and comparison between the values obtained; have been the three parts of the project. Not all areas could be measured. Deficiencies are found in most levels comprising the building; if there are spaces that have meet the values specified in the standard, with good maintenance of the lights and plan optimal replacement of damaged fittings, will do even more to improve lighting levels that present in the building. Technology installed at present has been not the best, from the point of view of efficiency, since a larger electric power flows without representing a better light intensity, otherwise the recommendation given to venture into the LED technology. (author) [es

  1. THE LEVEL OF EXPERIENCE OF THE BODY WHOLE IN DEVELOPMENTAL DISPRAXIC AND DIAGNOSTIC DISORDERS

    Directory of Open Access Journals (Sweden)

    Dragoslav KOPACEV

    2000-06-01

    Full Text Available The authors aim is to processed the level of experience of body whole in children with praxic and Gnostics disharmony. The authors were observed 46 children with dispraxis and disgnosis, age from 8-12 years, from different sex and with average intellectual capabilities. They have been treated at our institute in the period of 1998-2000. The tests for neuro-psychological esteem have been used.Children with dispraxis showed failure on the tests of Body scheme (92.3% and on the tests of gesticulate imitation too. Especially they failure in the phase of constructor of the body figure.Children with disgnosis showed better results at the tests of Body scheme (70%. They did all praxical activities normally, but they showed problems in recognition of some body parts.The mental cognition was not developed properly, dominantly in children with dispraxy (for figurative symbolism. In children with disgnosy assymbolism on the level of lingual structures is dominated. The author's conclusion is that Body scheme experience is the base of all psychic functions. Because the body scheme is not properly build, it is fragile of the attacks from the environment, and different clinical manifestations could be showed.

  2. Cerebrospinal fluid lactate level as a diagnostic biomarker for bacterial meningitis in children.

    Science.gov (United States)

    Mekitarian Filho, Eduardo; Horita, Sérgio Massaru; Gilio, Alfredo Elias; Nigrovic, Lise E

    2014-02-27

    Cerebrospinal fluid (CSF) lactate is a potential biomarker for bacterial meningitis in children. To this end, we performed a single-center retrospective cohort study of children from Sao Paulo, Brazil, with CSF pleocytosis to evaluate the ability of CSF lactate to distinguish between children with bacterial and aseptic meningitis. We determined the optimum cutoff point for CSF lactate using receiver-operator curve (ROC) analysis. We identified 451 children of whom 40 (9%) had bacterial meningitis. Children with bacterial meningitis had a higher median CSF lactate level [9.6 mmol/l, interquartile range (IQR) 3.2-38.5 mmol/l bacterial meningitis vs. 2.0 mmol/l, IQR 1.2-2.8 mmol/l aseptic meningitis]. A CSF lactate cutoff point of 3.0 mmol/l had a sensitivity of 95% [95% confidence interval (CI) 83-99%), specificity of 94% (95% CI 90-96%) and negative predictive value of 99.3% (95% CI 97.7-99.9%) for bacterial meningitis. In combination with a validated meningitis clinical prediction rule, the CSF lactate level can be used to distinguish between bacterial and aseptic meningitis in children with CSF pleocytosis.

  3. Diagnostic and interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, Thomas J. [Klinikum der Johann Wolfgang Goethe-Universitaet, Frankfurt am Main (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Reith, Wolfgang [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie; Rummeny, Ernst J. (ed.) [Technische Univ. Muenchen Klinikum rechts der Isar, Muenchen (Germany). Inst. fuer Radiologie

    2016-08-01

    This exceptional book covers all aspects of diagnostic and interventional radiology within one volume, at a level appropriate for the specialist. From the basics through diagnosis to intervention: the reader will find a complete overview of all areas of radiology. The clear, uniform structure, with chapters organized according to organ system, facilitates the rapid retrieval of information. Features include: Presentation of the normal radiological anatomy Classification of the different imaging procedures according to their diagnostic relevance Imaging diagnosis with many reference images Precise description of the interventional options The inclusion of many instructive aids will be of particular value to novices in decision making: Important take home messages and summaries of key radiological findings smooth the path through the jungle of facts Numerous tables on differential diagnosis and typical findings in the most common diseases offer a rapid overview and orientation Diagnostic flow charts outline the sequence of diagnostic evaluation All standard procedures within the field of interventional radiology are presented in a clinically relevant and readily understandable way, with an abundance of illustrations. This is a textbook, atlas, and reference in one: with more than 2500 images for comparison with the reader's own findings. This comprehensive and totally up-to-date book provides a superb overview of everything that the radiology specialist of today needs to know.

  4. Sensitivity of ecological soil-screening levels for metals to exposure model parameterization and toxicity reference values.

    Science.gov (United States)

    Sample, Bradley E; Fairbrother, Anne; Kaiser, Ashley; Law, Sheryl; Adams, Bill

    2014-10-01

    Ecological soil-screening levels (Eco-SSLs) were developed by the United States Environmental Protection Agency (USEPA) for the purposes of setting conservative soil screening values that can be used to eliminate the need for further ecological assessment for specific analytes at a given site. Ecological soil-screening levels for wildlife represent a simplified dietary exposure model solved in terms of soil concentrations to produce exposure equal to a no-observed-adverse-effect toxicity reference value (TRV). Sensitivity analyses were performed for 6 avian and mammalian model species, and 16 metals/metalloids for which Eco-SSLs have been developed. The relative influence of model parameters was expressed as the absolute value of the range of variation observed in the resulting soil concentration when exposure is equal to the TRV. Rank analysis of variance was used to identify parameters with greatest influence on model output. For both birds and mammals, soil ingestion displayed the broadest overall range (variability), although TRVs consistently had the greatest influence on calculated soil concentrations; bioavailability in food was consistently the least influential parameter, although an important site-specific variable. Relative importance of parameters differed by trophic group. Soil ingestion ranked 2nd for carnivores and herbivores, but was 4th for invertivores. Different patterns were exhibited, depending on which parameter, trophic group, and analyte combination was considered. The approach for TRV selection was also examined in detail, with Cu as the representative analyte. The underlying assumption that generic body-weight-normalized TRVs can be used to derive protective levels for any species is not supported by the data. Whereas the use of site-, species-, and analyte-specific exposure parameters is recommended to reduce variation in exposure estimates (soil protection level), improvement of TRVs is more problematic. © 2014 The Authors

  5. A Recombinant Multi-Stage Vaccine against Paratuberculosis Significantly Reduces Bacterial Level in Tissues without Interference in Diagnostics

    DEFF Research Database (Denmark)

    Jungersen, Gregers; Thakur, Aneesh; Aagaard, C.

    , PPDj-specific IFN-γ responses or positive PPDa or PPDb skin tests developed in vaccinees. Antibodies and cell-mediated immune responses were developed against FET11 antigens, however. At necropsy 8 or 12 months of age, relative Map burden was determined in a number of gut tissues by quantitative IS900...... PCR and revealed significantly reduced levels of Map and reduced histopathology. Diagnostic tests for antibody responses and cell-mediated immune responses, used as surrogates of infection, corroborated the observed vaccine efficacy: Five of seven non‐vaccinated calves seroconverted in ID Screen......-γ assay responses from 40 to 52 weeks compared to non-vaccinated calves. These results indicate the FET11 vaccine can be used to accelerate eradication of paratuberculosis while surveillance or test-and-manage control programs for tuberculosis and Johne’s disease remain in place. Funded by EMIDA ERA...

  6. Importance of the assessment of intracellular Ca2+ level as diagnostic tool of dysfunctional sperm

    Directory of Open Access Journals (Sweden)

    Wardah Alasmari

    2017-09-01

    Full Text Available Sperm functions are an important factor for fertility/pregnancy to be achieved. Sperm dysfunction is the most common cause of male infertility. The best option to help couples with such male factor to achieve a pregnancy, is using Assisted Reproductive Technology (ART, without defining the underlying cause of sperm dysfunction or male-factor infertility in general at the cellular and molecular levels. Thus, the limited success of ART in a proportion of male infertility cases is unsurprising. Ca2+ signalling plays a fundamental role in the regulation of sperm function. Interestingly, it appears that the potential exists to diagnose abnormalities in the Ca2+ channels that underlie sperm dysfunction. This raises the potential for future drug discovery to try to correct this defect by augmenting Ca2+ signalling such as Ca2+ store mobilisation or activating CatSper, as possible rational treatments for sperm dysfunction that may temporarily increase the capacity to interact with the egg. Such a pharmacological agent may provide a useful way of increasing the effectiveness of IUI or IVF over conventional IUI and IVF procedures.

  7. Comparative Evaluation for Assessing Oratest as a Diagnostic Tool for Evaluation of Plaque Levels & Gingivitis

    Directory of Open Access Journals (Sweden)

    Mahasweta Joshi

    2012-01-01

    Full Text Available Aims & Objectives: Periodontal disease comprises a group of inflammatory conditions of the supporting tissues of the teeth that are caused by bacteria. The present study was undertaken to evaluate whether Oratest could be used as a sensitive indicator of plaque levels and gingivitis. Material and Methods: Hundred caries free patients visiting the out-patient department of A.E.C.S. Maaruti College of Dental Sciences and Research Centre, Banglore were selected according to predetermined selection criteria. The study consisted of two clinical stages: Stage 1. Recording of Plaque Index (Loe, 1967 and Gingival Index (Loe & Silness 1963 in the subjects. Stage 2. Performance of the Oratest and recording the scores in the same subjects. The Oratest was performed by rinsing the mouth with sterilized UHT (Ultra high temperature milk. About 3 ml of expectorated milk was added to a test tube containing the 0.12 ml of 0.1% methylene blue. The time required for colour change from blue to white attained at the bottom of the tube was recorded. Plaque Index, Gingival Index and Oratest scores were compared using Student t test. Pearson correlation test was applied to assess correlation between the indices and Oratest scores. Results:The results of the study showed that as age increased plaque and Gingival Indexes also increased whereas Oratest scores decreased. No significant difference between males and females was found in mean values of Plaque Index, Gingival Index and Oratest scores. Negative correlation was seen between Plaque Index and Oratest scores (r = 0.724 and also between Gingival Index and Oratest scores (r = 0.728. Conclusions: The study showed high correlation between the plaque and gingival indices and Oratest scores. This study validates Oratest as a predictable & sensitive test to assess periodontal disease.

  8. Factors that affect the level of detectability of objects of low contrast in diagnostic radiology

    International Nuclear Information System (INIS)

    Zuniga Vargas, F.

    2001-01-01

    The diagnosed imageneologia is every day more used by the medical staff to obtain diagnoses of diverse illnesses. In this branch, the conventional equipments of tubes of X Rays, equipments with fluoroscopic, angiographos, on-line tomographos, ultrasound equipment of magnetic resonance are used. All of them finally produce an image which will be used for the radiologist to evaluate the structures and pathology with in order to give to emit a good and precise diagnosis. From the total of radiation that the man receives annually, the medical irradiations are the main contributors after natural radiations. The applications of the ionized radiations in the medical area have as an objective to provide diagnosis or treatment to the ill patient. To obtain an image of good quality is fundamental, so that the doctor carries out a good diagnosis. The images depend on many physical factors, such as the type of the used equipment, ability of the operator that takes the badge, maintenance of the equipment, badge quality, etc. The images in which the diagnosis is based on are a gathering of gray different tones that draw the anatomy of interest. Therefore, an injury should have different physical characteristics (grosor, density) to stand out from its environment. This notable capacity is known as radiological contrast. Studies which allow the quantification of the radiation levels' effect, the optic badge densities and the observers' physical particularities for the detection of low-contrast objects have not been done in Costa Rica The physician is the one responsible of implementing the quality programs that lead to the gathering of better images. From now on, the asserted diagnosis falls right into the radiologist's experience, who receives the theoretical training and practices of the different diagnosed modalities during his or her residence's years. Besides, the radiologist can collaborate with the improvement of the accuracy of the diagnosis, if he or she recommends the

  9. Status, quality and specific needs of Zika virus (ZIKV) diagnostic capacity and capability in National Reference Laboratories for arboviruses in 30 EU/EEA countries, May 2016.

    NARCIS (Netherlands)

    Mögling, Ramona; Zeller, Hervé; Revez, Joana; Koopmans, Marion; Reusken, Chantal

    2017-01-01

    With international travel, Zika virus (ZIKV) is introduced to Europe regularly. A country's ability to robustly detect ZIKV introduction and local transmission is important to minimise the risk for a ZIKV outbreak. Therefore, sufficient expertise and diagnostic capacity and capability are required

  10. Free insulin-like growth factor I serum levels in 1430 healthy children and adults, and its diagnostic value in patients suspected of growth hormone deficiency

    DEFF Research Database (Denmark)

    Juul, A; Holm, K; Kastrup, K W

    1997-01-01

    fraction of the total IGF-I circulates in its free form, which is believed to be the biologically active form. However, our knowledge of the clinical or physiological value of determination of free IGF-I in serum is limited at present. In adults, the diagnostic value of total IGF-I and IGFBP-3......, commercially available immunoradiometric assay (Diagnostic Systems Laboratories) to establish valid normative data for this analysis. We studied the diagnostic value of free IGF-I in relation to total IGF-I and IGFBP-3 determinations in adults who were suspected of GHD. A GH provocative test, using oral...... determinations in patients suspected of GHD has only been reported in a few studies, whereas no previous reports on the diagnostic value of free IGF-I levels in adults suspected of GHD exist. Serum levels of free IGF-I were determined in 1430 healthy children, adolescents, and adults by a newly developed...

  11. Free insulin-like growth factor I serum levels in 1430 healthy children and adults, and its diagnostic value in patients suspected of growth hormone deficiency

    DEFF Research Database (Denmark)

    Juul, A; Holm, K; Kastrup, K W

    1997-01-01

    fraction of the total IGF-I circulates in its free form, which is believed to be the biologically active form. However, our knowledge of the clinical or physiological value of determination of free IGF-I in serum is limited at present. In adults, the diagnostic value of total IGF-I and IGFBP-3...... determinations in patients suspected of GHD has only been reported in a few studies, whereas no previous reports on the diagnostic value of free IGF-I levels in adults suspected of GHD exist. Serum levels of free IGF-I were determined in 1430 healthy children, adolescents, and adults by a newly developed......, commercially available immunoradiometric assay (Diagnostic Systems Laboratories) to establish valid normative data for this analysis. We studied the diagnostic value of free IGF-I in relation to total IGF-I and IGFBP-3 determinations in adults who were suspected of GHD. A GH provocative test, using oral...

  12. Diagnostic value of combined determination of serum tumor markers (NSE, CA-242, TPA, CEA) levels in patients with lung cancer

    International Nuclear Information System (INIS)

    Liu Juzhen; Cai Tietie; Qin Shana

    2007-01-01

    Objective: To investigate the diagnostic value of combined determination of serum NSE, CA242, tissue polypeptide antigen (TPA) and CEA levels in patients with primary lung cancer. Methods: Serum NSE, CA242, TPA and CEA levels were determined with ELISA in (1) 102 patients with various types of primary lung carcinoma (adenocarcinoma 38, squamous cell carcinoma 32, small cell lung carcinoma 32) (2) 33 patients with open lung T. B. and (3) 30 controls. Results: (1) In patients with lung cancer, serum levels of all the four markers were increased and significantly higher than their respective values in patients with open lung T.B. and controls. (2) Positive rate of combined any two markers were 75% for adenocarcinoma, 50% for squamous cell carcinoma and 65% for small cell lung carcinoma, while false positive rate was only 9% for T.B patients and none for the controls. (3) The most appropriate single marker for each specific type of lung cancer was: NSE for SCLC (sensitivity 72%, specificity 97%, CA242 for adenocarcinoma sensitivity 62%, specificity 90%). Conclusion: Combined determination of these tumor markers would improve the sensitivity and specificity for diagnosis of primary lung carcinoma. (authors)

  13. Diagnostic value of combined determination of serum AFP, CEA, CA199, SF levels in patients with primary hepatic carcinoma

    International Nuclear Information System (INIS)

    Wu Jiaming; Rui Zhilian

    2005-01-01

    Objective: To investigate the diagnostic value of combined detection of four tumor markers in patients with possible malignant change in liver disorders. Methods: Serum AFP, CEA, CA199 and SF levels were determined with chemiluminescence immunoassay (CLIA) in 49 patients with primary liver carcinoma, 7 patients with metastatic liver carcinoma, 40 patients with hepatic cirrhosis, 47 patients with HBV hepatitis and 30 controls. Results: The serum levels of AFP, CEA, SF in patients with primary hepatic cancer and serum levels of AFP, SF in patients with hepatic cirrhosis were all significantly higher than those in controls (P 0.05). Moreover, positive rate of combined determination of AFP, CEA, CA199, SF in patients with primary hepatic cancer was significantly higher than that in patients with metastatic liver cancer. Conclusion: With combined determination of these four tumor markers, the detection rate of primary hepatic carcinoma could be enhanced to above 95%. Also, differential diagnosis between primary and metastatic hepatic cancers could be facilitated. (authors)

  14. Differential diagnostic value of combined detection of serum CA153, CEA and TPA levels in patients with breast tumor

    International Nuclear Information System (INIS)

    Ding Wei

    2007-01-01

    Objective: To assess the differential diagnostic value of combined detection of serum CA153, CEA and TPA levels in patients with breast tumor. Methods: Serum levels of CA153, CEA and TPA were measured with RIA in 269 patients with breast tumor and 150 controls. Results: The serum levels of CA153, CEA and TPA in patients with breast cancer were significantly higher than those in the patients with benign breast tumor and controls. The positive rate of CA153 was 63.8% in the patients with breast cancer and that of CEA and TPA was 22.4% and 62.1% respectively, with combined detection of CA153 and CEA, the positive rate was 69.8%, with CA153 and TPA combined, the positive rate was 87.1%, with the three marker combined, the positive rate was 90.5%. The specificity was 77.9% with CA153, 77.9% with CA153 and CEA, 71.9% with CA153 and TPA, and 73.4% with all the three markers combined. Conclusion: The positive rate was increased remarkably with combined detection of CA153, CEA and TPA, however the specificity was not much changed, so the combined detection was valuable for differential diagnosis. (authors)

  15. Towards a research informed teaching experience within a diagnostic radiography curriculum: The level 4 (year 1) student holistic experience

    International Nuclear Information System (INIS)

    Higgins, Robert; Hogg, Peter; Robinson, Leslie

    2013-01-01

    Aim: This article discusses the level 4 (year 1) diagnostic radiography student holistic experience of the Research-informed Teaching experience (RiTe) at the University of Salford, UK. The purpose of RiTe is to expose undergraduate radiography students to more formal research, as part of their normal teaching and learning experience. Method: A grounded theory approach was adopted and a focus group with eight level 4 students was used to explore and evaluate the student experience and perception of RiTe. Results: Open coding defined categories and sub-categories, with axial and selective coding used to interrogate and explore the relationships between the focus group data. A number of insights were gained into the student holistic experience of RiTe. The issue of leadership for level 4 students was also identified. Discussion: The focus group participants found RiTe to be an extremely positive learning experience. RiTe also facilitated their translation of learnt theory into clinical skills knowledge alongside their understanding of and desire to participate in more research as undergraduates. The article also highlights areas for future research.

  16. A suggestion of reference data for flow distribution at ankle and foot level using quantitative 99Tc-HDP three-phase bone scintigraphy

    DEFF Research Database (Denmark)

    Tøndevold, Niklas; Reving, Sofie; Møller, Nette

    2012-01-01

    To determine reference intervals for quantitative 99mTc-hydroxymethylene diphosphonate (99mTc-HDP) three-phase bone scintigraphy regarding flow distribution at ankle and mid-foot level.......To determine reference intervals for quantitative 99mTc-hydroxymethylene diphosphonate (99mTc-HDP) three-phase bone scintigraphy regarding flow distribution at ankle and mid-foot level....

  17. Farm-level risk factors for Fasciola hepatica infection in Danish dairy cattle as evaluated by two diagnostic methods.

    Science.gov (United States)

    Takeuchi-Storm, Nao; Denwood, Matthew; Hansen, Tina Vicky Alstrup; Halasa, Tariq; Rattenborg, Erik; Boes, Jaap; Enemark, Heidi Larsen; Thamsborg, Stig Milan

    2017-11-09

    The prevalence of bovine fasciolosis in Denmark is increasing but appropriate guidelines for control are currently lacking. In order to help develop a control strategy for liver fluke, a risk factor study of farm management factors was conducted and the utility of bulk tank milk (BTM ELISA) as a tool for diagnosis in Danish dairy cattle farms was assessed. This case-control study aimed to identify farm-level risk factors for fasciolosis in Danish dairy farms (> 50 animals slaughtered in 2013) using two diagnostic methods: recordings of liver condemnation at slaughter, and farm-level Fasciola hepatica antibody levels in BTM. A case farm was defined as having a minimum of 3 incidents of liver condemnation due to liver fluke at slaughter (in any age group) during 2013, and control farms were located within 10 km of at least one case farm and had no history of liver condemnation due to liver fluke during 2011-2013. The selected farmers were interviewed over telephone about grazing and control practices, and BTM from these farms was collected and analysed by ELISA in 2014. The final complete dataset consisting of 131 case and 63 control farms was analysed using logistic regression. Heifers grazing on wet pastures, dry cows grazing on wet pastures, herd size, breed and concurrent beef cattle production were identified as risk factors associated with being classified as a case farm. With the categorised BTM ELISA result as the response variable, heifers grazing on wet pastures, dry cows grazing on wet pastures, and purchase of cows were identified as risk factors. Within the case and control groups, 74.8 and 12.7% of farms were positive for fasciolosis on BTM ELISA, respectively. The differences are likely to be related to the detection limit of the farm-level prevalence by the BTM ELISA test, time span between slaughter data and BTM, and the relatively low sensitivity of liver inspection at slaughter. Control of bovine fasciolosis in Denmark should target heifers and

  18. Farm-level risk factors for Fasciola hepatica infection in Danish dairy cattle as evaluated by two diagnostic methods

    Directory of Open Access Journals (Sweden)

    Nao Takeuchi-Storm

    2017-11-01

    Full Text Available Abstract Background The prevalence of bovine fasciolosis in Denmark is increasing but appropriate guidelines for control are currently lacking. In order to help develop a control strategy for liver fluke, a risk factor study of farm management factors was conducted and the utility of bulk tank milk (BTM ELISA as a tool for diagnosis in Danish dairy cattle farms was assessed. Methods This case-control study aimed to identify farm-level risk factors for fasciolosis in Danish dairy farms (> 50 animals slaughtered in 2013 using two diagnostic methods: recordings of liver condemnation at slaughter, and farm-level Fasciola hepatica antibody levels in BTM. A case farm was defined as having a minimum of 3 incidents of liver condemnation due to liver fluke at slaughter (in any age group during 2013, and control farms were located within 10 km of at least one case farm and had no history of liver condemnation due to liver fluke during 2011–2013. The selected farmers were interviewed over telephone about grazing and control practices, and BTM from these farms was collected and analysed by ELISA in 2014. The final complete dataset consisting of 131 case and 63 control farms was analysed using logistic regression. Results Heifers grazing on wet pastures, dry cows grazing on wet pastures, herd size, breed and concurrent beef cattle production were identified as risk factors associated with being classified as a case farm. With the categorised BTM ELISA result as the response variable, heifers grazing on wet pastures, dry cows grazing on wet pastures, and purchase of cows were identified as risk factors. Within the case and control groups, 74.8 and 12.7% of farms were positive for fasciolosis on BTM ELISA, respectively. The differences are likely to be related to the detection limit of the farm-level prevalence by the BTM ELISA test, time span between slaughter data and BTM, and the relatively low sensitivity of liver inspection at slaughter. Conclusions

  19. Results of Drug addiction Test and its Correlation With the Demographic Specifications Among People Referred to Yazd Addiction Diagnostic Laboratory Centre

    Directory of Open Access Journals (Sweden)

    2014-05-01

    Full Text Available Abstract Introduction: Addiction changes people from positive, active and healthy beings to consuming and negative patients. This study was carried out with the aim of determining the prevalence of the abuse of epioid substances among people referring to Yazd Addiction Diagnosis Laboratory using Rapid Test and Chromatography. Methods: In this descriptive cross-sectional study, all people who attended Yazd Addiction Diagnosis Laboratory for any reason, that is, marriage, employment or obtaining job license between 1386 and 1388, were examined. Totally, 2790 individuals were selected randomly. First, their demographic information was entered in the questionnaire. Then, urine samples were collected at the presence of a laboratory technician and tested using Ennissan Strip Rapid Test if the result was positive, the rest of the sample was tested with Chromatography. Results: Totally, 2790 individuals were surveyed in this study. The mean age of the participants was 25.9±7.2 years. About 62.9% were male and the rest were female. In addition, the reason for taking the test was marriage in 73.2%, employment in 15.5%, obtaining job license in 3.3% and other reasons for others. The prevalence of the abuse of opioid substances was 5.3% (95% CI 4.5% - 6.1%. Conclusions: Many test takers are aware of the fact that the result of the drug test becomes negative after three days of withdrawal, which might be the reason for the low prevalence of addiction in this study. However, prenuptial testing for addiction is quite prudent and necessary. Moreover, calculation of OR showed a male to female ratio of 15 to 1 for opioid abuse which was significant. Higher age, lower education level, labor work and working freelance, smoking and history of addiction in family were other risk factors for opioid substance abuse. Keywords: Addiction test, Addiction prevalence rate, Rapid test, Yazd

  20. Serum 25-hydroxyvitamin D Levels in Patients Referred to Clinical Laboratories in Various Parts of Mashhad- Northeastern Iran

    Directory of Open Access Journals (Sweden)

    Ali Akbar Shamsian

    2015-06-01

    Full Text Available Introduction: Vitamin D has an important role in maintaining human health. The main source of vitamin D production is skin exposure to sunlight. Accordingly with the spread of apartment life culture, growth of industrial cities and the increase of air pollution; vitamin D deficiency and its implications is an important factor in the appearance of debilitating diseases in different age categories (especially for children, adults and elderly people.   Materials and Methods: A retrospective cross-sectional study based on an objective was conducted on 1,110 patients who were selected randomly. These patients have been referred to “center of education culture and research” laboratories (2 laboratories and 8 specialized laboratories for vitamin D test in the city of Mashhad. And after conducting the study, the collected data was analyzed using SPSS 13 software.   Results: The prevalence of vitamin D deficiency in the population under study was 68.8%. Vitamin D levels were significantly lower in males in comparison with females (P

  1. Order of 24 October 2011 related to diagnosis reference levels in radiology and nuclear medicine; Arrete du 24 octobre 2011 relatif aux niveaux de reference diagnostiques en radiologie et en medecine nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Grall, J.Y. [Ministere du travail, de l' emploi et de la sante, Direction generale de la sante, 14, avenue Duquesne, 75350 PARIS 07 SP (France)

    2012-01-14

    This order defines diagnosis reference levels for examinations exposing to the most common or irradiating ionizing radiations in the case of radiology and nuclear medicine. It also specifies the role of the person authorized to use nuclear medicine equipment, the role of the IRSN in collecting and analysing data. Doses are specified in appendix for different types of examinations

  2. Do blood tests cause anemia in hospitalized patients? The effect of diagnostic phlebotomy on hemoglobin and hematocrit levels.

    Science.gov (United States)

    Thavendiranathan, Paaladinesh; Bagai, Akshay; Ebidia, Albert; Detsky, Allan S; Choudhry, Niteesh K

    2005-06-01

    To determine whether phlebotomy contributes to changes in hemoglobin and hematocrit levels in hospitalized general internal medicine patients. Retrospective cohort study. General internal medicine inpatient service at a tertiary care hospital. All adult patients discharged from the Toronto General Hospital's internal medicine service between January 1 and June 30, 2001. A total of 989 hospitalizations were reviewed and 404 hospitalizations were included in our analysis. Mean (SD) hemoglobin and hematocrit changes during hospitalization were 7.9 (12.6) g/L (Phemoglobin and hematocrit were predicted by the volume of phlebotomy, length of hospital stay, admission hemoglobin/hematocrit value, age, Charlson comorbidity index, and admission intravascular volume status. The volume of phlebotomy remained a strong predictor of drop in hemoglobin and hematocrit after adjusting for other predictors using multivariate analysis (Phemoglobin and hematocrit of 7.0 g/L and 1.9%, respectively. Phlebotomy is highly associated with changes in hemoglobin and hematocrit levels for patients admitted to an internal medicine service and can contribute to anemia. This anemia, in turn, may have significant consequences, especially for patients with cardiorespiratory diseases. Knowing the expected changes in hemoglobin and hematocrit due to diagnostic phlebotomy will help guide when to investigate anemia in hospitalized patients.

  3. Quality of referral: What information should be included in a request for diagnostic imaging when a patient is referred to a clinical radiologist?

    Science.gov (United States)

    G Pitman, Alexander

    2017-06-01

    Referral to a clinical radiologist is the prime means of communication between the referrer and the radiologist. Current Australian and New Zealand government regulations do not prescribe what clinical information should be included in a referral. This work presents a qualitative compilation of clinical radiologist opinion, relevant professional recommendations, governmental regulatory positions and prior work on diagnostic error to synthesise recommendations on what clinical information should be included in a referral. Recommended requirements on what clinical information should be included in a referral to a clinical radiologist are as follows: an unambiguous referral; identity of the patient; identity of the referrer; and sufficient clinical detail to justify performance of the diagnostic imaging examination and to confirm appropriate choice of the examination and modality. Recommended guideline on the content of clinical detail clarifies when the information provided in a referral meets these requirements. High-quality information provided in a referral allows the clinical radiologist to ensure that exposure of patients to medical radiation is justified. It also minimises the incidence of perceptual and interpretational diagnostic error. Recommended requirements and guideline on the clinical detail to be provided in a referral to a clinical radiologist have been formulated for professional debate and adoption. © 2017 The Royal Australian and New Zealand College of Radiologists.

  4. Effect of psychological preparation on anxiety level before colonoscopy in outpatients referred to Golestan Hospital in Ahvaz

    Institute of Scientific and Technical Information of China (English)

    Hatam Boustani; Sirus Pakseresht; Mohammad-Reza Haghdoust; Saeid Qanbari; Hadis Mehregan-Nasab

    2017-01-01

    BACKGROUND:Gastrointestinal disorders are common complaints for which endoscopy and colonoscopy are the most important diagnostic procedures.Anxiety is an unpleasant,ambiguous feeling of apprehension and fear of unknown origin that occurs during stressful situations or injury.Lack of sufficient information and fear of pain can cause anxiety prior to a colonoscopy,reducing the number of patients willing to undergo the procedure and increasing colonoscopy time.The aim of this study was to evaluate the efficacy of psychological preparation on anxiety before colonoscopy in patients presenting to Golestan Hospital during the years 1994 and 1995.MATERIAL and METHODS:This study was a double-blind clinical trial of patients presenting to the colonoscopy unit in Golestan Hospital in 1994 and 1995.A total of 80 patients were divided into two groups:intervention and control.A primary assessment of anxiety was performed using Spielberger's State-Trait Anxiety Inventory.Before the colonoscopy,the State-Trait Anxiety Inventory was completed by the patients again.The effectiveness of psychological preparation before colonoscopy and its effect on anxiety were evaluated using statistical software SPSS 20.RE SULTS:The mean age of participants was 46.33 ± 12.2 years in the intervention group and 44.8 ± 12.26 years in the control group.In this study,there were 41 males (51.3%) and 39 females (48.7%);15 patients (18.7%) were single and the rest married.In terms of demographic variables,there were no significant differences between the two groups (p > 0.05).The average scores of state and trait anxiety in the intervention group showed a statistically significant difference before and after the intervention (p =0.000).CONCLUSION:Trait and state anxiety levels after psychological preparation showed a statistically significant reduction.This indicates the effectiveness of intervention programs to reduce anxiety before colonoscopy.

  5. Stuttering Thoughts: Negative Self-Referent Thinking Is Less Sensitive to Aversive Outcomes in People with Higher Levels of Depressive Symptoms.

    Science.gov (United States)

    Iijima, Yudai; Takano, Keisuke; Boddez, Yannick; Raes, Filip; Tanno, Yoshihiko

    2017-01-01

    Learning theories of depression have proposed that depressive cognitions, such as negative thoughts with reference to oneself, can develop through a reinforcement learning mechanism. This negative self-reference is considered to be positively reinforced by rewarding experiences such as genuine support from others after negative self-disclosure, and negatively reinforced by avoidance of potential aversive situations. The learning account additionally predicts that negative self-reference would be maintained by an inability to adjust one's behavior when negative self-reference no longer leads to such reward. To test this prediction, we designed an adapted version of the reversal-learning task. In this task, participants were reinforced to choose and engage in either negative or positive self-reference by probabilistic economic reward and punishment. Although participants were initially trained to choose negative self-reference, the stimulus-reward contingencies were reversed to prompt a shift toward positive self-reference (Study 1) and a further shift toward negative self-reference (Study 2). Model-based computational analyses showed that depressive symptoms were associated with a low learning rate of negative self-reference, indicating a high level of reward expectancy for negative self-reference even after the contingency reversal. Furthermore, the difficulty in updating outcome predictions of negative self-reference was significantly associated with the extent to which one possesses negative self-images. These results suggest that difficulty in adjusting action-outcome estimates for negative self-reference increases the chance to be faced with negative aspects of self, which may result in depressive symptoms.

  6. Stuttering Thoughts: Negative Self-Referent Thinking Is Less Sensitive to Aversive Outcomes in People with Higher Levels of Depressive Symptoms

    Directory of Open Access Journals (Sweden)

    Yudai Iijima

    2017-08-01

    Full Text Available Learning theories of depression have proposed that depressive cognitions, such as negative thoughts with reference to oneself, can develop through a reinforcement learning mechanism. This negative self-reference is considered to be positively reinforced by rewarding experiences such as genuine support from others after negative self-disclosure, and negatively reinforced by avoidance of potential aversive situations. The learning account additionally predicts that negative self-reference would be maintained by an inability to adjust one’s behavior when negative self-reference no longer leads to such reward. To test this prediction, we designed an adapted version of the reversal-learning task. In this task, participants were reinforced to choose and engage in either negative or positive self-reference by probabilistic economic reward and punishment. Although participants were initially trained to choose negative self-reference, the stimulus-reward contingencies were reversed to prompt a shift toward positive self-reference (Study 1 and a further shift toward negative self-reference (Study 2. Model-based computational analyses showed that depressive symptoms were associated with a low learning rate of negative self-reference, indicating a high level of reward expectancy for negative self-reference even after the contingency reversal. Furthermore, the difficulty in updating outcome predictions of negative self-reference was significantly associated with the extent to which one possesses negative self-images. These results suggest that difficulty in adjusting action-outcome estimates for negative self-reference increases the chance to be faced with negative aspects of self, which may result in depressive symptoms.

  7. Characteristics of the Remote Sensing Data Used in the Proposed Unfccc REDD+ Forest Reference Emission Levels (frels)

    Science.gov (United States)

    Johnson, B. A.; Scheyvens, H.; Samejima, H.; Onoda, M.

    2016-06-01

    Developing countries must submit forest reference emission levels (FRELs) to the UNFCCC to receive incentives for REDD+ activities (e.g. reducing emissions from deforestation/forest degradation, sustainable management of forests, forest carbon stock conservation/enhancement). These FRELs are generated based on historical CO2 emissions in the land use, land use change, and forestry sector, and are derived using remote sensing (RS) data and in-situ forest carbon measurements. Since the quality of the historical emissions estimates is affected by the quality and quantity of the RS data used, in this study we calculated five metrics (i-v below) to assess the quality and quantity of the data that has been used thus far. Countries could focus on improving on one or more of these metrics for the submission of future FRELs. Some of our main findings were: (i) the median percentage of each country mapped was 100%, (ii) the median historical timeframe for which RS data was used was 11.5 years, (iii) the median interval of forest map updates was 4.5 years, (iv) the median spatial resolution of the RS data was 30m, and (v) the median number of REDD+ activities that RS data was used for operational monitoring of was 1 (typically deforestation). Many new sources of RS data have become available in recent years, so complementary or alternative RS data sets for generating future FRELs can potentially be identified based on our findings; e.g. alternative RS data sets could be considered if they have similar or higher quality/quantity than the currently-used data sets.

  8. Diagnostic outcomes of 27 children referred by pediatricians to a genetics clinic in the Netherlands with suspicion of fetal alcohol spectrum disorders

    NARCIS (Netherlands)

    Abdelmalik, Nadia; van Haelst, Mieke; Mancini, Grazia; Schrander-Stumpel, Connie; Marcus-Soekarman, Dominique; Hennekam, Raoul; Cobben, Jan Maarten

    2013-01-01

    The characteristics of fetal alcohol spectrum disorders (FASD) constitute a specific facial phenotype, growth failure and neurodevelopmental defects. Reported FASD prevalences vary widely from 0.08 per 1,000 up to 68.0-89.2 per 1,000. We aimed to evaluate to which extent children referred with a

  9. A leading-edge hardware family for diagnostics applications and low-level RF in CERN's ELENA ring

    CERN Document Server

    Angoletta, M E; Jaussi, M; Leiononen, P; Levens, T E; Molendijk, J C; Sanchez-Quesada, J; Simonin, J

    2013-01-01

    The CERN Extra Low ENergy Antiproton (ELENA) Ring is a new synchrotron that will be commissioned in 2016 to further decelerate the antiprotons transferred from the CERN’s Antiproton Decelerator (AD). The requirements for the acquisition and treatment of signals for longitudinal diagnostics are very demanding, owing to the revolution frequency swing as well as to the digital signal processing required. The requirements for the Low-Level Radio-Frequency (LLRF) system are very demanding as well, especially in terms of revolution frequency swing, dynamic range and low noise required by the cavity voltage control and digital signal processing to be performed. Both sets of requirements will be satisfied by using a leading-edge hardware family, developed to cover the LLRF needs of all synchrotrons in the Meyrin site; it will be first deployed in 2014 in the CERN’s PSB and in the medical machine MedAustron. This paper gives an overview of the main building blocks of the hardware family and of th...

  10. Patients exposure assessment for radiographic procedures in diagnostic radiology

    International Nuclear Information System (INIS)

    Arandjic, D.; Ciraj-Bjelac, O.; Stankovic, K.; Lazarevic, Dj.; Ciraj-Bjelac, O.)

    2007-01-01

    In this work the results of dose assessment for the most frequent radiographic procedures in diagnostic radiology are shown. Entrance surface doses were assessed for 7 radiographic procedures. Three hospitals, six x-ray units in total, were enrolled in investigation. Patient doses were estimated based on results of x-ray tube output measurements. Finally, doses were compared with Diagnostic reference level. Higher dose values were observed for chest examinations. In comparison with results from other countries, doses from this procedure in Serbia are significantly higher. Estimated doses for other procedures were well below Diagnostic reference levels [sr

  11. Biosphere modeling for safety assessment to high-level radioactive waste geological disposal. Application of reference biosphere methodology to safety assesment of geological disposal

    International Nuclear Information System (INIS)

    Baba, Tomoko; Ishihara, Yoshinao; Ishiguro, Katsuhiko; Suzuki, Yuji; Naito, Morimasa

    2000-01-01

    In the safety assessment of a high-level radioactive waste disposal system, it is required to estimate future radiological impacts on human beings. Consideration of living habits and the human environment in the future involves a large degree of uncertainty. To avoid endless speculation aimed at reducing such uncertainty, an approach is applied for identifying and justifying a 'reference biosphere' for use in safety assessment in Japan. considering a wide range of Japanese geological environments, saline specific reference biospheres' were developed using an approach consistent with the BIOMOVS II reference biosphere methodology. (author)

  12. Age- and Gender-Specific Reference Intervals for Fasting Blood Glucose and Lipid Levels in School Children Measured With Abbott Architect c8000 Chemistry Analyzer

    OpenAIRE

    Tamimi, Waleed; Albanyan, Esam; Altwaijri, Yasmin; Tamim, Hani; Alhussein, Fahad

    2012-01-01

    Reference intervals for pubertal characteristics are influenced by genetic, geographic, dietary and socioeconomic factors. Therefore, the aim of this study was to establish age-specific reference intervals of glucose and lipid levels among local school children. This was cross-sectional study, conducted among Saudi school children. Fasting blood samples were collected from 2149 children, 1138 (53%) boys and 1011 (47%) girls, aged 6 to 18 years old. Samples were analyzed on the Architect c8000...

  13. Creation of nuclear power stations for export. Adapting a reference power station from the technical level of a national programme

    International Nuclear Information System (INIS)

    Marcaillou, J.; Haond, H.; Py, J.P.

    1977-01-01

    The recent evolution of primary energy supplies places those countries with a nuclear industry in an exporting role. Exporting countries have generally developed a limited number of national reactor types and attempt to extend their manufacture with as few changes as possible. The EDF in France is implementing an important 900-MW(e) PWR programme based on Framatome nuclear reactors, initially conceived by Westinghouse. Standardization imposes constraints, has limits, but offers incontestable advantages in terms of reliability, availability and security. These advantages were highly appreciated during the introduction into service of conventional thermal loads. Importing countries are all concerned to purchase a proven model. However, various local restrictions are often present, which are usually different from those accounted for in the export model, thus resulting in a need for modification. The different ways of considering the inescapable constraints can be analysed and their influence on the 'disfigurement' of the reactor model can be examined. Some of these constraints are connected with characteristics of the site. The nature of the soil and the seismicity influence the foundation and the depth of the installation and the choice between a foundation on antiseismic supports or structural reinforcement. The hydrology (risk of flooding or of deviation of the cold source) influences the choice between elevation of the installation and a protective dike, and also the stand-by coolant circuit. The atmospheric conditions and the temperature of cooling water influence the materials and their conditioning as well as the power level of the station. The surrounding demography influences the waste treatment systems. The characteristics of the electricity network influence the plan of the electric power supply and the conditions of operation. Finally, the characteristics of the personnel of the undertaking provide training problems. Other parameters to be taken into

  14. Phenotypic and genotypic characteristics of carbapenem-resistant Enterobacteriaceae in a tertiary-level reference hospital in Turkey.

    Science.gov (United States)

    Baran, Irmak; Aksu, Neriman

    2016-04-06

    Enterobacteriaceae are among the most common pathogens that are responsible for serious community-acquired, hospital-acquired, and health-care associated infections. The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) have become an increasing concern for healthcare services worldwide. Infections caused by these bacteria have been associated with significant morbidity and mortality and treatment options have been limited. The rapid and accurate detection of carbapenem resistance in these bacteria is important for infection control. The aim of this study was to investigate the phenotypic and genotypic features of CRE strains isolated in a tertiary-level reference hospital in Turkey. A total of 181 CRE strains were included in the study. Antimicrobial susceptibility rates were tested using Vitek 2 system. Modified Hodge test (MHT) was performed using meropenem and ertapenem discs. Metallo-β-lactamase antimicrobial gradient test (E-test MBL strips) were used for evaluation of metallo-β-lactamase production. A multiplex PCR was used for detection of carbapenems resistance genes (IMP, VIM, KPC, NDM-1 and OXA-48). The OXA-48 gene was detected in 86 strains, NDM-1 gene in six strains, VIM gene in one strain. IMP and KPC genes were not identified. Three strains produced both OXA-48 and NDM-1 and one strain produced both OXA-48 and VIM. In two patients more than one genus of OXA-48 positive CREs was isolated. Ninety-two of the isolates were multidrug-resistant. One hundred and ten isolates were MHT with meropenem (MEM-MHT) positive and 109 isolates were MHT with ertapenem (ERT-MHT) positive. Nine of the isolates were positive with E-test MBL strips. The sensitivity of MEM-MHT and ERT-MHT for detection of OXA-48 was 70.9 and 70.6 %, respectively. MEM-MHT was found highly discriminative for OXA-48 Escherichia coli (p Enterobacteriaceae in the hospital environment. While OXA-48 is still the most common source of carbapenem resistance in

  15. Anthropometric Indicators in Children Referred to a Tertiary-level Public Health Care Institution from Buenos Aires, Argentina

    International Nuclear Information System (INIS)

    Janjetic, Mariana Andrea; Mantero, Paula; Zubillaga, Marcela Beatriz; Boccio, José; Goldman, Cinthia

    2014-01-01

    Full text: Introduction: Stunting is a multifactorial phenomenon with a high prevalence in developing countries. Helicobacter pylori, a bacterium that colonizes the gastric mucosa, has been related to growth impairment due to micronutrient malabsorption. However this hypothesis remains controversial. Objective: The aim of our work was to determine anthropometric indicators in children referred to a Tertiary-level Public Health Care Institution from Buenos Aires, Argentina, for upper gastrointestinal symptoms evaluation. Methods: 525 children (4-16 y) assisting to the Gastroenterology Unit of the Hospital de Niños “Sor María Ludovica”, La Plata, Argentina, were diagnosed for H. pylori infection by the 13C-Urea Breath Test. Weight and height were measured for calculation of anthropometric indicators height for age (HAZ), weight for age (WAZ) and Body Mass Index for age (BMI) using the Anthro Plus 2007 software of the World Health Organization. Statistical analysis was performed by Student’s t Test, Mann-Whitney Test and lineal regression. Results: Prevalence of H. pylori infection was 25.1% (95% CI, 21.5-29.5), with a mean age of the children similar in both groups, 10.1y (95% CI, 9.8-10.3y). Mean HAZ and WAZ were -0.40 (95% CI, -0.57-[-0.22]) and -0.31 (95% CI, -0.51-[-0.11]) in the positive group, and -0.18 (95% CI, -0.28-[-0.09]) and -0.10 (95% CI, -0.21-0.01) in the negative group. HAZ was significantly lower in the positive group (p = 0.04), while no significant differences were found for WAZ (p = 0.07) and BMI for age (p = 0.20) between both groups. However, after adjusting for confounding factors these differences were no longer significant. Stunting was found in 4.5% (95% CI, 2.1-9.6) and 3.3% (95% CI, 1.9-5.6) of the H. pylori positive and negative children respectively, while underweight was observed in 5.3% (95% CI, 2.6-10.5) and 6.7% (95% CI, 4.6-9.6) of the above mentioned groups. Conclusions: Prevalence of stunting and underweight were low in

  16. Pulse Wave Velocity as Marker of Preclinical Arterial Disease: Reference Levels in a Uruguayan Population Considering Wave Detection Algorithms, Path Lengths, Aging, and Blood Pressure

    Directory of Open Access Journals (Sweden)

    Ignacio Farro

    2012-01-01

    Full Text Available Carotid-femoral pulse wave velocity (PWV has emerged as the gold standard for non-invasive evaluation of aortic stiffness; absence of standardized methodologies of study and lack of normal and reference values have limited a wider clinical implementation. This work was carried out in a Uruguayan (South American population in order to characterize normal, reference, and threshold levels of PWV considering normal age-related changes in PWV and the prevailing blood pressure level during the study. A conservative approach was used, and we excluded symptomatic subjects; subjects with history of cardiovascular (CV disease, diabetes mellitus or renal failure; subjects with traditional CV risk factors (other than age and gender; asymptomatic subjects with atherosclerotic plaques in carotid arteries; patients taking anti-hypertensives or lipid-lowering medications. The included subjects (n=429 were categorized according to the age decade and the blood pressure levels (at study time. All subjects represented the “reference population”; the group of subjects with optimal/normal blood pressures levels at study time represented the “normal population.” Results. Normal and reference PWV levels were obtained. Differences in PWV levels and aging-associated changes were obtained. The obtained data could be used to define vascular aging and abnormal or disease-related arterial changes.

  17. The Level of Diagnostic Tests' Preparation Skills among the Teachers of the First Three Elementary Grades' Teachers at the Directorate of Education of Bani Kinana District

    Science.gov (United States)

    Yaghmour, Kholoud Subhi; Obaidat, Luai Taleb; Hamadneh, Qaseem Mohammad

    2016-01-01

    This study aimed at exploring the level of Diagnostic Tests' Preparation Skills among the teachers of the first Three Elementary Grades at the Directorate of Education of Bani Kinana District, and its relationship to the variables of gender, academic qualification, and years of experience. The sample of the study consisted of (264) male and female…

  18. Leveling the playing field: bringing development of biomarkers and molecular diagnostics up to the standards for drug development.

    Science.gov (United States)

    Poste, George; Carbone, David P; Parkinson, David R; Verweij, Jaap; Hewitt, Stephen M; Jessup, J Milburn

    2012-03-15

    Molecular diagnostics are becoming increasingly important in clinical research to stratify or identify molecularly profiled patient cohorts for targeted therapies, to modify the dose of a therapeutic, and to assess early response to therapy or monitor patients. Molecular diagnostics can also be used to identify the pharmacogenetic risk of adverse drug reactions. The articles in this CCR Focus section on molecular diagnosis describe the development and use of markers to guide medical decisions regarding cancer patients. They define sources of preanalytic variability that need to be minimized, as well as the regulatory and financial challenges involved in developing diagnostics and integrating them into clinical practice. They also outline a National Cancer Institute program to assist diagnostic development. Molecular diagnostic clinical tests require rigor in their development and clinical validation, with sensitivity, specificity, and validity comparable to those required for the development of therapeutics. These diagnostics must be offered at a realistic cost that reflects both their clinical value and the costs associated with their development. When genome-sequencing technologies move into the clinic, they must be integrated with and traceable to current technology because they may identify more efficient and accurate approaches to drug development. In addition, regulators may define progressive drug approval for companion diagnostics that requires further evidence regarding efficacy and safety before full approval can be achieved. One way to accomplish this is to emphasize phase IV postmarketing, hypothesis-driven clinical trials with biological characterization that would permit an accurate definition of the association of low-prevalence gene alterations with toxicity or response in large cohorts.

  19. The diagnostic contribution of the frontal lumbar spine radiograph in community referred low back pain - A prospective study of 1030 patients

    Energy Technology Data Exchange (ETDEWEB)

    Khoo, L.A.L. E-mail: lisanne.khoo@stgeorges.nhs.uk; Heron, C.; Patel, U.; Given-Wilson, R.; Grundy, A.; Khaw, K.T.; Dundas, D

    2003-08-01

    AIM: The diagnostic contribution of the anteroposterior (AP) view was studied to assess whether this view could be omitted safely, thus reducing the radiation burden received by patients undergoing lumbar spine radiography. MATERIALS AND METHODS: Prospective analysis of 1030 consecutive referrals for lumbar spine radiography from general practice. RESULTS: In the majority of cases (90.5%) the AP view was non-contributory. In 4.2% the diagnosis was strengthened and it was altered in 4.6%. However, in the latter group only 1.3% of the total were considered significant alterations. These were cases of possible, but not definite, pars defects and sacroiliitis. Specific important conditions such as infection, malignancy and benign tumours were not missed on the lateral view alone, in our study population. The radiation burden is reduced by 75% by omitting the AP view. CONCLUSION: A single lateral view is an adequate examination, with the proviso that sacroiliac joint disease is not assessed on this view and some pars defects and facet joint degenerative changes may be overlooked. The radiation protection gains are considerable. A single lateral lumbar view is now our routine practice unless sacroiliitis is a specific clinical concern.

  20. Estimating prevalence and diagnostic test characteristics of bovine cysticercosis in Belgium in the absence of a 'gold standard' reference test using a Bayesian approach.

    Science.gov (United States)

    Jansen, Famke; Dorny, Pierre; Gabriël, Sarah; Eichenberger, Ramon Marc; Berkvens, Dirk

    2018-04-30

    A Bayesian model was developed to estimate values for the prevalence and diagnostic test characteristics of bovine cysticercosis (Taenia saginata) by combining results of four imperfect tests. Samples of 612 bovine carcases that were found negative for cysticercosis during routine meat inspection collected at three Belgian slaughterhouses, underwent enhanced meat inspection (additional incisions in the heart), dissection of the predilection sites, B158/B60 Ag-ELISA and ES Ab-ELISA. This Bayesian approach allows for the combination of prior expert opinion with experimental data to estimate the true prevalence of bovine cysticercosis in the absence of a gold standard test. A first model (based on a multinomial distribution and including all possible interactions between the individual tests) required estimation of 31 parameters, while only allowing for 15 parameters to be estimated. Including prior expert information about specificity and sensitivity resulted in an optimal model with a reduction of the number of parameters to be estimated to 8. The estimated bovine cysticercosis prevalence was 33.9% (95% credibility interval: 27.7-44.4%), while apparent prevalence based on meat inspection is only 0.23%. The test performances were estimated as follows (sensitivity (Se) - specificity (Sp)): enhanced meat inspection (Se 2.87% - Sp 100%), dissection of predilection sites (Se 69.8% - Sp 100%), Ag-ELISA (Se 26.9% - Sp 99.4%), Ab-ELISA (Se 13.8% - Sp 92.9%). Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Diagnostic performance of magnetic resonance imaging in the assessment of periosteal reactions in bone sarcomas using conventional radiography as the reference

    Science.gov (United States)

    de Sá Neto, José Luiz; Simão, Marcelo Novelino; Crema, Michel Daoud; Engel, Edgard Eduard; Nogueira-Barbosa, Marcello Henrique

    2017-01-01

    Objective: To evaluate the performance of magnetic resonance imaging (MRI) in detecting periosteal reactions and to compare MRI and conventional radiography (CR) in terms of the classification of periosteal reactions. Materials and Methods: Retrospective study of 42 consecutive patients (mean age, 22 years; 20 men) with a confirmed diagnosis of osteosarcoma or Ewing's sarcoma, MRI and CR images having been acquired pretreatment. Three blinded radiologists detected periosteal reactions and evaluated each periosteal reaction subtype in CR and MRI images: Codman's triangle; laminated; and spiculated. The CR was used as a benchmark to calculate the diagnostic performance. We used the kappa coefficient to assess interobserver reproducibility. A two-tailed Fisher's exact test was used in order to assess contingency between CR and MRI classifications. Results: In the detection of periosteal reactions, MRI showed high specificity, a high negative predictive value, and low-to-moderate sensitivity. For CR and for MRI, the interobserver agreement for periosteal reaction was almost perfect, whereas, for the classification of different subtypes of periosteal reaction, it was higher for the Codman's triangle subtype and lower for the spiculated subtype. There was no significant difference between MRI and CR in terms of the classifications (p < 0.05). Conclusion: We found no difference between MRI and CR in terms of their ability to classify periosteal reactions. MRI showed high specificity and almost perfect interobserver agreement for the detection of periosteal reactions. The interobserver agreement was variable for the different subtypes of periosteal reaction. PMID:28670029

  2. Diagnostic performance of magnetic resonance imaging in the assessment of periosteal reactions in bone sarcomas using conventional radiography as the reference

    Directory of Open Access Journals (Sweden)

    José Luiz de Sá Neto

    Full Text Available Abstract Objective: To evaluate the performance of magnetic resonance imaging (MRI in detecting periosteal reactions and to compare MRI and conventional radiography (CR in terms of the classification of periosteal reactions. Materials and Methods: Retrospective study of 42 consecutive patients (mean age, 22 years; 20 men with a confirmed diagnosis of osteosarcoma or Ewing's sarcoma, MRI and CR images having been acquired pretreatment. Three blinded radiologists detected periosteal reactions and evaluated each periosteal reaction subtype in CR and MRI images: Codman's triangle; laminated; and spiculated. The CR was used as a benchmark to calculate the diagnostic performance. We used the kappa coefficient to assess interobserver reproducibility. A two-tailed Fisher's exact test was used in order to assess contingency between CR and MRI classifications. Results: In the detection of periosteal reactions, MRI showed high specificity, a high negative predictive value, and low-to-moderate sensitivity. For CR and for MRI, the interobserver agreement for periosteal reaction was almost perfect, whereas, for the classification of different subtypes of periosteal reaction, it was higher for the Codman's triangle subtype and lower for the spiculated subtype. There was no significant difference between MRI and CR in terms of the classifications (p < 0.05. Conclusion: We found no difference between MRI and CR in terms of their ability to classify periosteal reactions. MRI showed high specificity and almost perfect interobserver agreement for the detection of periosteal reactions. The interobserver agreement was variable for the different subtypes of periosteal reaction.

  3. Programme level implementation of malaria rapid diagnostic tests (RDTs) use: outcomes and cost of training health workers at lower level health care facilities in Uganda.

    Science.gov (United States)

    Kyabayinze, Daniel J; Asiimwe, Caroline; Nakanjako, Damalie; Nabakooza, Jane; Bajabaite, Moses; Strachan, Clare; Tibenderana, James K; Van Geetruyden, Jean Pierre

    2012-04-20

    The training of health workers in the use of malaria rapid diagnostic tests (RDTs) is an important component of a wider strategy to improve parasite-based malaria diagnosis at lower level health care facilities (LLHFs) where microscopy is not readily available for all patients with suspected malaria. This study describes the process and cost of training to attain competence of lower level health workers to perform malaria RDTs in a public health system setting in eastern Uganda. Health workers from 21 health facilities in Uganda were given a one-day central training on the use of RDTs in malaria case management, including practical skills on how to perform read and interpret the test results. Successful trainees subsequently integrated the use of RDTs into their routine care for febrile patients at their LLHFs and transferred their acquired skills to colleagues (cascade training model). A cross-sectional evaluation of the health workers' competence in performing RDTs was conducted six weeks following the training, incorporating observation, in-depth interviews with health workers and the review of health facility records relating to tests offered and antimalarial drug (AMD) prescriptions pre and post training. The direct costs relating to the training processes were also documented. Overall, 135 health workers were trained including 63 (47%) nursing assistants, a group of care providers without formal medical training. All trainees passed the post-training concordance test with ≥ 80% except 12 that required re-training. Six weeks after the one-day training, 51/64 (80%) of the health workers accurately performed the critical steps in performing the RDT. The performance was similar among the 10 (16%) participants who were peer-trained by their trained colleagues. Only 9 (14%) did not draw the appropriate amount of blood using pipette. The average cost of the one-day training was US$ 101 (range $92-$112), with the main cost drivers being trainee travel and per

  4. Programme level implementation of malaria rapid diagnostic tests (RDTs use: outcomes and cost of training health workers at lower level health care facilities in Uganda

    Directory of Open Access Journals (Sweden)

    Kyabayinze Daniel J

    2012-04-01

    Full Text Available Abstract Background The training of health workers in the use of malaria rapid diagnostic tests (RDTs is an important component of a wider strategy to improve parasite-based malaria diagnosis at lower level health care facilities (LLHFs where microscopy is not readily available for all patients with suspected malaria. This study describes the process and cost of training to attain competence of lower level health workers to perform malaria RDTs in a public health system setting in eastern Uganda. Methods Health workers from 21 health facilities in Uganda were given a one-day central training on the use of RDTs in malaria case management, including practical skills on how to perform read and interpret the test results. Successful trainees subsequently integrated the use of RDTs into their routine care for febrile patients at their LLHFs and transferred their acquired skills to colleagues (cascade training model. A cross-sectional evaluation of the health workers’ competence in performing RDTs was conducted six weeks following the training, incorporating observation, in-depth interviews with health workers and the review of health facility records relating to tests offered and antimalarial drug (AMD prescriptions pre and post training. The direct costs relating to the training processes were also documented. Results Overall, 135 health workers were trained including 63 (47% nursing assistants, a group of care providers without formal medical training. All trainees passed the post-training concordance test with ≥ 80% except 12 that required re-training. Six weeks after the one-day training, 51/64 (80% of the health workers accurately performed the critical steps in performing the RDT. The performance was similar among the 10 (16% participants who were peer-trained by their trained colleagues. Only 9 (14% did not draw the appropriate amount of blood using pipette. The average cost of the one-day training was US$ 101 (range $92-$112, with the

  5. The IAEA Biomass programme: reference biospheres for long-term safety assessment of high level waste disposal facilities

    International Nuclear Information System (INIS)

    Metcalf, Phil; Crossland, Ian; Torres, Carlos; Crossland, Ian J.

    2002-01-01

    Phil Metcalf and Ian Crossland presented the IAEA Biomass project. Phil Metcalf explained that the Biomass project, begun in 1996, by an international forum organised by the IAEA was a very good exercise for exchanging information through technical meetings and documentation such as Biomass newsletters or CD Rom. Ian Crossland continued by giving a presentation of the Biomass theme 1 that concerns the radioactive waste disposal topic. Its objective was mainly to develop the reference biosphere methodology and to demonstrate its usefulness through some exercises related to the development of a practical set of example biospheres such as: 1. drinking water well, 2. agricultural irrigation, with a well source and 3. Set of natural groundwater discharges to natural, semi-natural systems. Input data would always change to accommodate a given repository simulation and location. Thus this project must be seen as a good exercise for the application of a methodology and should be considered as a good source of reference biospheres that might be viewed as a benchmark for comparison with site-specific safety assessments for a selected number of radionuclides. The main conclusion from the Biomass theme 1 project was that there appears to be an international consensus on preparing generic reference biospheres for postclosure safety assessment but waste management organisations should also consider the specific requirements of regulators and other stakeholders

  6. Evaluation of the uncertainty around the mean level of 137Cs fallout at undisturbed reference site: A simple statistical approach

    International Nuclear Information System (INIS)

    Mabit, L.; Gonsalves, B.C.; Chen, X.; Toloza, A.; Weltin, G.; Darby, I.G.; Padilla-Alvarez, R.

    2015-01-01

    One of the major issues related to the use of 137 Cs as a soil erosion/sedimentation tracer is the selection of the reference site which is used to estimate the initial 137 Cs fallout input (also termed reference inventory). The initial 137 Cs fallout input is a key component of the conversion models used to estimate erosion and sedimentation rates from the 137 Cs data set. The selection and evaluation of the validity of reference sites have been explained in detail in the recent IAEA TECDOC 1741 ‘‘Guidelines for using Fallout radionuclides to assess erosion and effectiveness of soil conservation strategies’’. An investigation was carried out at the experimental research station of the Austrian Agency for Health and Food Safety (AGES), in Austria, Grabenegg (48°07'40 N , 15°13'16 E ). Located at an altitude of 260 m a.s.l, with an annual average temperature of 8.4 °C and annual precipitation of 686 mm, the soil of this area has been classified as Gleyic Cambisol with a silt-loamy texture

  7. Harmonization of nuclear and radiation safety regulations for nuclear power plants with reference levels of Western European Nuclear Regulators Association (WENRA)

    International Nuclear Information System (INIS)

    Bojchuk, V.S.; Mikolajchuk, O.A.; Gromov, G.V.; Dibach, O.M.; Godovanyuk, G.M.; Nosovs'kij, A.V.

    2014-01-01

    Self-evaluation of the Ukrainian regulations on nuclear and radiation safety that apply to nuclear power plants for compliance with the reference levels of the Western European Nuclear Regulators Association (WENRA) is presented. Proposals on improvement of the regulations upon self-evaluation are provided

  8. Low-level radioactive waste disposal operations worldwide, with special reference to organic compounds in leachates and gases

    International Nuclear Information System (INIS)

    Rushbrook, P.E.; McGahan, D.J.

    1988-01-01

    Low- and intermediate-level radioactive wastes are defined and ground disposal practices worldwide are discussed. The organic content of low-level wastes is tabulated and the organic composition of leachates and gaseous emissions from low-level wastes in the U.K. and U.S.A. are discussed. The radionuclide content of these leachates is tabulated. (U.K.)

  9. Ocular findings and reference values for selected ophthalmic diagnostic tests in the macaroni penguin (Eudyptes chrysolophus) and southern rockhopper penguin (Eudyptes chrysocome).

    Science.gov (United States)

    Bliss, Cassandra D; Aquino, Susette; Woodhouse, Sarah

    2015-01-01

    To describe ophthalmic examination findings and standard diagnostic test results in 2 penguin species. Macaroni & Southern Rockhopper Penguins. Complete ophthalmic examinations including Schirmer tear test (STT), modified phenol red thread test (PTT), tonometry, and echobiometry were performed on penguins housed at the Detroit Zoo. Mean and standard deviation of ophthalmic tests are reported and compared for significance using two sample t-tests with significance set at P Penguins, and 68% of Rockhopper Penguins. There were anterior segment anomalies in all eyes with cataracts consistent with lens-induced uveitis. The mean modified PTT for the Macaronis was 24.7 ± 6.37 mm/15 s and 25.1 ± 7.07 mm/15 s in the Rockhoppers. The mean STT value for the Macaronis was 12.1 ± 5.43 mm/min and 11.0 ± 3.96 mm/min in the Rockhoppers. Mean intraocular pressure (IOP) for the Macaronis was 21.9 ± 7.05 mmHg measured by applanation tonometry and 29.1 ± 7.16 mmHg using rebound tonometry. The Rockhoppers had a mean IOP of 20.0 ± 5.77 mmHg and 24.1 ± 5.09 mmHg for applanation and rebound tonometry, respectively. In both populations, there was a significant difference in IOP measurement between the two instruments. In the Macaroni penguins, the presence of cataracts correlated significantly with increased age and lower IOP readings. Anterior chamber distance and axial globe length were significantly greater in males than in females in both penguin species. © 2013 American College of Veterinary Ophthalmologists.

  10. Diagnostic development

    International Nuclear Information System (INIS)

    Barnett, C.F.; Brisson, D.A.; Greco, S.E.

    1978-01-01

    During the past year the far-infrared or submillimeter diagnostic research program resulted in three major developments: (1) an optically pumped 0.385-μm D 2 O-laser oscillator-amplifier system was operated at a power level of 1 MW with a line width of less than 50 MHz; (2) a conical Pyrex submillimeter laser beam dump with a retention efficiency greater than 10 4 was developed for the ion temperature Thompson scattering experiment; and (3) a new diagnostic technique was developed that makes use of the Faraday rotation of a modulated submillimeter laser beam to determine plasma current profile. Measurements of the asymmetric distortion of the H/sub α/ (6563 A) spectral line profile show that the effective toroidal drift velocity, dv/sub two vertical bars i/dT/sub i/, may be used as an indicator of plasma quality and as a complement to other ion temperature diagnostics

  11. Endogenous steroid hormone levels in early pregnancy and risk of testicular cancer in the offspring: a nested case-referent study.

    Science.gov (United States)

    Holl, Katsiaryna; Lundin, Eva; Surcel, Heljä-Marja; Grankvist, Kjell; Koskela, Pentti; Dillner, Joakim; Hallmans, Göran; Wadell, Göran; Olafsdottir, Gudridur H; Ogmundsdottir, Helga M; Pukkala, Eero; Lehtinen, Matti; Stattin, Pär; Lukanova, Annekatrin

    2009-06-15

    According to the leading hypothesis on testicular cancer (TC) etiology exposure to a specific pattern of steroid hormones in utero, in particular, to high levels of estrogens and low levels of androgens is the major determinant of TC risk in the offspring. We performed a case-referent study nested within Finnish, Swedish and Icelandic maternity cohorts exploiting early pregnancy serum samples to evaluate the role of maternal endogenous steroid hormones with regard to the risk of TC. TC cases and referents were aged between 0 and 25 years. For each case-index mother pair, three or four matched referent-referent mother pairs were identified using national population registries. First trimester or early second trimester sera were retrieved from the index mothers of 73 TC cases and 286 matched referent mothers, and were tested for dehydroepiandrosterone sulfate (DHEAS), androstenedione, testosterone, estradiol, estrone, and sex hormone binding globulin (SHBG). Offspring of mothers with high DHEAS levels had a significantly decreased risk of TC (OR for highest vs. lowest DHEAS quartile, 0.18 (95% CI 0.06-0.58). In contrast, offspring of mothers with high androstenedione levels had an increased risk of TC (OR 4.1; 95% CI 1.2-12.0). High maternal total estradiol level also tended to be associated with an increased risk of TC in the offspring (OR 32; 95% CI 0.98-1,090). We report the first direct evidence that interplay of maternal steroid hormones in the early pregnancy is important in the etiology of TC in the offspring. Copyright 2008 UICC.

  12. Study on the diagnostic value of determination of changes of serum CA125 and CA19-9 levels in patients with endometriosis

    International Nuclear Information System (INIS)

    Liu Aimin

    2008-01-01

    Objective: To explore the diagnostic value of determination of changes of serum CA125 and CA19-9 levels in patients with endometriosis. Methods: Serum CA125 and CA19-9 levels were determined with RIA in 45 patients with endometriosis and 40 controls. Results: Serum levels of CA125 and CA19-9 in patients with endometriosis (89.63 ± 30.16u/ml and 95.62±43.67u/ml respectively) were significantly higher than those (16.26±6.37u/ml and 20.26±8.25u/ml respectively) in controls (P<0. 001). Sensitivity of CA125 for diagnosis of endometriosis was 77.78% and that of CA19-9 was 62.22%, while the specificity was 92.50% and 90.00% respectively. If we only took the patients with both markers elevated as being diagnostically positive, the sensitivity would naturally be lower (57.78%) but the specificity would be 100%. Levels of the markers were significantly higher in stage III, IV patients than those in patients with stage I, II disease (P<0.01). Conclusion: Combined determination of serum CA125 and CA19-9 levels were of highly specific diagnostic value in patients with endometriosis. (authors)

  13. Plasma Lactate Dehydrogenase Levels Predict Mortality in Acute Aortic Syndromes: A Diagnostic Accuracy and Observational Outcome Study.

    Science.gov (United States)

    Morello, Fulvio; Ravetti, Anna; Nazerian, Peiman; Liedl, Giovanni; Veglio, Maria Grazia; Battista, Stefania; Vanni, Simone; Pivetta, Emanuele; Montrucchio, Giuseppe; Mengozzi, Giulio; Rinaldi, Mauro; Moiraghi, Corrado; Lupia, Enrico

    2016-02-01

    In acute aortic syndromes (AAS), organ malperfusion represents a key event impacting both on diagnosis and outcome. Increased levels of plasma lactate dehydrogenase (LDH), a biomarker of malperfusion, have been reported in AAS, but the performance of LDH for the diagnosis of AAS and the relation of LDH with outcome in AAS have not been evaluated so far.This was a bi-centric prospective diagnostic accuracy study and a cohort outcome study. From 2008 to 2014, patients from 2 Emergency Departments suspected of having AAS underwent LDH assay at presentation. A final diagnosis was obtained by aortic imaging. Patients diagnosed with AAS were followed-up for in-hospital mortality.One thousand five hundred seventy-eight consecutive patients were clinically eligible, and 999 patients were included in the study. The final diagnosis was AAS in 201 (20.1%) patients. Median LDH was 424 U/L (interquartile range [IQR] 367-557) in patients with AAS and 383 U/L (IQR 331-460) in patients with alternative diagnoses (P < 0.001). Using a cutoff of 450 U/L, the sensitivity of LDH for AAS was 44% (95% confidence interval [CI] 37-51) and the specificity was 73% (95% CI 69-76). Overall in-hospital mortality for AAS was 23.8%. Mortality was 32.6% in patients with LDH ≥ 450 U/L and 16.8% in patients with LDH < 450 U/L (P = 0.006). Following stratification according to LDH quartiles, in-hospital mortality was 12% in the first (lowest) quartile, 18.4% in the second quartile, 23.5% in the third quartile, and 38% in the fourth (highest) quartile (P = 0.01). LDH ≥ 450 U/L was further identified as an independent predictor of death in AAS both in univariate and in stepwise logistic regression analyses (odds ratio 2.28, 95% CI 1.11-4.66; P = 0.025), in addition to well-established risk markers such as advanced age and hypotension. Subgroup analysis showed excess mortality in association with LDH ≥ 450 U/L in elderly, hemodynamically stable and in nonsurgically

  14. Assessing the potential for salmon recovery via floodplain restoration: a multitrophic level comparison of dredge-mined to reference segments.

    Science.gov (United States)

    Bellmore, J Ryan; Baxter, Colden V; Ray, Andrew M; Denny, Lytle; Tardy, Kurt; Galloway, Evelyn

    2012-03-01

    Pre-restoration studies typically focus on physical habitat, rather than the food-base that supports aquatic species. However, both food and habitat are necessary to support the species that habitat restoration is frequently aimed at recovering. Here we evaluate if and how the productivity of the food-base that supports fish production is impaired in a dredge-mined floodplain within the Yankee Fork Salmon River (YFSR), Idaho (USA); a site where past restoration has occurred and where more has been proposed to help recover anadromous salmonids. Utilizing an ecosystem approach, we found that the dredged segment had comparable terrestrial leaf and invertebrate inputs, aquatic primary producer biomass, and production of aquatic invertebrates relative to five reference floodplains. Thus, the food-base in the dredged segment did not necessarily appear impaired. On the other hand, we observed that off-channel aquatic habitats were frequently important to productivity in reference floodplains, and the connection of these habitats in the dredged segment via previous restoration increased invertebrate productivity by 58%. However, using a simple bioenergetic model, we estimated that the invertebrate food-base was at least 4× larger than present demand for food by fish in dredged and reference segments. In the context of salmon recovery efforts, this observation questions whether additional food-base productivity provided by further habitat restoration would be warranted in the YFSR. Together, our findings highlight the importance of studies that assess the aquatic food-base, and emphasize the need for more robust ecosystem models that evaluate factors potentially limiting fish populations that are the target of restoration.

  15. Assessing the Potential for Salmon Recovery via Floodplain Restoration: A Multitrophic Level Comparison of Dredge-Mined to Reference Segments

    Science.gov (United States)

    Bellmore, J. Ryan; Baxter, Colden V.; Ray, Andrew M.; Denny, Lytle; Tardy, Kurt; Galloway, Evelyn

    2012-03-01

    Pre-restoration studies typically focus on physical habitat, rather than the food-base that supports aquatic species. However, both food and habitat are necessary to support the species that habitat restoration is frequently aimed at recovering. Here we evaluate if and how the productivity of the food-base that supports fish production is impaired in a dredge-mined floodplain within the Yankee Fork Salmon River (YFSR), Idaho (USA); a site where past restoration has occurred and where more has been proposed to help recover anadromous salmonids. Utilizing an ecosystem approach, we found that the dredged segment had comparable terrestrial leaf and invertebrate inputs, aquatic primary producer biomass, and production of aquatic invertebrates relative to five reference floodplains. Thus, the food-base in the dredged segment did not necessarily appear impaired. On the other hand, we observed that off-channel aquatic habitats were frequently important to productivity in reference floodplains, and the connection of these habitats in the dredged segment via previous restoration increased invertebrate productivity by 58%. However, using a simple bioenergetic model, we estimated that the invertebrate food-base was at least 4× larger than present demand for food by fish in dredged and reference segments. In the context of salmon recovery efforts, this observation questions whether additional food-base productivity provided by further habitat restoration would be warranted in the YFSR. Together, our findings highlight the importance of studies that assess the aquatic food-base, and emphasize the need for more robust ecosystem models that evaluate factors potentially limiting fish populations that are the target of restoration.

  16. Definition of reference ranges for free T4, TSH, and thyroglobulin levels in healthy subjects of the Jaén Health District.

    Science.gov (United States)

    Olmedo Carrillo, Pablo; Santiago Fernández, Piedad; García Fuentes, Eduardo; Ureña Fernández, Tomás; Gutiérrez Alcántara, Carmen; Sánchez-Malo, Carolina; Gassó Campos, Manuela; Martínez Ramírez, María José

    2017-10-01

    The treatment guidelines for thyroid dysfunction recommend defining reference ranges for thyroid hormones in each area through assessment of local population data considering the iodine nutritional status. The aim of this study was to define the reference ranges of free thyroxine (FT4), TSH, and thyroglobulin levels in a general population from Jaen, an area of southern Spain with an adequate iodine nutritional status, and whether they were associated with urinary iodine levels. A cross-sectional study was conducted in 1,003 subjects of the general population of the Jaen Health District. Levels of urinary iodine, FT4, TSH, thyroglobulin, and thyroid peroxidase (TPO) antibodies were measured according to age and sex. Median and mean urinary iodine levels were 110.59μg/L and 130.11μg/L respectively. Median TSH level was 1.83μIU/mL (p2.5=0.56μIU/mL, p97.5=4.66μIU/mL). Median FT4 level was 0.84ng/dL (p2.5=0.62ng/dL, p97.5=1.18ng/dL). TPO antibodies were detected in 5.7% of subjects. There was no correlation between urinary iodine levels and FT4, TSH or TPO antibodies. Subjects with positive TPO antibodies had higher TSH levels (3.34μIU/L versus 2.14μIU/mL, P=.001; odds ratio=2.42). Urinary iodine levels in Jaen are optimal according to World Health Organization standards. Reference ranges of FT4, TSH, and thyroglobulin do not differ from those reported in the literature and are no associated to urinary iodine levels. The prevalence of positive TPO antibodies was similar to that reported in other Spanish areas. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Diagnostic performance of in vivo 3-T MRI for articular cartilage abnormalities in human osteoarthritic knees using histology as standard of reference

    International Nuclear Information System (INIS)

    Saadat, Ehsan; Jobke, Bjoern; Chu, Bill; Lu, Ying; Cheng, Jonathan; Li, Xiaojuan; Majumdar, Sharmila; Link, Thomas M.; Ries, Michael D.

    2008-01-01

    The purpose of this study was (1) to evaluate the sensitivity, specificity and accuracy of sagittal in vivo 3-T intermediate-weighted fast spin-echo (iwFSE) sequences in the assessment of knee cartilage pathologies using histology as the reference standard in patients undergoing total knee replacement, and (2) to correlate MR imaging findings typically associated with osteoarthritis such as bone marrow edema pattern (BMEP) and cartilage swelling with histological findings. Tibial plateaus and femoral condyles of eight knees of seven patients were resected during surgery, and sagittal histological sections were prepared for histology. Preoperative MRI findings were compared to the corresponding region in histological sections for thickness, surface integrity and signal pattern of cartilage, and histological findings in areas of BMEP and swelling were documented. The overall sensitivity, specificity and accuracy were 72%, 69% and 70% for thickness, 69%, 74% and 73% for surface and 36%, 62% and 45% for intracartilaginous signal pattern. For all cases of BMEP on MRI subchondral ingrowth of fibrovascular tissue and increased bone remodeling were observed. MRI using fat-saturated iwFSE sequences showed good performance in assessing cartilage thickness and surface lesions, while signal changes of cartilage were not suited to characterize the severity of cartilage degeneration as validated by histology. (orig.)

  18. Task-oriented comparison of power spectral density estimation methods for quantifying acoustic attenuation in diagnostic ultrasound using a reference phantom method.

    Science.gov (United States)

    Rosado-Mendez, Ivan M; Nam, Kibo; Hall, Timothy J; Zagzebski, James A

    2013-07-01

    Reported here is a phantom-based comparison of methods for determining the power spectral density (PSD) of ultrasound backscattered signals. Those power spectral density values are then used to estimate parameters describing α(f), the frequency dependence of the acoustic attenuation coefficient. Phantoms were scanned with a clinical system equipped with a research interface to obtain radiofrequency echo data. Attenuation, modeled as a power law α(f)= α0 f (β), was estimated using a reference phantom method. The power spectral density was estimated using the short-time Fourier transform (STFT), Welch's periodogram, and Thomson's multitaper technique, and performance was analyzed when limiting the size of the parameter-estimation region. Errors were quantified by the bias and standard deviation of the α0 and β estimates, and by the overall power-law fit error (FE). For parameter estimation regions larger than ~34 pulse lengths (~1 cm for this experiment), an overall power-law FE of 4% was achieved with all spectral estimation methods. With smaller parameter estimation regions as in parametric image formation, the bias and standard deviation of the α0 and β estimates depended on the size of the parameter estimation region. Here, the multitaper method reduced the standard deviation of the α0 and β estimates compared with those using the other techniques. The results provide guidance for choosing methods for estimating the power spectral density in quantitative ultrasound methods.

  19. Diagnostic performance of in vivo 3-T MRI for articular cartilage abnormalities in human osteoarthritic knees using histology as standard of reference

    Energy Technology Data Exchange (ETDEWEB)

    Saadat, Ehsan [University of California San Francisco, School of Medicine and Department of Radiology, San Francisco, CA (United States); Jobke, Bjoern; Chu, Bill; Lu, Ying; Cheng, Jonathan; Li, Xiaojuan; Majumdar, Sharmila; Link, Thomas M. [University of California San Francisco, Department of Radiology, San Francisco, CA (United States); Ries, Michael D. [University of California San Francisco, Department of Orthopaedic Surgery, San Francisco, CA (United States)

    2008-10-15

    The purpose of this study was (1) to evaluate the sensitivity, specificity and accuracy of sagittal in vivo 3-T intermediate-weighted fast spin-echo (iwFSE) sequences in the assessment of knee cartilage pathologies using histology as the reference standard in patients undergoing total knee replacement, and (2) to correlate MR imaging findings typically associated with osteoarthritis such as bone marrow edema pattern (BMEP) and cartilage swelling with histological findings. Tibial plateaus and femoral condyles of eight knees of seven patients were resected during surgery, and sagittal histological sections were prepared for histology. Preoperative MRI findings were compared to the corresponding region in histological sections for thickness, surface integrity and signal pattern of cartilage, and histological findings in areas of BMEP and swelling were documented. The overall sensitivity, specificity and accuracy were 72%, 69% and 70% for thickness, 69%, 74% and 73% for surface and 36%, 62% and 45% for intracartilaginous signal pattern. For all cases of BMEP on MRI subchondral ingrowth of fibrovascular tissue and increased bone remodeling were observed. MRI using fat-saturated iwFSE sequences showed good performance in assessing cartilage thickness and surface lesions, while signal changes of cartilage were not suited to characterize the severity of cartilage degeneration as validated by histology. (orig.)

  20. Clinical diagnostic ultrasound

    International Nuclear Information System (INIS)

    Barnett, E.; Morley, P.

    1986-01-01

    This textbook on diagnostic ultrasound covers the main systems, with emphasis being placed on the clinical application of diagnostic ultrasound in everyday practice. It provides not only a textbook for postgraduates (particularly FRCR candidates), but also a reference work for practitioners of clinical ultrasound and clinicians generally

  1. k0-NAA applied to certified reference materials and hair samples. Evaluation of exposure level in a galvanising industry

    International Nuclear Information System (INIS)

    Menezes, M.A. de B.C.; Pereira Maia, E.C.

    2000-01-01

    The k 0 parametric neutron activation analysis has been applied since 1995 in the Radiochemical Sector/CDTN, Belo Horizonte, Brazil. Several certified reference materials were studied with the aim of analysing biological samples. This work is related to an IAEA co-ordinated research project whose goal is to make a survey of the exposures to metals related to occupational diseases. It has been conducted by CDTN and government departments of health. The hair samples as bioindicators were donated by galvanising factory workers in Belo Horizonte. This city and surrounding area are important industrial centres and that industry is responsible for the majority of patients who look for medical assistance because of metal contamination. The Al, Co, Cu, Cr, La, Mn, Sb and V concentrations determined in the workers' samples suggest endogenous contamination. (author)

  2. Medical reference dosimetry using EPR measurements of alanine: Development of an improved method for clinical dose levels

    International Nuclear Information System (INIS)

    Helt-Hansen, Jakob; Andersen, Claus Erik; Rosendal, Flemming; Kofoed, Inger Matilde

    2009-01-01

    Electron spin resonance (EPR) is used to determine the absorbed dose of alanine dosimeters exposed to clinical photon beams in a solid-water phantom. Alanine is potentially suitable for medical reference dosimetry, because of its near water equivalence over a wide energy spectrum, low signal fading, non-destructive measurement and small dosimeter size. Material and Methods. A Bruker EMX-micro EPR spectrometer with a rectangular cavity and a measurement time of two minutes per dosimeter was used for reading of irradiated alanine dosimeters. Under these conditions a new algorithm based on scaling of known spectra was developed to extract the alanine signal. Results. The dose accuracy, including calibration uncertainty, is less than 2% (k=1) above 4 Gy (n=4). The measurement uncertainty is fairly constant in absolute terms (∼30 mGy) and the relative uncertainty therefore rises for dose measurements below 4 Gy. Typical reproducibility is <1% (k=1) above 10 Gy and <2% between 4 and 10 Gy. Below 4 Gy the uncertainty is higher. A depth dose curve measurement was performed in a solid-water phantom irradiated to a dose of 20 Gy at the maximum dose point (dmax) in 6 and 18 MV photon beams. The typical difference between the dose measured with alanine in solid water and the dose measured with an ion chamber in a water tank was about 1%. A difference of 2% between 6 and 18 MV was found, possibly due to non-water equivalence of the applied phantom. Discussion. Compared to previously published methods the proposed algorithm can be applied without normalisation of phase shifts caused by changes in the g-value of the cavity. The study shows that alanine dosimetry is a suitable candidate for medical reference dosimetry especially for quality control applications

  3. Treatment of renal osteopathy by Rocaltrol, with special reference to parathormone levels and X-ray examinations

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, R.L.

    The effects of treatment of renal osteopathy with 1.25 (OH)/sub 2/D/sub 3/ was evaluated in 24 chronic hemodialysis patients. The best results of treatment were displayed in patients in whom 1.25 (OH)/sub 2/D/sub 3/ determined only a slow rise in plasma calcium levels. In these patients iPTH, alkaline phosphatase levels, and osteoblast counts in bone biopsies were initially high. Definite improvement of bone resorption was found on X-ray examination. In contrast in patients with low iPTH, low alkaline phosphatase levels, and low osteoblast counts, administration of 1.25 (OH)/sub 2/D/sub 3/ determined a fast rise of plasma calcium levels. No X-ray modifications could be detected.

  4. Treatment of renal osteopathy by Rocaltrol, with special reference to parathormone levels and X-ray examinations

    International Nuclear Information System (INIS)

    Schmitt, R.L.

    1981-01-01

    The effects of treatment of renal osteopathy with 1.25 (OH) 2 D 3 was evaluated in 24 chronic hemodialysis patients. The best results of treatment were displayed in patients in whom 1.25 (OH) 2 D 3 determined only a slow rise in plasma calcium levels. In these patients iPTH, alkaline phosphatase levels, and osteoblast counts in bone biopsies were initially high. Definite improvement of bone resorption was found on X-ray examination. In contrast in patients with low iPTH, low alkaline phosphatase levels, and low osteoblast counts, administration of 1.25 (OH) 2 D 3 determined a fast rise of plasma calcium levels. No X-ray modifications could be detected. (orig.) [de

  5. Magnetic resonance imaging and magnetic resonance arthrography of the shoulder: dependence on the level of training of the performing radiologist for diagnostic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Theodoropoulos, John S. [University of Toronto, Division of Orthopaedics, Mount Sinai Hospital and the University Health Network, Toronto, ON (Canada); Andreisek, Gustav [University of Toronto, Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, Toronto, ON (Canada); University Hospital Zuerich, Institute for Diagnostic Radiology, Zuerich (Switzerland); Harvey, Edward J. [McGill University, Division of Orthopaedics, MUHC - Montreal General Hospital, Montreal, Quebec (Canada); Wolin, Preston [Center for Athletic Medicine, Chicago, IL (United States)

    2010-07-15

    Discrepancies were identified between magnetic resonance (MR) imaging and clinical findings in patients who had MR imaging examinations evaluated by community-based general radiologists. The purpose of this study was to evaluate the diagnostic performance of MR imaging examinations of the shoulder with regard to the training level of the performing radiologist. A review of patient charts identified 238 patients (male/female, 175/63; mean age, 40.4 years) in whom 250 arthroscopies were performed and who underwent MR imaging or direct MR arthrography in either a community-based or hospital-based institution prior to surgery. All MR imaging and surgical reports were reviewed and the diagnostic performance for the detection of labral, rotator cuff, biceps, and Hill-Sachs lesions was determined. Kappa and Student's t test analyses were performed in a subset of cases in which initial community-based MR images were re-evaluated by hospital-based musculoskeletal radiologists, to determine the interobserver agreement and any differences in image interpretation. The diagnostic performance of community-based general radiologists was lower than that of hospital-based sub-specialized musculoskeletal radiologists. A sub-analysis of re-evaluated cases showed that musculoskeletal radiologists performed better. {kappa} values were 0.208, 0.396, 0.376, and 0.788 for labral, rotator cuff, biceps, and Hill-Sachs lesions (t test statistics: p =<0.001, 0.004, 0.019, and 0.235). Our results indicate that the diagnostic performance of MR imaging and MR arthrography of the shoulder depends on the training level of the performing radiologist, with sub-specialized musculoskeletal radiologists having a better diagnostic performance than general radiologists. (orig.)

  6. Density-dependent lines of one- and two-electron ions in diagnostics of laboratory plasma. I. The rates of collision relaxation of excited levels

    Energy Technology Data Exchange (ETDEWEB)

    Shevelko, V P; Skobelev, I Yu; Vinogradov, A V [Lebedev Physical Institute, Academy of Sciences of the USSR, Moscow, USSR

    1977-01-01

    Plasma devices with inertial plasma confinement such as laser produced plasmas, exploding wires, plasma focus, etc., which have been rapidly developed during recent years., appear to be very intensive sources of spectral line radiation in far UV and X-ray regions. Analysis of this radiation provides a good tool for plasma diagnostics with very high electron densities up to 10/sup 22/cm/sup -3/. In this work, consisting of two parts, the authors consider the mechanism of the formation of spectral lines in hot and dense plasma. The key point for density diagnostics is the fact that for some ion levels the rate of collisional relaxation has the same order of magnitude as the radiative decay. Thus the intensities of spectral lines arising from these levels show a strong dependence on electron density which makes diagnostics possible. In this paper, emphasis is laid on the calculation of rates of transition between close ion levels induced by electron or ion impact, which usually gives the main contribution to the collisional relaxation constants. The influence of plasma polarization effects on the collision frequency in a dense plasma is also considered.

  7. Recent levels of radionuclides in lichens from southwest Poland with particular reference to 134Cs and 137Cs

    International Nuclear Information System (INIS)

    Seaward, M.R.D.; Bylinska, E.A.

    1988-01-01

    Analyses of Umbilicaria species collected from southwest Poland in August 1986 have shown there to be significant increases in levels of various radionuclides since previous analyses based on fieldwork in 1978-1979. The composition and ratio of the various radionuclides, particularly in respect of 134 Cs and 137 Cs, exhibit a characteristic signature consistent with contamination derived from the accident at the Chernobyl nuclear reactor in April 1986. Intraspecific variation in levels of 137 Cs in Umbilicaria is related to such factors as location, altitude and, to a lesser degree, aspect; interspecific variation in levels is related to ecological requirements and geographical pattern, and hence the same factors, although morphological differences in thalli may be implicated. (author)

  8. Climate in France during the 21. century - Regionalized scenarios - Reference indices for the metropolitan region - Evolution at sea level

    International Nuclear Information System (INIS)

    Peings, Yannick; Planton, Serge; Deque, Michel; Jamous, Marc; Le Treut, Herve; Gallee, Hubert; Li, Laurent; Jouzel, J.

    2011-01-01

    After some comments on climate modelling (models, scenarios, uncertainties, regional predictions), the first part reports the study of several temperature indices (minimum, average and maximum daily temperature, number of days with abnormally high or low temperature, number of days of heat wave, number of days with negative temperatures, and so on.), precipitation indices (daily and extreme precipitations, dry periods, snow falls). It also discusses soil humidity index, strong wind index, river flow rate, and sea level. The second part reports simulation results for indices in metropolitan France according to the French Aladin-Climat, LMDZ and MAR models. The third volume reports evolutions and predictions of average sea level at the planet scale and along the French coasts, and discusses impacts related to sea level change (coast erosion, submersion, salt intrusion)

  9. Progress in diagnostic techniques for sc cavities

    International Nuclear Information System (INIS)

    Reece, C.E.

    1988-01-01

    While routinely achieved performance characteristics of superconducting cavities have now reached a level which makes them useful in large scale applications, achieving this level has come only through the knowledge gained by systematic studies of performance limiting phenomena. Despite the very real progress that has been made, the routine performance of superconducting cavities still falls far short of both the theoretical expectations and the performance of a few exception examples. It is the task of systematically applied diagnostic techniques to reveal additional information concerning the response of superconducting surfaces to applied RF fields. Here recent developments in diagnostic techniques are discussed. 18 references, 12 figures

  10. The study of chloroform levels during water disinfection by chlorination reference to health risk in drinking water of karachi (pakistan)

    International Nuclear Information System (INIS)

    Khawaja, H.A.; Khattak, I.

    2008-01-01

    This study presents the levels of the chloroform formation during water disinfiction treatment by chlorination with the subsequent formation of by-products like trihalomethanes (THMs) are formed. These THMs in drinking water are found in the form of chloroform, bromodichloromethane, Chlorodibromomethane and bromoform. Out of these four compounds chloroform is the major culprit and Contribute 9.0% of the total THMs concentration (I). Therefore the present work was focused on the Estimation of levels of chloroform in the drinking water samples of Karachi city (Pakistan) by using Bootstrapping statistical technique with regards to the average cancer risk in the community. (author)

  11. Towards diagnostics for a fusion reactor

    International Nuclear Information System (INIS)

    Costley, A. E.

    2009-01-01

    The requirements for measurements on modern tokamak fusion plasmas are outlined, and the techniques and systems used to make the measurements, usually referred to as 'diagnostics', are introduced. The basics of three particular diagnostics - magnetics, neutron systems and a laser based optical system - are outlined as examples of modern diagnostic systems, and the implementation of these diagnostics on a current tokamak (JET) are described. The next major step in magnetic confinement fusion is the construction and operation of the International Thermonuclear Experimental Reactor (ITER), which is a joint project of China, Europe, Japan, India, Korea, the Russian Federation, and the United States. Construction has begun in Cadarache, France. It is expected that ITER will operate at the 500 MW level. Because of the harsh environment in the vacuum vessel where many diagnostic components are located, the development of diagnostics for ITER is a major challenge - arguably the most difficult challenge ever undertaken in the field of diagnostics. The main elements in the diagnostic step are outlined using the three chosen techniques as examples. Finally, the step beyond ITER to a demonstration reactor, DEMO, that is expected to produce several GWs of fusion power is considered and the impact on diagnostics outlined. It is shown that the applicability and development steps needed for the individual diagnostics techniques will differ. The challenges for DEMO diagnostics are substantial and a dedicated effort should be made to find and develop new techniques, and especially techniques appropriate to the DEMO environment. It is argued that the limitations and difficulties in diagnostics should be a consideration in the optimization and designs of DEMO. (author)

  12. Reference levels for assays in opened installations of industrial radiography; Niveis de referencia para ensaios em instalacoes abertas de radiografia industrial

    Energy Technology Data Exchange (ETDEWEB)

    Leocadio, Joao C.; Tauhata, Luiz [Instituto de Radioprotecao e Dosimetria (IRD), Rio de Janeiro, RJ (Brazil); Crispim, Verginia R. [Universidade Federal, Rio de Janeiro, RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia. Programa de Engenharia Nuclear

    2001-07-01

    This work had as objectives to analyze the facilities open of industrial x-ray to obtain the distribution of doses in the operators and present proposed for the reference levels. The results of the monitoring revealed an improvement of the radiation protection conditions in the facilities and that the risk of potential exposure was reduced. The advantage of the proposed reference levels is that the supervisors would enlarge the frequency of audits in the facilities opened to accomplish the investigations and interventions.The facilities open with 'bunkers' presented distributions with 95% of the doses below 0,2 mSv and the distributions of the facilities with cordoned area they had 75% of the doses below 0,4 mSv. (author)

  13. 1-GWh diurnal load-leveling superconducting magnetic energy storage system reference design. Appendix A: energy storage coil and superconductor

    International Nuclear Information System (INIS)

    Schermer, R.I.

    1979-09-01

    The technical aspects of a 1-GWh Superconducting Magnetic Energy Storage (SMES) coil for use as a diurnal load-leveling device in an electric utility system are presented. The superconductor for the coil is analyzed, and costs for the entire coil are developed

  14. Projecting deforestation trends on Espiritu Santo island, Vanuatu, using a spatial modeling approach : a case study to develop a spatially explicit forest reference emission level for REDD+

    OpenAIRE

    Méndez Zeballos, Dorys

    2015-01-01

    As agreed under United Nations Framework Convention on Climate Change, activities reducing emissions from deforestation, forest degradation, sustainable management of forests, enhancement and conservation of forest carbon stocks (REDD+) provide financial incentives to countries mitigating climate change. Countries are requested to develop so-called national forest reference levels (FRLs) as a benchmark to measure performance of land-use policy adjustments. FRLs are constructed combining infor...

  15. Relevance of biotic pathways to the long-term regulation of nuclear-waste disposal. Topical report on reference western arid low-level sites

    International Nuclear Information System (INIS)

    McKenzie, D.H.; Cadwell, L.L.; Eberhardt, L.E.; Kennedy, W.E. Jr.; Peloquin, R.A.; Simmons, M.A.

    1982-10-01

    The purpose of the work reported here was to develop an order of magnitude estimate for the potential dose to man resulting from biotic transport mechanisms at a reference western arid low-level waste site. A description of the reference site is presented that includes the waste inventories, site characteristics and biological communities. Parameter values for biotic transport processes are based on data reported in current literature. Transport and exposure scenarios are developed for assessing biotic transport during 100 years following site closure. Calculations of radionuclide decay and waste container decomposition are made to estimate the quantities available for biotic transport. Dose to a man occupying the reference site following the 100 years of biotic transport are calculated. These dose estimates are compared to dose estimates for the intruder-agricultural scenario reported in the DEIS for 10 CFR 61 (NRC). Dose to man estimates as a result of biotic transport are estimated to be of the same order of magnitude as the dose resulting from the more commonly evaluated human intrusion scenario. The reported lack of potential importance of biotic transport at low-level waste sites in earlier assessment studies is not confirmed by the findings presented in this report. These results indicate that biotic transport has the potential to influence low-level waste site performance. Through biotic transport, radionuclides may be moved to locations where they can enter exposure pathways to man

  16. Observations on ostertagiasis in young cattle over two grazing seasons with special reference to plasma pepsinogen levels.

    Science.gov (United States)

    Armour, J; Bairden, K; Duncan, J L; Jennings, F W; Parkins, J J

    1979-12-01

    The epidemiology of ostertagiasis in south west Scotland was studied in groups of cattle grazed through two successive grazing seasons separated by a period of winter housing. Towards the end of the first grazing season (September) the numbers of infective larvae (L3) on the pasture had increased to high levels (up to 24,000 L3 per kg) which resulted in high faecal egg counts, worm burdens, plasma pepsinogen levels and the occurrence of clinical ostertagiasis in the calves. By late spring (May) at the onset of the second grazing season, there was an almost complete mortality of the overwintered L3 on the pasture followed by the appearance of moderately high numbers of a new population of L3 in September (up to 9000 L3 per kg). The latter increase in the numbers of L3 was reflected by negligible faecal egg counts, low worm burdens and a moderate elevation of plasma pepsinogens in the second year animals. It therefore seems that although young cattle acquire a good immunity to Ostertagia ostertagi after one season at grass the small infections established in the early part of the second season are capable of contaminating the pasture to levels which could be dangerous for susceptible stock. An allergic reaction in the abomasal mucosa could be the basis of the elevated pepsinogens present in the second year animals.

  17. Re-recognition of Age-dependent Reference Range for the Serum Creatinine Level in Teenagers - A Case of Slowly Progressive Tubulointerstitial Nephritis which Occurred in an Adolescent.

    Science.gov (United States)

    Ono, Hiroyuki; Nagai, Kojiro; Shibata, Eriko; Matsuura, Motokazu; Kishi, Seiji; Inagaki, Taizo; Minato, Masanori; Yoshimoto, Sakiya; Ueda, Sayo; Obata, Fumiaki; Nishimura, Kenji; Tamaki, Masanori; Kishi, Fumi; Murakami, Taichi; Abe, Hideharu; Kinoshita, Yukiko; Urushihara, Maki; Kagami, Shoji; Doi, Toshio

    2017-08-15

    For the first time, a 15-year-old boy was found to have a slight degree of proteinuria and microscopic hematuria during annual school urinalysis screening. His kidney function had already severely deteriorated. A kidney biopsy revealed tubulointerstitial nephritis (TIN) with diffuse inflammatory cell infiltration. His medical records showed his serum creatinine level to be 0.98 mg/dL two years ago, which was abnormally high considering his age. Although the etiology of slowly progressive TIN was unclear, glucocorticoid and immunosuppressant therapy improved his kidney function. This case report suggests that all doctors should recognize the reference range for the serum creatinine level in teenagers.

  18. Cost-effectiveness analysis of malaria rapid diagnostic tests for appropriate treatment of malaria at the community level in Uganda

    DEFF Research Database (Denmark)

    Hansen, Kristian S; Ndyomugyenyi, Richard; Magnussen, Pascal

    2017-01-01

    was a cost-effectiveness analysis of the introduction of malaria rapid diagnostic tests (mRDTs) performed by CHWs in two areas of moderate-to-high and low malaria transmission in rural Uganda. CHWs were trained to perform mRDTs and treat children with artemisinin-based combination therapy (ACT......) in the intervention arm while CHWs offered treatment based on presumptive diagnosis in the control arm. Data on the proportion of children with fever 'appropriately treated for malaria with ACT' were captured from a randomised trial. Health sector costs included: training of CHWs, community sensitisation, supervision...

  19. Pilot project for the establishment of diagnosis reference level in pediatric computerized tomography in Rio de Janeiro city, RJ, Brazil; Projeto piloto para o estabelecimento de niveis de referencia de diagnostico em tomografia computadorizada pediatrica no municipio do Rio de Janeiro, RJ, Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Jesus, Fillipe Machado de

    2014-08-01

    Computed tomography (CT) is an important method of diagnostic imaging has been widely used around the world. However, this important diagnostic tool has led to a considerable increase in the frequency of examinations, often without proper clinical justification. Consequently, CT is one of the diagnostic procedures that contributes most to the collective dose. Scientific studies show that the concern in pediatric procedures should be even higher. Despite the fact that these patients have a higher radiosensitivity and a higher life expectancy, the protocols of the examinations are not optimized and adult protocols are applied. Moreover, a recent study performed in the United States showed that one third of the examinations was not justified. The aim of this study was to conduct a pilot study of dose indicators in pediatric CT in four hospitals, in order to verify the feasibility of the diagnostic reference levels establishment for the county of Rio de Janeiro. The dose descriptors were estimated from the beam dosimetry by applying the protocols used in each examination. The total patient sample included 358 children of different age groups. The results observed in examinations of whole trunk (routine chest, upper abdomen and pelvis) and upper abdomen in Institution A, for patients aged 5-10 years, indicated that the mAs values used were not properly selected for patients' body mass index, presenting however, conformity with UK reference levels. In the case of head CT scans and routine chest CT scans in Institution B, although patients aged 5-10 years have shown conformity with UK reference levels, the kV and mAs values used, in some examinations, were also inappropriate for the patient characteristics. Similar result was observed in examinations of head and high resolution chest for patients neonates, in Institution D. For head and routine chest examinations of 1-5 years' age group, was Institution B that showed the lowest DLP values. This result was due to

  20. GLM Proxy Data Generation: Methods for Stroke/Pulse Level Inter-Comparison of Ground-Based Lightning Reference Networks

    Science.gov (United States)

    Cummins, Kenneth L.; Carey, Lawrence D.; Schultz, Christopher J.; Bateman, Monte G.; Cecil, Daniel J.; Rudlosky, Scott D.; Petersen, Walter Arthur; Blakeslee, Richard J.; Goodman, Steven J.

    2011-01-01

    In order to produce useful proxy data for the GOES-R Geostationary Lightning Mapper (GLM) in regions not covered by VLF lightning mapping systems, we intend to employ data produced by ground-based (regional or global) VLF/LF lightning detection networks. Before using these data in GLM Risk Reduction tasks, it is necessary to have a quantitative understanding of the performance of these networks, in terms of CG flash/stroke DE, cloud flash/pulse DE, location accuracy, and CLD/CG classification error. This information is being obtained through inter-comparison with LMAs and well-quantified VLF/LF lightning networks. One of our approaches is to compare "bulk" counting statistics on the spatial scale of convective cells, in order to both quantify relative performance and observe variations in cell-based temporal trends provided by each network. In addition, we are using microsecond-level stroke/pulse time correlation to facilitate detailed inter-comparisons at a more-fundamental level. The current development status of our ground-based inter-comparison and evaluation tools will be presented, and performance metrics will be discussed through a comparison of Vaisala s Global Lightning Dataset (GLD360) with the NLDN at locations within and outside the U.S.

  1. Empirical likelihood-based confidence intervals for the sensitivity of a continuous-scale diagnostic test at a fixed level of specificity.

    Science.gov (United States)

    Gengsheng Qin; Davis, Angela E; Jing, Bing-Yi

    2011-06-01

    For a continuous-scale diagnostic test, it is often of interest to find the range of the sensitivity of the test at the cut-off that yields a desired specificity. In this article, we first define a profile empirical likelihood ratio for the sensitivity of a continuous-scale diagnostic test and show that its limiting distribution is a scaled chi-square distribution. We then propose two new empirical likelihood-based confidence intervals for the sensitivity of the test at a fixed level of specificity by using the scaled chi-square distribution. Simulation studies are conducted to compare the finite sample performance of the newly proposed intervals with the existing intervals for the sensitivity in terms of coverage probability. A real example is used to illustrate the application of the recommended methods.

  2. Relevance of biotic pathways to the long-term regulation of nuclear waste disposal. Topical report on reference eastern humid low-level sites

    International Nuclear Information System (INIS)

    McKenzie, D.H.; Cadwell, L.L.; Eberhardt, L.E.; Kennedy, W.E. Jr.; Peloquin, R.A.; Simmons, M.A.

    1983-01-01

    The purpose of the work reported here was to develop an order-of-magnitude estimate for the potential dose to man resulting from biotic transport mechanisms at a humid reference low-level waste site in the eastern US. A description of the reference site is presented that includes the waste inventories, site characteristics and biological communites. Parameter values for biotic transport processes are based on data reported in current literature. Transport and exposure scenarios are developed for assessing biotic transport during 500 years following site closure. Calculations of radionuclide decay and waste container decomposition are made to estimate the quantities available for biotic transport. Doses to man are calculated for the biological transport of radionucludes at the reference site after loss of institutional control. These dose estimates are compared to dose estimates we calculated for the intruder-agricultural scenarios reported in the DEIS for 10 CFR 61 (NRC). Dose to man estimates as a result of cumulative biotic transport are calculated to be of the same order-of-magnitude as the dose resulting from the more commonly evaluated human intrusion scenario. The reported lack of potential importance of biotic transport at low-level waste sites in earlier assessment studies is not confirmed by findings presented in this report. Through biotic transport, radionuclides can be moved to locations where they can enter exposure pathways to man

  3. X-ray radiographic experimental investigation of the reference level in hydrostatic level measurement systems for boiling water reactors; Roentgen-radiografische Untersuchung des Referenzfuellstandes bei der hydrostatischen Fuellstandsmessung in Siedewasserreaktoren

    Energy Technology Data Exchange (ETDEWEB)

    Schulz, S.; Hampel, R. [Hochschule Zittau/Goerlitz, Zittau (Germany). Inst. fuer Prozesstechnik, Prozessautomatisierung und Messtechnik (IPM); Boden, S. [Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden (Germany). Inst. fuer Fluiddynamik

    2012-11-01

    Hydrostatic level control is of high priority for normal operation safety of BWR-type reactors. For the prevention of undershooting the limiting values precise and secure measuring techniques are indispensable. Actually the filling level is determined form the hydrostatic pressure difference to a reference column. For the secure non-invasive detection of the phase boundary water/steam in inclined tubes the X-ray radiography has been chosen. The experiments were aimed to study possible geometric influences on the water/steam phase boundary. It was shown that the reference filling level is not significantly changed in spite of permanent phase transitions, provided an ideal mechanical construction of the system is given. Future experiments shall be focused on the analysis of interface behavior in case of non-ideal geometries (welds).

  4. Establishing a soil reference system for fertility assessment and monitoring at plot level in the highlands of Mindanao, Philippines

    Directory of Open Access Journals (Sweden)

    Guadalupe D. Calalang

    2014-08-01

    Full Text Available The study was conducted in the crop production areas of Miarayon Village, along the volcanic footslope of Mt. Kalatungan, Talakag, Bukidnon, Philippines. The elevation range of the longitudinal toposequence is 1,900 to 1,300 m asl. Production areas in the intermediate part of the toposequence (Salsalan are located at about 1,600 to 1,400 m asl and in the lower part (Mambuaw at 1,400 to 1,300 m asl. A total of 24 plots (12 in each location which were planted to potatoes, carrots and corn were investigated. Soils are “Andic” Cambisol in open and convex positions and “Andic” Umbrisol in concave positions and toeslopes. The soil pH values ranged from 5.0-5.9. TOC and TN content were medium to high (4.1-8.9% and 0.30-0.80% respectively with C/N ratios from 8-15. Range values of available Ca, Mg, K and Na were 1.9-11.24, 0.16-2.14 and 0.20-1.13, 0.04-0.13 cmol+kg-1, respectively. Top soil horizon exchangeable Al in Mambuaw was higher than in Salsalan. The differences in TN, C/N ratio and available K levels between the two locations were very highly significant, TOC was highly significant and for soil pH and available Ca and sum of bases, their disparities were significant. Available Mg and Na did not differ between the two sites. Mean potato yield in Salsalan was 8.97 tha-1 more than in Mambuaw. Mean carrot yield in Salsalan was 2.39 tha-1 lesser than in Mambuaw. Mean corn yield in Salsalan was higher than in Mambuaw by 0.29 tha-1 only. Correlations between potato yields with TOC, TN, and available Ca were highly significant while soil pH and K were significant. There was no relationship detected between potato yields and Mg and Na. There was no association detected between carrot yields with topsoil nutrient levels. Correlations were noted in corn yields with available Ca, Mg and K.

  5. Dose limits, constraints, reference levels. What does it mean for radiation protection?; Grenzwerte, Richtwerte, Referenzwerte. Was bedeutet das fuer den Strahlenschutz

    Energy Technology Data Exchange (ETDEWEB)

    Breckow, J. [Technische Hochschule Mittelhessen (THM), Giessen (Germany). Inst. fuer Medizinische Physik und Strahlenschutz (IMPS)

    2016-07-01

    The established concept of radiation protection with its basic principles justification, optimization, and limitation has proved its value and is going to be continued. In its deeper meaning, however, the concept is rather subtle and complex. Furthermore, in some aspects there remain some breaches or inconsistencies. This is just true for the terms dose limit, reference lever, and constraint that are tightly associated with the radiation protection principles. In order to guarantee the ability of radiation protection in whole extent, the subtle differences of meaning have to be communicated. There is a permanent need to defend the conceptual function of these terms against deliberate or undeliberate misinterpretations. Reference levels are definitely not the same as dose limits and they may not be misused as such. Any attempt to misinterpret fundamental radiation protection principles for selfish purposes should discouraged vigorously.

  6. [An exploratory study on the diagnostic cutoff value of International HIV-associated Dementia Scale in minority ethnic groups with different educational levels, in Guangxi].

    Science.gov (United States)

    Zhao, Ting-ting; Feng, Qi-ming; Liang, Hao; Tang, Xian-yan; Wei, Bo

    2011-11-01

    Using Intelligence Scale of Mini Mental State Estimated (MMSE) as the gold standard to determine the relevance of International HIV-associated Dementia Scale (IHDS) in minority ethnic areas in Guangxi populations with different cultural values. Corresponding boundary value related to the authenticity and reliability on IHDS were also evaluated. 200 patients with HIV infection were randomly selected from the minority ethnic groups in Guangxi. For each infected person, MMSE and IHDS blind scale were tested at the same period. Using the results from MMSE scale test as the gold standard, ROC curve and IHDS scale in Guangxi minority populations with different education levels which related to the diagnosis of dementia-HIV values were determined. The value of a specific sector under the IHDS sensitivity, specificity, and internal consistency coefficients was also evaluated. When considering the infected person did not differ on their educational level, the IHDS scale diagnostic cutoff appeared as 8.25, while IHDS sensitivity as 0.925, specificity as 0.731 and Kappa as 0.477 (P education groups showed different IHDS diagnostic cutoff values. People with high school, secondary school or higher education levels, the IHDS diagnosis appeared to be 8.25, when sensitivity was 0.917, specificity was 0.895 and Kappa was 0.722 (P education level, the IHDS appeared to be 7.25. When sensitivity was 0.875, specificity was 0.661 and Kappa was 0.372 (P value (IHDS ≤ 10 points). When using IHDS to perform the HIV related dementia screening program, in the minority areas of Guangxi, culture context, the degree and difference of HIV infection should be considered, especially in using IHDS diagnostic cutoff values.

  7. Study on the diagnostic value of combined determination of serum CA125, CA199 and SIL-2R levels in patients with endometriosis

    International Nuclear Information System (INIS)

    Yang Jingxiu; Shi Shaohong; Wang Yuping; Xie Xueqin; Qin Jibao

    2005-01-01

    Objective: To investigate the diagnostic values of combined determination of serum CA125, CA199 and SIL-2R levels in patients with endometriosis. Methods: Serum CA125, CA199 were measured with RIA and SIL-2R levels with ELISA in 54 patients with endometriosis and 35 controls. Results: The serum levels of CA125, CA199 and SIL-2R in patients with endometriosis were significantly higher than those in controls (P<0.01). The sensitivity and speciality of CA125 for endometriosis was 70.2% and 80.4% respectively, the sensitivity and speciality of CA199 for endometriosis was 62.4% and 71.8% respectively, the sensitivity and speciality of SIL-2R was 89.5% and 60.2% respectively. The sensitivity of the combined determination of CA125, CA199 and SIL-2R for endometriosis was 86.8% being significantly higher than that of CA125 and CA199 respectively. Conclusion: Combined determination of the serum CA125, CA199 and SIL-2R levels in serum can increase the diagnostic sensitivity for endometriosis. (authors)

  8. [Diagnostic evaluation of the developmental level in children identified at risk of delay through the Child Development Evaluation Test].

    Science.gov (United States)

    Rizzoli-Córdoba, Antonio; Campos-Maldonado, Martha Carmen; Vélez-Andrade, Víctor Hugo; Delgado-Ginebra, Ismael; Baqueiro-Hernández, César Iván; Villasís-Keever, Miguel Ángel; Reyes-Morales, Hortensia; Ojeda-Lara, Lucía; Davis-Martínez, Erika Berenice; O'Shea-Cuevas, Gabriel; Aceves-Villagrán, Daniel; Carrasco-Mendoza, Joaquín; Villagrán-Muñoz, Víctor Manuel; Halley-Castillo, Elizabeth; Sidonio-Aguayo, Beatriz; Palma-Tavera, Josuha Alexander; Muñoz-Hernández, Onofre

    The Child Development Evaluation (or CDE Test) was developed in Mexico as a screening tool for child developmental problems. It yields three possible results: normal, slow development or risk of delay. The modified version was elaborated using the information obtained during the validation study but its properties according to the base population are not known. The objective of this work was to establish diagnostic confirmation of developmental delay in children 16- to 59-months of age previously identified as having risk of delay through the CDE Test in primary care facilities. A population-based cross-sectional study was conducted in one Mexican state. CDE test was administered to 11,455 children 16- to 59-months of age from December/2013 to March/2014. The eligible population represented the 6.2% of the children (n=714) who were identified at risk of delay through the CDE Test. For inclusion in the study, a block randomization stratified by sex and age group was performed. Each participant included in the study had a diagnostic evaluation using the Battelle Development Inventory, 2 nd edition. From the 355 participants included with risk of delay, 65.9% were male and 80.2% were from rural areas; 6.5% were false positives (Total Development Quotient ˃90) and 6.8% did not have any domain with delay (Domain Developmental Quotient <80). The proportion of delay for each domain was as follows: communication 82.5%; cognitive 80.8%; social-personal 33.8%; motor 55.5%; and adaptive 41.7%. There were significant differences in the percentages of delay both by age and by domain/subdomain evaluated. In 93.2% of the participants, developmental delay was corroborated in at least one domain evaluated. Copyright © 2015 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  9. Thyroid diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Scriba, P C; Boerner, W; Emrich, S; Gutekunst, R; Herrmann, J; Horn, K; Klett, M; Krueskemper, H L; Pfannenstiel, P; Pickardt, C R

    1985-03-01

    None of the in-vitro and in-vivo methods listed permits on unambiguous diagnosis when applied alone, owing to the fact that similar or even identical findings are obtained for various individual parameters in different thyroid diseases. Further, especially the in-vitro tests are also subject to extrathyroidal effects which may mask the typical findings. The limited and varying specificity and sensitivity of the tests applied, as well as the falsification of results caused by the patients' idiosyncracies and the methodology, make it necessary to interpret and evaluate the in-vivo and in-vitro findings only if the clinical situation (anamnesis and physical examination) is known. For maximum diagnostic quality of the tests, the initial probability of the assumed type of thyroid disease must be increased (formulation of the clinical problem). The concepts of exclusion diagnosis and identification must be distinguished as well as the diagnosis of functional disturbances on the one hand and of thyroid diseases on the other. Both of this requires a qualified, specific and detailed anamnesis and examination procedure, and the clinical examination remains the obligatory basis of clinical diagnostics. In case of inexplicable discrepancies between the clinical manifestations and the findings obtained with specific methods, or between the findings obtained with a specific method, the patient should be referred to an expert institution, or the expert institution should be consulted.

  10. Thyroid diagnostics

    International Nuclear Information System (INIS)

    Scriba, P.C.; Boerner, W.; Emrich, S.; Gutekunst, R.; Herrmann, J.; Horn, K.; Klett, M.; Krueskemper, H.L.; Pfannenstiel, P.; Pickardt, C.R.; Reiners, C.; Reinwein, D.; Schleusener, H.

    1985-01-01

    None of the in-vitro and in-vivo methods listed permits on unambiguous diagnosis when applied alone, owing to the fact that similar or even identical findings are obtained for various individual parameters in different thyroid diseases. Further, especially the in-vitro tests are also subject to extrathyroidal effects which may mask the typical findings. The limited and varying specificity and sensitivity of the tests applied, as well as the falsification of results caused by the patients' idiosyncracies and the methodology, make it necessary to interpret and evaluate the in-vivo and in-vitro findings only if the clinical situation (anamnesis and physical examination) is known. For maximum diagnostic quality of the tests, the initial probability of the assumed type of thyroid disease must be increased (formulation of the clinical problem). The concepts of exclusion diagnosis and identification must be distinguished as well as the diagnosis of functional disturbances on the one hand and of thyroid diseases on the other. Both of this requires a qualified, specific and detailed anamnesis and examination procedure, and the clinical examination remains the obligatory basis of clinical diagnostics. In case of inexplicable discrepancies between the clinical manifestations and the findings obtained with specific methods, or between the findings obtained with a specific method, the patient should be referred to an expert institution, or the expert institution should be consulted. (orig./MG) [de

  11. Low-level cadmium exposure in Toyama City and its surroundings in Toyama prefecture, Japan, with references to possible contribution of shellfish intake to increase urinary cadmium levels

    International Nuclear Information System (INIS)

    Yamagami, T.; Ezaki, T.; Moriguchi, J.; Fukui, Y.; Okamoto, S.; Ukai, H.; Sakurai, H.; Aoshima, K.; Ikeda, M.

    2006-01-01

    Objectives: This study was initiated to examine if exposure to cadmium (Cd) was high also outside of the previously identified Itai-itai disease endemic region in the Jinzu River basin in Toyama prefecture in Japan. Methods: Morning spot urine samples were collected in June-August 2004 from 651 adult women (including 535 never-smokers) in various regions in Toyama prefecture, and subjected to urinalyses for cadmium (Cd), α 1 -microglobulin (α 1 -MG), β 2 -microglobulin (β 2 -MG), N-acetyl-β-D-glucosaminidase (NAG), specific gravity (SG or sg) and creatinine (CR or cr). Three months later, the second urine samples were collected from those with elevated Cd in urine (e.g., ≥ 4 μg/g cr), together with answers to questionnaires on shellfish consumption. Results: The geometric mean (GM) Cd, α 1 -MG, β 2 -MG and NAG (after correction for CR) for the total participants were 2.0 μg/g cr, 2.4 mg/g cr, 104 μg/g cr and 2.8 units/g cr, respectively; further analysis with never-smoking cases only did not induce significant changes in these parameters. Analyses of the second urine samples from the high Cd subjects showed that there was substantial decrease (to about a half) in Cd in the 3-month period, and that the decrease was accompanied by reduction in α 1 -MG and NAG (β 2 -MG did not show elevation even in the first samples). The urinalysis results in combination with the results of the questionnaire survey suggest that the high urinary Cd was temporary and might be induced by intake of shellfish that is edible whole. Conclusions: The overall findings appear to suggest that Cd exposure in Toyama populations (outside of the Itai-itai disease endemic region) was at the levels commonly observed on the coast of the Sea of Japan, and that the Cd level in urine might be modified by the intake of some types of seafood. Further studies are necessary to elucidate the relation of urinary Cd with seafood intake

  12. Low-level cadmium exposure in Toyama City and its surroundings in Toyama prefecture, Japan, with references to possible contribution of shellfish intake to increase urinary cadmium levels

    Energy Technology Data Exchange (ETDEWEB)

    Yamagami, T. [Hokuriku Health Service Association, Toyama 930-0177 (Japan); Ezaki, T. [Kyoto Industrial Health Association, 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku, Kyoto 604-8472 (Japan); Moriguchi, J. [Kyoto Industrial Health Association, 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku, Kyoto 604-8472 (Japan); Fukui, Y. [Kyoto Industrial Health Association, 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku, Kyoto 604-8472 (Japan); Okamoto, S. [Kyoto Industrial Health Association, 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku, Kyoto 604-8472 (Japan); Ukai, H. [Kyoto Industrial Health Association, 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku, Kyoto 604-8472 (Japan); Sakurai, H. [Occupational Health Research and Development Center, Japan Industrial Safety and Health Association, Minato-ku, Tokyo 108-0014 (Japan); Aoshima, K. [Hagino Hospital, Fuchu-machi, Toyama 939-2723 (Japan); Ikeda, M. [Kyoto Industrial Health Association, 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku, Kyoto 604-8472 (Japan)]. E-mail: ikeda@kyotokojohokenkai.or.jp

    2006-06-01

    Objectives: This study was initiated to examine if exposure to cadmium (Cd) was high also outside of the previously identified Itai-itai disease endemic region in the Jinzu River basin in Toyama prefecture in Japan. Methods: Morning spot urine samples were collected in June-August 2004 from 651 adult women (including 535 never-smokers) in various regions in Toyama prefecture, and subjected to urinalyses for cadmium (Cd), {alpha}{sub 1}-microglobulin ({alpha}{sub 1}-MG), {beta}{sub 2}-microglobulin ({beta}{sub 2}-MG), N-acetyl-{beta}-D-glucosaminidase (NAG), specific gravity (SG or sg) and creatinine (CR or cr). Three months later, the second urine samples were collected from those with elevated Cd in urine (e.g., {>=} 4 {mu}g/g cr), together with answers to questionnaires on shellfish consumption. Results: The geometric mean (GM) Cd, {alpha}{sub 1}-MG, {beta}{sub 2}-MG and NAG (after correction for CR) for the total participants were 2.0 {mu}g/g cr, 2.4 mg/g cr, 104 {mu}g/g cr and 2.8 units/g cr, respectively; further analysis with never-smoking cases only did not induce significant changes in these parameters. Analyses of the second urine samples from the high Cd subjects showed that there was substantial decrease (to about a half) in Cd in the 3-month period, and that the decrease was accompanied by reduction in {alpha}{sub 1}-MG and NAG ({beta}{sub 2}-MG did not show elevation even in the first samples). The urinalysis results in combination with the results of the questionnaire survey suggest that the high urinary Cd was temporary and might be induced by intake of shellfish that is edible whole. Conclusions: The overall findings appear to suggest that Cd exposure in Toyama populations (outside of the Itai-itai disease endemic region) was at the levels commonly observed on the coast of the Sea of Japan, and that the Cd level in urine might be modified by the intake of some types of seafood. Further studies are necessary to elucidate the relation of urinary Cd

  13. Methodology for setting the reference levels in the measurements of the dose rate absorbed in air due to the environmental gamma radiation

    International Nuclear Information System (INIS)

    Dominguez Ley, Orlando; Capote Ferrera, Eduardo; Caveda Ramos, Celia; Alonso Abad, Dolores

    2008-01-01

    Full text: The methodology for setting the reference levels of the measurements of the gamma dose rate absorbed in the air is described. The registration level was obtained using statistical methods. To set the alarm levels, it was necessary to begin with certain affectation level, which activates the investigation operation mode when being reached. It is was necessary to transform this affectation level into values of the indicators selected to set the appearance of an alarm in the network, allowing its direct comparison and at the same time a bigger operability of this one. The affectation level was assumed as an effective dose of 1 mSv/y, which is the international dose limit for public. The conversion factor obtained in a practical way as a consequence of the Chernobyl accident was assumed, converting the value of annual effective dose into values of effective dose rate in air. These factors are the most important in our work, since the main task of the National Network of Environmental Radiological Surveillance of the Republic of Cuba is detecting accidents with a situations regional affectation, and this accident is precisely an example of pollution at this scale. The alarm level setting was based on the results obtained in the first year of the Chernobyl accident. For this purpose, some transformations were achieved. In the final results, a correction factor was introduced depending on the year season the measurement was made. It was taken into account the influence of different meteorological events on the measurement of this indicator. (author)

  14. An audit of diagnostic reference levels in interventional cardiology and radiology: Are there differences between academic and non-academic centres?

    International Nuclear Information System (INIS)

    Samara, E. T.; Aroua, A.; De palma, R.; Stauffer, J. C.; Schmidt, S.; Trueb, P. R.; Stuessi, A.; Treier, R.; Bochud, F.; Verdun, F. R.

    2012-01-01

    A wide variation in patient exposure has been observed in interventional radiology and cardiology. The purpose of this study was to investigate the patient dose from fluoroscopy-guided procedures performed in non-academic centres when compared with academic centres. Four procedures (coronary angiography, percutaneous coronary intervention, angiography of the lower limbs and percutaneous transluminal angioplasty of the lower limbs) were evaluated. Data on the dose-area product, fluoroscopy time and number of images for 1000 procedures were obtained from 23 non-academic centres and compared with data from 5 academic centres. No differences were found for cardiology procedures performed in non-academic centres versus academic ones. However, significantly lower doses were delivered to patients for procedures of the lower limbs when they were performed in non-academic centres. This may be due to more complex procedures performed in the academic centres. Comparison between the centres showed a great variation in the patient dose for these lower limb procedures. (authors)

  15. Clinical diagnostic value of combined determination of serum tPSA, cPSA and IGF-I levels in patients with prostatic disorders

    International Nuclear Information System (INIS)

    Zhang Bashan; Zhang Zigang; Lai Fudi

    2008-01-01

    Objective: To investigate the diagnostic value of combined determination of serum total prostatic specific antigen (tPSA), complex prostatic specific antigen (cPSA) and IGF-I levels in patients with prostatic disorders. Methods: Serum tPSA, cPSA (with CLIA) and IGF-I (with IRMA) levels were determined in 41 patients with prostatic carcinoma, 60 patients with benign prosta- tic hypertrophy (BPH) and 55 controls. Results: The serum tPSA, cPSA and IGF-I levels in patients with prostatic cancer were significantly higher than those in patients with BPH and controls (P<0.01). Taking the cut-off values of 4ng/ml, 3.6ng/ml and 150 for tPSA, cPSA and IGF-I respectively, the combined determination of these three items would yield a sensitivity of 88.6%, specificity of 84.9%, positive predicative value of 83% and negative predicative value of 90.0% for diagnosis of prostatic cancer. Conclusion: Combined determination of tPSA, cPSA and IGF-I would yield better sensitive and accurate diagnostic rate in patients with prostatic cancer, especially in those with laboratory values within the 'grey zone'. (authors)

  16. Viability study of a construction of invasive high voltage meter for the National Reference Laboratory of the Brazilian Net Calibration in Diagnostic Radiology, the National Laboratory of Metrology of the Ionizing Radiation - LNMRI

    International Nuclear Information System (INIS)

    Quaresma, D.S.; Peixoto, J.G.P.; Pereira, M.A.G.

    2007-01-01

    This work has studied the parameters for the construction of an invasive high voltage meter for the National Reference Laboratory of the Brazilian Net Calibration in Diagnostic Radiology, the National Laboratory of Metrology of the Ionizing Radiation - LNMRI. This study took into consideration the necessity of quality control of the of X-rays equipment required by Ministry of Health - MS, through the regulation N.453. To satisfy the demands of the MS, the recommendation of the norm IEC 61676 was analyzed by using the quantity of Practical Peak Voltage (PPV) in the measurements of the voltage discharge applied to the X-rays tubes, the infra structures of metrology available in the country to offer tracking the components of the high voltage meter through INMETRO and the difficulty of adaptation of the high voltage meter analyser III U in relation to the Pan tak HF160 equipment in which respect the connection of the high voltage cable and the voltage limitations due to the electric configuration of the high voltage generator of the constant potential Pantak HF160 equipment. (author)

  17. Post-exposure vaccination with multi-stage vaccine significantly reduce map level in tissues without interference in diagnostics

    DEFF Research Database (Denmark)

    Thakur, Aneesh; Aagaard, Claus; Melvang, Heidi Mikkelsen

    A new (Fet11) vaccine against paratuberculosis based on recombinant antigens from acute and latent stages of Map infection was developed to be used without interference with diagnostic tests for bovine TB and Johne’s disease. Calves were orally inoculated with 2x10E10 live Map in their third week...... of life and randomly assigned to four groups of seven calves each. One group was left unvaccinated, while other calves were post-exposure vaccinated with either a whole-cell vaccine at 16 weeks, or Fet11 vaccine at 3 and 7, or 16 and 20 weeks of age, respectively. Antibody responses were measured by ID...... Screen® ELISA and individual vaccine protein ELISAs along with FACS and IFN-γ responses to PPDj and to individual vaccine proteins. At termination 8 or 12 months of age, Map burden in a number of gut tissues was determined by quantitative IS900 PCR and histopathology. Fet11 vaccination of calves at 16...

  18. A two-level approach to VLBI terrestrial and celestial reference frames using both least-squares adjustment and Kalman filter algorithms

    Science.gov (United States)

    Soja, B.; Krasna, H.; Boehm, J.; Gross, R. S.; Abbondanza, C.; Chin, T. M.; Heflin, M. B.; Parker, J. W.; Wu, X.

    2017-12-01

    The most recent realizations of the ITRS include several innovations, two of which are especially relevant to this study. On the one hand, the IERS ITRS combination center at DGFI-TUM introduced a two-level approach with DTRF2014, consisting of a classical deterministic frame based on normal equations and an optional coordinate time series of non-tidal displacements calculated from geophysical loading models. On the other hand, the JTRF2014 by the combination center at JPL is a time series representation of the ITRF determined by Kalman filtering. Both the JTRF2014 and the second level of the DTRF2014 are thus able to take into account short-term variations in the station coordinates. In this study, based on VLBI data, we combine these two approaches, applying them to the determination of both terrestrial and celestial reference frames. Our product has two levels like DTRF2014, with the second level being a Kalman filter solution like JTRF2014. First, we compute a classical TRF and CRF in a global least-squares adjustment by stacking normal equations from 5446 VLBI sessions between 1979 and 2016 using the Vienna VLBI and Satellite Software VieVS (solution level 1). Next, we obtain coordinate residuals from the global adjustment by applying the level-1 TRF and CRF in the single-session analysis and estimating coordinate offsets. These residuals are fed into a Kalman filter and smoother, taking into account the stochastic properties of the individual stations and radio sources. The resulting coordinate time series (solution level 2) serve as an additional layer representing irregular variations not considered in the first level of our approach. Both levels of our solution are implemented in VieVS in order to test their individual and combined performance regarding the repeatabilities of estimated baseline lengths, EOP, and radio source coordinates.

  19. Clinical diagnostic value of combined determination of serum TSGF, CEA, CYFRA21-1 and NSE levels in patients with lung cancer

    International Nuclear Information System (INIS)

    Sun Qihe; Sun Bin

    2008-01-01

    Objective: To explore the clinical diagnostic value of combined determination of serum TSGF, CEA, CYFRA21-1 and NSE levels in patients with lung cancer. Methods: The four serum tumor markers were determined with RIA or other methods in 179 patients with lung cancer, 48 patients with benign lung diseases and 51 controls. Results: The serum levels of all these four markers in the cancer patients were significantly higher (P<0.05-P<0.01) than those in patients with benign pulmonary disorders with the exception of: (1) Serum TSGF, CEA and NSE levels in patients with stage I and II squamous cell carcinoma (n=37) and (2) serum NSE levels in patients with stage I and II adenocarcinoma (n=32). As a whole, the levels of the markers increased along with the increase of the severity of the disease. Conclusion: For the early diagnosis of lung cancer, serum CYFRA21-1 levels determination is the most specific and serum NSE levels determination for diagnosis in patients with NSCLC is the least sensitive. The combined determination of tumor markers is the best choice. (authors)

  20. Derived emergency reference levels for the introduction of countermeasures in the early to intermediate phases of emergencies involving the release of radioactive materials to atmosphere

    International Nuclear Information System (INIS)

    Linsley, G.S.; Crick, M.J.; Simmonds, J.R.; Haywood, S.M.

    1986-03-01

    Derived Emergency Reference Levels (DERLs) are practical quantities intended for use in the aftermath of an accident involving the release of radioactive materials to atmosphere and for use in preparing emergency plans for the protection of the public. The results of environmental measurements may be compared with them as a means of assessing the seriousness of the release and in order to form judgements on the need to institute protective countermeasures. DERLs are the practical expression of Emergency Reference Levels, the radiological criteria for planning the introduction of emergency countermeasures. DERLs have been evaluated for a range of radionuclides which could be released in the event of an accident and for a number of different exposure pathways that are relevant in the initial phase of an accident. These pathways are: inhalation of activity both in the plume and resuspended from the ground; skin irradiation by β-emitting noble gases in the cloud; doses from β-emitters deposited on the skin; and external γ irradiation from ground deposits. (author)

  1. Paleoclimatological context and reference level of the 2°C and 1.5°C Paris Agreement long-term temperature limits

    Science.gov (United States)

    Lüning, Sebastian; Vahrenholt, Fritz

    2017-12-01

    The Paris Agreement adopted in December 2015 during the COP21 conference stipulates that the increase in the global average temperature is to be kept well below 2°C above “pre-industrial levels” and that efforts are pursued to limit the temperature increase to 1.5°C above “pre-industrial levels”. In order to further increase public acceptance of these limits it is important to transparently place the target levels and their baselines in a paleoclimatic context of the past 150,000 years (Last Interglacial, LIG) and in particular of the last 10,000 years (Holocene; Present Interglacial, PIG). Intense paleoclimatological research of the past decade has firmed up that pre-industrial temperatures have been highly variable which needs to be reflected in the pre-industrial climate baseline definitions. The currently used reference level 1850-1900 represents the end of the Little Ice Age (LIA).The LIA represents the coldest phase of the last 10,000 years when mean temperatures deviated strongly negatively from the Holocene average and which therefore are hard to justify as a representative pre-industrial baseline. The temperature level reached during the interval 1940-1970 may serve as a better reference level as it appears to roughly correspond to the average pre-industrial temperature of the past two millennia. Placing the climate limits in an enlarged paleoclimatic context will help to demonstrate that the chosen climate targets are valid and represent dangerous extremes of the known natural range of Holocene temperature variability.

  2. Tune-Based Halo Diagnostics

    International Nuclear Information System (INIS)

    Cameron, Peter

    2003-01-01

    Tune-based halo diagnostics can be divided into two categories -- diagnostics for halo prevention, and diagnostics for halo measurement. Diagnostics for halo prevention are standard fare in accumulators, synchrotrons, and storage rings, and again can be divided into two categories -- diagnostics to measure the tune distribution (primarily to avoid resonances), and diagnostics to identify instabilities (which will not be discussed here). These diagnostic systems include kicked (coherent) tune measurement, phase-locked loop (PLL) tune measurement, Schottky tune measurement, beam transfer function (BTF) measurements, and measurement of transverse quadrupole mode envelope oscillations. We refer briefly to tune diagnostics used at RHIC and intended for the SNS, and then present experimental results. Tune-based diagnostics for halo measurement (as opposed to prevention) are considerably more difficult. We present one brief example of tune-based halo measurement

  3. Comparative clinical evaluation of glycosylated haemoglobin level in healthy and chronic periodontitis patients: A chairside diagnostic method.

    Science.gov (United States)

    Srinivasa, T S; Agrawal, Parul; Goyal, Pravesh; Farista, Sana; Sowmya, N K; Deonani, Sushmita

    2015-01-01

    Glycosylated haemoglobin (HbA1c) level can consequently be interpreted as an average of the blood glucose present over the past 3-4 months. Periodontitis is associated with glycemic control in patients with diabetes. The purpose of this study was to determine the level of HbA1c in healthy and periodontitis patients who were previously not diagnosed with diabetes mellitus. A total of 40 patients were selected for study and divided into two groups. Group 1 included patients with a healthy periodontium, and Group 2 included patients suffering from chronic periodontitis. Finger stick blood was collected by special collection unit (A1CNOW+® Bayer Health Care, Tarrytown New York, USA), for estimating level of HbA1c. Both groups showed similar HbA1c levels clinically with slight increase in levels in the test group, but was statistically significant (test--5.66 ± 0.35%, control--5.17 ± 0.3% P = 0.003). Indians are at a high-risk of developing periodontitis and diabetes. These data suggest a possible link between periodontitis and glycemic control in nondiabetic individuals, periodontal disease may be a potential contributor to the development of type 2 diabetes.

  4. Comparative clinical evaluation of glycosylated haemoglobin level in healthy and chronic periodontitis patients: A chairside diagnostic method

    Directory of Open Access Journals (Sweden)

    T S Srinivasa

    2015-01-01

    Full Text Available Objective and Background: Glycosylated haemoglobin (HbA1c level can consequently be interpreted as an average of the blood glucose present over the past 3-4 months. Periodontitis is associated with glycemic control in patients with diabetes. The purpose of this study was to determine the level of HbA1c in healthy and periodontitis patients who were previously not diagnosed with diabetes mellitus. Materials and Methods: A total of 40 patients were selected for study and divided into two groups. Group 1 included patients with a healthy periodontium, and Group 2 included patients suffering from chronic periodontitis. Finger stick blood was collected by special collection unit (A1CNOW +® Bayer Health Care, Tarrytown New York, USA, for estimating level of HbA1c. Result: Both groups showed similar HbA1c levels clinically with slight increase in levels in the test group, but was statistically significant (test - 5.66 ± 0.35%, control - 5.17 ± 0.3% P = 0.003. Conclusion: Indians are at a high-risk of developing periodontitis and diabetes. These data suggest a possible link between periodontitis and glycemic control in nondiabetic individuals, periodontal disease may be a potential contributor to the development of type 2 diabetes.

  5. tavgM_2d_slv_Nx: MERRA 2D IAU Diagnostic, Single Level Meteorology, Monthly Mean 0.667 x 0.5 degree V5.2.0 (MATMNXSLV) at GES DISC

    Data.gov (United States)

    National Aeronautics and Space Administration — The MATMNXSLV or tavgM_2d_slv_Nx data product is the MERRA Data Assimilation System 2-Dimensional atmospheric single-level diagnostics that is time averaged...

  6. tavg1_2d_slv_Nx: MERRA 2D IAU Diagnostic, Single Level Meteorology, Time Average 1-hourly 0.667 x 0.5 degree V5.2.0 (MAT1NXSLV) at GES DISC

    Data.gov (United States)

    National Aeronautics and Space Administration — The MAT1NXSLV or tavg1_2d_slv_Nx data product is the MERRA Data Assimilation System 2-Dimensional atmospheric single-level diagnostics that is time averaged...

  7. Diagnostic performance of initial serum albumin level for predicting in-hospital mortality among aspiration pneumonia patients.

    Science.gov (United States)

    Kim, Hyosun; Jo, Sion; Lee, Jae Baek; Jin, Youngho; Jeong, Taeoh; Yoon, Jaechol; Lee, Jeong Moon; Park, Boyoung

    2018-01-01

    The predictive value of serum albumin in adult aspiration pneumonia patients remains unknown. Using data collected during a 3-year retrospective cohort of hospitalized adult patients with aspiration pneumonia, we evaluated the predictive value of serum albumin level at ED presentation for in-hospital mortality. 248 Patients were enrolled; of these, 51 cases died (20.6%). The mean serum albumin level was 3.4±0.7g/dL and serum albumin levels were significantly lower in the non-survivor group than in the survivor group (3.0±0.6g/dL vs. 3.5±0.6g/dL). In the multivariable logistic regression model, albumin was associated with in-hospital mortality significantly (adjusted odds ratio 0.30, 95% confidential interval (CI) 0.16-0.57). The area under the receiver operating characteristics (AUROC) for in-hospital survival was 0.72 (95% CI 0.64-0.80). The Youden index was 3.2g/dL and corresponding sensitivity, specificity, positive predictive value, negative predictive value, positive and negative likelihood ratio were 68.6%, 66.5%, 34.7%, 89.1%, 2.05 and 0.47, respectively. High sensitivity (98.0%) was shown at albumin level of 4.0g/dL and high specificity (94.9%) was shown at level of 2.5g/dL. Initial serum albumin levels were independently associated with in-hospital mortality among adult patients hospitalized with aspiration pneumonia and demonstrated fair discriminative performance in the prediction of in-hospital mortality. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Pre-diagnostic plasma 25-hydroxyvitamin D levels and risk of non-melanoma skin cancer in women.

    Directory of Open Access Journals (Sweden)

    Geyu Liang

    Full Text Available Recent reports have shown that vitamin D status was inversely associated with the risk of various cancers. However, few studies examined the association between vitamin D levels and risk of skin cancer.We prospectively evaluated the association between baseline plasma 25(OHD levels and the risk of incident squamous cell carcinoma (SCC and basal cell carcinoma (BCC among 4,641 women from the Nurses' Health Study (NHS and the NHS II with 510 incident BCC cases and 75 incident SCC cases. We used multivariate logistic regression models to calculate odds ratios (ORs and 95% confidence intervals (CIs.Plasma 25(OHD levels were positively associated with risk of BCC after adjusting for age at blood draw, season of blood draw, lab batch, hair color, burning tendency, the number of sunburns, and ultra-violet B flux of residence at blood collection. Women in the highest quartile of 25(OHD had more than 2-fold increased risk of BCC compared with women in the lowest quartile (OR = 2.07, 95% CI = 1.52-2.80, P for trend <0.0001. We also found a significantly positive association between plasma 25(OHD levels and SCC risk after adjusting for the same covariates (OR, highest vs. lowest quartile = 3.77, 95% CI = 1.70-8.36, P for trend= 0.0002.In this prospective study of women, plasma vitamin D levels were positively associated with non-melanoma skin cancer risk. Considering that most circulating vitamin D is due to sun exposure, the positive association between plasma vitamin D and non-melanoma skin cancer is confounded by sun exposure. Our data suggest that one-time measurement of plasma vitamin D levels may reasonably reflect long-term sun exposure and predict the risk of non-melanoma skin cancer.

  9. Growth references

    NARCIS (Netherlands)

    Buuren, S. van

    2007-01-01

    A growth reference describes the variation of an anthropometric measurement within a group of individuals. A reference is a tool for grouping and analyzing data and provides a common basis for comparing populations.1 A well known type of reference is the age-conditional growth diagram. The

  10. LEVELS OF PATIENTS EXPOSURE AND A POTENTIAL FOR OPTIMIZATION OF THE PET DIAGNOSTICS IN THE RUSSIAN FEDERATION

    Directory of Open Access Journals (Sweden)

    L. A. Chipiga

    2017-01-01

    examinations in Russia and for the intercomparison of results obtained in different positron emission tomography departments. Low dose computed tomography protocols, justification of diagnostic and multiphase computed tomography protocols, application of tube current modulation system and modern reconstruction algorithms, education and training of the staff in the field of radiation protection should be used for optimization of radiation protection of patient. 

  11. Diagnostic investigations of DKK-1 and PDCD5 expression levels as independent prognostic markers of human chondrosarcoma.

    Science.gov (United States)

    Zarea, Mojtaba; Mohammadian Bajgiran, Amirhossein; Sedaghati, Farnoush; Hatami, Negin; Taheriazam, Afshin; Yahaghi, Emad; Shakeri, Mohammadreza

    2016-07-01

    In this study, we investigated the expression levels of Dickkopf-1 (DKK-1) and programmed cell death 5 (PDCD5) by using quantitative real-time PCR and immunohistochemistry in patients with chondrosarcoma. The DKK-1 mRNA levels were significantly higher in chondrosarcoma when compared with the corresponding nontumor tissues (mean ± SD: 4.23 ± 1.54; 1.54 ± 0.87; P = 0.001). PDCD5 mRNA levels were remarkably deceased in tumor tissues when compared with corresponding nontumor tissues (mean ± SD: 1.94 ± 0.73; 5.42 ± 1.73; P = 0.001). The high and moderate DKK-1 expressions were observed for 60% of chondrosarcoma samples in comparison with 27.5% of corresponding nontumor tissues (P  =  0.001). Moreover, low expression of PDCD5 was found in 67.5% of the tumor tissues when compared with the nontumor tissues (32.5%; P = 0.002). The results of this study showed that high DKK-1 expression levels were strongly related to MSTS stage (P = 0.011) and the advancement of histological grade (P chondrosarcoma. © 2016 IUBMB Life, 68(7):597-601, 2016. © 2016 International Union of Biochemistry and Molecular Biology.

  12. Combined assessment of DYRK1A, BDNF and homocysteine levels as diagnostic marker for Alzheimer’s disease

    Science.gov (United States)

    Janel, N; Alexopoulos, P; Badel, A; Lamari, F; Camproux, A C; Lagarde, J; Simon, S; Feraudet-Tarisse, C; Lamourette, P; Arbones, M; Paul, J L; Dubois, B; Potier, M C; Sarazin, M; Delabar, J M

    2017-01-01

    Early identification of Alzheimer’s disease (AD) risk factors would aid development of interventions to delay the onset of dementia, but current biomarkers are invasive and/or costly to assess. Validated plasma biomarkers would circumvent these challenges. We previously identified the kinase DYRK1A in plasma. To validate DYRK1A as a biomarker for AD diagnosis, we assessed the levels of DYRK1A and the related markers brain-derived neurotrophic factor (BDNF) and homocysteine in two unrelated AD patient cohorts with age-matched controls. Receiver-operating characteristic curves and logistic regression analyses showed that combined assessment of DYRK1A, BDNF and homocysteine has a sensitivity of 0.952, a specificity of 0.889 and an accuracy of 0.933 in testing for AD. The blood levels of these markers provide a diagnosis assessment profile. Combined assessment of these three markers outperforms most of the previous markers and could become a useful substitute to the current panel of AD biomarkers. These results associate a decreased level of DYRK1A with AD and challenge the use of DYRK1A inhibitors in peripheral tissues as treatment. These measures will be useful for diagnosis purposes. PMID:28632203

  13. Co-inheritance of α0 -thalassemia elevates Hb A2 level in homozygous Hb E: Diagnostic implications.

    Science.gov (United States)

    Singha, K; Srivorakun, H; Fucharoen, G; Fucharoen, S

    2017-10-01

    Differentiation of homozygous hemoglobin (Hb) E with and without α 0 -thalassemia is subtle on routine hematological ground. We examined in a large cohort of homozygous Hb E if the level of Hb A 2 is helpful. A total of 592 subjects with homozygous Hb E were recruited from ongoing thalassemia screening program. Additionally, five couples at risk of having fetuses with Hb Bart's hydrops fetalis who were homozygous Hb E were also investigated. Hb analysis was performed using capillary electrophoresis system. Globin genotypes were defined by DNA analysis. Subjects were classified into four groups including pure homozygous Hb E (n=532), homozygous Hb E/α 0 -thalassemia (n=48), Hb Constant Spring EE Bart's disease (n=8), and Hb EE Bart's disease (n=4). The levels of Hb A 2 were found, respectively, to be 4.97±0.69, 6.64±1.02, 4.86±0.87, and 7.60±1.04%. Among five couples at risk, α 0 -thalassemia was identified in three subjects with Hb A 2 >6.0%. Increased Hb A 2 level is a useful marker for differentiation of homozygous Hb E with and without α 0 -thalassemia. This should lead to a significant reduction in number of referral cases of homozygous Hb E for molecular testing of α 0 -thalassemia in routine practice. © 2017 John Wiley & Sons Ltd.

  14. [Full blood count reference values in children of 8 to 12 years old residing at 2,760 m above sea level].

    Science.gov (United States)

    Armando García-Miranda, L; Contreras, I; Estrada, J A

    2014-04-01

    To determine reference values for full blood count parameters in a population of children 8 to 12 years old, living at an altitude of 2760 m above sea level. Our sample consisted of 102 individuals on whom a full blood count was performed. The parameters included: total number of red blood cells, platelets, white cells, and a differential count (millions/μl and %) of neutrophils, lymphocytes, monocytes, eosinophils and basophils. Additionally, we obtained values for hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, concentration of corpuscular hemoglobin and red blood cell distribution width. The results were statistically analyzed with a non-parametric test, to divide the sample in quartiles and obtain the lower and upper limits for our intervals. Moreover, the values for the intervals obtained from this analysis were compared to intervals obtained estimating+- 2 standard deviations above and below from our mean values. Our results showed significant differences compared to normal interval values reported for the adult Mexican population in most of the parameters studied. The full blood count is an important laboratory test used routinely for the initial assessment of a patient. Values of full blood counts in healthy individuals vary according to gender, age and geographic location; therefore, each population should have its own reference values. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  15. Associated factors for higher lead and cadmium blood levels, and reference values derived from general population of São Paulo, Brazil

    International Nuclear Information System (INIS)

    Kira, Carmen Silvia; Sakuma, Alice Momoyo; De Capitani, Eduardo Mello; Umbelino de Freitas, Clarice; Cardoso, Maria Regina Alves; Gouveia, Nelson

    2016-01-01

    Human activities are associated with emissions of various metals into the environment, among which the heavy metals lead and cadmium stand out, as they pose a risk to human life even at low concentrations. Thus, accurate knowledge of the levels of these metals exhibited by the overall population, including children, is important. The aim of this study was to estimate the concentrations of lead and cadmium in the blood of adults, adolescents and children residing in the city of São Paulo, assess factors associated with higher lead and cadmium blood levels, and to establish reference values for this population. The study sample consisted of 669 adults over 20 years old, 264 adolescents aged 12 to 19 years old and 391 children under 11 years old from both genders. The samples were collected at the end of 2007 and during 2008 in different city zones. Higher blood lead concentration was significantly associated with gender, smoking, offal intake, area of residence and age. The blood cadmium concentration was significantly associated with gender, smoking, consumption of distilled beverages and age. The reference values of lead and cadmium established for adults above 20 years old were 33 μg/L and 0.6 μg/L, respectively, for adolescents (12 to 19 years old) were 31 μg/L and 0.6 μg/L, respectively and for children under 11 years old were 29 μg/L and 0.2 μg/L, respectively. The results of this study indicate that the exposure levels of the investigated population to lead and cadmium are low. - Highlights: • The exposure of population of São Paulo city to lead and cadmium is low. • Pb level was associated with gender, smoking, offal intake, area of residence, age. • Cd level was associated with gender, smoking, distilled beverages, age. • RV for Pb in blood for children and adolescents were 29 and 31 μg/L, respectively. • RV for Cd in blood for children and adolescents were 0.2 and 0.6 μg/L, respectively.

  16. Associated factors for higher lead and cadmium blood levels, and reference values derived from general population of São Paulo, Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Kira, Carmen Silvia, E-mail: carmkira@ial.sp.gov.br [Instituto Adolfo Lutz, Centro de Materiais de Referência, Av. Dr. Arnaldo, 355, São Paulo, SP CEP 01246-000 (Brazil); Sakuma, Alice Momoyo [Instituto Adolfo Lutz, Centro de Materiais de Referência, Av. Dr. Arnaldo, 355, São Paulo, SP CEP 01246-000 (Brazil); De Capitani, Eduardo Mello [Universidade Estadual de Campinas — UNICAMP, Faculdade de Ciências Médicas, Departamento de Clínica Médica, Centro de Controle de Intoxicações (Brazil); Umbelino de Freitas, Clarice [Secretaria de Estado da Saúde/SP, Coordenadoria de Controle de Doenças (Brazil); Cardoso, Maria Regina Alves [Universidade de São Paulo, Faculdade de Saúde Pública, Departamento de Epidemiologia (Brazil); Gouveia, Nelson [Universidade de São Paulo — USP, Faculdade de Medicina, Departamento de Medicina Preventiva (Brazil)

    2016-02-01

    Human activities are associated with emissions of various metals into the environment, among which the heavy metals lead and cadmium stand out, as they pose a risk to human life even at low concentrations. Thus, accurate knowledge of the levels of these metals exhibited by the overall population, including children, is important. The aim of this study was to estimate the concentrations of lead and cadmium in the blood of adults, adolescents and children residing in the city of São Paulo, assess factors associated with higher lead and cadmium blood levels, and to establish reference values for this population. The study sample consisted of 669 adults over 20 years old, 264 adolescents aged 12 to 19 years old and 391 children under 11 years old from both genders. The samples were collected at the end of 2007 and during 2008 in different city zones. Higher blood lead concentration was significantly associated with gender, smoking, offal intake, area of residence and age. The blood cadmium concentration was significantly associated with gender, smoking, consumption of distilled beverages and age. The reference values of lead and cadmium established for adults above 20 years old were 33 μg/L and 0.6 μg/L, respectively, for adolescents (12 to 19 years old) were 31 μg/L and 0.6 μg/L, respectively and for children under 11 years old were 29 μg/L and 0.2 μg/L, respectively. The results of this study indicate that the exposure levels of the investigated population to lead and cadmium are low. - Highlights: • The exposure of population of São Paulo city to lead and cadmium is low. • Pb level was associated with gender, smoking, offal intake, area of residence, age. • Cd level was associated with gender, smoking, distilled beverages, age. • RV for Pb in blood for children and adolescents were 29 and 31 μg/L, respectively. • RV for Cd in blood for children and adolescents were 0.2 and 0.6 μg/L, respectively.

  17. Low-level radioactive waste from commercial nuclear reactors. Volume 3. Bibliographic abstracts of significant source references. Part 2. Bibliography for treatment, storage, disposal and transportation regulatory constraints

    Energy Technology Data Exchange (ETDEWEB)

    Jolley, R.L.; Rodgers, B.R.

    1986-05-01

    The overall task of this program was to provide an assessment of currently available technology for treating commercial low-level radioactive waste (LLRW), to initiate development of a methodology for choosing one technology for a given application, and to identify research needed to improve current treatment techniques and decision methodology. The resulting report is issued in four volumes. Volume 3 of this series is a collection of abstracts of most of the reference documents used for this study. Because of the large volume of literature, the abstracts have been printed in two separate parts. Federal, state, and local regulations affect the decision process for selecting technology applications. Regulations may favor a particular technology and may prevent application of others. Volume 3, part 2 presents abstracts of the regulatory constraint documents that relate to all phases of LLRW management (e.g., treatment, packaging, storage, transportation, and disposal).

  18. Assessment of homogeneity of candidate reference material at the nanogram level and investigation on representativeness of single particle analysis using electron probe X ray microanalysis

    International Nuclear Information System (INIS)

    Ro, Chul-Un; Hoornaerta, S.; Griekena, R. van

    2002-01-01

    Particulate samples of a candidate reference material are evaluated on their homogeneity from bottle to bottle using electron probe X ray microanalysis technique. The evaluation on the homogeneity is done by the utilization of the Kolmogorov-Smirnov statistics to the processing of the quantitative electron probe X ray microanalysis data. Due to a limitation, existing even in computer controlled electron probe X ray microanalysis, in terms of analysis time and expenses, the number of particles analyzed is much smaller compared to that in the sample. Therefore, it is investigated whether this technique provides representative analysis results for the characteristics of the sample, even though a very small portion of the sample is really analyzed. Furthermore, the required number of particles for the analysis, to insure a certain level of reproducibility, e.g. 5% relative standard deviation, is determined by the application of the Ingamells sampling theory. (author)

  19. Mitigation diagnostics

    International Nuclear Information System (INIS)

    Hall, S.T.

    1990-01-01

    This paper reports that experience in the remediation of schools and other large buildings has shown the importance of the effects of both the location of geologic sources and HVAC-induced distribution of indoor radon. In general, elevated radon in areas of schools with evenly distributed HVAC pressures are correlated with maximum soil radon emanations. However, strong or unequal HVAC effects can redistribute indoor radon to areas away from the direct source. Effective remediation required a complete understanding of both contributions. In some schools, highest indoor radon levels were located near large return ducts and were attributed to proximity to negative HVAC pressure. Successful sub-slab depressurization systems were installed, however, in rooms with lower indoor but greatest sub-slab radon levels, closest to the source. This shows the inadequacy of using indoor radon levels alone as a basis for remediation. Wings of two other schools with radon problems have equivalent window fan coil units in rooms of equal size and no central HVAC system. Highest indoor radon levels correlated well with highest sub-slab radon levels due to the equivalent effects of the window units. Diagnostic tests in other schools have revealed: blockwall radon transport to upper floors; high blockwall radon adjacent to sub-slab sources; and elevated indoor radon over crawlspace being drawn upward by HVAC-induced negative pressure, determined from indoor to outdoor micromanometer measurements

  20. Reference values on safety regulation of land disposal of low level radioactive solid waste (the second interim report) and its incorporation into legal regulations

    International Nuclear Information System (INIS)

    Aoki, Terumi

    1994-01-01

    Safety regulation of land disposal of low level radioactive solid waste in Japan is based on 'the basic philosophy on the safety regulation of land disposal of low level radioactive solid waste' determined by the Nuclear safety Committee (October 1985). The basic philosophy on the upper limit of radioactivity of disposed wastes was published as the reference values in the interim report (February 1987) and in the second interim report (June 1992). In the second interim report, the upper limits of radioactivity are established for three types of solid radioactive wastes: 1) metals, incombustible or flame resistant wastes generated nuclear reactor facilities and solidified in vessels, 2) large metallic structures generated from decommissioning of reactor facilities and difficult to solidify in vessels, and 3) radioactive concrete waste generated from decommissioning of reactor facilities. The upper limits of radioactivity are presented for C-14, Co-60, Ni-63, Sr-90, Cs-137, alfa-emmitters, Ca-41 (for concrete) and Eu-152 (for concrete). Related laws and regulations in Japan on safe disposal of low level wastes are explained. (T.H.)

  1. Field estimation of the flock-level diagnostic specificity of an enzyme-linked immunosorbent assay for Avian metapneumovirus antibodies in turkeys.

    Science.gov (United States)

    Muñoz-Zanzi, Claudia; Trampel, Darrell; Hanson, Tim; Harrison, Kristen; Goyal, Sagar; Cortinas, Roberto; Lauer, Dale

    2009-03-01

    Routine serologic testing for Avian metapneumovirus (AMPV) infection of turkey flocks at slaughter is currently being used to monitor changes in the occurrence of AMPV infection in endemic areas and can also be used to detect the emergence of infection in currently unaffected areas. Because of the costs associated with false-positive results, particularly in areas that are free of AMPV infection, there is a need to obtain improved estimates of flock-level specificity (SP). The objective of this study was to estimate flock-level SP of a program to monitor AMPV infection in turkey flocks at processing using a standard enzyme-linked immunosorbent assay (ELISA). A study was carried out in which 37 AMPV-free flocks from 7 Midwest operations were followed serologically. Six percent, 3%, and 0.2% of total samples tested AMPV positive at 8 weeks, 12 weeks, and at processing, respectively. Overall, flock-level SP increased as the cutoff increased and as age increased. Flock-level SP at processing was 97%, if a cutoff of 1 was used (the flock was classified as positive if at least 1 sample tested positive), and 100%, if any other cutoff was used. Administration of antibiotics (P = 0.02) and vaccination for Bordetella avium (P = 0.08) were positively associated with the probability of (false) positive test results. These findings suggest possible cross-reactions with other infections and highlight the need to consider variable diagnostic performance depending on farm conditions.

  2. [Reference citation].

    Science.gov (United States)

    Brkić, Silvija

    2013-01-01

    Scientific and professional papers represent the information basis for scientific research and professional work. References important for the paper should be cited within the text, and listed at the end of the paper. This paper deals with different styles of reference citation. Special emphasis was placed on the Vancouver Style for reference citation in biomedical journals established by the International Committee of Medical Journal Editors. It includes original samples for citing various types of articles, both printed and electronic, as well as recommendations related to reference citation in accordance with the methodology and ethics of scientific research and guidelines for preparing manuscripts for publication.

  3. Patient dosimetry in diagnostic radiology

    Directory of Open Access Journals (Sweden)

    Ciraj-Bjelac Olivera F.

    2003-01-01

    Full Text Available The objective of this work is to assess patient organ doses, effective doses and entrance surface doses in conventional diagnostic radiology procedures for standard adult patient. The survey consists of measurements of doses delivered to 239 patients in nine types of X-ray examinations. Three types of data were collected: X-ray machine data, patient data, and output measurements. Entrance surface dose was assessed based on the survey data and subsequently, using conversion coefficients, the organ doses and effective doses were calculated. Values of the entrance surface dose and the effective dose were estimated to be 0.4 to 5.8 mGy and 0.03 to 3.00 mSv for different examinations. Derived doses were compared with recommended general diagnostic reference levels. The impact of examination parameters on dose values was discussed. Except for posterior-anterior chest examination, all estimated doses are lower than stated reference levels. Survey data are aimed at helping development of national quality control and radiation protection programmed for medical exposures.

  4. Reference Assessment

    Science.gov (United States)

    Bivens-Tatum, Wayne

    2006-01-01

    This article presents interesting articles that explore several different areas of reference assessment, including practical case studies and theoretical articles that address a range of issues such as librarian behavior, patron satisfaction, virtual reference, or evaluation design. They include: (1) "Evaluating the Quality of a Chat Service"…

  5. The costs of heart failure in Poland from the public payer's perspective. Polish programme assessing diagnostic procedures, treatment and costs in patients with heart failure in randomly selected outpatient clinics and hospitals at different levels of care: POLKARD.

    Science.gov (United States)

    Czech, Marcin; Opolski, Grzegorz; Zdrojewski, Tomasz; Dubiel, Jacek S; Wizner, Barbara; Bolisęga, Dorota; Fedyk-Łukasik, Małgorzata; Grodzicki, Tomasz

    2013-01-01

    Heart failure (HF) is a chronic disease of great clinical and economic significance for both the healthcare system and patients themselves. To determine the consumption of medical resources for treatment and care of HF patients and to estimate the related costs. The study involved 400 primary care practices and 396 specialist outpatient clinics, as well as 259 hospitals at all reference levels. The sample was representative and supplemented with patient interview data. Based on the consumption of particular resources and the unit costs of services in 2011, costs of care for HF patients in Poland were estimated. Separate analyses were conducted depending on the stage of the disease (according to NYHA classification I-IV). The public payer's perspective and a one year time horizon were adopted. Direct annual costs of an HF patient's treatment in Poland may range between PLN 3,373.23 and 7,739.49 (2011), the main cost item being hospitalisation. The total costs for the healthcare system could be as high as PLN 1,703 million, which is 3.16% of the National Health Fund's budget (Ex. rate from 05.03.2012: 1 EUR = 4.14 PLN). The costs of treating heart failure in Poland are high; proper allocation of resources to diagnostic procedures and treatment may contribute to rationalisation of the relevant expenditure.

  6. Reference Intervals for Urinary Cotinine Levels and the Influence of Sampling Time and Other Predictors on Its Excretion Among Italian Schoolchildren

    Directory of Open Access Journals (Sweden)

    Carmela Protano

    2018-04-01

    Full Text Available (1 Background: Environmental Tobacco Smoke (ETS exposure remains a public health problem worldwide. The aims are to establish urinary (u- cotinine reference values for healthy Italian children, to evaluate the role of the sampling time and of other factors on children’s u-cotinine excretion. (2 Methods: A cross-sectional study was performed on 330 children. Information on participants was gathered by a questionnaire and u-cotinine was determined in two samples for each child, collected during the evening and the next morning. (3 Results: Reference intervals (as the 2.5th and 97.5th percentiles of the distribution in evening and morning samples were respectively equal to 0.98–4.29 and 0.91–4.50 µg L−1 (ETS unexposed and 1.39–16.34 and 1.49–20.95 µg L−1 (ETS exposed. No statistical differences were recovered between median values found in evening and morning samples, both in ETS unexposed and exposed. Significant predictors of u-cotinine excretions were ponderal status according to body mass index of children (β = 0.202; p-value = 0.041 for evening samples; β = 0.169; p-value = 0.039 for morning samples and paternal educational level (β = −0.258; p-value = 0.010; for evening samples; β = −0.013; p-value = 0.003 for morning samples. (4 Conclusions: The results evidenced the need of further studies for assessing the role of confounding factors on ETS exposure, and the necessity of educational interventions on smokers for rising their awareness about ETS.

  7. Recent references

    International Nuclear Information System (INIS)

    Ramavataram, S.

    1991-01-01

    In support of a continuing program of systematic evaluation of nuclear structure data, the National Nuclear Data Center maintains a complete computer file of references to the nuclear physics literature. Each reference is tagged by a keyword string, which indicates the kinds of data contained in the article. This master file of Nuclear Structure References (NSR) contains complete keyword indexes to literature published since 1969, with partial indexing of older references. Any reader who finds errors in the keyword descriptions is urged to report them to the National Nuclear Data Center so that the master NSR file can be corrected. In 1966, the first collection of Recent References was published as a separate issue of Nuclear Data Sheets. Every four months since 1970, a similar indexed bibliography to new nuclear experiments has been prepared from additions to the NSR file and published. Beginning in 1978, Recent References was cumulated annually, with the third issue completely superseding the two issues previously published during a given year. Due to publication policy changes, cumulation of Recent Reference was discontinued in 1986. The volume and issue number of all the cumulative issues published to date are given. NNDC will continue to respond to individual requests for special bibliographies on nuclear physics topics, in addition to those easily obtained from Recent References. If the required information is available from the keyword string, a reference list can be prepared automatically from the computer files. This service can be provided on request, in exchange for the timely communication of new nuclear physics results (e.g., preprints). A current copy of the NSR file may also be obtained in a standard format on magnetic tape from NNDC. Requests for special searches of the NSR file may also be directed to the National Nuclear Data Center

  8. Circulating Plasma Levels of MicroRNA-21 and MicroRNA-221 Are Potential Diagnostic Markers for Primary Intrahepatic Cholangiocarcinoma

    Science.gov (United States)

    Kemeny, Nancy; Kingham, T. Peter; Allen, Peter J.; D’Angelica, Michael I.; DeMatteo, Ronald P.; Betel, Doron; Klimstra, David; Jarnagin, William R.; Ventura, Andrea

    2016-01-01

    Background MicroRNAs (miRNAs) are potential biomarkers in various malignancies. We aim to characterize miRNA expression in intrahepatic cholangiocarcinoma (ICC) and identify circulating plasma miRNAs with potential diagnostic and prognostic utility. Methods Using deep-sequencing techniques, miRNA expression between tumor samples and non-neoplastic liver parenchyma were compared. Overexpressed miRNAs were measured in plasma from an independent cohort of patients with cholangiocarcinoma using RT-qPCR and compared with that healthy volunteers. The discriminatory ability of the evaluated plasma miRNAs between patients and controls was evaluated with receiving operating characteristic (ROC) curves. Results Small RNAs from 12 ICC and 11 tumor-free liver samples were evaluated. Unsupervised hierarchical clustering using the miRNA expression data showed clear grouping of ICC vs. non-neoplastic liver parenchyma. We identified 134 down-regulated and 128 upregulated miRNAs. Based on overexpression and high fold-change, miR21, miR200b, miR221, and miR34c were measured in plasma from an independent cohort of patients with ICC (n = 25) and healthy controls (n = 7). Significant overexpression of miR-21 and miR-221 was found in plasma from ICC patients. Furthermore, circulating miR-21 demonstrated a high discriminatory ability between patients with ICC and healthy controls (AUC: 0.94). Conclusion Among the differentially expressed miRNAs in ICC, miR-21 and miR-221 are overexpressed and detectable in the circulation. Plasma expression levels of these miRNAs, particularly miR-21, accurately differentiates patients with ICC from healthy controls and could potentially serve as adjuncts in diagnosis. Prospective validation and comparison with other hepatobiliary malignancies is required to establish their potential role as diagnostic and prognostic biomarkers. PMID:27685844

  9. Clinical diagnostic value of combined determination of serum RF, AKA and anti-CCP antibody levels in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Zhao Hongcan; Xiang Guoqian

    2005-01-01

    Objective; To investigate the clinical usefulness of combined determination of serum rheumatic factor (RF), anti-keratin antibody (AKA) and anti-cyclic citrullinated peptide antibody (anti-CCP antibody) levels for early diagnosis in patients with rheumatoid arthritis (RA). Methods: Serum RF ( with rate-nephelometry), AKA (with indirect immuno-fluorescence) and anti-CCP antibody (with ELISA) levels were determined in 40 patients with RA, 30 patients with SLE and 30 controls. Results: For diagnosis of RA; the sensitivity and specificity of RF was 70.0% and 90.0% respectively, the sensitivity and specificity of AKA was 35.0% and 96.7%, the sensitivity and specificity of anti-CCP-antibody was 85% and 93.3% respectively. With combined determination of RF, AKA and anti-CCP antibody, the sensitivity and specificity would be the highest, being 97.07 and 99.8% respectively. Conclusion: RF, AKA and anti-CCP antibody were useful diagnostic serum markers for rheumatoid arthritis and combined determination of these markers would be very useful for early diagnosis. (authors)

  10. Clinical diagnostic value of determination of serum lschemia modified albumin, homocysteine and high-sensitivity C-reactive protein levels in patients with acute coronary syndrome

    International Nuclear Information System (INIS)

    Lu Weiqun; Jiang Donglin; Lu Weigu

    2009-01-01

    Objective: To study the clinical diagnostic value of determination of serum ischemia modified albumin (IMA), homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) levels in patients with acute coronary syndrome (ACS). Methods: Serum IMA (with albumin-cobalt binding assay), Hcy (with ELISA) and hs-CRP (with RIA) levels were determined in 73 patients with ACS within 3 hours after onset of chest pain and 40 controls. Results: The sensitivity of IMA was 87.67%, the specificity was 100%. The area under curve of ROC was 0.985 (95% confidence interval 0.969 ∼ 1.001). All the figures were higher than those of Hcy and hs-CRP. Combined determination of IMA, Hcy and hs-CRP, would increass the sensitivity to 97.26%. Conclusion: IMA is one of the earliest sensitive indicators for clinical diagnosis of early myocardial ischemia in patients with ACS. Combined determination of IMA, Hcy and hs-CRP would be even more sensitive. (authors)

  11. Experimental exposure to cadmium affects metallothionein-like protein levels but not survival and growth in wolf spiders from polluted and reference populations

    Energy Technology Data Exchange (ETDEWEB)

    Eraly, Debbie, E-mail: debbie.eraly@ugent.b [Terrestrial Ecology Unit, Department of Biology, Ghent University, K.L. Ledeganckstraat 35, 9000 Ghent (Belgium); Hendrickx, Frederik, E-mail: frederik.hendrickx@naturalsciences.b [Terrestrial Ecology Unit, Department of Biology, Ghent University, K.L. Ledeganckstraat 35, 9000 Ghent (Belgium); Royal Belgian Institute of Natural Sciences, Department of Entomology, Vautierstraat 29, 1000 Brussels (Belgium); Bervoets, Lieven, E-mail: lieven.bervoets@ua.ac.b [Ecophysiology, Biochemistry and Toxicology Group, Department of Biology, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp (Belgium); Lens, Luc, E-mail: luc.lens@ugent.b [Terrestrial Ecology Unit, Department of Biology, Ghent University, K.L. Ledeganckstraat 35, 9000 Ghent (Belgium)

    2010-06-15

    Both local adaptation and acclimation in tolerance mechanisms may allow populations to persist under metal pollution. However, both mechanisms are presumed to incur (energetic) costs and to trade-off with other life-history traits. To test this hypothesis, we exposed Pardosa saltans (Lycosidae) spiderlings originating from metal-polluted and unpolluted sites to a controlled cadmium (Cd) treatment, and compared contents of metal-binding metallothionein-like proteins (MTLPs), internal metal concentrations, and individual survival and growth rates with a reference treatment. While increased MTLP concentrations in offspring originating from both polluted and unpolluted populations upon exposure indicates a plastic tolerance mechanism, survival and growth rates remain largely unaffected, independent of the population of origin. However, MTLP and Cd concentrations were not significantly correlated. We suggest that MTLP production may be an important mechanism enabling P. saltans populations to persist in ecosystems polluted with heavy metals above a certain level. - Spiders from metal-polluted and unpolluted populations show a similar increase in MTLP production when exposed to Cd, with unaffected growth and survival.

  12. Experimental exposure to cadmium affects metallothionein-like protein levels but not survival and growth in wolf spiders from polluted and reference populations

    International Nuclear Information System (INIS)

    Eraly, Debbie; Hendrickx, Frederik; Bervoets, Lieven; Lens, Luc

    2010-01-01

    Both local adaptation and acclimation in tolerance mechanisms may allow populations to persist under metal pollution. However, both mechanisms are presumed to incur (energetic) costs and to trade-off with other life-history traits. To test this hypothesis, we exposed Pardosa saltans (Lycosidae) spiderlings originating from metal-polluted and unpolluted sites to a controlled cadmium (Cd) treatment, and compared contents of metal-binding metallothionein-like proteins (MTLPs), internal metal concentrations, and individual survival and growth rates with a reference treatment. While increased MTLP concentrations in offspring originating from both polluted and unpolluted populations upon exposure indicates a plastic tolerance mechanism, survival and growth rates remain largely unaffected, independent of the population of origin. However, MTLP and Cd concentrations were not significantly correlated. We suggest that MTLP production may be an important mechanism enabling P. saltans populations to persist in ecosystems polluted with heavy metals above a certain level. - Spiders from metal-polluted and unpolluted populations show a similar increase in MTLP production when exposed to Cd, with unaffected growth and survival.

  13. Reference binding energies of transition metal carbides by core-level x-ray photoelectron spectroscopy free from Ar+ etching artefacts

    Science.gov (United States)

    Greczynski, G.; Primetzhofer, D.; Hultman, L.

    2018-04-01

    We report x-ray photoelectron spectroscopy (XPS) core level binding energies (BE's) for the widely-applicable groups IVb-VIb transition metal carbides (TMCs) TiC, VC, CrC, ZrC, NbC, MoC, HfC, TaC, and WC. Thin film samples are grown in the same deposition system, by dc magnetron co-sputtering from graphite and respective elemental metal targets in Ar atmosphere. To remove surface contaminations resulting from exposure to air during sample transfer from the growth chamber into the XPS system, layers are either (i) Ar+ ion-etched or (ii) UHV-annealed in situ prior to XPS analyses. High resolution XPS spectra reveal that even gentle etching affects the shape of core level signals, as well as BE values, which are systematically offset by 0.2-0.5 eV towards lower BE. These destructive effects of Ar+ ion etch become more pronounced with increasing the metal atom mass due to an increasing carbon-to-metal sputter yield ratio. Systematic analysis reveals that for each row in the periodic table (3d, 4d, and 5d) C 1s BE increases from left to right indicative of a decreased charge transfer from TM to C atoms, hence bond weakening. Moreover, C 1s BE decreases linearly with increasing carbide/metal melting point ratio. Spectra reported here, acquired from a consistent set of samples in the same instrument, should serve as a reference for true deconvolution of complex XPS cases, including multinary carbides, nitrides, and carbonitrides.

  14. National reference doses for dental cephalometric radiography.

    Science.gov (United States)

    Holroyd, J R

    2011-12-01

    Diagnostic reference levels (DRLs) are an important tool in the optimisation of clinical radiography. Although national DRLs are provided for many diagnostic procedures including dental intra-oral radiography, there are currently no national DRLs set for cephalometric radiography. In the absence of formal national DRLs, the Health Protection Agency (HPA) has previously published National Reference Doses (NRDs) covering a wide range of diagnostic X-ray examinations. The aim of this study was to determine provisional NRDs for cephalometric radiography. Measurements made by the Dental X-ray Protection Service (DXPS) of the HPA, as part of the cephalometric X-ray equipment testing service provided to dentists and dental trade companies throughout the UK, were used to derive provisional NRDs. Dose-area product measurements were made on 42 X-ray sets. Third quartile dose-area product values for adult and child lateral cephalometric radiography were found to be 41 mGy cm² and 25 mGy cm², respectively, with individual measurements ranging from 3 mGy cm² to 108 mGy cm². This report proposes provisional NRDs of 40 mGy cm² and 25 mGy cm² for adult and child lateral cephalometric radiographs, respectively; these doses could be considered by employers when establishing their local DRLs.

  15. Clinical Correlates and Prognostic Value of Plasma Galectin-3 Levels in Degenerative Aortic Stenosis: A Single-Center Prospective Study of Patients Referred for Invasive Treatment

    Directory of Open Access Journals (Sweden)

    Beata Bobrowska

    2017-04-01

    Full Text Available Galectin-3 (Gal-3, a β-galactoside-binding lectin, has been implicated in myocardial fibrosis, development of left ventricular (LV dysfunction and transition from compensated LV hypertrophy to overt heart failure (HF, being a novel prognostic marker in HF. Risk stratification is crucial for the choice of the optimal therapy in degenerative aortic stenosis (AS, affecting elderly subjects with coexistent diseases. Our aim was to assess correlates and prognostic value of circulating Gal-3 in real-world patients with degenerative AS referred for invasive treatment. Gal-3 levels were measured at admission in 80 consecutive patients with symptomatic degenerative AS (mean age: 79 ± 8 years; aortic valve area (AVA index: 0.4 ± 0.1 cm2/m2. The therapeutic strategy was chosen following a dedicated multidisciplinary team-oriented approach, including surgical valve replacement (n = 11, transcatheter valve implantation (n = 19, balloon aortic valvuloplasty (BAV (n = 25 and optimal medical therapy (n = 25. Besides routine echocardiographic indices, valvulo-arterial impedance (Zva, an index of global LV afterload, was computed. There were 22 deaths over a median follow-up of 523 days. Baseline Gal-3 correlated negatively with estimated glomerular filtration rate (eGFR (r = −0.61, p < 0.001 and was unrelated to age, symptomatic status, AVA index, LV ejection fraction, LV mass index or Zva. For the study group as a whole, Gal-3 tended to predict mortality (Gal-3 >17.8 vs. Gal-3 <17.8 ng/mL; hazard ratio (HR: 2.03 (95% confidence interval, 0.88–4.69, p = 0.09, which was abolished upon adjustment for eGFR (HR: 1.70 (0.61–4.73, p = 0.3. However, in post-BAV patients multivariate-adjusted pre-procedural Gal-3 was associated with worse survival (HR: 7.41 (1.52–36.1, p = 0.01 regardless of eGFR. In conclusion, the inverse eGFR–Gal-3 relationship underlies a weak association between Gal-3 and adverse outcome in patients with degenerative AS referred for

  16. Systematic evaluation of a secondary method for measuring diagnostic-level medical ultrasound transducer output power based on a large-area pyroelectric sensor

    Science.gov (United States)

    Zeqiri, B.; Žauhar, G.; Rajagopal, S.; Pounder, A.

    2012-06-01

    A systematic study of the application of a novel pyroelectric technique to the measurement of diagnostic-level medical ultrasound output power is described. The method exploits the pyroelectric properties of a 0.028 mm thick membrane of polyvinylidene fluoride (PVDF), backed by an acoustic absorber whose ultrasonic absorption coefficient approaches 1000 dB cm-1 at 3 MHz. When exposed to an ultrasonic field, absorption of ultrasound adjacent to the PVDF-absorber interface results in heating and the generation of a pyroelectric output voltage across gold electrodes deposited on the membrane. For a sensor large enough to intercept the whole of the acoustic beam, the output voltage can be calibrated for the measurement of acoustic output power. A number of key performance properties of the method have been investigated. The technique is very sensitive, with a power to voltage conversion factor of typically 0.23 V W-1. The frequency response of a particular embodiment of the sensor in which acoustic power reflected at the absorber-PVDF interface is subsequently returned to the pyroelectric membrane to be absorbed, has been evaluated over the frequency range 1.5 MHz to 10 MHz. This has shown the frequency response to be flat to within ±4%, above 2.5 MHz. Below this frequency, the sensitivity falls by 20% at 1.5 MHz. Linearity of the technique has been demonstrated to within ±1.6% for applied acoustic power levels from 1 mW up to 120 mW. A number of other studies targeted at assessing the achievable measurement uncertainties are presented. These involve: the effects of soaking, the influence of the angle of incidence of the acoustic beam, measurement repeatability and sensitivity to transducer positioning. Additionally, over the range 20 °C to 30 °C, the rate of change in sensitivity with ambient temperature has been shown to be +0.5% °C-1. Implications of the work for the development of a sensitive, traceable, portable, secondary method of ultrasound output power

  17. Quality guarantee of images as a way for obtained lower levels of radiation doses in diagnostic x-ray rooms: criteria for licensing

    International Nuclear Information System (INIS)

    Castellanos, C.A.

    1996-01-01

    This work constitutes a criticism to the present system for licensing in diagnostic x-ray installations in Guatemala. A series of recommendations are made with the aim of obtaining the best diagnostic imaging. This procedure leads to obtain lower doses of radiation for patients and workers

  18. Establishing Local Reference Dose Values and Optimisation Strategies

    International Nuclear Information System (INIS)

    Connolly, P.; Moores, B.M.

    2000-01-01

    The revised EC Patient Directive 97/43 EURATOM introduces the concepts of clinical audit, diagnostic reference levels and optimisation of radiation protection in diagnostic radiology. The application of reference dose levels in practice involves the establishment of reference dose values as actual measurable operational quantities. These values should then form part of an ongoing optimisation and audit programme against which routine performance can be compared. The CEC Quality Criteria for Radiographic Images provides guidance reference dose values against which local performance can be compared. In many cases these values can be improved upon quite considerably. This paper presents the results of a local initiative in the North West of the UK aimed at establishing local reference dose values for a number of major hospital sites. The purpose of this initiative is to establish a foundation for both optimisation strategies and clinical audit as an ongoing and routine practice. The paper presents results from an ongoing trial involving patient dose measurements for several radiological examinations upon the sites. The results of an attempt to establish local reference dose values from measured dose values and to employ them in optimisation strategies are presented. In particular emphasis is placed on the routine quality control programmes necessary to underpin this strategy including the effective data management of results from such programmes and how they can be employed to optimisation practices. (author)

  19. Molecular Diagnostics

    OpenAIRE

    Choe, Hyonmin; Deirmengian, Carl A.; Hickok, Noreen J.; Morrison, Tiffany N.; Tuan, Rocky S.

    2015-01-01

    Orthopaedic infections are complex conditions that require immediate diagnosis and accurate identification of the causative organisms to facilitate appropriate management. Conventional methodologies for diagnosis of these infections sometimes lack accuracy or sufficient rapidity. Current molecular diagnostics are an emerging area of bench-to-bedside research in orthopaedic infections. Examples of promising molecular diagnostics include measurement of a specific biomarker in the synovial fluid...

  20. Clinical diagnostic significance of combined detection of serum and pleural effusion levels of CEA, NSE, CYFRA21-1, SCC-Ag in patients with lung cancer

    International Nuclear Information System (INIS)

    Bian Baoxiang; Hu Nan; Wu Fenglei; Yang Chengxi

    2008-01-01

    Objective: To appraise the clinical diagnostic significance of combined detection of serum and chest fluid levels of CEA, NSE, CYFRA21-1 and SCC-Ag in patients with lung cancer. Methods: Serum and pleural effusion contents of CEA, NSE, CYFRA21-1 and SCC-Ag were determined with RIA in 54 patients with lung cancer and 35 patients with benign lung disorders. Results: The serum and pleural effusion contents of CEA, NSE, CYFRA21-1 and SCC-Ag in patients with lung cancer were significantly higher than those in patients with benign lung disorders (P<0.01). The contents of CEA, NSE, CYFRA21-1 and SCC-Ag in patients pleural effusion were significantly higher than those in patients serum (P<0.01). For combined detection of CEA, NSE, CYFRA21-1 and SCC-Ag in serum and pleural effusion, the positive rate was 83.33% and 92.59% respectively. Conclusion: Combined detection of CEA, NSE, CYFRA21-1 and SCC-Ag contents in serum and pleural effusion can increase the positive rate of lung cancer diagnosis. (authors)

  1. Level of information about gynaecological prevention in teenagers at risk from social exclusion, referred by family court rulings to juvenile attendance centres – a pilot study

    Directory of Open Access Journals (Sweden)

    Marcin Bobiński

    2015-09-01

    Full Text Available Introduction and objective. The objective of the study was to present preliminary results of a pilot study concerning the level of knowledge of gynaecological prevention, conducted in teenagers referred by court rulings to a juvenile attendance centre. Materials and method. The instrument was an anonymous survey questionnaire completed by participants in health prevention classes in late 2010 and early 2011. The studied group consisted of teenagers aged 15–17 years (mean age: 15.72 years, median = 16 years, SD = 0.679 who were under probation officers’ supervision in the Zamość region of south-eastern Poland. The sample size was 101 persons – 51 boys (50.50%, 50 girls (49.5%. Results. According to the respondents, the most important reasons for seeing a gynaecologist were: menstrual disorders (70.30%, suspicion of pregnancy (63.37% and pain or burning sensations while urinating (58.42%. The following were regarded as prevalent cancers in women: cancers of the breast (99.01%, cervix (89.1%, and ovaries (62.38%. Over 92% of subjects stated that it was possible to protect oneself from cervical cancer, but only 41.5% of respondents indicated the correct definition of the term ‘cytology’. Statistical analysis focused on differences between genders. A higher self-assessment of mental health was shown in boys. Conclusions. Teenagers of similar background may find it more difficult to gain access to knowledge about health prophylaxis, including gynaecological prevention. Efforts should be intensified in order to ‘equalize health opportunities’ through appropriate preparation of teaching curricula (including health education and philosophy of medicine.

  2. Reference dosimetry for CT in the UK

    International Nuclear Information System (INIS)

    Shrimpton, P.C.; Wall, B.F.

    2001-01-01

    Computed tomography is firmly established as a major source of population exposure from diagnostic x-ray examinations and thus a particular focus for radiological protection initiatives. The concept of reference doses is widely recognised as a useful and practical tool for promoting improvements in the optimisation of protection for patients undergoing radiological examinations. National diagnostic reference levels (DRLs) have already been successfully applied in the UK for some conventional x-ray examinations within a framework for advice on patient protection. This approach is being extended to include CT, utilising the robust methodology for reference dosimetry that has been developed by the European Commission (EC) for the particular conditions of exposure in CT. This is based on the dosimetric concepts of weighted computed tomography dose index (CTDI w ) per slice in serial scanning or per rotation in helical scanning, and dose-length product (DLP) per complete examination. Notwithstanding some initial values proposed by the EC, specific national DRLs for CT practice in the UK will be established on the basis of widescale national survey data. (author)

  3. Patient dosimetry in diagnostic radiology

    International Nuclear Information System (INIS)

    Shrimpton, P.C.

    2000-01-01

    Full text: X-ray examinations remain an essential and widely used diagnostic tool in medicine and hence the most significant source of exposure to man-made radiation for populations. Patterns of practice in diagnostic radiology continue to evolve, with overall growth in the numbers of procedures worldwide and, particularly in developed countries, increasing importance for complex procedures such as computed tomography (CT) and interventional techniques. In order to maximise the benefits from x-rays relative to the associated radiation risks, there is a need to ensure the prior justification of all examinations and the optimisation of patient protection such that doses are as low as reasonably practicable to meet specific clinical requirements. Accordingly, patient dosimetry is a fundamental requirement in diagnostic radiology. Detailed measurements for the assessment of risks or comparison of different types of procedure require the estimation of organ and effective doses. Such comprehensive dosimetry necessarily involves the simulation of clinical practice using anthropomorphic phantoms, with either measurements in a physical phantom or calculations utilising a mathematical phantom. Simpler measurements for the routine monitoring of dose in x-ray departments can be based on practical quantities such as entrance surface dose, dose-area product and, for CT, weighted CT dose index and dose-length product. Widescale surveys reveal significant variations between departments in the typical doses for a given type of procedure and potential scope for dose reductions. In order to promote improvements in practice, the results of periodic dose surveys in departments should be compared with appropriate standards, such as diagnostic reference levels for adult and paediatric patients, that are set nationally or locally for the purposes of promoting critical review of the equipment and techniques in use. Patient dosimetry should form an essential element of routine quality

  4. Nicotine, acetanilide and urea multi-level2H-,13C- and15N-abundance reference materials for continuous-flow isotope ratio mass spectrometry

    Science.gov (United States)

    Schimmelmann, A.; Albertino, A.; Sauer, P.E.; Qi, H.; Molinie, R.; Mesnard, F.

    2009-01-01

    Accurate determinations of stable isotope ratios require a calibration using at least two reference materials with different isotopic compositions to anchor the isotopic scale and compensate for differences in machine slope. Ideally, the S values of these reference materials should bracket the isotopic range of samples with unknown S values. While the practice of analyzing two isotopically distinct reference materials is common for water (VSMOW-SLAP) and carbonates (NBS 19 and L-SVEC), the lack of widely available organic reference materials with distinct isotopic composition has hindered the practice when analyzing organic materials by elemental analysis/isotope ratio mass spectrometry (EA-IRMS). At present only L-glutamic acids USGS40 and USGS41 satisfy these requirements for ??13C and ??13N, with the limitation that L-glutamic acid is not suitable for analysis by gas chromatography (GC). We describe the development and quality testing of (i) four nicotine laboratory reference materials for on-line (i.e. continuous flow) hydrogen reductive gas chromatography-isotope ratio mass-spectrometry (GC-IRMS), (ii) five nicotines for oxidative C, N gas chromatography-combustion-isotope ratio mass-spectrometry (GC-C-IRMS, or GC-IRMS), and (iii) also three acetanilide and three urea reference materials for on-line oxidative EA-IRMS for C and N. Isotopic off-line calibration against international stable isotope measurement standards at Indiana University adhered to the 'principle of identical treatment'. The new reference materials cover the following isotopic ranges: ??2Hnicotine -162 to -45%o, ??13Cnicotine -30.05 to +7.72%, ?? 15Nnicotine -6.03 to +33.62%; ??15N acetanilide +1-18 to +40.57%; ??13Curea -34.13 to +11.71%, ??15Nurea +0.26 to +40.61% (recommended ?? values refer to calibration with NBS 19, L-SVEC, IAEA-N-1, and IAEA-N-2). Nicotines fill a gap as the first organic nitrogen stable isotope reference materials for GC-IRMS that are available with different ??13N

  5. Nicotine, acetanilide and urea multi-level 2H-, 13C- and 15N-abundance reference materials for continuous-flow isotope ratio mass spectrometry.

    Science.gov (United States)

    Schimmelmann, Arndt; Albertino, Andrea; Sauer, Peter E; Qi, Haiping; Molinie, Roland; Mesnard, François

    2009-11-01

    Accurate determinations of stable isotope ratios require a calibration using at least two reference materials with different isotopic compositions to anchor the isotopic scale and compensate for differences in machine slope. Ideally, the delta values of these reference materials should bracket the isotopic range of samples with unknown delta values. While the practice of analyzing two isotopically distinct reference materials is common for water (VSMOW-SLAP) and carbonates (NBS 19 and L-SVEC), the lack of widely available organic reference materials with distinct isotopic composition has hindered the practice when analyzing organic materials by elemental analysis/isotope ratio mass spectrometry (EA-IRMS). At present only L-glutamic acids USGS40 and USGS41 satisfy these requirements for delta13C and delta15N, with the limitation that L-glutamic acid is not suitable for analysis by gas chromatography (GC). We describe the development and quality testing of (i) four nicotine laboratory reference materials for on-line (i.e. continuous flow) hydrogen reductive gas chromatography-isotope ratio mass-spectrometry (GC-IRMS), (ii) five nicotines for oxidative C, N gas chromatography-combustion-isotope ratio mass-spectrometry (GC-C-IRMS, or GC-IRMS), and (iii) also three acetanilide and three urea reference materials for on-line oxidative EA-IRMS for C and N. Isotopic off-line calibration against international stable isotope measurement standards at Indiana University adhered to the 'principle of identical treatment'. The new reference materials cover the following isotopic ranges: delta2H(nicotine) -162 to -45 per thousand, delta13C(nicotine) -30.05 to +7.72 per thousand, delta15N(nicotine) -6.03 to +33.62 per thousand; delta15N(acetanilide) +1.18 to +40.57 per thousand; delta13C(urea) -34.13 to +11.71 per thousand, delta15N(urea) +0.26 to +40.61 per thousand (recommended delta values refer