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Sample records for diagnostics scoping study

  1. Automated diagnostics scoping study. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Quadrel, R.W.; Lash, T.A.

    1994-06-01

    The objective of the Automated Diagnostics Scoping Study was to investigate the needs for diagnostics in building operation and to examine some of the current technologies in automated diagnostics that can address these needs. The study was conducted in two parts. In the needs analysis, the authors interviewed facility managers and engineers at five building sites. In the technology survey, they collected published information on automated diagnostic technologies in commercial and military applications as well as on technologies currently under research. The following describe key areas that the authors identify for the research, development, and deployment of automated diagnostic technologies: tools and techniques to aid diagnosis during building commissioning, especially those that address issues arising from integrating building systems and diagnosing multiple simultaneous faults; technologies to aid diagnosis for systems and components that are unmonitored or unalarmed; automated capabilities to assist cause-and-effect exploration during diagnosis; inexpensive, reliable sensors, especially those that expand the current range of sensory input; technologies that aid predictive diagnosis through trend analysis; integration of simulation and optimization tools with building automation systems to optimize control strategies and energy performance; integration of diagnostic, control, and preventive maintenance technologies. By relating existing technologies to perceived and actual needs, the authors reached some conclusions about the opportunities for automated diagnostics in building operation. Some of a building operator`s needs can be satisfied by off-the-shelf hardware and software. Other needs are not so easily satisfied, suggesting directions for future research. Their conclusions and suggestions are offered in the final section of this study.

  2. Oxidizer Scoping Studies

    Energy Technology Data Exchange (ETDEWEB)

    Chancellor, Christopher John [Los Alamos National Laboratory

    2016-11-07

    The purpose of this report is to present the results of the acceptable knowledge (AK) review of oxidizers present in active waste streams, provide a technical analysis of the oxidizers, and report the results of the scoping study testing. This report will determine the fastest burning oxidizer to be used in the development of a Test Plan for Preparation and Testing of Sorbents Mixed with Oxidizer found in Transuranic Waste (DWT-TP-001). The companion report, DWT-RPT-002, Sorbent Scoping Studies, contains similar information for sorbents identified during the AK review of TRU waste streams. The results of the oxidizer and sorbent scoping studies will be used to inform the QL1 test plan. The QL1 test results will support the development of a basis of knowledge document that will evaluate oxidizing chemicals and sorbents in TRU waste and provide guidance for treatment.

  3. Sorbent Scoping Studies

    Energy Technology Data Exchange (ETDEWEB)

    Chancellor, Christopher John [Los Alamos National Lab. (LANL), Carlsbad, NM (United States). Difficult Waste Team

    2016-11-14

    The Los Alamos National Laboratory–Carlsbad Operations (LANL-CO) office was tasked by the DOE CBFO, Office of the Manager to perform a review of the acceptable knowledge (AK) to identify the oxidizers and sorbents in transuranic (TRU) waste streams, to conduct scoping studies on the oxidizers and sorbents identified in AK review to inform the Quality Level 1 (QL1) testing, and to conduct a series of QL1 tests to provide the scientific data to support a basis of knowledge document for determining the criteria for (1) accepting waste at the Waste Isolation Pilot Plant (WIPP) without treatment, (2) determining waste that will require treatment, and (3) if treatment is required, how the treatment must be performed. The purpose of this report is to present the results of the AK review of sorbents present in active waste streams, provide a technical analysis of the sorbent list, report the results of the scoping studies for the fastest-burning organic sorbent, and provide the list of organic and inorganic sorbents to be used in the development of a Test Plan for Preparation and Testing of Sorbents Mixed with Oxidizer found in Transuranic Waste (DWT-TP-001). The companion report, DWT-RPT-001, Oxidizer Scoping Studies, has similar information for oxidizers identified during the AK review of TRU waste streams. The results of the oxidizer and sorbent scoping studies will be used to inform the QL1 test plan. The QL1 test results will support the development of a basis of knowledge document that will evaluate oxidizing chemicals and sorbents in TRU waste and provide guidance for treatment.

  4. Scoping Study: Networked Microgrids.

    Energy Technology Data Exchange (ETDEWEB)

    Trinklei, Eddy; Parker, Gordon; Weaver, Wayne; Robinett, Rush; Babe Gauchia, Lucia; Ten, Chee-Wooi; Bower, Ward; Glover, Steven F.; Bukowski, Steve

    2014-10-01

    This report presents a scoping study for networked microgrids which are defined as "Interoperable groups of multiple Advanced Microgrids that become an integral part of the electricity grid while providing enhanced resiliency through self-healing, aggregated ancillary services, and real-time communication." They result in optimal electrical system configurations and controls whether grid-connected or in islanded modes and enable high penetrations of distributed and renewable energy resources. The vision for the purpose of this document is: "Networked microgrids seamlessly integrate with the electricity grid or other Electric Power Sources (EPS) providing cost effective, high quality, reliable, resilient, self-healing power delivery systems." Scoping Study: Networked Microgrids September 4, 2014 Eddy Trinklein, Michigan Technological University Gordon Parker, Michigan Technological University Wayne Weaver, Michigan Technological University Rush Robinett, Michigan Technological University Lucia Gauchia Babe, Michigan Technological University Chee-Wooi Ten, Michigan Technological University Ward Bower, Ward Bower Innovations LLC Steve Glover, Sandia National Laboratories Steve Bukowski, Sandia National Laboratories Prepared by Michigan Technological University Houghton, Michigan 49931 Michigan Technological University

  5. Networked Microgrids Scoping Study

    Energy Technology Data Exchange (ETDEWEB)

    Backhaus, Scott N. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Dobriansky, Larisa [General MicroGrids, San Diego, CA (United States); Glover, Steve [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Liu, Chen-Ching [Washington State Univ., Pullman, WA (United States); Looney, Patrick [Brookhaven National Lab. (BNL), Upton, NY (United States); Mashayekh, Salman [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Pratt, Annabelle [National Renewable Energy Lab. (NREL), Golden, CO (United States); Schneider, Kevin [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stadler, Michael [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Starke, Michael [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wang, Jianhui [Argonne National Lab. (ANL), Argonne, IL (United States); Yue, Meng [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2016-12-05

    Much like individual microgrids, the range of opportunities and potential architectures of networked microgrids is very diverse. The goals of this scoping study are to provide an early assessment of research and development needs by examining the benefits of, risks created by, and risks to networked microgrids. At this time there are very few, if any, examples of deployed microgrid networks. In addition, there are very few tools to simulate or otherwise analyze the behavior of networked microgrids. In this setting, it is very difficult to evaluate networked microgrids systematically or quantitatively. At this early stage, this study is relying on inputs, estimations, and literature reviews by subject matter experts who are engaged in individual microgrid research and development projects, i.e., the authors of this study The initial step of the study gathered input about the potential opportunities provided by networked microgrids from these subject matter experts. These opportunities were divided between the subject matter experts for further review. Part 2 of this study is comprised of these reviews. Part 1 of this study is a summary of the benefits and risks identified in the reviews in Part 2 and synthesis of the research needs required to enable networked microgrids.

  6. ACQUIRING SCOPE: A LONGITUDINAL STUDY

    Directory of Open Access Journals (Sweden)

    Miao-Ling Hsieh

    2008-06-01

    Full Text Available Based on the spontaneous data of a Chinese-speaking child collected from 1 year old up to 4+ years old, this study focuses on the development of his scope by examining the scope interaction between negation and quantified NPs that occur in preverbal positions. It is found that the child is sensitive to scope at 3;2, an age much earlier than the age reported in other studies (e.g., age of 6 in Lee 1991. Further evidence shows that the child has mastered scope of negation and scope in general at the age of 4. First, starting from age 4;3, the child has managed to mark universal quantifiers and wh-phrases as well as duration phrases occurring in the preverbal position with scope markers such as dou ‘all’ and you ‘have’. Second, by the age of 4;5, the child has placed duration phrases in target positions in relation to negation.

  7. Residential ventilation standards scoping study

    Energy Technology Data Exchange (ETDEWEB)

    McKone, Thomas E.; Sherman, Max H.

    2003-10-01

    The goals of this scoping study are to identify research needed to develop improved ventilation standards for California's Title 24 Building Energy Efficiency Standards. The 2008 Title 24 Standards are the primary target for the outcome of this research, but this scoping study is not limited to that timeframe. We prepared this scoping study to provide the California Energy Commission with broad and flexible options for developing a research plan to advance the standards. This document presents the findings of a scoping study commissioned by the Public Interest Energy Research (PIER) program of the California Energy Commission to determine what research is necessary to develop new residential ventilation requirements for California. This study is one of three companion efforts needed to complete the job of determining the ventilation needs of California residences, determining the bases for setting residential ventilation requirements, and determining appropriate ventilation technologies to meet these needs and requirements in an energy efficient manner. Rather than providing research results, this scoping study identifies important research questions along with the level of effort necessary to address these questions and the costs, risks, and benefits of pursuing alternative research questions. In approaching these questions and corresponding levels of effort, feasibility and timing were important considerations. The Commission has specified Summer 2005 as the latest date for completing this research in time to update the 2008 version of California's Energy Code (Title 24).

  8. Effect of extended scope physiotherapists assessments in orthopaedic diagnostic setting: a systematic review

    DEFF Research Database (Denmark)

    Trøstrup, Jeanette; Juhl, Carsten Bogh; Mikkelsen, Lone Ramer

    2017-01-01

    Background Patients with musculoskeletal diseases can potentially be assessed by an extended scope physiotherapist (ESP) instead of by an orthopaedic surgeon (OS). Objectives To evaluate the effectiveness of the diagnostic musculoskeletal assessment performed by ESP compared to OS. Data sources...... and satisfaction in studies with high, moderate and low risk of bias. Limitations Risk of bias in the included studies. Conclusion and implication of key findings Diagnostic assessments performed by ESP may be as beneficial as or even better than assessment performed by OSs in terms diagnostic agreement, costs...... and satisfaction. However, the methodological quality was generally too low to determine the clear effectiveness of ESP assessment, and more high quality studies are needed....

  9. Diagnostic studies in amyloidosis

    NARCIS (Netherlands)

    Hazenberg, Bouke Pier Cornelis

    2007-01-01

    In this thesis two diagnostic techniques are studied in amyloidosis. Systemic amyloidosis is characterized by deposition of amyloid fibrils (tiny fibres) throughout the body resulting in damage of vital organs. Amyloid can be detected in a tissue specimen stained with Congo red: red-stained amyloid

  10. Electron beam diagnostics study

    International Nuclear Information System (INIS)

    Garganne, P.

    1989-08-01

    This paper summarizes the results of a study on beam diagnostics, using carbon wire scanners and optical transition radiation (DTR) monitors. The main consideration consists in the material selection, taking their thermal properties and their effect on the beam into account [fr

  11. Insensitivity to Scope in Contingent Valuation Studies

    DEFF Research Database (Denmark)

    Søgaard, Rikke; Lindholt, Jes Sanddal; Gyrd-Hansen, Dorte

    2012-01-01

    and mental budgeting explain scope insensitivity there are grounds for rejecting valuations, whereas other factors such as the alternative theoretical framework of regret theory may render insensitivity to scope a result of rational thinking. It is concluded that future contingent valuation studies should......Background: The credibility of contingent valuation studies has been questioned because of the potential occurrence of scope insensitivity, i.e. that respondents do not react to higher quantities or qualities of a good. Objective: The aim of this study was to examine the extent of scope...... insensitivity and to assess the relevance of potential explanations that may help to shed light on how to appropriately handle this problem in contingent valuation studies. Methods: We surveyed a sample of 2004 men invited for cardiovascular disease screening. Each respondent had three contingent valuation...

  12. Special safeguards study. Scopes of work

    International Nuclear Information System (INIS)

    1975-06-01

    The Special Safeguards Study (SSS) will be conducted by a combination of (1) contacts with other agencies, (2) NRC staff studies and analysis and (3) contracted studies in specific areas. Most of the study effort will be carried out by contractual support activities. These activities will be devoted to providing technical information, primarily qualitative because of the short term of the study, to enable the staff to determine the most cost-effective sets of measures for plutonium recycle and high-enriched uranium fuel cycle safeguards. The scope of work for these activities is given. The scope of work describes tasks that range from confirming the Commission's safeguards objective to defining specific protection systems for the following siting arrangements: dispersed sites, collocated fuel cycle plants, and mixed parks where reactors, reprocessing plants and fuel fabrication plants are collocated. (U.S.)

  13. Groundwater and climate change research scoping study

    OpenAIRE

    Jackson, C.R.; Cheetham, M.; Guha, P.

    2006-01-01

    This scoping study has reviewed much of the published literature in the field of climate change and groundwater research. Whilst it is not exhaustive with regard to groundwater quality issues, most of the published literature relating to climate change and groundwater resources, particularly in the UK, is covered. Further work is required to identify current research needs relating to the effects of climate change on groundwater quality. The study of the effects of climate chan...

  14. Tokamak Engineering Technology Facility scoping study

    Energy Technology Data Exchange (ETDEWEB)

    Stacey, W.M. Jr.; Abdou, M.A.; Bolta, C.C.

    1976-03-01

    A scoping study for a Tokamak Engineering Technology Facility (TETF) is presented. The TETF is a tokamak with R = 3 m and I/sub p/ = 1.4 MA based on the counterstreaming-ion torus mode of operation. The primary purpose of TETF is to demonstrate fusion technologies for the Experimental Power Reactor (EPR), but it will also serve as an engineering and radiation test facility. TETF has several technological systems (e.g., superconducting toroidal-field coil, tritium fuel cycle, impurity control, first wall) that are prototypical of EPR.

  15. Neutronics scoping studies for the NET blanket

    International Nuclear Information System (INIS)

    Daenner, W.

    1984-01-01

    The NET team presently pursues three types of blankets: a water cooled 17LiPb83 blanket and a helium cooled ceramic breeder blanket with either lead or beryllium as a neutron multiplier. For all three types the most important results from neutronics scoping studies are summarized which were directed towards exploiting the respective design concepts for maximum tritium breeding. The values reached are - in the above order - 1.16, 1.03 and 1.13, the latter two assuming LiAlO 2 as the breeding material. In all cases a high 6 Li enrichment and, in case of the Be multiplied blanket, a high proportion of multiplier material is necessary. The beryllium multiplied ceramic breeder blanket design offers the potential for improving the tritium breeding capability by choosing ceramics other than the LiAlO 2 . (author)

  16. Mobile Health Initiatives in Vietnam: Scoping Study.

    Science.gov (United States)

    Lam, Jeffrey A; Dang, Linh Thuy; Phan, Ngoc Tran; Trinh, Hue Thi; Vu, Nguyen Cong; Nguyen, Cuong Kieu

    2018-04-24

    Mobile health (mHealth) offers a promising solution to the multitude of challenges the Vietnamese health system faces, but there is a scarcity of published information on mHealth in Vietnam. The objectives of this scoping study were (1) to summarize the extent, range, and nature of mHealth initiatives in Vietnam and (2) to examine the opportunities and threats of mHealth utilization in the Vietnamese context. This scoping study systematically identified and extracted relevant information from 20 past and current mHealth initiatives in Vietnam. The study includes multimodal information sources, including published literature, gray literature (ie, government reports and unpublished literature), conference presentations, Web-based documents, and key informant interviews. We extracted information from 27 records from the electronic search and conducted 14 key informant interviews, allowing us to identify 20 mHealth initiatives in Vietnam. Most of the initiatives were primarily funded by external donors (n=15), while other initiatives were government funded (n=1) or self-funded (n=4). A majority of the initiatives targeted vulnerable and hard-to-reach populations (n=11), aimed to prevent the occurrence of disease (n=12), and used text messaging (short message service, SMS) as part of their intervention (n=14). The study revealed that Vietnamese mHealth implementation has been challenged by factors including features unique to the Vietnamese language (n=4) and sociocultural factors (n=3). The largest threats to the popularity of mHealth initiatives are the absence of government policy, lack of government interest, heavy dependence on foreign funding, and lack of technological infrastructure. Finally, while current mHealth initiatives have already demonstrated promising opportunities for alternative models of funding, such as social entrepreneurship or private business models, sustainable mHealth initiatives outside of those funded by external donors have not yet been

  17. Cementitious waste option scoping study report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, A.E.; Taylor, D.D.

    1998-02-01

    A Settlement Agreement between the Department of Energy (DOE) and the State of Idaho mandates that all high-level radioactive waste (HLW) now stored at the Idaho Chemical Processing Plant (ICPP) on the Idaho National Engineering and Environmental Laboratory (INEEL) will be treated so that it is ready to be moved out of Idaho for disposal by a target date of 2035. This study investigates the nonseparations Cementitious Waste Option (CWO) as a means to achieve this goal. Under this option all liquid sodium-bearing waste (SBW) and existing HLW calcine would be recalcined with sucrose, grouted, canisterized, and interim stored as a mixed-HLW for eventual preparation and shipment off-Site for disposal. The CWO waste would be transported to a Greater Confinement Disposal Facility (GCDF) located in the southwestern desert of the US on the Nevada Test Site (NTS). All transport preparation, shipment, and disposal facility activities are beyond the scope of this study. CWO waste processing, packaging, and interim storage would occur over a 5-year period between 2013 and 2017. Waste transport and disposal would occur during the same time period.

  18. Cementitious waste option scoping study report

    International Nuclear Information System (INIS)

    Lee, A.E.; Taylor, D.D.

    1998-02-01

    A Settlement Agreement between the Department of Energy (DOE) and the State of Idaho mandates that all high-level radioactive waste (HLW) now stored at the Idaho Chemical Processing Plant (ICPP) on the Idaho National Engineering and Environmental Laboratory (INEEL) will be treated so that it is ready to be moved out of Idaho for disposal by a target date of 2035. This study investigates the nonseparations Cementitious Waste Option (CWO) as a means to achieve this goal. Under this option all liquid sodium-bearing waste (SBW) and existing HLW calcine would be recalcined with sucrose, grouted, canisterized, and interim stored as a mixed-HLW for eventual preparation and shipment off-Site for disposal. The CWO waste would be transported to a Greater Confinement Disposal Facility (GCDF) located in the southwestern desert of the US on the Nevada Test Site (NTS). All transport preparation, shipment, and disposal facility activities are beyond the scope of this study. CWO waste processing, packaging, and interim storage would occur over a 5-year period between 2013 and 2017. Waste transport and disposal would occur during the same time period

  19. What are scoping studies? A review of the nursing literature.

    Science.gov (United States)

    Davis, Kathy; Drey, Nick; Gould, Dinah

    2009-10-01

    Scoping studies are increasingly undertaken as distinct activities. The interpretation, methodology and expectations of scoping are highly variable. This suggests that conceptually, scoping is a poorly defined ambiguous term. The distinction between scoping as an integral preliminary process in the development of a research proposal or a formative, methodologically rigorous activity in its own right has not been extensively examined. The aim of this review is to explore the nature and status of scoping studies within the nursing literature and develop a working definition to ensure consistency in the future use of scoping as a research related activity. This paper follows an interpretative scoping review methodology. An explicit systematic search strategy included literary and web-based key word searches and advice from key researchers. Electronic sources included bibliographic and national research register databases and a general browser. The scoping studies varied widely in terms of intent, procedural and methodological rigor. An atheoretical stance was common although explicit conceptual clarification and development of a topic was limited. Four different levels of inquiry ranging from preliminary descriptive surveys to more substantive conceptual approaches were conceptualised. These levels reflected differing dimensional distinctions in which some activities constitute research whereas in others the scoping activities appear to fall outside the remit of research. Reconnaissance emerges as a common synthesising construct to explain the purpose of scoping. Scoping studies in relation to nursing are embryonic and continue to evolve. Its main strengths lie in its ability to extract the essence of a diverse body of evidence giving it meaning and significance that is both developmental and intellectually creative. As with other approaches to research and evidence synthesis a more standardized approach is required.

  20. Learning Kinematics with a V-Scope: A Case Study.

    Science.gov (United States)

    Trumper, Ricardo

    1997-01-01

    Studies the effect of V-Scope activities on the performance of 11th-grade students in analyzing kinematics graphs. Students were challenged to construct different kinds of graphs using their own movements as well as the motion of a dynamics cart. Results indicate that the V-Scope kinematics laboratory activities can promote kinematics concepts and…

  1. PDR diagnostics study with CLOUDY

    International Nuclear Information System (INIS)

    Xue Rui; Huang Maohai

    2009-01-01

    A series of plane-parallel photodissociation region (PDR) models are calculated using the spectral synthesis code CLOUDY. These models span a wide range of physical conditions, with gas densities of n = 10 2 - 10 6 cm -3 and incident far-ultraviolet (FUV) fields of G 0 = 10 0 - 10 6 (where G 0 is the FUV flux in units of the local interstellar value), which are comparable with various astrophysical environments from interstellar diffuse clouds to the dense neutral gas around galactic compact H II regions. Based on the calculated results, we study the thermal balance of PDR gas and the emissions of [C II], [C I] and [O I] fine-structure lines under different physical conditions. The intensities and strength ratios of the studied lines, which are frequently used as PDR diagnostics, are presented using contour diagrams as functions of n and G 0 . We compare the calculated PDR surface gas temperatures T s with those from Kaufman et al. and find that T s from our models are systematically higher over most of the adopted n-G 0 parameter space. The predicated line intensities and ratios from our work and those from Kaufman et al. can be different by a factor greater than 10, and such large differences usually occur near the border of our parameter space. The different methods of treating the dust grain physics, the change of H 2 formation and dissociation rates, and the improvement in the radiation transfer of line emissions in our CLOUDY models are likely to be the major reasons for the divergences. Our models represent an up-to-date treatment of PDR diagnostic calculations and can be used to interpret observational data. Meanwhile, the uncertainties in the treatment of microphysics and chemical processes in PDR models have significant effects on PDR diagnostics.

  2. Diagnostic accuracy of organ electrodermal diagnostics | Szopinski ...

    African Journals Online (AJOL)

    Objective. To estimate the diagnostic accuracy as well as the scope of utilisation of a new bio-electronic method of organ diagnostics. Design. Double-blind comparative study of the diagnostic results obtained by means of organ electrodermal diagnostics (OED) and clinical diagnoses, as a criterion standard. Setting.

  3. Biomechanical research on bowed string musicians: a scoping study.

    Science.gov (United States)

    Kelleher, Leila K; Campbell, Kody R; Dickey, James P

    2013-12-01

    Performing arts biomechanics is concerned with quantifying the musculoskeletal demands of artistic tasks. The growing body of related research has prompted this scoping study, solely focused on quantitative research, to summarize the state of the science, identify knowledge gaps, and identify opportunities for future research. To identify, summarize, and categorize quantitative research on the biomechanics of violin, viola, cello, and double bass players, using scoping study methodology. Established scoping study methodology was used to identify and categorize existing research. We identified 74 articles for review. Of these, 34 met our scoping study criteria and were included in this study. Twenty-one of the 34 articles that met the scoping criteria were published since 2000. Investigations using electromyography (16 studies) and kinematics (15 studies) comprise the bulk of the research. Two studies employed force transducers for data collection. Violinists were the most frequently studied musicians (22 studies) and double bass players were the least (1 study). Fewer than half of the studies used solely professional musicians as their subjects (13 studies). This scoping study confirmed that quantitative biomechanical research into bowed string musicians has been performed with increasing frequency and that there are voids in the research, particularly in investigating mechanisms of injury and protective strategies. Currently, arts biomechanics research is largely descriptive in nature. There are few studies that investigate protective strategies, although it is expected that the field will progress to incorporate this type of research.

  4. Nuclear power plant diagnostics study at the Midland training simulator

    International Nuclear Information System (INIS)

    Reifman, J.; Rank, P.; Lee, J.C.

    1991-01-01

    Training simulators provide a real world environment for testing advanced diagnostic and control systems as an aid to nuclear power plant operators. The simulators not only duplicate the hardware din the actual control room, allowing for analysis of man-machine interface, but also represent the dynamic behavior of the reference plant in real-time, in a realistic manner. Training simulators provide the means to representing the reference plant operations in a wide range of operation conditions including off-normal and emergency conditions. Transient events with very low probability of occurrence can then be represented and used to test the capabilities of advanced diagnostic and control systems. For these reasons, full-scope operator training simulators have been used as a test bed for a number of advanced diagnostic concepts. The University of Michigan and Consumers Power Company have been collaborating in a program devoted to the development and study of advanced concepts for automatic diagnostics and control of nuclear power plants. The program has been focused on the use of the full-scope operator training Midland Nuclear Power Plant Unit 2 (MNP-2) Simulator for development, testing, and verification of advanced diagnostics concepts. In their current efforts, the authors have developed two artificial intelligent (AI) diagnostic concepts that have been applied to the MNP-2 Simulator: the systematic generation and updating of a rule-based knowledge system for nuclear power plant diagnostics and a nonlinear parameter estimation algorithm called the simulation filter. The simulation filter algorithm is used with the MNP-2 Simulator to improve the simulation of the Three Mile Island Unit 2 (TMI-2) accident. 11 refs., 4 figs

  5. Demand Responsive Lighting: A Scoping Study

    Energy Technology Data Exchange (ETDEWEB)

    Rubinstein, Francis; Kiliccote, Sila

    2007-01-03

    The objective of this scoping study is: (1) to identify current market drivers and technology trends that can improve the demand responsiveness of commercial building lighting systems and (2) to quantify the energy, demand and environmental benefits of implementing lighting demand response and energy-saving controls strategies Statewide. Lighting systems in California commercial buildings consume 30 GWh. Lighting systems in commercial buildings often waste energy and unnecessarily stress the electrical grid because lighting controls, especially dimming, are not widely used. But dimmable lighting equipment, especially the dimming ballast, costs more than non-dimming lighting and is expensive to retrofit into existing buildings because of the cost of adding control wiring. Advances in lighting industry capabilities coupled with the pervasiveness of the Internet and wireless technologies have led to new opportunities to realize significant energy saving and reliable demand reduction using intelligent lighting controls. Manufacturers are starting to produce electronic equipment--lighting-application specific controllers (LAS controllers)--that are wirelessly accessible and can control dimmable or multilevel lighting systems obeying different industry-accepted protocols. Some companies make controllers that are inexpensive to install in existing buildings and allow the power consumed by bi-level lighting circuits to be selectively reduced during demand response curtailments. By intelligently limiting the demand from bi-level lighting in California commercial buildings, the utilities would now have an enormous 1 GW demand shed capability at hand. By adding occupancy and light sensors to the remotely controllable lighting circuits, automatic controls could harvest an additional 1 BkWh/yr savings above and beyond the savings that have already been achieved. The lighting industry's adoption of DALI as the principal wired digital control protocol for dimming ballasts

  6. PVT Degradation Studies: Acoustic Diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Dib, Gerges [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Tucker, Brian J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Kouzes, Richard T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Smith, Philip J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2017-04-01

    Under certain environmental conditions, polyvinyl toluene (PVT) plastic scintillator has been observed to undergo internal fogging. This document reports on a study of acoustic techniques to determine whether they can provide a diagnostic for the fogging of PVT. Different ultrasound techniques were employed for detecting the level of internal fogging in PVT, including wave velocity measurements, attenuation, nonlinear acoustics, and acoustic microscopy. The results indicate that there are linear relations between the wave velocity and wave attenuation with the level of internal fogging. The effects of fogging on ultrasound wave attenuation is further verified by acoustic microscopy imaging, where regions with fog in the specimen demonstration higher levels of attenuation compared to clear regions. Results from the nonlinear ultrasound measurements were inconclusive due to high sensitivities to transducer coupling and fixture variabilities.

  7. Dosimetric studies in diagnostic radiology

    International Nuclear Information System (INIS)

    Mohamadain, K. E. M.

    2004-04-01

    A dosimetric study in pediatric radiology and adult patients was currently being carried out at the pediatrics units of two large hospitals in Rio de Janeiro city: IPPMG (Instituto de Pediatric e Puericultura Martagao Gesteira, University hospital of federal University of Rio de Janeiro), IFF (Instituto Fernandes Figueira, FIOCRUZ) and Hospital Geral de Bonsucesso, a large public hospital in Rio de Janeiro city (HGB) Brazil. The dosimetric study was also performed at three pediatrics units in Sudan, namely, Ahmed Gasim, Khartoum and Omdurman hospitals. For chest x-ray examination the entrance skin dose(ESD) for AP, PA and LAT projections of pediatric patients, and the scattered dose at the thyroid, ovary and gonads have been obtained with thermoluminescent dosimeters (TLD) and with use of a software package Dosecal in thr Brazilian hospitals, and with the software dosecal in the Sudanese hospitals.The aim of this work was to estimate the entrance skin dose (ESD), the effective dose (ED) and the body organ dose (BOD) for chest x-ray exposure in pediatric patients, and different exams for adults patients, and to compare the results obtained in the tow Countries Sudan and Brazil with the reference dose level. For ESD evaluation of the chest x-ray, three different TL dosimeters have been used, namely LiF: Mg, Ti (TLD 100) CaSo 4 : Dy and LiF:Mg, Cu,P (TLD 100 H). The age intervals considered were: 0-1 years, 1-5 years, 5-10 years and 10-15 years. The results obtained with all dosimeters were in good agreement with, those obtained by the dosecal software, especially for AP and PA projection. However, some discrepancies were found for the LAT projection. The results within Brazil were some what consistent while in Sudan, large difference were observed, it was also noted that the doses in Brazil hospitals were less than the reference dose levels while in Sudanese hospitals the doses were higher than the reference dose levels. For adult patients only the software dosecal

  8. CIT diagnostic computer interface studies

    International Nuclear Information System (INIS)

    Rauch, W.; Hayes, S.; Lowrance, J.; Oliaro, G.; Sauthoff, N.; Sichta, P.; Stark, W.

    1987-01-01

    This paper presents the on-going work performed in proposing instrumentation equipment and communications networks for the Diagnostic Data Acquisition and Diagnostic Instrumentation and Control System for the Compact Ignition Torus (CIT), which will begin operation in 1993. Consideration is given to the system criteria and requirements and their influence on the appropriate application of instrumentation and communication technologies to the system. This paper concentrates on the investigation of the bus communication technologies as they apply to the CIT data acquisition system. It compares CAMAC, VME, and FASTBUS as standards for data acquisition. The paper describes the connectivity between VAX equipment and CAMAC and VME instrumentation systems. Instrumentation and communication functionality and performance levels are presented as factors important to the overall data acquisition system performance

  9. Virtual interconnection platform initiative scoping study

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yong [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Kou, Gefei [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Pan, Zuohong [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Liu, Yilu [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); King Jr., Thomas J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-01-01

    Due to security and liability concerns, the research community has limited access to realistic large-scale power grid models to test and validate new operation and control methodologies. It is also difficult for industry to evaluate the relative value of competing new tools without a common platform for comparison. This report proposes to develop a large-scale virtual power grid model that retains basic features and represents future trends of major U.S. electric interconnections. This model will include realistic power flow and dynamics information as well as a relevant geospatial distribution of assets. This model will be made widely available to the research community for various power system stability and control studies and can be used as a common platform for comparing the efficacies of various new technologies.

  10. Oak Ridge Tokamak experimental power reactor study scoping report

    Energy Technology Data Exchange (ETDEWEB)

    Roberts, M.

    1977-03-01

    This report presents the scoping studies performed as the initial part of the program to produce a conceptual design for a Tokamak Experimental Power Reactor (EPR). The EPR as considered in this study is to employ all systems necessary for significant electric power production at continuous high duty cycle operation; it is presently scheduled to be the final technological step before a Demonstration Reactor Plant (Demo). The scoping study tasks begin with an exploration and identification of principal problem areas and then concentrate on consideration and evaluation of alternate design choices for each of the following major systems: Plasma Engineering and Physics, Nuclear, Electromagnetics, Neutral Beam Injection, and Tritium Handling. In addition, consideration has been given to the integration of these systems and requirements arising out of their incorporation into an EPR. One intent of this study is to document the paths explored in search of the appropriate EPR characteristics. To satisfy this intent, the explorations are presented in chart form outlining possible options in key areas with extensive supporting footnotes. An important result of the scoping study has been the development and definition of an EPR reference design to serve as (1) a common focus for the continuing design study and (2) a guide for associated development programs. In addition, the study has identified research and development requirements essential to facilitate the successful conceptual design, construction, and operation of an EPR.

  11. A Scoping Review on Studies of Cyberbullying Prevalence Among Adolescents.

    Science.gov (United States)

    Brochado, Sandra; Soares, Sara; Fraga, Sílvia

    2017-12-01

    This descriptive scoping aims to understand how the prevalence of cyberbullying has been estimated across studies. A systematic scoping review of cyberbullying empirical studies was conducted by using three bibliographic databases to search for papers published between January 2004 and August 2014. A protocol was defined to identify the relevant papers. Papers selected were included in a data sheet developed by the authors to record specific findings. In total, 159 studies were included in the scoping review. Most of the prevalence studies were conducted in the last 4 years, mainly in North America ( n = 77) and in Europe ( n = 65). High methodological heterogeneity was found among the studies, which may contribute to explain variability in prevalence estimates. Cyberbullying experiences were assessed through several different perspectives: focused only on victims, focused only on perpetrators, or focused on both victims and perpetrators (without differentiating between if they are victims or perpetrators). Most of the studies tend to assess cybervictimization experiences. However, even considering the same perspective, the same country, and the same recall period, a high variability in the estimates was observed. As a main conclusion, the way in which the prevalence of cyberbullying is estimated is influenced by methodological research options.

  12. Study of methodology diversification in diagnostics

    International Nuclear Information System (INIS)

    Suda, Kazunori; Yonekawa, Tsuyoshi; Yoshikawa, Shinji; Hasegawa, Makoto

    1999-03-01

    There are several research activities to enhance safety and reliability of nuclear power plant operation and maintenance. We are developing a concept of an autonomous operation system where the role of operators is replaced with artificial intelligence. The purpose of the study described in this report is to develop a operator support system in abnormal plant situations. Conventionally, diagnostic modules based on individual methodology such as expert system have been developed and verified. In this report, methodology diversification is considered to integrate diagnostic modules which performance are confirmed using information processing technique. Technical issues to be considered in diagnostic methodology diversification are; 1)reliability of input data, 2)diversification of knowledge models, algorithms and reasoning schemes, 3)mutual complement and robustness. The diagnostic module utilizing the different approaches defined along with strategy of diversification was evaluated using fast breeder plant simulator. As a result, we confirmed that any singular diagnostic module can not meet accuracy criteria for the entire set of anomaly events. In contrast with this, we confirmed that every abnormality could be precisely diagnosed by a mutual combination. In other words, legitimacy of approach selected by strategy of diversification was shown, and methodology diversification attained clear efficiency for abnormal diagnosis. It has been also confirmed that the diversified diagnostic system implemented in this study is able to maintain its accuracy even in case that encountered scale of abnormality is different from reference cases embedded in the knowledge base. (author)

  13. Diagnostic radiography: A study in distancing

    International Nuclear Information System (INIS)

    Reeves, Pauline J.; Decker, Sola

    2012-01-01

    Aims: This article aims to explore the ways in which diagnostic radiographers use distancing as a tool for emotional management in radiography practice. Methods: This review utilises data from oral history interviews undertaken as part of a larger study documenting the oral history of the diagnostic radiography profession in the United Kingdom as recounted by 24 participants. Results: The results are presented as illustrative of various aspects of the role of the diagnostic radiographer including the initial choice of diagnostic radiography as a profession, the endemic use of particular terminology, the nature of the encounter in diagnostic radiography (including that of sectional imaging) and whether the role is really patient-centred. Conclusions: The article concludes by suggesting that distancing from the patient is mediated by the need for physical touch in order to position the patient for radiography and also makes the suggestion that those opting for diagnostic radiography as a career may do so because they want a profession which is more distanced from the patient and that, even where this is not the case initially, individuals are socialised into adopting the ‘feeling rules’ of the profession. The article concludes by outlining potential areas for further research.

  14. Scope: Opportunities for International Study of Global Environmental Issues.

    Science.gov (United States)

    Defries, Ruth, S.; And Others

    1985-01-01

    Describes the origin, function, and involvements of the Scientific Committee on Problems of the Environment (SCOPE). Outlines SCOPE's governing principles and explains its operating procedures. Provides summaries of current projects, with a listing of available reports and publications. (ML)

  15. Scoping Study Investigating PWR Instrumentation during a Severe Accident Scenario

    Energy Technology Data Exchange (ETDEWEB)

    Rempe, J. L. [Rempe and Associates, LLC, Idaho Falls, ID (United States); Knudson, D. L. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Lutz, R. J. [Lutz Nuclear Safety Consultant, LLC, Asheville, NC (United States)

    2015-09-01

    significantly exceeded QE limits for extended time periods for the low frequency STSBO sequence evaluated in this study. It is recognized that the core damage frequency (CDF) of the sequence evaluated in this scoping effort would be considerably lower if evaluations considered new FLEX equipment being installed by industry. Nevertheless, because of uncertainties in instrumentation response when exposed to conditions beyond QE limits and alternate challenges associated with different sequences that may impact sensor performance, it is recommended that additional evaluations of instrumentation performance be completed to provide confidence that operators have access to accurate, relevant, and timely information on the status of reactor systems for a broad range of challenges associated with risk important severe accident sequences.

  16. Evidence of accessibility and utility of point-of-care diagnostics as an integral part of prevention of mother-to-child transmission services: systematic scoping review protocol.

    Science.gov (United States)

    Katoba, Juliet; Hangulu, Lydia; Mashamba-Thompson, Tivani Phosa

    2017-11-04

    Point-of-care (POC) testing has been shown to help improve healthcare access in resource-limited settings. However, there is paucity of evidence on accessibility of POC testing for prevention of mother-to-child transmission (PMTCT) in resource-limited settings. We propose to conduct a systematic scoping review to map the evidence on POC testing services for PMTCT. A scoping review framework, proposed by Arksey and O'Malley, will guide the study. A comprehensive literature search will be performed in the following electronic databases: PubMed, Science Direct, Cochrane Central, Google Scholar and databases within EBSCOhost (Medline and CINAHL). The primary research articles published in peer-reviewed journals and grey articles addressing our question will be included. One reviewer will conduct title screening and the results will be exported to endnote library. Two independent reviewers will perform abstract, then full article screening in parallel. The same process shall be employed to extract data from eligible studies. Data analysis will involve a narrative summary of included studies and thematic content analysis aided by NVIVO software V.11. The mixed methods assessment tool will be used to assess the quality of studies that will be included. Ethical approval is not applicable to this study. The study findings will be disseminated through publication in a peer-reviewed journal and presentations at conferences related to syphilis, HIV, PMTCT, bacterial infections and POC diagnostics. CRD42017056267. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Synergies between renewable energy and fresh water production. Scoping study

    Energy Technology Data Exchange (ETDEWEB)

    Geurts, F.; Noothout, P.; Schaap, A. [Ecofys Netherlands, Utrecht (Netherlands)

    2011-02-15

    The IEA Implementing Agreement for Renewable Energy Technology Deployment (IEA-RETD) investigated the opportunities for coupling renewable energy systems with fresh water supply systems. The four main conclusions of the scoping study, carried out by Ecofys, are: (1) Fresh water production based on desalination technologies provide most options for synergies with renewable energy production; (2) Linking desalination to renewable sources is currently not economically viable; (3) There is a large potential for small scale (decentralised) desalination plants; (4) Current commercially-sized desalination technologies are in need of a constant operation point. Reverse osmosis and thermal membrane technologies might give future synergies as deferrable load.

  18. Klipperaas study site. Scope of activities and main results

    International Nuclear Information System (INIS)

    Ahlbom, K.; Andersson, J.E.; Andersson, Peter; Ittner, T.; Tiren, S.; Ljunggren, C.

    1992-09-01

    During the period from 1977 - 1986 SKB (Swedish Nuclear Fuel and Waste Management Co.) performed surface and borehole investigations of 14 study sites for the purpose of assessing their suitability for a repository of spent nuclear fuel. The next phase in the SKB site selection rpogramme will be to perform detailed characterisation, including characterization from shafts and/or tunnels, of two or three sites. The detailed investigations will continue over several years to provide all the data needed for a licensing application to build a repository. Such an application is foreseen to be given to the authorities around the year 2003. It is presently not clear if any of the study sites will be selected as a site for detailed characterization. Other sites with geological and/or socio-economical characteristics judged more favorable may very well be the ones selected. However, as a part of the background documentation needed for the site selection studies to come, summary reports will be prepared for most study sites. These reports will include scope of activities, main results, uncertainties and need of complementary investigations. This report concern the Klipperaas study site. The main topics are the scope of activities, geologic model, geohydrological model, groundwater chemistry, assessment of solute transport, and rock mechanics

  19. Study on GPU Computing for SCOPE2 with CUDA

    International Nuclear Information System (INIS)

    Kodama, Yasuhiro; Tatsumi, Masahiro; Ohoka, Yasunori

    2011-01-01

    For improving safety and cost effectiveness of nuclear power plants, a core calculation code SCOPE2 has been developed, which adopts detailed calculation models such as the multi-group nodal SP3 transport calculation method in three-dimensional pin-by-pin geometry to achieve high predictability. However, it is difficult to apply the code to loading pattern optimizations since it requires much longer computation time than that of codes based on the nodal diffusion method which is widely used in core design calculations. In this study, we studied possibility of acceleration of SCOPE2 with GPU computing capability which has been recognized as one of the most promising direction of high performance computing. In the previous study with an experimental programming framework, it required much effort to convert the algorithms to ones which fit to GPU computation. It was found, however, that this conversion was tremendously difficult because of the complexity of algorithms and restrictions in implementation. In this study, to overcome this complexity, we utilized the CUDA programming environment provided by NVIDIA which is a versatile and flexible language as an extension to the C/C++ languages. It was confirmed that we could enjoy high performance without degradation of maintainability through test implementation of GPU kernels for neutron diffusion/simplified P3 equation solvers. (author)

  20. Laser diagnostics for microgravity droplet studies

    Science.gov (United States)

    Winter, Michael

    1993-01-01

    Rapid advances have recently been made in numerical simulation of droplet combustion under microgravity conditions, while experimental capabilities remain relatively primitive. Calculations can now provide detailed information on mass and energy transport, complex gas-phase chemistry, multi-component molecular diffusion, surface evaporation and heterogeneous reaction, which provides a clearer picture of both quasi-steady as well as dynamic behavior of droplet combustion. Experiments concerning these phenomena typically result in pictures of the burning droplets, and the data therefrom describe droplet surface regression along with flame and soot shell position. With much more precise, detailed, experimental diagnostics, significant gains could be made on the dynamics and flame structural changes which occur during droplet combustion. Since microgravity experiments become increasingly more expensive as they progress from drop towers and flights to spaceborne experiments, there is a great need to maximize the information content from these experiments. Sophisticated measurements using laser diagnostics on individual droplets and combustion phenomena are now possible. These include measuring flow patterns and temperature fields within droplets, vaporization rates and vaporization enhancement, radical species profiling in flames and gas-phase flow-tagging velocimetry. Although these measurements are sophisticated, they have undergone maturation to the degree where with some development, they are applicable to studies of microgravity droplet combustion. This program beginning in September of 1992, will include a series of measurements in the NASA Learjet, KC-135 and Drop Tower facilities for investigating the range of applicability of these diagnostics while generating and providing fundamental data to ongoing NASA research programs in this area. This program is being conducted in collaboration with other microgravity investigators and is aimed toward supplementing

  1. Cost-of-illness studies: concepts, scopes, and methods

    Directory of Open Access Journals (Sweden)

    Changik Jo

    2014-12-01

    Full Text Available Liver diseases are one of the main causes of death, and their ever-increasing prevalence is threatening to cause significant damage both to individuals and society as a whole. This damage is especially serious for the economically active population in Korea. From the societal perspective, it is therefore necessary to consider the economic impacts associated with liver diseases, and identify interventions that can reduce the burden of these diseases. The cost-of-illness study is considered to be an essential evaluation technique in health care. By measuring and comparing the economic burdens of diseases to society, such studies can help health-care decision-makers to set up and prioritize health-care policies and interventions. Using economic theories, this paper introduces various study methods that are generally applicable to most disease cases for estimating the costs of illness associated with mortality, morbidity, disability, and other disease characteristics. It also presents concepts and scopes of costs along with different cost categories from different research perspectives in cost estimations. By discussing the epidemiological and economic grounds of the cost-of-illness study, the reported results represent useful information about several evaluation techniques at an advanced level, such as cost-benefit analysis, cost-effectiveness analysis, and cost-utility analysis.

  2. Cost-of-illness studies: concepts, scopes, and methods

    Science.gov (United States)

    2014-01-01

    Liver diseases are one of the main causes of death, and their ever-increasing prevalence is threatening to cause significant damage both to individuals and society as a whole. This damage is especially serious for the economically active population in Korea. From the societal perspective, it is therefore necessary to consider the economic impacts associated with liver diseases, and identify interventions that can reduce the burden of these diseases. The cost-of-illness study is considered to be an essential evaluation technique in health care. By measuring and comparing the economic burdens of diseases to society, such studies can help health-care decision-makers to set up and prioritize health-care policies and interventions. Using economic theories, this paper introduces various study methods that are generally applicable to most disease cases for estimating the costs of illness associated with mortality, morbidity, disability, and other disease characteristics. It also presents concepts and scopes of costs along with different cost categories from different research perspectives in cost estimations. By discussing the epidemiological and economic grounds of the cost-of-illness study, the reported results represent useful information about several evaluation techniques at an advanced level, such as cost-benefit analysis, cost-effectiveness analysis, and cost-utility analysis. PMID:25548737

  3. Implementing RFID in a hospital library: a scoping study.

    Science.gov (United States)

    Norwood, Joseph; Skinner, Ben

    2012-06-01

    This article discusses a scoping study on implementing radio frequency identification device (RFID) in a hospital library context, conducted by Joseph Norwood for his MA dissertation at the University of Brighton. The study was carried out during the summer of 2011 to support possible RFID implementation at the Brighton and Sussex University Hospitals (BSUH) Trust, and the library staff were able to use the findings to good effect to create a business plan. This article also acts as the template for the new Dissertations into Practice feature, which was introduced in the March issue (Marshall, A. Health Information and Libraries Journal 2012, 29, 72). The dissertation highlighted here is very practical in nature and had immediate and quantifiable benefits for the Trust library. Future feature articles are likely to reflect the range of health-related dissertation topics which students choose and will include studies on user information behaviour, information services related to mental health and well-being, as well as the impact of technology on health-related library or information services.AM. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

  4. International Scoping Study of a Future Accelerator Neutrino Complex

    International Nuclear Information System (INIS)

    Zisman, Michael S.

    2006-01-01

    The International Scoping Study (ISS), launched at NuFact05 to evaluate the physics case for a future neutrino facility, along with options for the accelerator complex and detectors, is laying the foundations for a subsequent conceptual-design study. It is hosted by Rutherford Appleton Laboratory (RAL) and organized by the international community, with participants from Europe, Japan, and the U.S. Here we cover the work of the Accelerator Working Group. For the 4-MW proton driver, linacs, synchrotrons, and Fixed-Field Alternating Gradient (FFAG) rings are considered. For targets, issues of both liquid-metal and solid materials are examined. For beam conditioning, (phase rotation, bunching, and ionization cooling), we evaluate schemes both with and without cooling, the latter based on scaling-FFAG rings. For acceleration, we examine scaling FFAGs and hybrid systems comprising linacs, dogbone RLAs, and non-scaling FFAGs. For the decay ring, we consider racetrack and triangular shapes, the latter capable of simultaneously illuminating two different detectors at different long baselines. Comparisons are made between various technical approaches to identify optimum design choices

  5. Obesity studies in the circumpolar Inuit: a scoping review

    Directory of Open Access Journals (Sweden)

    Tracey Galloway

    2012-07-01

    Full Text Available Background. Among circumpolar populations, recent research has documented a significant increase in risk factors which are commonly associated with chronic disease, notably obesity. Objective. The present study undertakes a scoping review of research on obesity in the circumpolar Inuit to determine the extent obesity research has been undertaken, how well all subpopulations and geographic areas are represented, the methodologies used and whether they are sufficient in describing risk factors, and the prevalence and health outcomes associated with obesity. Design. Online databases were used to identify papers published 1992–2011, from which we selected 38 publications from Canada, the United States, and Greenland that used obesity as a primary or secondary outcome variable in 30 or more non-pregnant Inuit (“Eskimo” participants aged 2 years or older. Results. The majority of publications (92% reported cross-sectional studies while 8% examined retrospective cohorts. All but one of the studies collected measured data. Overall 84% of the publications examined obesity in adults. Those examining obesity in children focused on early childhood or adolescence. While most (66% reported 1 or more anthropometric indices, none incorporated direct measures of adiposity. Evaluated using a customized quality assessment instrument, 26% of studies achieved an “A” quality ranking, while 18 and 39% achieved quality rankings of “B” and “C”, respectively. Conclusions. While the quality of studies is generally high, research on obesity among Inuit would benefit from careful selection of methods and reference standards, direct measures of adiposity in adults and children, studies of preadolescent children, and prospective cohort studies linking early childhood exposures with obesity outcomes throughout childhood and adolescence.

  6. Scoping studies: behavior and control of lithium and lithium aerosols

    Energy Technology Data Exchange (ETDEWEB)

    Jeppson, D W

    1982-01-01

    The HEDL scoping studies examining the behavior of lithium and lithium aerosols have been conducted to determine and examine potential safety and environmental issues for postulated accident conditions associated with the use of lithium as a fusion reactor blanket and/or coolant. Liquid lithium reactions with air, nitrogen, carbon dioxide and concretes have been characterized. The effectiveness of various powder extinguishing agents and methods of application were determined for lithium-air reactions. The effectiveness of various lithium aerosol collection methods were determined and the volatilization and transport of radioactive metals potentially associated with lithium-air reactions were evaluated. Liquid lithium atmosphere reactions can be safely controlled under postulated accident conditions, but special handling practices must be provided. Lithium-concrete reactions should be avoided because of the potential production of high temperatures, corrosive environment and hydrogen. Carbon microspheres are effective in extinguishing well established lithium-air reactions for the lithium quantities tested (up to 10 kg). Large mass loading of lithium aerosols can be efficiently collected with conventional air cleaning systems. Potentially radioactive species (cobalt, iron and manganese) will be volatilized in a lithium-air reaction in contact with neutron activated stainless steel.

  7. Environmental health scoping study at Bruce Heavy Water Plant

    International Nuclear Information System (INIS)

    Prior, M.; Mostrom, M.; Coppock, R.; Florence, Z.

    1995-10-01

    There are concerns that hydrogen sulfide released from the Heavy Water Plant near Kincardine, Ontario may be the cause of the mortalities and morbidities observed in a nearby flock of sheep. The Philosopher's Wool sheep farm is about four kilometres south-southeast of the Bruce Heavy Water Plant. Ontario Hydro, the owner and operator of the Bruce Heavy Water Plant, claims that hydrogen sulphide emissions from the Bruce Heavy Water Plant are within regulatory limits and well below levels that cause harm. Accordingly, the Atomic Energy Control Board commissioned the Alberta Environmental Centre, Alberta Department of Environmental Protection, to develop a scoping study for this environmental health issue. The first objective was to describe a field investigation model to define clearly the environmental health and operation of the sheep farm. The second objective was to describe possible exposure patterns and develop a holistic environmental pathway model. If appropriate, the third study objective was to describe animal models of the actual situation to elucidate specific aspects of the environmental health concerns. It was not the objective of this report to provide a definitive answer to the present environmental health issue. Ontario Hydro provided data to the Alberta Environmental Centre, as di the sheep farmer, the attending veterinarian, the University of Guelph study team, and the Atomic Energy Control Board. A six-tiered strategy of sequential evaluations of the ovine health problem is based on the multiple-response paradigm. It assumes the observed ovine health results are the result of multiple effector events. Each tier constitutes a separate, but inter-related, study. Sequential evaluation and feedback of each tier allow sound scientific judgements and efficient use of resources. (author). 59 refs., 11 tabs., 22 figs

  8. Rehabilitation after total joint replacement: a scoping study.

    Science.gov (United States)

    L Snell, Deborah; Hipango, Julia; Sinnott, K Anne; Dunn, Jennifer A; Rothwell, Alastair; Hsieh, C Jean; DeJong, Gerben; Hooper, Gary

    2018-07-01

    The evidence supporting rehabilitation after joint replacement, while vast, is of variable quality making it difficult for clinicians to apply the best evidence to their practice. We aimed to map key issues for rehabilitation following joint replacement, highlighting potential avenues for new research. We conducted a scoping study including research published between January 2013 and December 2016, evaluating effectiveness of rehabilitation following hip and knee total joint replacement. We reviewed this work in the context of outcomes described from previously published research. Thirty individual studies and seven systematic reviews were included, with most research examining the effectiveness of physiotherapy-based exercise rehabilitation after total knee replacement using randomized control trial methods. Rehabilitation after hip and knee replacement whether carried out at the clinic or monitored at home, appears beneficial but type, intensity and duration of interventions were not consistently associated with outcomes. The burden of comorbidities rather than specific rehabilitation approach may better predict rehabilitation outcome. Monitoring of recovery and therapeutic attention appear important but little is known about optimal levels and methods required to maximize outcomes. More work exploring the role of comorbidities and key components of therapeutic attention and the therapy relationship, using a wider range of study methods may help to advance the field. Implications for Rehabilitation Physiotherapy-based exercise rehabilitation after total hip replacement and total knee replacement, whether carried out at the clinic or monitored at home, appears beneficial. Type, intensity, and duration of interventions do not appear consistently associated with outcomes. Monitoring a patient's recovery appears to be an important component. The available research provides limited guidance regarding optimal levels of monitoring needed to achieve gains following hip

  9. The High/Scope Perry Preschool Study: A Case Study in Random Assignment.

    Science.gov (United States)

    Schweinhart, Lawrence J.

    2000-01-01

    Studied the long-term benefits of preschool programs for young children living in poverty in the High/Scope Perry Preschool Study, which examined the lives of 123 African Americans randomly divided into a preschool treatment group and a no-preschool comparison group. Cost-benefit analyses of data on these students to age 27 show beneficial effects…

  10. Diagnostics

    DEFF Research Database (Denmark)

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

    2007-01-01

    In order to support the operation of ITER and the planned experimental programme an extensive set of plasma and first wall measurements will be required. The number and type of required measurements will be similar to those made on the present-day large tokamaks while the specification...... 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......&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...

  11. Scoping study into wound management nurse practitioner models of practice.

    Science.gov (United States)

    Gibb, Michelle A; Edwards, Helen E; Gardner, Glenn E

    2015-04-01

    The primary objective of this research was to investigate wound management nurse practitioner (WMNP) models of service for the purposes of identifying parameters of practice and how patient outcomes are measured. A scoping study was conducted with all authorised WMNPs in Australia from October to December 2012 using survey methodology. A questionnaire was developed to obtain data on the role and practice parameters of authorised WMNPs in Australia. The tool comprised seven sections and included a total of 59 questions. The questionnaire was distributed to all members of the WMNP Online Peer Review Group, to which it was anticipated the majority of WMNPs belonged. Twenty-one WMNPs responded (response rate 87%), with the results based on a subset of respondents who stated that, at the time of the questionnaire, they were employed as a WMNP, therefore yielding a response rate of 71% (n=15). Most respondents (93%; n=14) were employed in the public sector, with an average of 64 occasions of service per month. The typical length of a new case consultation was 60 min, with 32 min for follow ups. The most frequently performed activity was wound photography (83%; n=12), patient, family or carer education (75%; n=12), Doppler ankle-brachial pressure index assessment (58%; n=12), conservative sharp wound debridement (58%; n=12) and counselling (50%; n=12). The most routinely prescribed medications were local anaesthetics (25%; n=12) and oral antibiotics (25%; n=12). Data were routinely collected by 91% of respondents on service-related and wound-related parameters to monitor patient outcomes, to justify and improve health services provided. This study yielded important baseline information on this professional group, including data on patient problems managed, the types of interventions implemented, the resources used to accomplish outcomes and how outcomes are measured.

  12. Scope of radon monitoring for earthquake-studies in India

    International Nuclear Information System (INIS)

    Virk, H.S.

    1994-01-01

    In India, there is scope for investigating and exploiting radon as a precursor for earthquakes and for exploration of hydrocarbon deposits. This report mainly deals with the investigations carried out in Kangra and Chamba valleys of Himachal Pradesh under Himalayan Seismicity Project of Department of Science and Technology, Govt. of India. 20 refs., 4 figs., 1 tab

  13. Diagnostic needs for fluctuations and transport studies

    International Nuclear Information System (INIS)

    Carreras, B.A.

    1992-01-01

    The identification of fundamental transport mechanisms in magnetically confined plasmas is a critical issue for the magnetic fusion program. Recent progress in understanding fluctuations and transport is well correlated with the development and use of new diagnostics, but there a great deal of information is still missing. Some of the required measurements are well beyond our present diagnostic capabilities, but some are within reach and could answer critical questions in this area of research. Some of these critical issues are discussed

  14. Diagnostic test systematic reviews: bibliographic search filters ("Clinical Queries") for diagnostic accuracy studies perform well.

    Science.gov (United States)

    Kastner, Monika; Wilczynski, Nancy L; McKibbon, Ann K; Garg, Amit X; Haynes, R Brian

    2009-09-01

    Systematic reviews of health care topics are valuable summaries of all pertinent studies on focused questions. However, finding all relevant primary studies for systematic reviews remains challenging. To determine the performance of the Clinical Queries sensitive search filter for diagnostic accuracy studies for retrieving studies for systematic reviews. We compared the yield of the sensitive Clinical Queries diagnosis search filter for MEDLINE and EMBASE to retrieve studies in diagnostic accuracy systematic reviews reported in ACP Journal Club in 2006. Twelve of 22 diagnostic accuracy reviews (452 included studies) met the inclusion criteria. After excluding 11 studies not in MEDLINE or EMBASE, 95% of articles (417 of 441) were captured by the sensitive Clinical Queries diagnosis search filter (MEDLINE and EMBASE combined). Of 24 studies not retrieved by the filter, 22 were not diagnostic accuracy studies. Reanalysis of the Clinical Queries filter without these 22 nondiagnosis articles increased its performance to 99% (417 of 419). We found no substantive impact of the two articles missed by the Clinical Queries filter on the conclusions of the systematic reviews in which they were cited. The sensitive Clinical Queries diagnostic search filter captured 99% of articles and 100% of substantive articles indexed in MEDLINE and EMBASE in diagnostic accuracy systematic reviews.

  15. [Value of bacteriologic studies within the scope of forensic autopsies].

    Science.gov (United States)

    Schneider, V

    1985-01-01

    The various questions regarding bacteriological investigations within the scope of forensic autopsies are discussed in the light of our own cases and with regard to the relevant literature: estimate of the age of the corpse on the basis of decomposition changes caused by bacteria; determination of so-called bacteriograms from the point of view of criminalistics; supplementary investigations of the cause of death. Iatrogenic infections (e.g., gangrene) are gone into in more detail, as is so-called infantile botulism within the scope of the "sudden infant death syndrome". Finally, it is pointed out that when doing forensic autopsies, thought should also be given to illnesses that have only been known for a few years, examples being legionnaires' disease and the toxic shock syndrome ("tampon sickness").

  16. Evaluating School Obesity-related Policies Using Surveillance Tools: Lessons from The ScOPE Study

    OpenAIRE

    Nanney, Marilyn S.; Nelson, Toben F.; Kubik, Martha Y.; Coulter, Sara; Davey, Cynthia S.; MacLehose, Richard; Rode, Peter

    2014-01-01

    The evidence evaluating the association between school obestiy prevention policies and student weight is mixed. The lack of consistent findings may result, in part, from limited evaluation approaches. The goal of this paper is to demonstrate the use of surveillance data to address methodological gaps and opportunities in the school policy evaluation literature using lessons from the School Obesity-related Policy Evaluation (ScOPE) study. The ScOPE study uses a repeated, cross-sectional study ...

  17. Improving the methodological framework for diagnostic studies

    NARCIS (Netherlands)

    Naaktgeboren, C.A.

    2015-01-01

    The salient question to ask when evaluating a diagnostic test is “Does the use of this test lead to improved health outcomes?”. Tests lead to improved health outcomes by identifying patients who will benefit from clinical action. Therefore, to improve health outcomes, a test must be able to

  18. Scoping a field experiment: error diagnostics of TRMM precipitation radar estimates in complex terrain as a basis for IPHEx2014

    Science.gov (United States)

    Duan, Y.; Wilson, A. M.; Barros, A. P.

    2015-03-01

    A diagnostic analysis of the space-time structure of error in quantitative precipitation estimates (QPEs) from the precipitation radar (PR) on the Tropical Rainfall Measurement Mission (TRMM) satellite is presented here in preparation for the Integrated Precipitation and Hydrology Experiment (IPHEx) in 2014. IPHEx is the first NASA ground-validation field campaign after the launch of the Global Precipitation Measurement (GPM) satellite. In anticipation of GPM, a science-grade high-density raingauge network was deployed at mid to high elevations in the southern Appalachian Mountains, USA, since 2007. This network allows for direct comparison between ground-based measurements from raingauges and satellite-based QPE (specifically, PR 2A25 Version 7 using 5 years of data 2008-2013). Case studies were conducted to characterize the vertical profiles of reflectivity and rain rate retrievals associated with large discrepancies with respect to ground measurements. The spatial and temporal distribution of detection errors (false alarm, FA; missed detection, MD) and magnitude errors (underestimation, UND; overestimation, OVR) for stratiform and convective precipitation are examined in detail toward elucidating the physical basis of retrieval error. The diagnostic error analysis reveals that detection errors are linked to persistent stratiform light rainfall in the southern Appalachians, which explains the high occurrence of FAs throughout the year, as well as the diurnal MD maximum at midday in the cold season (fall and winter) and especially in the inner region. Although UND dominates the error budget, underestimation of heavy rainfall conditions accounts for less than 20% of the total, consistent with regional hydrometeorology. The 2A25 V7 product underestimates low-level orographic enhancement of rainfall associated with fog, cap clouds and cloud to cloud feeder-seeder interactions over ridges, and overestimates light rainfall in the valleys by large amounts, though this

  19. Scoping study for a national strategic plan for transportation information management

    Science.gov (United States)

    2003-06-01

    To address the lack of management for transportation information, the American Association of State Highway and Transportation Officials Standing Committee on Research determined that a scoping study should be done to examine the major issues confron...

  20. Facilitating Prospective Registration of Diagnostic Accuracy Studies: A STARD Initiative

    NARCIS (Netherlands)

    Korevaar, Daniël A.; Hooft, Lotty; Askie, Lisa M.; Barbour, Virginia; Faure, Hélène; Gatsonis, Constantine A.; Hunter, Kylie E.; Kressel, Herbert Y.; Lippman, Hannah; McInnes, Matthew D.; Moher, David; Rifai, Nader; Cohen, Jérémie F.; Bossuyt, Patrick M.

    2017-01-01

    Although the introduction of prospective trial registration policies has been successful in reducing waste in research, diagnostic accuracy studies are rarely registered. We describe why diagnostic accuracy studies should be registered, and where and how this can be done. Advantages of registration

  1. Study of recent Ebola virus outbreak and lessons learned: A scoping study

    OpenAIRE

    Nidhi Bhatnagar; Manoj Grover; Atul Kotwal; Himanshu Chauhan

    2016-01-01

    Background: The recent Ebola outbreak notified in West Africa recorded 6,553 cases and 3,083 deaths till 30th September 2014. This is the longest reported outbreak, suggesting poor preparedness and inadequate public health response. Learning from these experiences can help taking future disease-control measures in West Africa and elsewhere. Materials and Methods: This scoping study was done to summarize a range of evidences available on the current “Ebola Viral Disease” (EVD) outbreak. All ar...

  2. FMIT test-end instrumentation systems scoping study

    International Nuclear Information System (INIS)

    Fuller, J.L.; Dixon, N.E.; Sheen, E.M.

    1982-06-01

    For the Fusion Materials Irradiation Test facility (FMIT), the high power density of the accelerated deuteron beam and the unique nature of the liquid lithium target underscore the need for sensitive, fast and reliable test-end diagnostic instrumentation. The intense radiation environment in the test cell places severe limits on candidate systems, as to a lesser degree do thermal and lithium compatibility factors. A beam-target diagnostic station at 180 in the HEBT can facilitate source emission and spot-on-target imaging. Analyses support the feasibility of several candidate imaging systems. Incorporation of electromagnetic and electrostatic beam position detectors as part of the target assembly, as previously proposed, should also be feasible. The possibilities for on-line, real-time ultrasonic/acoustic target diagnosis are favorable. The use of redundant thermocouple and ion detector test assembly beam location detectors is also supported because of the possible problems with thermocouples in the intense 14-MeV neutron field and the simplicity of the ion detectors

  3. Extending the scope of diagnostic chromosome analysis: detection of single gene defects using high-resolution SNP microarrays.

    Science.gov (United States)

    Bruno, Damien L; Stark, Zornitza; Amor, David J; Burgess, Trent; Butler, Kathy; Corrie, Sylvea; Francis, David; Ganesamoorthy, Devika; Hills, Louise; James, Paul A; O'Rielly, Darren; Oertel, Ralph; Savarirayan, Ravi; Prabhakara, Krishnamurthy; Salce, Nicholas; Slater, Howard R

    2011-12-01

    Microarray analysis has provided significant advances in the diagnosis of conditions resulting from submicroscopic chromosome abnormalities. It has been recommended that array testing should be a "first tier" test in the evaluation of individuals with intellectual disability, developmental delay, congenital anomalies, and autism. The availability of arrays with increasingly high probe coverage and resolution has increased the detection of decreasingly small copy number changes (CNCs) down to the intragenic or even exon level. Importantly, arrays that genotype SNPs also detect extended regions of homozygosity. We describe 14 examples of single gene disorders caused by intragenic changes from a consecutive set of 6,500 tests using high-resolution SNP microarrays. These cases illustrate the increased scope of cytogenetic testing beyond dominant chromosome rearrangements that typically contain many genes. Nine of the cases confirmed the clinical diagnosis, that is, followed a "phenotype to genotype" approach. Five were diagnosed by the laboratory analysis in the absence of a specific clinical diagnosis, that is, followed a "genotype to phenotype" approach. Two were clinically significant, incidental findings. The importance of astute clinical assessment and laboratory-clinician consultation is emphasized to optimize the value of microarrays in the diagnosis of disorders caused by single gene copy number and sequence mutations. © 2011 Wiley-Liss, Inc.

  4. Analyzing paired diagnostic studies by estimating the expected benefit

    DEFF Research Database (Denmark)

    Gerke, Oke; Høilund-Carlsen, Poul Flemming; Vach, Werner

    2015-01-01

    When the efficacy of a new medical drug is compared against that of an established competitor in a randomized controlled trial, the difference in patient-relevant outcomes, such as mortality, is usually measured directly. In diagnostic research, however, the impact of diagnostic procedures is of ......, using data from a previously published study, we illustrate the possible insights to be gained from the application of formal inference techniques to determine the expected benefit....

  5. Evaluating school obesity-related policies using surveillance tools: lessons from the ScOPE study.

    Science.gov (United States)

    Nanney, Marilyn S; Nelson, Toben F; Kubik, Martha Y; Coulter, Sara; Davey, Cynthia S; MacLehose, Richard; Rode, Peter A

    2014-09-01

    The evidence evaluating the association between school obestiy prevention policies and student weight is mixed. The lack of consistent findings may result, in part, from limited evaluation approaches. The goal of this article is to demonstrate the use of surveillance data to address methodological gaps and opportunities in the school policy evaluation literature using lessons from the School Obesity-Related Policy Evaluation (ScOPE) study. The ScOPE study uses a repeated, cross-sectional study design to evaluate the association between school food and activity policies in Minnesota and behavioral and weight status of youth attending those schools. Three surveillance tools are used to accomplish study goals: Minnesota School Health Profiles (2002-2012), Minnesota Student Survey (2001-2013), and National Center for Educational Statistics. The ScOPE study takes two broad steps. First, we assemble policy data across multiple years and monitor changes over time in school characteristics and the survey instrument(s), establish external validity, and describe trends and patterns in the distribution of policies. Second, we link policy data to student data on health behaviors and weight status, assess nonresponse bias, and identify cohorts of schools. To illustrate the potential for program evaluators, the process, challenges encountered, and solutions used in the ScOPE study are presented. © 2014 Society for Public Health Education.

  6. "Clustering" Documents Automatically to Support Scoping Reviews of Research: A Case Study

    Science.gov (United States)

    Stansfield, Claire; Thomas, James; Kavanagh, Josephine

    2013-01-01

    Background: Scoping reviews of research help determine the feasibility and the resource requirements of conducting a systematic review, and the potential to generate a description of the literature quickly is attractive. Aims: To test the utility and applicability of an automated clustering tool to describe and group research studies to improve…

  7. A study on diagnostic techniques of pump operating condition

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Du Eon; Park, Jong Ho; Song, Gyu Jo; Shin, Pil Kwon; Lee, Nam Gil; Shin, Wan Sun; Kang, Hyeon Taek; Lee, Taek Sang [Chungnam National Univ., Taejon (Korea, Republic of)

    1998-03-15

    The scope and contents investigate and reviewed are as follows : establishment of study plan and references survey, review of related problems and inservice test standards of safety injection pump in use nuclear power plant, review of the study results in laboratory, the theoretical investigation of temperature rise according to mini-flow rate of pump, mini-flow rate working characteristics of high and low pressure injection pumps at nuclear power plants, setup of testing equipment for measuring ampere, discharge pressure and vibration, selection and behaviors analysis of major parameters concerning pump degradation.

  8. STARD for Abstracts : Essential items for reporting diagnostic accuracy studies in journal or conference abstracts

    NARCIS (Netherlands)

    Cohen, Jérémie F; Korevaar, Daniël A; Gatsonis, Constantine A.; Glasziou, Paul; Hooft, Lotty|info:eu-repo/dai/nl/279922078; Moher, David; Reitsma, Johannes B.|info:eu-repo/dai/nl/189853107; de Vet, Henrica C. W.; Bossuyt, Patrick Mm

    2017-01-01

    Many abstracts of diagnostic accuracy studies are currently insufficiently informative. We extended the STARD (Standards for Reporting Diagnostic Accuracy) statement by developing a list of essential items that authors should consider when reporting diagnostic accuracy studies in journal or

  9. STARD for Abstracts: essential items for reporting diagnostic accuracy studies in journal or conference abstracts

    NARCIS (Netherlands)

    Cohen, Jérémie F.; Korevaar, Daniël A.; Gatsonis, Constantine A.; Glasziou, Paul P.; Hooft, Lotty; Moher, David; Reitsma, Johannes B.; de Vet, Henrica Cw; Bossuyt, Patrick M.

    2017-01-01

    Many abstracts of diagnostic accuracy studies are currently insufficiently informative. We extended the STARD (Standards for Reporting Diagnostic Accuracy) statement by developing a list of essential items that authors should consider when reporting diagnostic accuracy studies in journal or

  10. A diagnostic study of Antarctic fog

    Science.gov (United States)

    Lazzara, Matthew A.

    2008-10-01

    The United States Antarctic Program (USAP) is the largest scientific research program in the Antarctic and requires a considerable aviation operation. Although fog is one of the top three forecast problems related to flights aborted due to weather, it is largely unstudied. The objective of this project is to gain an understanding of fog that affects McMurdo Station, Antarctica and its nearby airfields. This understanding is gained through analyses of surface based weather observations, satellite measurements and numerical weather prediction models. Multi-channel satellite observations indicate that most austral summer fog events are "advective" in nature. This is supported by weather observations from McMurdo Station and nearby airfields where fog occurs at moderate wind speeds, and primarily from the eastward direction. Analyses using both a back trajectory model and mesoscale numerical model are consistent with this finding. The primary source region for fog is found to be from the southeast over the Ross Ice Shelf (72% of the cases studied), while only a minority of cases (23%) reveals a secondary source of fog from the north along the Scott Coast with airflow influences from the East Antarctic Plateau. McMurdo experiences two fog seasons with a primary peak in January and a secondary peak in September. Fog events are often short lived---typically 1 to 3 hours, though some can last up to 30 hours. Fog occurrences over the last 30 years appear to be decreasing. Time series analysis between the observed fog variability and large-scale circulations (e.g., El Nino, Antarctic Oscillation) yielded no correlations, while there is only a limited relationship of fog occurrence to ice concentration in nearby Lewis Bay and McMurdo Sound. Fog is more likely to take place at the nearby airfields rather than at McMurdo Station, which is consistent with the advective nature of the fog.

  11. Radionuclide scan and other diagnostic studies in goitre patients in ...

    African Journals Online (AJOL)

    The aims of this study were to determine the pattern of radionuclide scan, its accuracy in diagnosing the nature of the lesion of a thyroid disease and comparing this with other available diagnostic techniques. Methods: This was a retrospective study that evaluated 124 patients with goiters who underwent clinical evaluation, ...

  12. Midwifery scope of practice among staff nurses: a grounded theory study in Gujarat, India.

    Science.gov (United States)

    Sharma, Bharati; Johansson, Eva; Prakasamma, M; Mavalankar, Dileep; Christensson, Kyllike

    2013-06-01

    midwifery is a part of the nursing profession in India. This current study explores and describes the midwifery scope of practice among staff nurses. a grounded theory approach was used to develop a model. Twenty-eight service providers from the maternity sections of public health facilities, selected through purposive and theoretical sampling were interviewed in-depth. Unstructured observations in the labour wards were also used for developing the model. the midwifery practice of staff nurses was limited in scope compared to international standards of midwifery. Their practice was circumstance driven, ranging from extended to marginal depending on the context. Their right to practice was not legally defined, but they were not specifically prohibited from practice. As a consequence, the staff nurses faced loss of skills, and deskilling when their practice was restricted. Their practice was perceived as risky, when the scope of practice was extended because it was not rightfully endorsed, the nurses having no officially recognized right to practice midwifery at that level. The clinical midwifery education of nursing and midwifery students was marginalized because the education of medical students was given priority, and the students only got exposed to the restricted practice of staff nurses. unclear definitions of the right to practice and the scope of practice have led to the un-utilized potential of staff nurses practising midwifery. This is detrimental because India faces an acute shortage of qualified personnel to meet the need in providing human resources for maternal health. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Study for the design method of multi-agent diagnostic system to improve diagnostic performance for similar abnormality

    International Nuclear Information System (INIS)

    Minowa, Hirotsugu; Gofuku, Akio

    2014-01-01

    Accidents on industrial plants cause large loss on human, economic, social credibility. In recent, studies of diagnostic methods using techniques of machine learning such as support vector machine is expected to detect the occurrence of abnormality in a plant early and correctly. There were reported that these diagnostic machines has high accuracy to diagnose the operating state of industrial plant under mono abnormality occurrence. But the each diagnostic machine on the multi-agent diagnostic system may misdiagnose similar abnormalities as a same abnormality if abnormalities to diagnose increases. That causes that a single diagnostic machine may show higher diagnostic performance than one of multi-agent diagnostic system because decision-making considering with misdiagnosis is difficult. Therefore, we study the design method for multi-agent diagnostic system to diagnose similar abnormality correctly. This method aimed to realize automatic generation of diagnostic system where the generation process and location of diagnostic machines are optimized to diagnose correctly the similar abnormalities which are evaluated from the similarity of process signals by statistical method. This paper explains our design method and reports the result evaluated our method applied to the process data of the fast-breeder reactor Monju

  14. Market for small waste gasification projects - preliminary scoping study

    International Nuclear Information System (INIS)

    1999-01-01

    This report presents the findings of a market analysis for small waste gasification/pyrolysis plant in the UK. The overall objectives of the study are to assess the potential merits in establishing a demonstration plant in the UK, and to identify the size, profile and characteristics of the potential market based on municipal solid waste (MSW) feedstock. (author)

  15. High performance APCS conceptual design and evaluation scoping study

    International Nuclear Information System (INIS)

    Soelberg, N.; Liekhus, K.; Chambers, A.; Anderson, G.

    1998-02-01

    This Air Pollution Control System (APCS) Conceptual Design and Evaluation study was conducted to evaluate a high-performance (APC) system for minimizing air emissions from mixed waste thermal treatment systems. Seven variations of high-performance APCS designs were conceptualized using several design objectives. One of the system designs was selected for detailed process simulation using ASPEN PLUS to determine material and energy balances and evaluate performance. Installed system capital costs were also estimated. Sensitivity studies were conducted to evaluate the incremental cost and benefit of added carbon adsorber beds for mercury control, specific catalytic reduction for NO x control, and offgas retention tanks for holding the offgas until sample analysis is conducted to verify that the offgas meets emission limits. Results show that the high-performance dry-wet APCS can easily meet all expected emission limits except for possibly mercury. The capability to achieve high levels of mercury control (potentially necessary for thermally treating some DOE mixed streams) could not be validated using current performance data for mercury control technologies. The engineering approach and ASPEN PLUS modeling tool developed and used in this study identified APC equipment and system performance, size, cost, and other issues that are not yet resolved. These issues need to be addressed in feasibility studies and conceptual designs for new facilities or for determining how to modify existing facilities to meet expected emission limits. The ASPEN PLUS process simulation with current and refined input assumptions and calculations can be used to provide system performance information for decision-making, identifying best options, estimating costs, reducing the potential for emission violations, providing information needed for waste flow analysis, incorporating new APCS technologies in existing designs, or performing facility design and permitting activities

  16. Point systems in Games for Health: A bibliometric scoping study

    OpenAIRE

    Kokol, Peter

    2018-01-01

    Very few details about point systems used in games for health are reported in scientific literature. To shed some light on this topic a bibliometric study, analyzing the papers containing terms related to games for health and point systems was performed and a mini taxonomy was derived. The search string game* AND health AND (point* OR score) AND system* in a Scopus bibliographic database was used to produce the corpus. We limited the search to articles, reviews and conference papers written i...

  17. High performance APCS conceptual design and evaluation scoping study

    Energy Technology Data Exchange (ETDEWEB)

    Soelberg, N.; Liekhus, K.; Chambers, A.; Anderson, G.

    1998-02-01

    This Air Pollution Control System (APCS) Conceptual Design and Evaluation study was conducted to evaluate a high-performance (APC) system for minimizing air emissions from mixed waste thermal treatment systems. Seven variations of high-performance APCS designs were conceptualized using several design objectives. One of the system designs was selected for detailed process simulation using ASPEN PLUS to determine material and energy balances and evaluate performance. Installed system capital costs were also estimated. Sensitivity studies were conducted to evaluate the incremental cost and benefit of added carbon adsorber beds for mercury control, specific catalytic reduction for NO{sub x} control, and offgas retention tanks for holding the offgas until sample analysis is conducted to verify that the offgas meets emission limits. Results show that the high-performance dry-wet APCS can easily meet all expected emission limits except for possibly mercury. The capability to achieve high levels of mercury control (potentially necessary for thermally treating some DOE mixed streams) could not be validated using current performance data for mercury control technologies. The engineering approach and ASPEN PLUS modeling tool developed and used in this study identified APC equipment and system performance, size, cost, and other issues that are not yet resolved. These issues need to be addressed in feasibility studies and conceptual designs for new facilities or for determining how to modify existing facilities to meet expected emission limits. The ASPEN PLUS process simulation with current and refined input assumptions and calculations can be used to provide system performance information for decision-making, identifying best options, estimating costs, reducing the potential for emission violations, providing information needed for waste flow analysis, incorporating new APCS technologies in existing designs, or performing facility design and permitting activities.

  18. Hydrogen Generation Rate Scoping Study of DOW Corning Antifoam Agent

    Energy Technology Data Exchange (ETDEWEB)

    Crawford, Charles

    2005-09-27

    The antifoam agent DOW Corning Q2-3183A will be added to waste streams in the Hanford River Protection Program-Waste Treatment and Immobilization Plant (RPP-WTP) to prevent foaming. It consists mostly of polydimethylsiloxane (PDMS) and polypropylene glycol (PPG). These and other minor constituents of the antifoam have organic constituents that may participate in radiolytic and chemical reactions that produce hydrogen in Hanford waste. It has been recommended by The WTP R&T Department recommended personnel to treat the organic compounds of the antifoam like the in a similar manner as other organic compounds that are native to the Hanford waste with respect to hydrogen production. This testing has investigated the radiolytic and thermal production of hydrogen from antifoam added to simulant waste solutions to determine if the organic components of the antifoam produce hydrogen in the same manner as the native organic species in Hanford waste. Antifoam additions for this testing were in the range of 4 to 10 wt% to ensure adequate hydrogen detection. Test conditions were selected to bound exposures to the antifoam agent in the WTP. These levels are higher than previously recommended values of 350 mg/L for actual applications in WTP tanks containing air spargers and pulse jet mixers. Limited degradation analyses for the organic components of the antifoam were investigated in this study. A more detailed study involving analyses of antifoam degradation and product formation is in progress at SRNL and results from that study will be reported at a later time. The total organic carbon (TOC) content of the Q2-3183A antifoam was measured to be 39.7 {+-} 4.9 wt% TOC. This measurement was performed in triplicate with on three different dilutions of the pure antifoam liquid using a TOC combustion analyzer instrument with catalytic oxidation, followed by CO{sub 2} quantification using an infrared detector. Test results from this study indicate that the WTP HGR correlation

  19. Replacement fuel scoping studies for the Annular Core Research Reactor

    International Nuclear Information System (INIS)

    Hays, K.; Martin, L.; Parma, E.

    1995-01-01

    Sandia National Laboratories Annular Core Research Reactor (ACRR) is undertaking a new mission for the Department of Energy: production of the radioisotope 99 Mo used in nuclear medicine applications. Isotope production is significantly different from previous programs conducted at the ACRR that typically required high intensity, short duration pulses. The current UO 2 -BeO fuel will power the initial startup phase of the production program, and can perform exceptionally well for this mission. However, this type of fuel is no longer available, commercially or otherwise. This paper presents the results of some preliminary studies of commercially available fuels

  20. A Scoping Study on the Ethics of Health Systems Research.

    Science.gov (United States)

    Bachani, Abdulgafoor M; Rattani, Abbas; Hyder, Adnan A

    2016-12-01

    Currently, health systems research (HSR) is reviewed by the same ethical standards as clinical research, which has recently been argued in the literature to be an inappropriate standard of evaluation. The issues unique to HSR warrant a different review by research ethics committees (RECs), as it does not impose the same risks to study participants as other types of clinical or public health research. However, there are limited tools and supporting documents that clarify the ethical considerations. Therefore, there is a need for additional reflection around ethical review of HSR and their consideration by RECs. The purpose of this paper is to review, understand, and synthesize the current state of literature and practice to inform these deliberations and the larger discourse on ethics review guidelines for HSR. This paper presents a review of the literature on ethics of HSR in the biomedical, public health, and implementation research to identify ethical considerations specific to HSR; and to identify examples of commonly available guidance and/or tools for the ethical review of HSR studies. Fifteen articles were identified on HSR ethics issues, and forty-two international academic institutions were contacted (of the responses (n=29), no institution had special ethical guidelines for reviewing HSR) about their HSR ethics review guidelines. There appears to be a clear gap in the current health research ethics discourse around health systems research ethics. This review serves as a first step (to better understand the current status) towards a larger dialogue on the topic. © 2016 John Wiley & Sons Ltd.

  1. Therapy interventions for children with neurodisabilities: a qualitative scoping study.

    Science.gov (United States)

    Beresford, Bryony; Clarke, Susan; Maddison, Jane

    2018-01-01

    Therapy interventions emerged four times in the top 10 research priorities in a James Lind Alliance research prioritisation exercise for children with neurodisabilities (Morris C, Simkiss D, Busk M, Morris M, Allard A, Denness J, et al. Setting research priorities to improve the health of children and young people with neurodisability: a British Academy of Childhood Disability-James Lind Alliance Research Priority Setting Partnership. BMJ Open 2015; 5 :e006233). The National Institute for Health Research (NIHR) commissioned this study as part of an information-gathering exercise in response to this. The objectives were to (1) describe the current practice, approaches and schools of thought in relation to physiotherapy, occupational therapy and speech and language therapy for children with neurodisability; (2) explore clinical decision-making; (3) investigate views on outcomes and their measurement, particularly participation as an outcome, that is, the child's ability to have the opportunity to be involved in life situations and activities (e.g. communication, mobility, interpersonal interactions, self-care, learning and applying knowledge); (4) seek views on the aspects of therapy interventions that have an impact on outcomes; and (5) elicit stakeholder views on research needs and priorities. More than 70 professionals (therapists, service leads, paediatricians and education staff) and 25 parents participated in a qualitative interview (either individually or as part of a focus group). Professional thinking and models of service delivery are in a state of flux and development. There is a move towards goals-focused, family-centred approaches. Work tends to be highly individualised, with few protocols. Parents are certain of the value of therapies, although they may experience difficulties with provision and may seek (additional) private provision. Therapy interventions are conceived as three components: the therapist, the procedures/equipment, etc., and the wider

  2. Bias due to composite reference standards in diagnostic accuracy studies

    NARCIS (Netherlands)

    Schiller, Ian; van Smeden, Maarten; Hadgu, Alula; Libman, Michael; Reitsma, Johannes B; Dendukuri, Nandini

    2015-01-01

    Composite reference standards (CRSs) have been advocated in diagnostic accuracy studies in the absence of a perfect reference standard. The rationale is that combining results of multiple imperfect tests leads to a more accurate reference than any one test in isolation. Focusing on a CRS that

  3. Assessing variability in results in systematic reviews of diagnostic studies

    Directory of Open Access Journals (Sweden)

    Christiana A. Naaktgeboren

    2016-01-01

    Full Text Available Abstract Background To describe approaches used in systematic reviews of diagnostic test accuracy studies for assessing variability in estimates of accuracy between studies and to provide guidance in this area. Methods Meta-analyses of diagnostic test accuracy studies published between May and September 2012 were systematically identified. Information on how the variability in results was investigated was extracted. Results Of the 53 meta-analyses included in the review, most (n=48; 91 % presented variability in diagnostic accuracy estimates visually either through forest plots or ROC plots and the majority (n=40; 75 % presented a test or statistical measure for the variability. Twenty-eight reviews (53 % tested for variability beyond chance using Cochran’s Q test and 31 (58 % reviews quantified it with I2. 7 reviews (13 % presented between-study variance estimates (τ2 from random effects models and 3 of these presented a prediction interval or ellipse to facilitate interpretation. Half of all the meta-analyses specified what was considered a significant amount of variability (n=24; 49 %. Conclusions Approaches to assessing variability in estimates of accuracy varied widely between diagnostic test accuracy reviews and there is room for improvement. We provide initial guidance, complemented by an overview of the currently available approaches.

  4. What do register-based studies tell us about migrant mental health? A scoping review.

    Science.gov (United States)

    Patel, Kishan; Kouvonen, Anne; Close, Ciara; Väänänen, Ari; O'Reilly, Dermot; Donnelly, Michael

    2017-04-11

    Previous studies investigating the mental health of migrants have shown mixed results. The increased availability of register data has led to a growing number of register-based studies in this research area. This is the first scoping review on the use of registry and record-linkage data to examine the mental health of migrant populations. The aim of this scoping review is to investigate the topics covered and to assess the results yielded from these studies. We used a scoping review methodology to search MedLine, PubMed, PsychINFO, Web of Science, and SCOPUS for all register-based studies on the mental health of migrants. Two reviewers screened all papers, independently, using iteratively applied inclusion and exclusion criteria. Using gradually broadening inclusion and exclusion criteria for maximum "scope," newly published criteria developed to appraise the methodological quality of record-linkage studies were applied to eligible papers and data were extracted in a charting exercise. A total of 1309 papers were screened and appraised, 51 of which met the eligibility and quality criteria and were included in the review. This review identified four major domains of register-based research within the topic of migrant mental health: rates and risks of psychiatric disorders, rates and risks of suicide mortality, the use of psychotropic drugs, and health service utilisation and mental health-related hospitalisation rates. We found that whilst migrants can be at an increased risk of developing psychotic disorders and suicide mortality, they are less likely to use psychotropic medication and mental health-related services. This review systematically charts the register-based studies on migrants' mental health for the first time. It shows the main topics and gaps in knowledge in this research domain, discusses the disadvantages of register-based studies, and suggests new directions for forthcoming studies.

  5. Identifying relevant diagnostic studies in Medline. The diagnostic value of the erythrocyte sedimentation rate (ESR) and dipstick as an example.

    NARCIS (Netherlands)

    Weijden, T. van der; IJzermans, C.J.; Dinant, G.J.; Duijn, N.P. van; Vet, R. de; Buntinx, F.

    1997-01-01

    OBJECTIVE: We aimed to examine sensitivity and positive predictive value of MEDLINE searching for diagnostic studies, relevant for the primary health care setting. METHOD: Results of MEDLINE searches were compared with a reference standard collection of studies on two subjects, the diagnostic value

  6. Final report for the field-reversed configuration power plant critical-issue scoping study

    Energy Technology Data Exchange (ETDEWEB)

    Santarius, John F.; Mogahed, Elsayed A.; Emmert, Gilbert A.; Khater, Hesham Y.; Nguyen, Canh N.; Ryzhkov, Sergei V.; Stubna, Michael D.; Steinhauer, Loren C.; Miley, George H.

    2001-03-01

    This report describes research in which a team from the Universities of Wisconsin, Washington, and Illinois performed a scoping study of critical issues for field-reversed configuration (FRC) power plants. The key tasks for this research were (1) systems analysis of deuterium-tritium (D-T) FRC fusion power plants, and (2) conceptual design of the blanket and shield module for an FRC fusion core.

  7. Comparison of Diagnostic Ability of Storage Phosphor Plate in Detecting Proximal Caries with Direct Measurement by Stereomicroscope: A Pilot Study.

    Science.gov (United States)

    Vivek, Velayudhannair; Thomas, Sunila; Nair, Bindu J; Vineet, Alex Daniel; Thomas, Jincy; Ranimol, Prasanna; Vijayan, Aswathy K

    2015-09-28

    Radiography plays an important role in detection of interproximal caries. The aim of study is to compare diagnostic ability of photo stimulable phosphor (PSP) with direct measurement using stereomicroscope in detecting proximal caries. Hundred proximal surfaces of 50 extracted human posterior teeth were radiographed with dental X-ray unit. The image receptors used was storage phosphor plate Vista scan (size 2), (time of exposure 0.4 s). Radiographs were interpreted and caries lesions were classified on a 4-point scale suggested by Abesi et al. The teeth were sectioned with diamond disc and were examined under a stereomicroscope with 20x magnification. Diagnostic accuracy of digital image is similar to that observed with stereomicroscope. The PSP plate digital X ray system can effectively be employed for detecting proximal caries as compared to direct observation by stereomicro-scope. Further study with more number of observer/evaluator and large sample size is recommended.

  8. Statistical physics of medical diagnostics: Study of a probabilistic model

    Science.gov (United States)

    Mashaghi, Alireza; Ramezanpour, Abolfazl

    2018-03-01

    We study a diagnostic strategy which is based on the anticipation of the diagnostic process by simulation of the dynamical process starting from the initial findings. We show that such a strategy could result in more accurate diagnoses compared to a strategy that is solely based on the direct implications of the initial observations. We demonstrate this by employing the mean-field approximation of statistical physics to compute the posterior disease probabilities for a given subset of observed signs (symptoms) in a probabilistic model of signs and diseases. A Monte Carlo optimization algorithm is then used to maximize an objective function of the sequence of observations, which favors the more decisive observations resulting in more polarized disease probabilities. We see how the observed signs change the nature of the macroscopic (Gibbs) states of the sign and disease probability distributions. The structure of these macroscopic states in the configuration space of the variables affects the quality of any approximate inference algorithm (so the diagnostic performance) which tries to estimate the sign-disease marginal probabilities. In particular, we find that the simulation (or extrapolation) of the diagnostic process is helpful when the disease landscape is not trivial and the system undergoes a phase transition to an ordered phase.

  9. Asking the right questions: Scoping studies in the commissioning of research on the organisation and delivery of health services

    Directory of Open Access Journals (Sweden)

    Peckham Stephen

    2008-07-01

    Full Text Available Abstract Scoping studies have been used across a range of disciplines for a wide variety of purposes. However, their value is increasingly limited by a lack of definition and clarity of purpose. The UK's Service Delivery and Organisation Research Programme (SDO has extensive experience of commissioning and using such studies; twenty four have now been completed. This review article has four objectives; to describe the nature of the scoping studies that have been commissioned by the SDO Programme; to consider the impact of and uses made of such studies; to provide definitions for the different elements that may constitute a scoping study; and to describe the lessons learnt by the SDO Programme in commissioning scoping studies. Scoping studies are imprecisely defined but usually consist of one or more discrete components; most commonly they are non-systematic reviews of the literature, but other important elements are literature mapping, conceptual mapping and policy mapping. Some scoping studies also involve consultations with stakeholders including the end users of research. Scoping studies have been used for a wide variety of purposes, although a common feature is to identify questions and topics for future research. The reports of scoping studies often have an impact that extends beyond informing research commissioners about future research areas; some have been published in peer reviewed journals, and others have been published in research summaries aimed at a broader audience of health service managers and policymakers. Key lessons from the SDO experience are the need to relate scoping studies to a particular health service context; the need for scoping teams to be multi-disciplinary and to be given enough time to integrate diverse findings; and the need for the research commissioners to be explicit not only about the aims of scoping studies but also about their intended uses. This necessitates regular contact between researchers and

  10. Avoiding diagnostic errors in psychosomatic medicine: a case series study.

    Science.gov (United States)

    Koyama, Atsuko; Ohtake, Yoichi; Yasuda, Kanae; Sakai, Kiyohiro; Sakamoto, Ryo; Matsuoka, Hiromichi; Okumi, Hirokuni; Yasuda, Toshiko

    2018-01-01

    Non-organic lesions or diseases of unknown origin are sometimes misdiagnosed as "psychogenic" disorders or "psychosomatic" diseases. For the quality of life and safety of patients, recent attention has focused on diagnostic error. The aim of this study was to clarify the factors that affected misdiagnoses in psychosomatic medicine by examining typical cases and to explore strategies that reduce diagnostic errors. The study period was from January 2001 to August 2017. The data of patients who had visited the Department of Psychosomatic Medicine, Kindai University Hospital and its branches, Sakai Hospital and Nihonbashi Clinic, were collected. All patients were aged 16 years or over. Multiple factors, such as age, sex, presenting symptoms, initial diagnosis, final diagnosis, sources of re-diagnosis and types of diagnostic errors were retrospectively analyzed from the medical charts of 20 patients. Among them, four typical cases can be described as follows. Case 1; a 79-year-old woman, initially diagnosed with psychogenic vomiting due to depression that was changed to gastric torsion as the final diagnosis. Case 2; a 24-year-old man, diagnosed with an eating disorder that was later changed to esophageal achalasia. Case 10; a 60-year-old woman's diagnosis changed from conversion disorder to localized muscle atrophy. Case 19; a 68-year-old man, appetite loss from depression due to cancer changed to secondary adrenal insufficiency, isolated ACTH deficiency (IAD). This study showed that multiple factors related to misdiagnoses were combined and had a mutual influence. However, they can be summarized into two important clinical observations, diagnostic system-related problems and provider issues. Provider issues contain mainly cognitive biases such as Anchoring, Availability, Confirmation bias, Delayed diagnosis, and Representativeness. In order to avoid diagnostic errors, both a diagnostic system approach and the reduction of cognitive biases are needed. Psychosomatic

  11. Social studying and learning among medical students: a scoping review.

    Science.gov (United States)

    Keren, Daniela; Lockyer, Jocelyn; Ellaway, Rachel H

    2017-10-01

    Medical students study in social groups, which influence their learning, but few studies have investigated the characteristics of study groups and the impacts they have on students' learning. A scoping review was conducted on the topic of informal social studying and learning within medical education with the aim of appraising what is known regarding medical student attitudes to group study, the impact of group study on participants, and the methods that have been employed to study this. Using Arksey and O'Malley's scoping review principles, MEDLINE, EMBASE and CINAHL were searched, along with hand-searching and a targeted search of the grey literature; 18 peer reviewed and 17 grey literature records were included. Thematic conceptual analysis identified a number of themes, including: the nature of group study; the utility and value of group studying including social learning facilitating student engagement, social learning as a source of motivation and accountability, and social learning as a source of wellbeing; and student preferences related to group studying, including its homophilic nature, transgressiveness, and effectiveness. Despite these emerging factors, the evidence base for this phenomenon is small. The findings in this scoping review demonstrate a clear role for social interaction outside of the classroom, and encourage us to consider the factors in student networking, and the implications of this on medical students' academics. We also highlight areas in need of future research to allow us to better situate informal social learning within medical education and to enable educators to support this phenomenon.

  12. Case-control study of leukemia and diagnostic radiation exposure

    International Nuclear Information System (INIS)

    Yuasa, Hidemichi; Hamajima, Nobuyuki; Ueda, Ryuzo

    1997-01-01

    A case-control study of leukemia and diagnostic X-ray exposure was conducted by a multi-institution co-operative study group. The subjects were 134 patients with acute myelogenous leukemia, 57 with chronic myelogenous leukemia, 56 with acute lymphocytic leukemia and 50 with myelodysplasia syndrome, who were between 15 and 79 years old, and diagnosed at one of 27 hospitals between September 1993 and August 1995. The controls were 479 first-visit patients seen at eight of these 27 hospitals. History of diagnostic X-ray tests between 1982 and 1991 was determined by an anonymous self-administered questionnaire. The total relative dose of radiation exposure was calculated by summing the products of given weights and frequencies of each test. The relative risk was 0.83 (95% confidence interval (C.I.), 0.58-1.19) for relative dose of 10-30 (equivalent to 4-11 times of UGI series), 0.76 (0.48-1.20) for relative dose of 30 or more (more than 12 times of UGI series), when compared with relative dose of 0-10 (0-3 times of UGI series). Analysis according to type of leukemia revealed that only acute myelogenous leukemia had an estimated relative risk above unity (1.08, 95%, C.I. 0.69-1.69, for relative dose 10-30). This study did not support the hypothesis that diagnostic X-ray tests increases leukemia risk. (author)

  13. The capabilities and scope-of-practice requirements of advanced life support practitioners undertaking critical care transfers: A Delphi study

    Directory of Open Access Journals (Sweden)

    Monique Venter

    2016-11-01

    Full Text Available Background. Critical care transfers (CCT refer to the high level of care given during transport (via ambulance, helicopter or fixed-wing aircraft of patients who are of high acuity. In South Africa (SA, advanced life support (ALS paramedics undertake CCTs. The scope of ALS in SA has no extended protocol regarding procedures or medications in terms of dealing with these CCTs. Aim. The aim of this study was to obtain the opinions of several experts in fields pertaining to critical care and transport and to gain consensus on the skills and scope-of-practice requirements of paramedics undertaking CCTs in the SA setting. Methods. A modified Delphi study consisting of three rounds was undertaken using an online survey platform. A heterogeneous sample (n=7, consisting of specialists in the fields of anaesthesiology, emergency medicine, internal medicine, critical care, critical care transport and paediatrics, was asked to indicate whether, in their opinion, selected procedures and medications were needed within the scope of practice of paramedics undertaking CCTs. Results. After three rounds, consensus was obtained in 70% (57/81 of procedures and medications. Many of these items are not currently within the scope of paramedics’ training. The panel felt that paramedics undertaking these transfers should have additional postgraduate training that is specific to critical care. Conclusion. Major discrepancies exist between the current scope of paramedic practice and the suggested required scope of practice for CCTs. An extended scope of practice and additional training should be considered for these practitioners.

  14. Reliability studies of diagnostic methods in Indian traditional Ayurveda medicine

    DEFF Research Database (Denmark)

    Kurande, Vrinda Hitendra; Waagepetersen, Rasmus; Toft, Egon

    2013-01-01

    Recently, a need to develop supportive new scientific evidence for contemporary Ayurveda has emerged. One of the research objectives is an assessment of the reliability of diagnoses and treatment. Reliability is a quantitative measure of consistency. It is a crucial issue in classification (such...... diagnoses is in the formative stage. However, reliability studies in Ayurveda are in the preliminary stage. In this paper, examples are provided to illustrate relevant concepts of reliability studies of diagnostic methods and their implication in practice, education, and training. An introduction...... to reliability estimates and different study designs and statistical analysis is given for future studies in Ayurveda....

  15. Scoping study of integrated resource planning needs in the public utility sector

    Energy Technology Data Exchange (ETDEWEB)

    Garrick, C J; Garrick, J M; Rue, D R [NEOS Corp., Lakewood, CO (United States)

    1993-06-01

    Integrated resource planning (IRP) is an approach to utility resource planning that integrates the evaluation of supply- and demand-site options for providing energy services at the least cost. Many utilities practice IRP; however, most studies about IRP focus on investor-owned utilities (IOUs). This scoping study investigates the IRP activities and needs of public utilities (not-for-profit utilities, including federal, state, municipal, and cooperative utilities). This study (1) profiles IRP-related characteristics of the public utility sector, (2) articulates the needs of public utilities in understanding and implementing IRP, and (3) identifies strategies to advance IRP principles in public utility planning.

  16. Research at ITER towards DEMO: Specific reactor diagnostic studies to be carried out on ITER

    International Nuclear Information System (INIS)

    Krasilnikov, A. V.; Kaschuck, Y. A.; Vershkov, V. A.; Petrov, A. A.; Petrov, V. G.; Tugarinov, S. N.

    2014-01-01

    In ITER diagnostics will operate in the very hard radiation environment of fusion reactor. Extensive technology studies are carried out during development of the ITER diagnostics and procedures of their calibration and remote handling. Results of these studies and practical application of the developed diagnostics on ITER will provide the direct input to DEMO diagnostic development. The list of DEMO measurement requirements and diagnostics will be determined during ITER experiments on the bases of ITER plasma physics results and success of particular diagnostic application in reactor-like ITER plasma. Majority of ITER diagnostic already passed the conceptual design phase and represent the state of the art in fusion plasma diagnostic development. The number of related to DEMO results of ITER diagnostic studies such as design and prototype manufacture of: neutron and γ–ray diagnostics, neutral particle analyzers, optical spectroscopy including first mirror protection and cleaning technics, reflectometry, refractometry, tritium retention measurements etc. are discussed

  17. Research at ITER towards DEMO: Specific reactor diagnostic studies to be carried out on ITER

    Energy Technology Data Exchange (ETDEWEB)

    Krasilnikov, A. V.; Kaschuck, Y. A.; Vershkov, V. A.; Petrov, A. A.; Petrov, V. G.; Tugarinov, S. N. [Institution Project center ITER, Moscow (Russian Federation)

    2014-08-21

    In ITER diagnostics will operate in the very hard radiation environment of fusion reactor. Extensive technology studies are carried out during development of the ITER diagnostics and procedures of their calibration and remote handling. Results of these studies and practical application of the developed diagnostics on ITER will provide the direct input to DEMO diagnostic development. The list of DEMO measurement requirements and diagnostics will be determined during ITER experiments on the bases of ITER plasma physics results and success of particular diagnostic application in reactor-like ITER plasma. Majority of ITER diagnostic already passed the conceptual design phase and represent the state of the art in fusion plasma diagnostic development. The number of related to DEMO results of ITER diagnostic studies such as design and prototype manufacture of: neutron and γ–ray diagnostics, neutral particle analyzers, optical spectroscopy including first mirror protection and cleaning technics, reflectometry, refractometry, tritium retention measurements etc. are discussed.

  18. Scoping Study. Linking RE Promotion Policies with International Carbon Trade (LINK)

    Energy Technology Data Exchange (ETDEWEB)

    Castro, Paula; Hayashi, Daisuke; Kristiansen, Kjell Olav; Michaelowa, Axel; Stadelmann, Martin

    2011-06-15

    Implementing national policies may threaten the eligibility of renewable energy projects for Clean Development Mechanism/Joint Implementation (CDM/JI), thus reducing international development financing. Countries hence need to be very careful when crafting their national promotion policies. The objectives of the Renewable Energy Technology Deployment (IEA-RETD) project were to perform a scoping study on the interplay between national Renewable Energy (RE) promotion policies and international carbon trade. The study summarizes the ongoing discussion, describes the main barriers that may hinder -- or at least not sufficiently support -- the implementation of national RE promotion policies, and provides suggestions for removing these barriers.

  19. Small-scale biomass CHP using gasa turbines: a scoping study

    International Nuclear Information System (INIS)

    James, D.W.; Landen, R.

    1996-01-01

    Various options for small-scale (up to 250 KWe) Combined Heat and Power (CHP) plants evaluated in this scoping study. Plants using small gas turbines, and able to use biomass fuels when available are included. Three detailed case studies of small-scale biomass CHP plants are compared to match specific technical options with customer requirements. The commercial development of such biomass-fired CHP units, using gas turbines, is shown to be economically viable depending on fuel costs and the continuation of existing financial incentives. (UK)

  20. Protocol for a scoping review study to identify and classify patient-centred quality indicators.

    Science.gov (United States)

    Jolley, Rachel J; Lorenzetti, Diane L; Manalili, Kimberly; Lu, Mingshan; Quan, Hude; Santana, Maria J

    2017-01-05

    The concept of patient-centred care (PCC) is changing the way healthcare is understood, accepted and delivered. The Institute of Medicine has defined PCC as 1 of its 6 aims to improve healthcare quality. However, in Canada, there are currently no nationwide standards in place for measuring and evaluating healthcare from a patient-centred approach. In this paper, we outline our scoping review protocol to systematically review published and unpublished literature specific to patient-centred quality indicators that have been implemented and evaluated across various care settings. Arksey and O'Malley's scoping review methodology framework will guide the conduct of this scoping review. We will search electronic databases (MEDLINE, EMBASE, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Social Work Abstracts, Social Services Abstracts), grey literature sources and the reference lists of key studies to identify studies appropriate for inclusion. 2 reviewers will independently screen all abstracts and full-text studies for inclusion. We will include any study which focuses on quality indicators in the context of PCC. All bibliographic data, study characteristics and indicators will be collected and analysed using a tool developed through an iterative process by the research team. Indicators will be classified according to a predefined conceptual framework and categorised and described using qualitative content analysis. The scoping review will synthesise patient-centred quality indicators and their characteristics as described in the literature. This review will be the first step to formally identify what quality indicators have been used to evaluate PCC across the healthcare continuum, and will be used to inform a stakeholder consensus process exploring the development of a generic set of patient-centred quality indicators applicable to multiple care settings. The results will be disseminated through a peer

  1. Scoping studies to reduce ICPP high-level radioactive waste volumes for final disposal

    International Nuclear Information System (INIS)

    Knecht, D.A.; Berreth, J.R.; Chipman, N.A.; Cole, H.S.; Geczi, L.S.; Kerr, W.B.; Staples, B.A.

    1985-08-01

    This report presents the results of scoping studies carried out to determine the feasibility of the following candidate options to reduce high-level waste volume: (1) low-fluoride, low-volume glass, (2) glass-ceramic and ceramic, (3) Modified Zirflex, (4) inerts removal by neutralization, and (5) modified Fluorinel processes. The results of the scoping studies show that the glass-ceramic/ceramic waste forms and neutralization process with potential HLW volume reductions ranging from 60 to 80% appear feasible, based on laboratory-scale tests. The presently used Fluorinel process modified by reducing HF usage also appears to be feasible and could result in up to a 10% potential volume reduction. If the current process start-up tests verify the practicality, reduced HF usage will be implemented. The low-volume glass and Modified Zirflex processes may also be feasible, based on laboratory tests, but would require significantly more process development and/or modifications and could result in only a 20 to 30% potential volume reduction. Based on these scoping studies, it is recommended that (1) the glass-ceramic/ceramic and neutralization processes be developed further, (2) reduced HF use for the Modified Fluorinel process be implemented as soon as practical and other options reducing chemical usage for criticality control be evaluated, (3) basic development for the glass process be continued as a back-up technology, and (4) laboratory-scale radioactive fuel dissolution testing for the Modified Zirflex process be completed with further process development discontinued unless needed in the future

  2. The TITAN Reversed-Field Pinch fusion reactor study: Scoping phase report

    Energy Technology Data Exchange (ETDEWEB)

    1987-01-01

    The TITAN research program is a multi-institutional effort to determine the potential of the Reversed-Field Pinch (RFP) magnetic fusion concept as a compact, high-power-density, and ''attractive'' fusion energy system from economic (cost of electricity, COE), environmental, and operational viewpoints. In particular, a high neutron wall loading design (18 MW/m/sup 2/) has been chosen as the reference case in order to quantify the issue of engineering practicality, to determine the physics requirements and plasma operating mode, to assess significant benefits of compact systems, and to illuminate the main drawbacks. The program has been divided into two phases, each roughly one year in length: the Scoping Phase and the Design Phase. During the scoping phase, the TITAN design team has defined the parameter space for a high mass power density (MPD) RFP reactor, and explored a variety of approaches to the design of major subsystems. Two major design approaches consistent with high MPD and low COE, the lithium-vanadium blanket design and aqueous loop-in-pool design, have been selected for more detailed engineering evaluation in the design phase. The program has retained a balance in its approach to investigating high MPD systems. On the one hand, parametric investigations of both subsystems and overall system performance are carried out. On the other hand, more detailed analysis and engineering design and integration are performed, appropriate to determining the technical feasibility of the high MPD approach to RFP fusion reactors. This report describes the work of the scoping phase activities of the TITAN program. A synopsis of the principal technical findings and a brief description of the TITAN multiple-design approach is given. The individual chapters on Plasma Physics and Engineering, Parameter Systems Studies, Divertor, Reactor Engineering, and Fusion Power Core Engineering have been cataloged separately.

  3. Identifying priorities for establishing bilingual provision in nurse education: a scoping study.

    Science.gov (United States)

    Roberts, Gwerfyl W; Irvine, Fiona E; Tranter, Siobhan; Spencer, Llinos H

    2010-10-01

    Research evidence demonstrates that offering language choice to patients enhances the quality of healthcare provision. This has implications for the preparation of nurses for practice in bilingual settings, where legislation often leads to demands for health services in both languages and bilingual competence amongst healthcare providers. This paper reports on a scoping study of bilingual provision in nurse education in the bilingual context of Wales, UK, as a means of informing the evidence base for national strategic planning. The study incorporated three elements: (i) literature analysis (ii) policy review and (iii) stakeholder consultation (n=70). Six themes emerged from the stakeholder consultation, reflecting the main drivers and barriers associated with bilingual provision in course delivery. These themes aligned with findings identified from the policy and literature review that related to strategic, organisational and individual influences on bilingual educational provision. Strategic planning for bilingual provision in nurse education in Wales should take account of the factors that affect provision at different levels. These factors feature across bilingual settings outside the UK, thus giving the study international relevance and scope to inform the delivery of nurse education that meets the needs of wider diverse language communities. Copyright © 2009 Elsevier Ltd. All rights reserved.

  4. Laser diagnodent: a comparative study with other diagnostic techniques

    International Nuclear Information System (INIS)

    Godinho, Reugma Rego

    2002-01-01

    An evaluation of the Diagnodent equipment (Kavo Company, Germany) for the occlusal caries detection was dane through the comparison with other conventional diagnostic techniques, such as visual inspection, intra-oral micro camera and digital X-ray. The effectiveness of the equipment in the detection of hidden caries and its viability as a diagnosis method for caries in their initial stage was also studied. Fifty eight permanent molars and premolars teeth from patients with age between 6 and 30 years were studied. The obtained results indicated that the conventional methods employed for the caries diagnosis are unable to detect the carious lesion in its initial stage. The Diagnodent equipment has this capability to detect caries presenting a flawless surface, specially the hidden caries, allowing the dentist to decide between a preventive ar a conservative procedure. The main advantage of the Diagnodent is to be an objective method, compared to the visual and radiographic ones, that are dependent on the professional interpretation. The Diagnodent is, therefore, a promising alternative as an objective and standardized diagnosis method for the final diagnostic. (author)

  5. Cultural interventions to treat addictions in Indigenous populations: findings from a scoping study

    Science.gov (United States)

    2014-01-01

    Background Cultural interventions offer the hope and promise of healing from addictions for Indigenous people.a However, there are few published studies specifically examining the type and impact of these interventions. Positioned within the Honouring Our Strengths: Culture as Intervention project, a scoping study was conducted to describe what is known about the characteristics of culture-based programs and to examine the outcomes collected and effects of these interventions on wellness. Methods This review followed established methods for scoping studies, including a final stage of consultation with stakeholders. The data search and extraction were also guided by the “PICO” (Patient/population, Intervention, Comparison, and Outcome) method, for which we defined each element, but did not require direct comparisons between treatment and control groups. Twelve databases from the scientific literature and 13 databases from the grey literature were searched up to October 26, 2012. Results The search strategy yielded 4,518 articles. Nineteen studies were included from the United States (58%) and Canada (42%), that involved residential programs (58%), and all (100%) integrated Western and culture-based treatment services. Seventeen types of cultural interventions were found, with sweat lodge ceremonies the most commonly (68%) enacted. Study samples ranged from 11 to 2,685 clients. Just over half of studies involved quasi-experimental designs (53%). Most articles (90%) measured physical wellness, with fewer (37%) examining spiritual health. Results show benefits in all areas of wellness, particularly by reducing or eliminating substance use problems in 74% of studies. Conclusions Evidence from this scoping study suggests that the culture-based interventions used in addictions treatment for Indigenous people are beneficial to help improve client functioning in all areas of wellness. There is a need for well-designed studies to address the question of best relational

  6. Scoping Study of Airlift Circulation Technologies for Supplemental Mixing in Pulse Jet Mixed Vessels

    Energy Technology Data Exchange (ETDEWEB)

    Schonewill, Philip P. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Berglin, Eric J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Boeringa, Gregory K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Buchmiller, William C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Burns, Carolyn A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Minette, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-04-07

    At the request of the U.S. Department of Energy Office of River Protection, Pacific Northwest National Laboratory (PNNL) conducted a scoping study to investigate supplemental technologies for supplying vertical fluid motion and enhanced mixing in Waste Treatment and Immobilization Plant (WTP) vessels designed for high solids processing. The study assumed that the pulse jet mixers adequately mix and shear the bottom portion of a vessel. Given that, the primary function of a supplemental technology should be to provide mixing and shearing in the upper region of a vessel. The objective of the study was to recommend a mixing technology and configuration that could be implemented in the 8-ft test vessel located at Mid-Columbia Engineering (MCE). Several mixing technologies, primarily airlift circulator (ALC) systems, were evaluated in the study. This technical report contains a review of ALC technologies, a description of the PNNL testing and accompanying results, and recommended features of an ALC system for further study.

  7. Modern parameterization and explanation techniques in diagnostic decision support system: a case study in diagnostics of coronary artery disease.

    Science.gov (United States)

    Kukar, Matjaž; Kononenko, Igor; Grošelj, Ciril

    2011-06-01

    Coronary artery disease has been described as one of the curses of the western world, as it is one of its most important causes of mortality. Therefore, clinicians seek to improve diagnostic procedures, especially those that allow them to reach reliable early diagnoses. In the clinical setting, coronary artery disease diagnostics are typically performed in a sequential manner. The four diagnostic levels consist of evaluation of (1) signs and symptoms of the disease and electrocardiogram at rest, (2) sequential electrocardiogram testing during the controlled exercise, (3) myocardial perfusion scintigraphy, and (4) finally coronary angiography, that is considered as the "gold standard" reference method. Our study focuses on improving diagnostic performance of the third, virtually non-invasive, diagnostic level. Myocardial scintigraphy results in a series of medical images that are obtained by relatively inexpensive means. In clinical practice, these images are manually described (parameterized) by expert physicians. In the paper we present an innovative alternative to manual image evaluation-an automatic image parameterization on multiple resolutions, based on texture description with specialized association rules. Extracted image parameters are combined into more informative composite parameters by means of principal component analysis, and finally used to build automatic classifiers with machine learning methods. Our experiments with synthetic datasets show that association-rule-based multi-resolution image parameterization works very well for scintigraphic images of the heart. In coronary artery disease diagnostics we confirm these results as our approach significantly improves on clinical results in terms of diagnostic performance. We improve diagnostic accuracy by 17%, specificity by 12% and sensitivity by 22%. We also significantly improve the number of reliably diagnosed patients by 19% for positive diagnoses, and 16% for negative diagnoses, so that no costly

  8. A retrospective study of relevant diagnostic procedures in vulvodynia

    DEFF Research Database (Denmark)

    Petersen, Christina Damsted; Kristensen, Ellids; Lundvall, Lene

    2009-01-01

    OBJECTIVE: To identify objective clinical signs of vulvodynia and determine specific diagnostic tests for vulvodynia in women referred to a vulvar outpatient clinic for vulval complaints. STUDY DESIGN: A retrospective study was performed of the medical records of 201 consecutive Danish patients...... with vulvodynia in the vulvar clinic, 88.9% were correctly diagnosed before referral. The women with vulvodynia were more likely to report dyspareunia (chi2 = 7.89, p = 0.005) and stinging pain (chi2 = 3.74, p = 0.05). The nonvulvodynia group was more likely to report a tendency toward fissures (chi2 = 5.94, p...... pain are strongly associated with vulvodynia. Self-reported pruritus and a tendency toward fissures are not likely to be associated with vulvodynia. Whether vulvar biopsies should be performed regularly when redness and pain is present must...

  9. Effects of radiation exposure from radiopharmaceuticals used in diagnostic studies

    International Nuclear Information System (INIS)

    Witcofski, R.L.

    1981-01-01

    In the United States about 90 percent of man-made radiation exposure to the general population is from the use of radiation in diagnostic medicine. Although the doses of radiation from these procedures to individuals are generally quite small, large numbers of people are exposed. Estimates of the radiation doses associated with such use in the healing arts are approximately 15 million person-rem to the general population from diagnostic x ray and 3.3 million person-rem from the diagnostic use of radiopharmaceuticals. The purpose of this paper is to present what is known about the possible effects of radiation from diagnostic radiopharmaceuticals

  10. Influence of societal and practice contexts on health professionals’ clinical reasoning: a scoping study protocol

    Science.gov (United States)

    Carrier, Annie; Levasseur, Mélanie; Freeman, Andrew; Mullins, Gary; Quénec'hdu, Suzanne; Lalonde, Louise; Gagnon, Michaël; Lacasse, Francis

    2013-01-01

    Introduction In a context of constrained resources, the efficacy of interventions is a pivotal aim of healthcare systems worldwide. Efficacy of healthcare interventions is highly compromised if clinical reasoning (CR), the process that practitioners use to plan, direct, perform and reflect on client care, is not optimal. The CR process of health professionals is influenced by the institutional dimension (ie, legal, regulatory, administrative and organisational aspects) of their societal and practice contexts. Although several studies have been conducted with respect to the institutional dimension influencing health professionals’ CR, no clear integration of their results is yet available. The aim of this study is to synthesise and disseminate current knowledge on the influence of the institutional dimension of contexts on health professionals’ CR. Methods and analysis A scoping study of the scientific literature from January 1980 to March 2013 will be undertaken to summarise and disseminate research findings about the influence of the institutional dimension on CR. Numerous databases (n=18) from three relevant fields (healthcare, health law and politics and management) will be searched. Extended search strategies will include the manual search of bibliographies, health-related websites, public registries and journals of interest. Data will be collected and analysed using a thematic chart and content analysis. A systematic multidisciplinary team approach will allow optimal identification of relevant studies, as well as effective and valid content analysis and dissemination of the results. Discussion This scoping study will provide a rigorous, accurate and up-to-date synthesis of existing knowledge regarding: (1) those aspects of the institutional dimension of health professionals’ societal and practice contexts that impact their CR and (2) how these aspects influence health professionals’ CR. Through the synergy of a multidisciplinary research team from a

  11. Sensitivity study of a proposed polarimetry diagnostic on ASDEX upgrade

    International Nuclear Information System (INIS)

    Callaghan, H.P.; McCarthy, P.J.

    1994-09-01

    ASDEX-Upgrade currently uses FIR interferometry (DCN, 195 μm) as a technique for measuring line integrated electron density along eight chords of the plasma cross-section. A polarimetry diagnostic based on Faraday rotation using the existing setup would yield ∫ n e B.dl along the same chords which, in combination with the ∫ n e dl measurements, would provide additional information about the poloidal magnetic field. This would be helpful for reconstructing the q(ψ) profile, which is difficult to recover from external magnetic measurements alone. A sensitivity study to determine the effectiveness of adding polarimetry to ASDEX Upgrade is carried out using function parameterization on a simulated equilibrium database, together with a database of randomly chosen density profiles with four degrees of freedom. The robustness of the recovery in the presence of measurement noise and the effects of plasma birefringence are taken into account. (orig.)

  12. Diagnostic studies of abortion in Danish dairy herds

    DEFF Research Database (Denmark)

    Agerholm, J.S.; Willadsen, C. M.; Nielsen, Thomas Krogh

    1997-01-01

    Diagnostic findings in 218 aborted bovine foetuses are reported. The materials were examined in a matched case-control study of 69 Danish dairy herds with a sudden increase in the number of abortions and a corresponding 69 control herds. Foetuses aborted during the subsequent 6-month period were...... examined to identify the cause of abortion if possible. A total of 186 specimens were submitted from case herds and 32 from control herds. A likely cause of abortion was diagnosed in 73 foetuses. The most common cause was bovine viral diarrhoea virus (BVDV: 13%) followed by Neospora caninum infection (10......%), mycosis (5%) and Bacillus licheniformis infection (4%). Foetal and/or placental lesions were found in a further 27 cases. Only BVDV infection and neosporosis were diagnosed in more than one foetus per herd and only protozoal associated abortions occurred significantly more frequently in the case, rather...

  13. Centrality of Body and Embodiment in Nursing Care: A Scoping Study of the Italian Literature.

    Science.gov (United States)

    Marchetti, Anna; Piredda, Michela; De Marinis, Maria Grazia

    2016-01-01

    Nursing has based its practical work on contact and a relationship with the patient's body and embodiment; however, the international theoretical and empirical researches on these concepts are still neglected. The purpose of this scoping study is to map the breadth and depth with which body and embodiment are addressed in the Italian nursing literature, identifying the key concepts and the main sources and types of evidence available. Scoping study with qualitative content analysis. It was conducted in accordance with the framework outlined by Arksey and O'Malley and following the recommendations by Levac, Colquhoun, and O'Brien. The qualitative content analysis process was conducted according to Elo and Kyngäs. Lincoln and Guba's technique was followed to ensure trustworthiness. Searches were conducted within seven electronic databases of peer-reviewed literature, one electronic Italian database, six electronic database searches of grey literature, four free online nursing journals, four Internet search engines, and 10 key hard-copy Italian nursing journals. Through these searches, 2,536 records were identified, from which 18 were selected for the final review. Three generic categories emerged from qualitative content analysis: the conceptual category, the nursing care category, and the education category, each including eight, seven, and two subcategories, respectively. The central nursing concepts of body and embodiment definitely require greater and more continuous efforts of theoretical study and empirical research within the nursing discipline, both in Italy and internationally. A greater awareness of body and embodiment should guide nursing practice in caring for and supporting patients and also guide approaches to teaching and learning. Moreover, body and embodiment are concepts firmly rooted in nursing practice, and they are also ripe for future research and able to generate more holistic and complex ways of understanding patients. © 2015 Sigma Theta Tau

  14. Study of Primary Infertility in females by Diagnostic Laparoscopy ...

    African Journals Online (AJOL)

    Tubal block was one of the major causes of primary infertility. The diagnostic laparoscopy with hysterosalpingography (HSG) can be helpful to diagnose the tubal pathology. Keywords: Primary infertility, Diagnostic laparoscopy, hysterosalpingography, Tubal block. Internet Journal of Medical Update Vol. 1 (2) 2006: pp. 6-8.

  15. Diagnostic accuracy of temporomandibular disorder pain tests: a multicenter study

    NARCIS (Netherlands)

    Visscher, C.M.; Naeije, M.; de Laat, A.; Michelotti, A.; Nilner, M.; Craane, B.; Ekberg, E.; Farella, M.; Lobbezoo, F.

    2009-01-01

    AIMS: To estimate the diagnostic accuracy of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) clinical examination and of the dynamic/static tests for the recognition of TMD pain. Since the diagnosis of TMD pain is especially complicated in persistent orofacial pain

  16. Educación compensatoria: efectos recientes de un estudio clásico (High/Scope. [Compensatory education: recent effects from a classic study (High/Scope

    Directory of Open Access Journals (Sweden)

    Eduardo López

    2006-03-01

    Full Text Available This article analyzes two studies which prove that educating socially disadvantaged children in their early years is worthwhile in both the short term and long term. These two complementary studies –Perry and Curriculum-, promoted by the High/Scope Foundation in the sixties, evaluated the efficacy of their programmes at various moments until the sample reached age 40 (Perry and age 23 (Curriculum. We describe the studies and their educational programmes, analyze methodological issues related to longitudinal studies (sample, validity and variables and show the results from both their early school ages and later in their adult lives. Finally, we discuss the modificability of intelligence, the transfer of learning and the cost-benefit analysis of the programmes. Este artículo analiza dos estudios que prueban la tesis de que la educación de los desfavorecidos sociales en la edad temprana -3 y 4 años- merece la pena a corto y largo plazo. Para ello se analizan dos estudios preescolares complementarios –Perry y Curriculum -, de la Fundación High/Scope en los 60, evaluados en diversos momentos intermedios, el primero hasta alcanzar los 40 años y el segundo 23. Se describen los estudios y programas educativos, se analizan cuestiones metodológicas ligadas al seguimiento (muestra, validez, variables, se muestran los hallazgos, los tempranos específicamente escolares y otros de naturaleza distinta en la edad adulta. Finalmente se discute la modificabilidad de la inteligencia, transferencia de aprendizajes y el coste-beneficio del programa.

  17. Conducting systematic reviews of diagnostic studies: didactic guidelines

    Directory of Open Access Journals (Sweden)

    de Vet Henrica CW

    2002-07-01

    Full Text Available Abstract Background Although guidelines for critical appraisal of diagnostic research and meta-analyses have already been published, these may be difficult to understand for clinical researchers or do not provide enough detailed information. Methods Development of guidelines based on a systematic review of the evidence in reports of systematic searches of the literature for diagnostic research, of methodological criteria to evaluate diagnostic research, of methods for statistical pooling of data on diagnostic accuracy, and of methods for exploring heterogeneity. Results Guidelines for conducting diagnostic systematic reviews are presented in a stepwise fashion and are followed by comments providing further information. Examples are given using the results of two systematic reviews on the accuracy of the urine dipstick in the diagnosis of urinary tract infections, and on the accuracy of the straight-leg-raising test in the diagnosis of intervertebral disc hernia.

  18. A scoping nucleonics study for fusion high-temperature blanket designs

    International Nuclear Information System (INIS)

    Cheng, E.T.; Wong, C.P.C.

    1983-01-01

    A scoping study was performed to explore tritium breeding and energy-temperature splits in various blanket concepts for high-temperature process heat. Temperature limits for the lithium materials necessitate two blanket zones. One delivers heat at moderate temperatures ( 0 C) and breeds tritium. The other is a nonbreeding zone that produces heat at high temperatures. It is found that a system where all blanket modules breed tritium delivers more high-temperature heat than one where only some of the blanket modules produce tritium. Of those considered, a design where the high-temperature zone is placed between two breeding zones produces the highest fraction of high-temperature heat. When liquid lithium, Li 7 Pb 2 and Li 2 O tritium breeding materials are employed with two breeding zones, a tritium breeding ratio of 1.1 can be achieved while delivering 30 to 40% of the blanket heat at high temperature

  19. Field-Reversed Configuration Power Plant Critical-Issue Scoping Study

    International Nuclear Information System (INIS)

    Santarius, J. F.; Mogahed, E. A.; Emmert, G. A.; Khater, H. Y.; Nguyen, C. N.; Ryzhkov, S. V.; Stubna, M. D.

    2000-01-01

    A team from the Universities of Wisconsin, Washington, and Illinois performed an engineering scoping study of critical issues for field-reversed configuration (FRC) power plants. The key tasks for this research were (1) systems analysis for deuterium-tritium (D-T) FRC fusion power plants, and (2) conceptual design of the blanket and shield module for an FRC fusion core. For the engineering conceptual design of the fusion core, the project team focused on intermediate-term technology. For example, one decision was to use steele structure. The FRC systems analysis led to a fusion power plant with attractive features including modest size, cylindrical symmetry, good thermal efficiency (52%), relatively easy maintenance, and a high ratio of electric power to fusion core mass, indicating that it would have favorable economics

  20. Field-Reversed Configuration Power Plant Critical-Issue Scoping Study

    Energy Technology Data Exchange (ETDEWEB)

    Santarius, J. F.; Mogahed, E. A.; Emmert, G. A.; Khater, H. Y.; Nguyen, C. N.; Ryzhkov, S. V.; Stubna, M. D.

    2000-03-31

    A team from the Universities of Wisconsin, Washington, and Illinois performed an engineering scoping study of critical issues for field-reversed configuration (FRC) power plants. The key tasks for this research were (1) systems analysis for deuterium-tritium (D-T) FRC fusion power plants, and (2) conceptual design of the blanket and shield module for an FRC fusion core. For the engineering conceptual design of the fusion core, the project team focused on intermediate-term technology. For example, one decision was to use steele structure. The FRC systems analysis led to a fusion power plant with attractive features including modest size, cylindrical symmetry, good thermal efficiency (52%), relatively easy maintenance, and a high ratio of electric power to fusion core mass, indicating that it would have favorable economics.

  1. A scoping review of the use of theory in studies of knowledge translation.

    Science.gov (United States)

    Colquhoun, Heather L; Letts, Lori J; Law, Mary C; MacDermid, Joy C; Missiuna, Cheryl A

    2010-12-01

    Advancing the science of knowledge translation (KT) in occupational therapy is critical. Explicit application of theory can advance this science; yet, how theory is applied and the degree to which it can guide research remain poorly defined. To understand how theory is applied within KT research. A scoping review was conducted to examine and summarize the extent, range, and nature of the application of three specific KT theories: Diffusion of Innovations, Promoting Action on Research Implementation in Health Services framework, and Theory of Planned Behaviour. Theory use was seen most frequently in medicine and nursing. Only 3 of 90 articles were in rehabilitation. Five approaches to theory application were found, the most common being the use of to predict success of KT (57/90). In-depth study of the importance and methods of theory application in KT research is needed, in particular in occupational therapy.

  2. Air Quality Scoping Study for Ash Meadows National Wildlife Refuge, Nevada (EMSI April 2007)

    Energy Technology Data Exchange (ETDEWEB)

    Engelbrecht, Johann; Kavouras, Ilias; Campbell, Dave; Campbell, Scott; Kohl, Steven; Shafer, David

    2007-04-01

    The Desert Research Institute (DRI) is performing a scoping study as part of the U.S.Department of Energy’s Yucca Mountain Environmental Monitoring Systems Initiative (EMSI). The main objective is to obtain baseline air quality information for Yucca Mountain and an area surrounding the Nevada Test Site (NTS). Air quality and meteorological monitoring and sampling equipment housed in a mobile trailer (shelter) is collecting data at seven sites outside the NTS, including Ash Meadows National Wildlife Refuge, Sarcobatus Flat, Beatty, Rachel, Caliente, Pahranagat National Wildlife Refuge, and Crater Flat, and at four sites on the NTS. The trailer is stationed at any one site for approximately eight weeks at a time. Letter reports provide summaries of air quality and meteorological data, on completion of each site’s sampling program.

  3. Quality of dementia diagnostic evaluation for ethnic minority patients: a nationwide study

    DEFF Research Database (Denmark)

    Nielsen, T Rune; Andersen, Birgitte Bo; Kastrup, Marianne

    2011-01-01

    Background/Aims: Diagnostic evaluation of dementia for ethnic minority patients may be challenging. This study aimed to evaluate the quality of diagnostic evaluation of dementia for patients from ethnic minorities in Denmark. Methods: The Danish national hospital registers were used to identify p......: There are significant ethnic disparities in the quality of diagnostic evaluations and outcome of dementia in the secondary healthcare sector....

  4. Endoscopic closure of duodenal perforations by using an over-the-scope clip: a randomized, controlled porcine study.

    Science.gov (United States)

    von Renteln, Daniel; Rudolph, Hans-Ulrich; Schmidt, Arthur; Vassiliou, Melina C; Caca, Karel

    2010-01-01

    Duodenal perforations during diagnostic upper endoscopy are rare; however, when therapeutic techniques are performed, the reported incidence is as great as 2.8%. Surgical repair is usually mandated, but it is associated with significant morbidity and mortality. To compare closure of duodenal perforations by using an over-the-scope clip (OTSC) with a surgical closure. Randomized, controlled animal study. Animal facility laboratory. Domestic pigs (24 females). Large (10-mm) duodenal perforations were created by using an endoscopic needle-knife. The animals were randomly assigned to either open surgical repair (n=12) or endoscopic closure by using the OTSC system (n=12). Pressurized leak tests were performed during necropsy. One major bleed occurred because of a liver injury during creation of the duodenotomy. Mean time for endoscopic closure was 5 minutes (range, 3-8 min; SD +/- 2). No complications occurred during any of the closure procedures. At necropsy, all OTSC and surgical closures demonstrated complete sealing of duodenotomy sites. Pressurized leak tests demonstrated a mean burst pressure of 166 mm Hg (range, 80-260; SD +/- 65) for OTSC closures and 143 mm Hg (range, 30-300, SD +/- 83) for surgical sutures. Ex vivo intact duodenal specimens exhibited a mean burst pressure of 247 mm Hg (range, 200-300; SD +/- 35), which was significantly higher compared with in vivo OTSC and surgical closures (P < .01). There were no significant differences between burst pressures of OTSC and surgical closures (P = .461). Nonsurvival setting. Endoscopic closure of duodenal perforations by using the OTSC system is comparable with surgical closure in a nonsurvival porcine model. This technique is easy to perform and seems suitable for repairing duodenal perforations. 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  5. Rethinking research in the medical humanities: a scoping review and narrative synthesis of quantitative outcome studies.

    Science.gov (United States)

    Dennhardt, Silke; Apramian, Tavis; Lingard, Lorelei; Torabi, Nazi; Arntfield, Shannon

    2016-03-01

    The rise of medical humanities teaching in medical education has introduced pressure to prove efficacy and utility. Review articles on the available evidence have been criticised for poor methodology and unwarranted conclusions. To support a more nuanced discussion of how the medical humanities work, we conducted a scoping review of quantitative studies of medical humanities teaching. Using a search strategy involving MEDLINE, EMBASE and ERIC, and hand searching, our scoping review located 11 045 articles that referred to the use of medical humanities teaching in medical education. Of these, 62 studies using quantitative evaluation methods were selected for review. Three iterations of analysis were performed: descriptive, conceptual, and discursive. Descriptive analysis revealed that the medical humanities as a whole cannot be easily systematised based on simple descriptive categories. Conceptual analysis supported the development of a conceptual framework in which the foci of the arts and humanities in medical education can be mapped alongside their related epistemic functions for teaching and learning. Within the framework, art functioned as expertise, as dialogue or as a means of expression and transformation. In the discursive analysis, we found three main ways in which the relationship between the arts and humanities and medicine was constructed as, respectively, intrinsic, additive and curative. This review offers a nuanced framework of how different types of medical humanities work. The epistemological assumptions and discursive positioning of medical humanities teaching frame the forms of outcomes research that are considered relevant to curriculum decision making, and shed light on why dominant review methodologies make some functions of medical humanities teaching visible and render others invisible. We recommend the use of this framework to improve the rigor and relevance of future explorations of the efficacy and utility of medical humanities teaching

  6. The relevance and role of homestays in medical education: a scoping study.

    Science.gov (United States)

    Hughes, Bonnie Olivia; Moshabela, Mosa; Owen, Jenni; Gaede, Bernhard

    2017-01-01

    The community-based medical education curriculum is growing in popularity as a strategy to bring universal health coverage to underserved communities by providing medical students with hands-on training in primary health care. Accommodation and immersion of medical students within the community will become increasingly important to the success of community-based curricula. In the context of tourism, homestays, where local families host guests, have shown to provide an immersive accommodation experience. By exploring homestays in the educational context, this scoping study investigates their role in providing an immersive pedagogical experience for medical students. A scoping review was performed using the online databases ScienceDirect and the Duke University Library Database, which searches Academic Search Complete, JSTOR, LexisNexis Academic, Web of Science, Proquest, PubMed and WorldCat. Using the inclusion term 'homestays' and excluding the term 'tourism', 181 results were returned. AClose assessment using inclusion criteria narrowed this to 14 relevant articles. There is very little published research specific to the experience of medical students in community homestays, indicating a gap in the literature. However, the existing educational outcomes suggest homestays may have the potential to serve a significant role in medical education, especially as a component of decentralised or community-based programmes. The literature reveals that educational homestays influence language learning, cultural immersion, and the development of professional skills for health science careers. These outcomes relate to the level of engagement between students and hosts, including the catalytic role of community liaisons. Homestays offer a unique depth of experience that has the potential to enrich the education of participating students, and require further research, particularly in the context of distributed and decentralised training platforms for medical and health sciences

  7. PSYCHOLOGICAL DIAGNOSTICS OF STUDENTS ADAPTATION TO UNIVERSITY STUDIES

    Directory of Open Access Journals (Sweden)

    Olga A. Molokova

    2015-01-01

    Full Text Available Aim. The solution version of one of problems of psychology andpedagogical escort of students at the initial stage of their adaptation to training in higher education institution is stated in the study. Such maintenance obligatory includes diagnostics of a psychological state of pupils that in a traditional state demands considerable expenses by as teachers’ and first-year students’ forces and time. Possibility of elimination of this shortcoming is presented.Methods. The methods involve the modified Sklyayn’s technique which description is presented in K. Rogers’s works; the technique of the personal differential definition; the technique of definition of the psychological satisfaction in various vital spheres. Students’ relation to the research was found out during anonymous poll.Results. It is shown that, despite the positive relation to psychological researches from the majority of respondents, there is a problem of the obvious or latent unwillingness of some first-year students to participate in surveys and test work caused by work content and its duration. The alternative to tiresome measurements of indicators of adaptation of pupils to training in higher education institution is presented – the express diagnostics reduce time of monitoring and allow teachers to get students interested. Comparison of the results received at use of Sklyayn’s technique and a technique «Personal differential» shows that they investigate the same phenomenon at nonverbal and verbal levels: correlation of persons’ «real self» and «ideal self». However, if creation of verbal formulations of the person relation to what he/she is, and to what he/she wants to be, can cause difficulties by the examinee, the nonverbal diagnostics turned to subconsciousness, is not only simpler, but also reflects a psychological state of the person more precisely.Scientific novelty. Modification of the technique by Sklyayn is proposed; it

  8. A Scoping Review of Observational Studies Examining Relationships between Environmental Behaviors and Health Behaviors

    Directory of Open Access Journals (Sweden)

    Jayne Hutchinson

    2015-05-01

    Full Text Available Individual lifestyles are key drivers of both environmental change and chronic disease. We undertook a scoping review of peer-reviewed studies which examined associations between environmental and health behaviors of individuals in high-income countries. We searched EconLit, Medline, BIOSIS and the Social Science Citation Index. A total of 136 studies were included. The majority were USA-based cross-sectional studies using self-reported measures. Most of the evidence related to travel behavior, particularly active travel (walking and cycling and physical activity (92 studies or sedentary behaviors (19 studies. Associations of public transport use with physical activity were examined in 18 studies, and with sedentary behavior in one study. Four studies examined associations between car use and physical activity. A small number included other environmental behaviors (food-related behaviors (n = 14, including organic food, locally-sourced food and plate waste and other health behaviors ((n = 20 smoking, dietary intake, alcohol. These results suggest that research on individual environmental and health behaviors consists largely of studies examining associations between travel mode and levels of physical activity. There appears to be less research on associations between other behaviors with environmental and health impacts, and very few longitudinal studies in any domain.

  9. A Scoping Review of Observational Studies Examining Relationships between Environmental Behaviors and Health Behaviors.

    Science.gov (United States)

    Hutchinson, Jayne; Prady, Stephanie L; Smith, Michaela A; White, Piran C L; Graham, Hilary M

    2015-05-05

    Individual lifestyles are key drivers of both environmental change and chronic disease. We undertook a scoping review of peer-reviewed studies which examined associations between environmental and health behaviors of individuals in high-income countries. We searched EconLit, Medline, BIOSIS and the Social Science Citation Index. A total of 136 studies were included. The majority were USA-based cross-sectional studies using self-reported measures. Most of the evidence related to travel behavior, particularly active travel (walking and cycling) and physical activity (92 studies) or sedentary behaviors (19 studies). Associations of public transport use with physical activity were examined in 18 studies, and with sedentary behavior in one study. Four studies examined associations between car use and physical activity. A small number included other environmental behaviors (food-related behaviors (n = 14), including organic food, locally-sourced food and plate waste) and other health behaviors ((n = 20) smoking, dietary intake, alcohol). These results suggest that research on individual environmental and health behaviors consists largely of studies examining associations between travel mode and levels of physical activity. There appears to be less research on associations between other behaviors with environmental and health impacts, and very few longitudinal studies in any domain.

  10. Buildings of the Future Scoping Study: A Framework for Vision Development

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Na [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Goins, John D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-02-01

    The Buildings of the Future Scoping Study, funded by the U.S. Department of Energy (DOE) Building Technologies Office, seeks to develop a vision for what U.S. mainstream commercial and residential buildings could become in 100 years. This effort is not intended to predict the future or develop a specific building design solution. Rather, it will explore future building attributes and offer possible pathways of future development. Whether we achieve a more sustainable built environment depends not just on technologies themselves, but on how effectively we envision the future and integrate these technologies in a balanced way that generates economic, social, and environmental value. A clear, compelling vision of future buildings will attract the right strategies, inspire innovation, and motivate action. This project will create a cross-disciplinary forum of thought leaders to share their views. The collective views will be integrated into a future building vision and published in September 2015. This report presents a research framework for the vision development effort based on a literature survey and gap analysis. This document has four objectives. First, it defines the project scope. Next, it identifies gaps in the existing visions and goals for buildings and discusses the possible reasons why some visions did not work out as hoped. Third, it proposes a framework to address those gaps in the vision development. Finally, it presents a plan for a series of panel discussions and interviews to explore a vision that mitigates problems with past building paradigms while addressing key areas that will affect buildings going forward.

  11. 77 FR 25148 - Request for Information Regarding Scope, Methods, and Data Sources for Conducting Study of Pre...

    Science.gov (United States)

    2012-04-27

    ... The Dodd-Frank Act requires the Bureau to study the ``use'' of pre- dispute arbitration agreements....consumerfinance.gov/credit-cards/agreements/ . Prior to the Dodd-Frank Act, the Federal Reserve Board maintained a... Regarding Scope, Methods, and Data Sources for Conducting Study of Pre-Dispute Arbitration Agreements AGENCY...

  12. A comparative study of quality control in diagnostic radiology

    International Nuclear Information System (INIS)

    Kharita, M. H.; Khedr, M.S.; Wannus, K.M.

    2008-01-01

    The main objective of this comparative study was to evaluate the national quality assurance program for X-ray diagnostic radiology in Syrian governmental hospitals. Two periods were covered in this study, the first period was from 1986 to 1998 (52 hospitals and 149 X-ray machines were considered) and the second period from 1999 to 2005 (41 hospitals and 95 X-ray machines were considered). Most of the X-ray machines studied were within the acceptable performance, but few machines needed recalibration for some parameters. Considerable improvement of about 50% was reported in the second period. This improvement could be attributed to the establishment of an effective National Regulatory Authority in Syria in 1998 that introduced and gradually enforced the quality assurance requirement for X-ray equipment as part of the licensing process and to the relatively newer X-ray machines covered in the second period. The Author 2008. Published by Oxford Univ. Press. All rights reserved. (authors)

  13. Adolescent obesity in contextual settings: a scoping study of multilevel and hierarchical examinations.

    Science.gov (United States)

    Utley, J M; Affuso, O; Rucks, A C

    2016-10-01

    Multilevel/hierarchical obesity studies analyze adolescent and family, neighbourhood and social settings' characteristics to generate data needed to design prevention interventions. This scoping study summarizes such studies' characteristics and key findings to provide information to decision makers, which allows them to quickly grasp the state of the evidence and potential policy implications for adolescent obesity prevention. PubMed, CINAHLplus, PsychINFO and Sociological Abstracts were searched for peer-reviewed studies spanning 1 January 2000-31 August 2014. Inclusion criteria included (i) outcome weight status, physical activity and weight status, or physical activity alone if the aim was obesity prevention; (ii) 12- to 19-year-old participants in a cross-sectional study, a separate analysis in a cross-sectional study or a longitudinal follow-up. Nineteen studies were published in the United States of America; four in Canada; two in Spain, China and Vietnam, respectively; and one in Germany. Self-efficacy, parental physical activity support, perceived neighbourhood support, social cohesion and access to recreational facilities were associated with increased activity levels; neighbourhood physical disorder and perceived lack of safety associated with reduced physical activity levels. Overweight or obesity was associated with sugar-sweetened beverage intake and household availability thereof; reduced odds were reported with fruit and vegetable intake and household availability of these, daily breakfast and family meal frequency. Potential adolescent obesity risk regulators may be found at the individual, family or social contextual levels. © 2016 World Obesity.

  14. A study of diagnostic imaging in pancreatic trauma

    International Nuclear Information System (INIS)

    Hirota, Masashi; Kanazumi, Naohito; Kato, Koichi; Eguchi, Takehiko; Kobayashi, Hironobu; Suzuki, Yuichi; Kimura, Jiro; Ishii, Masataka

    2002-01-01

    Pancreatic trauma treatment depends on pancreatic ductal injury. We examined the usefulness and problems of diagnostic imaging, such as enhanced CT, ERP, and CT after ERP, in pancreatic trauma. Subjects were 12 patients with pancreatic trauma treated in our hospital between April 1993 and March 2000. Enhanced CT was performed in 6 patients undergoing diagnostic imagings and ERP in 4 of the 6. Overall diagnostic accuracy of pancreatic ductal injury in enhanced CT was 16.7% and accuracy in ERP with CT after ERP was 100%. Intraoperative diagnosis of main pancreatic ductal injury was difficult in 1 of 2 patients in whom ERP failed. The importance of preoperative diagnostic imaging is thus clear. We expect that MRCP, recently evaluated in pancreatic disease diagnosis, will become a new pancreatic trauma modality. (author)

  15. Social-Ecological Correlates in Adult Autism Outcome Studies: A Scoping Review.

    Science.gov (United States)

    Anderson, Kristy A; Roux, Anne M; Kuo, Alice; Shattuck, Paul T

    2018-04-01

    The transition into adulthood is a critical period in the life course that shapes later outcomes. Many adults on the autism spectrum fare poorly across a wide range of quality of life indicators. Understanding the multilevel factors that influence transition outcomes is necessary to develop strategies that promote better outcomes. In this scoping review, we characterize the use of social-ecological factors in adult autism outcome studies, identify understudied areas of research, and provide recommendations for future research. We conducted a literature search for studies in which the relationship between social-ecological factors and transition outcomes among transition-age youth with autism was assessed. We organized variables used in studies across 5 levels of influence: family-, interpersonal-, institutional-, community-, and policy-level factors. Our findings reveal that both breadth and depth of social-ecological factors usage in autism outcomes studies is limited because of the narrow inclusion of variables across social-ecological levels, the overreliance on a limited number of national data sets, and the overall lack of variation in research design. We propose 9 recommendations to inform the development of multilevel studies. Copyright © 2018 by the American Academy of Pediatrics.

  16. Quality of dementia diagnostic evaluation for ethnic minority patients: a nationwide study

    DEFF Research Database (Denmark)

    Nielsen, T Rune; Andersen, Birgitte Bo; Kastrup, Marianne

    2011-01-01

    Background/Aims: Diagnostic evaluation of dementia for ethnic minority patients may be challenging. This study aimed to evaluate the quality of diagnostic evaluation of dementia for patients from ethnic minorities in Denmark. Methods: The Danish national hospital registers were used to identify...... records were reviewed. An acceptable diagnostic workup was documented in only 23% of the patients. Dementia diagnosis was confirmed in 35%. Significant differences in the quality of the diagnostic evaluation were found between patients from ethnic minorities and the general population. Conclusion......: There are significant ethnic disparities in the quality of diagnostic evaluations and outcome of dementia in the secondary healthcare sector....

  17. Studies of RF sheaths and diagnostics on IShTAR

    Energy Technology Data Exchange (ETDEWEB)

    Crombé, K., E-mail: Kristel.Crombe@UGent.be [Department of Applied Physics, Ghent University, Ghent (Belgium); LPP-ERM/KMS, Royal Military Academy, Brussels (Belgium); Devaux, S.; Faudot, E.; Heuraux, S.; Moritz, J. [YIJL, UMR7198 CNRS-Université de Lorraine, Nancy (France); D’Inca, R.; Faugel, H.; Fünfgelder, H.; Jacquot, J.; Ochoukov, R. [Max-Planck-Institut für Plasmaphysik, Garching (Germany); Louche, F.; Tripsky, M.; Van Eester, D.; Wauters, T. [LPP-ERM/KMS, Royal Military Academy, Brussels (Belgium); Noterdaeme, J.-M. [Department of Applied Physics, Ghent University, Ghent (Belgium); Max-Planck-Institut für Plasmaphysik, Garching (Germany)

    2015-12-10

    IShTAR (Ion cyclotron Sheath Test ARrangement) is a linear magnetised plasma test facility for RF sheaths studies at the Max-Planck-Institut für Plasmaphysik in Garching. In contrast to a tokamak, a test stand provides more liberty to impose the parameters and gives better access for the instrumentation and antennas. The project will support the development of diagnostic methods for characterising RF sheaths and validate and improve theoretical predictions. The cylindrical vacuum vessel has a diameter of 1 m and is 1.1 m long. The plasma is created by an external cylindrical plasma source equipped with a helical antenna that has been designed to excite the m=1 helicon mode. In inductive mode, plasma densities and electron temperatures have been characterised with a planar Langmuir probe as a function of gas pressure and input RF power. A 2D array of RF compensated Langmuir probes and a spectrometer are planned. A single strap RF antenna has been designed; the plasma-facing surface is aligned to the cylindrical plasma to ease the modelling. The probes will allow direct measurements of plasma density profiles in front of the RF antenna, and thus a detailed study of the density modifications induced by RF sheaths, which influences the coupling. The RF antenna frequency has been chosen to study different plasma wave interactions: the accessible plasma density range includes an evanescent and propagative behaviour of slow or fast waves, and allows the study of the effect of the lower hybrid resonance layer.

  18. Comparative Study of the Sensitivity of Different Diagnostic Methods for the Laboratory Diagnosis of Buruli Ulcer Disease

    NARCIS (Netherlands)

    Herbinger, Karl-Heinz; Adjei, Ohene; Awua-Boateng, Nana-Yaa; Nienhuis, Willemien A.; Kunaa, Letitia; Siegmund, Vera; Nitschke, Joerg; Thompson, William; Klutse, Erasmus; Agbenorku, Pius; Schipf, Alexander; Reu, Simone; Racz, Paul; Fleischer, Bernhard; Beissner, Marcus; Fleischmann, Erna; Helfrich, Kerstin; van der Werf, Tjip S.; Loescher, Thomas; Bretzel, Gisela

    2009-01-01

    Background. Several diagnostic laboratory methods are available for case confirmation of Buruli ulcer disease. This study assessed the sensitivity of various diagnostic tests in relation to clinical presentation of the disease, type of diagnostic specimen, and treatment history. Methods. Swab

  19. RE-COMMUNICATE: Communication Best-Practices for Renewable Energies. Scoping Study

    Energy Technology Data Exchange (ETDEWEB)

    Bridle, Richard; Leopold, Aaron [International Institute for Sustainable Development (IISD), Geneva (Switzerland); Collings, Jonathan [Collings and Monney, London (United Kingdom); Cottrell, Jacqueline [Green Budget Germany- Forum Oekologisch-Soziale Marktwirtschaft] [Germany])

    2013-04-15

    An identified barrier to the widespread use of renewable energy technologies (RET) is the (mis-) perception in the public, at a political level and within the industry sector about the benefits, opportunities and capabilities of RET. One reason is that the communication of the RE sector may not be convincing enough. In November 2011 IEA-RETD organised a workshop in Berlin that discussed the topics of 'sending clear messages', and 'getting the RE cost perception right'. One of the conclusions was that renewables need a better positioning, which could be achieved through improved communication. Therefore, IEA-RETD commissioned a scoping study with the objective to provide ideas, techniques and case studies on how the benefits of renewable energies can be better communicated to and by policy makers, decision makers and other stakeholders. The study concluded that more targeted, effective renewable energy communications campaigns can be achieved through the use of more consistent, holistic and rigorous approaches to pre- and post-campaign development.

  20. Psychiatric diagnostic interviews for children and adolescents: A comparative study

    Science.gov (United States)

    Angold, Adrian; Erkanli, Alaattin; Copeland, William; Goodman, Robert; Fisher, Prudence W.; Costello, E. Jane

    2012-01-01

    Objective To compare examples of 3 styles of psychiatric interviews for youth: the Diagnostic Interview Schedule for Children (DISC) (“respondent-based”), the Child and Adolescent Psychiatric Assessment (CAPA) (“Interviewer-based”), and the Development and Well-Being Assessment (DAWBA) (“expert judgment”). Method Roughly equal numbers of males and females and White and African American participants aged 9–12 and 13–16 were recruited from primary care pediatric clinics. Participants (N=646) were randomly assigned to receive two of the three interviews, in counterbalanced order. Five modules were used: any depressive disorder, anxiety disorders, oppositional defiant disorder, conduct disorder, attention deficit-hyperactivity disorder. At 2 sessions about 1 week apart, parent and child completed 1 of 2 interviews plus 5 screening questionnaires. Results When interviewed with the DAWBA, 17.7% of youth had 1 or more diagnoses, compared with 47.1% (DISC) and 32.4% (CAPA). The excess of DISC diagnoses was accounted for by specific phobias. Agreement between interview pairs was .13–.48 for DAWBA-DISC comparisons, .21–.61 for DISC-CAPA comparisons, and .23–.48 for CAPA-DAWBA comparisons. DAWBA cases were associated with higher parent-report questionnaire scores than DISC/DAWBA cases, but equivalent child-report scores. Conclusions The DAWBA is shorter and cases were probably more severe, making it a good choice for clinical trials, but the user cannot examine the data in detail. The DISC and CAPA are similar in length and training needs. Either would be a better choice where false negatives must be avoided, as in case-control genetic studies, or when researchers need to study individual symptoms in detail. PMID:22525957

  1. Scope Definition

    DEFF Research Database (Denmark)

    Bjørn, Anders; Owsianiak, Mikołaj; Laurent, Alexis

    2017-01-01

    The scope definition is the second phase of an LCA. It determines what product systems are to be assessed and how this assessment should take place. This chapter teaches how to perform a scope definition. First, important terminology and key concepts of LCA are introduced. Then, the nine items...... making up a scope definition are elaborately explained: (1) Deliverables. (2) Object of assessment, (3) LCI modelling framework and handling of multifunctional processes, (4) System boundaries and completeness requirements, (5) Representativeness of LCI data, (6) Preparing the basis for the impact...... assessment, (7) Special requirements for system comparisons, (8) Critical review needs and (9) Planning reporting of results. The instructions relate both to the performance and reporting of a scope definition and are largely based on ILCD....

  2. Three principles to define the success of a diagnostic study could be identified

    DEFF Research Database (Denmark)

    Vach, Werner; Gerke, Oke; Høilund-Carlsen, Poul Flemming

    2012-01-01

    OBJECTIVE: Diagnostic studies are typically studies with two endpoints, sensitivity and specificity. To define the success of a diagnostic study, results for these two endpoints have to be combined in an appropriate manner. STUDY DESIGN AND SETTING: Identification of criteria to define the succes...

  3. Gender, citizenship and dementia care: a scoping review of studies to inform policy and future research.

    Science.gov (United States)

    Bartlett, Ruth; Gjernes, Trude; Lotherington, Ann-Therese; Obstefelder, Aud

    2018-01-01

    Gender is a neglected dimension in public discourse related to people with dementia. Those living with this condition are typically portrayed in policies and strategies in gender neutral terms as 'people with dementia' and 'family carers' as if gender does not matter, when clearly it does. The purpose of this scoping review was to take stock of knowledge about gender differences in relation to dementia care to inform policy and future research. The work is grounded in a feminist perspective to citizenship, as this provide a lens with which to expose and examine gendered assumptions within dementia studies. A search of four databases, including CINAHL, Web of Science, Medline and Cochrane was conducted using systematic techniques between May and July 2014. A repeat search was conducted in February 2015. We found a significant amount of valuable research concerned with gender differences in relation to dementia care published from 1990 to 2014; the majority of which lacks a feminist citizenship perspective. Moreover, a disproportionate number of studies focused solely on caregivers rather than citizens with dementia. As such, questions about gender equality are not being raised and the voices of men and women with dementia are silent. Thus we argue for increased gender-sensitivity in policy making and recommend that social scientists inject a feminist citizenship perspective into their work. © 2016 John Wiley & Sons Ltd.

  4. Breast cancer information and support needs for women with intellectual disabilities: a scoping study.

    Science.gov (United States)

    Collins, Karen; McClimens, Alex; Mekonnen, Stella; Wyld, Lynda

    2014-08-01

    To examine the compass and nature of relevant research and identify gaps in the current evidence in order to determine the priority of future research about breast cancer and intellectual disability (ID). A scoping study that comprised of a consultation exercise with a wide range of key stakeholders (n = 26) from one northern city (Sheffield) within the UK. This study identified numerous gaps in the current evidence base. It highlighted a dearth of research that focuses specifically on the information and support needs of women with IDs (and their carers) across the breast cancer patient pathway. Within the interviews, whilst 'reasonable adjustments' were being made and there was evidence of good practice, they were neither strategic nor systematic. Participants suggested that future research should focus on devising protocols to advise on the legal, ethical and clinical imperatives so that clinical governance in this area is assured. There remains a dearth of research or practice guidelines at every stage of the breast cancer care pathway for women with ID. This may arguably lead to late diagnosis, suboptimal treatment and management and overall survival rates for this group. Further research is needed to understand the specific information and support needs of both women with ID (and their formal and informal carers) through the breast care pathway and to identify appropriate protocols, strategies and interventions in order to address these. Copyright © 2014 John Wiley & Sons, Ltd.

  5. The scope of physiotherapy services provided in public ICUs in Greece: A pilot study.

    Science.gov (United States)

    Grammatopoulou, Eirini; Charmpas, Theodoros N; Strati, Eftychia G; Nikolaos, Tsamis; Evagelodimou, Afroditi; Vlassia Belimpasaki; Skordilis, Emmanouil K

    2017-02-01

    The aim of the present study was to determine the scope of physiotherapy services provided in Greek ICUs in Athens. A cross-sectional study was conducted with two postal questionnaires administered separately, one for ICU directors and one for ICU physiotherapists. Responses were received from 19 ICU directors and 103 physiotherapists employed in all the adult public mixed medical and surgical ICUs across Athens. The response rate for the survey completion was 100% for ICU directors and 68.7% for physiotherapists. The results showed a 1:50 to 1:12 range in the ratio of physiotherapists to ICU beds. Among the 19 ICUs, 15 (78.9%) employed physiotherapists on a rotational basis, while four (21.0%) retained them exclusively. On weekdays, all surveyed ICUs were covered by physiotherapists in the morning and 10/19 (52.6%) during the afternoon. On weekends, 12/19 (63.2%) of the surveyed ICUs reported physiotherapy care during the morning and 4/19 (21.0%) during both morning and afternoon. All 103 physiotherapists conducted airway clearance techniques and progressive mobilization, 92/103 (89.3%) were involved in extubating patients, 102/103 (99.0%) in passive and active range of motion exercises, and 61/103 (59.2%) in walking. In conclusion, all Greek ICUs in Athens surveyed had physiotherapy cover. The physiotherapists working in these ICUs in Athens were involved in respiratory care and mobilization.

  6. Opportunities for Demand Response in California Agricultural Irrigation: A Scoping Study

    Energy Technology Data Exchange (ETDEWEB)

    Marks, Gary [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wilcox, Edmund [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Olsen, Daniel [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goli, Sasank [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2013-01-02

    California agricultural irrigation consumes more than ten billion kilowatt hours of electricity annually and has significant potential for contributing to a reduction of stress on the grid through demand response, permanent load shifting, and energy efficiency measures. To understand this potential, a scoping study was initiated for the purpose of determining the associated opportunities, potential, and adoption challenges in California agricultural irrigation. The primary research for this study was conducted in two ways. First, data was gathered and parsed from published sources that shed light on where the best opportunities for load shifting and demand response lie within the agricultural irrigation sector. Secondly, a small limited survey was conducted as informal face-to-face interviews with several different California growers to get an idea of their ability and willingness to participate in permanent load shifting and/or demand response programs. Analysis of the data obtained from published sources and the survey reveal demand response and permanent load shifting opportunities by growing region, irrigation source, irrigation method, grower size, and utility coverage. The study examines some solutions for demand response and permanent load shifting in agricultural irrigation, which include adequate irrigation system capacity, automatic controls, variable frequency drives, and the contribution from energy efficiency measures. The study further examines the potential and challenges for grower acceptance of demand response and permanent load shifting in California agricultural irrigation. As part of the examination, the study considers to what extent permanent load shifting, which is already somewhat accepted within the agricultural sector, mitigates the need or benefit of demand response for agricultural irrigation. Recommendations for further study include studies on how to gain grower acceptance of demand response as well as other related studies such as

  7. Diagnostic Examination for Students Entering Graduate Study in Soil Science.

    Science.gov (United States)

    Loynachan, T. E.

    1988-01-01

    Reports that students with soil science background performed better on a diagnostic examination; no relationship existed between exam performance and country of origin, degree sought, or undergraduate class quartile. Concludes that exam results, the grade received in a beginning graduate-level course and the cumulative graduate grade-point average…

  8. Procalcitonin in cerebrospinal fluid in meningitis : a prospective diagnostic study

    NARCIS (Netherlands)

    Alons, Imanda M E; Verheul, Rolf J; Kuipers, Irma; Jellema, Korné; Wermer, Marieke J H; Algra, Ale; Ponjee, Gabriëlle

    2016-01-01

    OBJECTIVES: Bacterial meningitis is a severe but treatable condition. Clinical symptoms may be ambiguous and current diagnostics lack sensitivity and specificity, complicating diagnosis. Procalcitonin (PCT) is a protein that is elevated in serum in bacterial infection. We aimed to assess the value

  9. Conducting systematic reviews of diagnostic studies: didactic guidelines.

    NARCIS (Netherlands)

    Devillé, W.L.; Buntinx, F.; Bouter, L.M.; Montori, V.M.; Vet, H.C.W. de; Windt, D.A.W.M. van der; Bezemer, P.D.

    2002-01-01

    Background: Although guidelines for critical appraisal of diagnostic research and meta-analyses have already been published, these may be difficult to understand for clinical researchers or do not provide enough detailed information. Methods: Development of guidelines based on a systematic review of

  10. Conducting systematic reviews of diagnostic studies : didactic guidelines.

    NARCIS (Netherlands)

    Devillé, Walter L.; Buntinx, Frank; Bouter, Lex M.; Montori, Victor M.; de Vet, Henrica C.W.; van der Windt, Danielle A.W.M.; Bezemer, P. Dick

    2002-01-01

    BACKGROUND: Although guidelines for critical appraisal of diagnostic research and meta-analyses have already been published, these may be difficult to understand for clinical researchers or do not provide enough detailed information. METHODS: Development of guidelines based on a systematic review of

  11. GPs' perspectives on the diagnostic work-up in patients with shoulder pain: a qualitative study.

    Science.gov (United States)

    Ottenheijm, Ramon P G; Hesselmans, Nicolle J J M; Kemper, Anouk; Moser, Albine; de Bie, Rob A; Dinant, Geert-Jan; Cals, Jochen W L

    2014-06-01

    The diagnostic work-up of patients with shoulder pain in general practice is complex. General practitioners' (GPs) guidelines advise a pragmatic diagnostic work-up in which additional imaging has a limited role. However, diagnostic ultrasounds are increasingly ordered by GPs, which seems to reflect complexity in management of shoulder pain. This study aimed to explore GPs' perspectives on the diagnostic work-up of patients with shoulder pain. This study has a qualitative exploratory design with an inductive approach and was carried out in Dutch general practice. The study population consisted of 18 Dutch GPs who were sampled purposefully with a spread in clinical experience and ordering diagnostic ultrasound. Data were gathered by means of semi-structured interviews and analysed following principles of the constant comparative method. Three main categories with subcategories emerged that captured the diagnostic work-up of shoulder pain: variety in diagnostic classifications [(non-)specific diagnosis and interdisciplinary differences], establishing strategies for diagnostic work-up (use of existing tools and motives to deviate from existing tools), and strategies dealing with diagnostic uncertainties (accepting diagnostic uncertainties, diagnostic imaging tests, and interdisciplinary consultation and referral). Despite the availability of evidence-based shoulder guidelines, GPs experience uncertainties during diagnostic work-up and apply different strategies when dealing with these uncertainties. At some point, GPs as well as patients seem to have a need for a specific diagnosis. Currently, there appears to be little agreement if, or in which phase of shoulder pain, diagnostic ultrasound is useful or indicated. © 2014 John Wiley & Sons, Ltd.

  12. Scoping studies to reduce ICPP high-level radioactive waste volumes for final disposal

    International Nuclear Information System (INIS)

    Knecht, D.A.; Berreth, J.R.; Chipman, N.A.; Cole, H.S.; Staples, B.A.; Kerr, W.B.

    1986-01-01

    The Defense Waste Management Plan (DWMP) of June 1983 presents a reference plan for the long-term management of Idaho Chemical Processing Plant (ICPP) high-level wastes (HLW) with a goal of disposing the annual output in at least 500 canisters per year after FY 2007. Based on the available technology to immobilize ICPP HLW into a glass, at least 1700 canisters could be produced per year after FY 2007. Because of potentially high disposal costs, fuel dissolution, waste treatment, and waste immobilization were evaluated as possible processes to reduce immobilized high-level waste volumes. The results of these scoping studies show that modifications in the presently used fuel dissolution processes to reduce usage of inert materials could result in up to a 72% potential volume reduction when combined with a ceramic waste form. The ceramic-based waste form appears to be feasible with a potential HLW volume reduction of 60%. The neutralization process also appears to be feasible with a potential volume reduction of 80%, but may require significant development. The low-volume glass and Modified Zirflex processes may be feasible but would require significantly more process development and/or modifications and could result in only a 20 to 30% potential volume reduction; thus, they are not recommended for further development

  13. Educational Strategies to Enhance Reflexivity Among Clinicians and Health Professional Students: A Scoping Study

    Directory of Open Access Journals (Sweden)

    Rachel Landy

    2016-09-01

    Full Text Available Reflexivity involves the ability to understand how one's social locations and experiences of advantage or disadvantage have shaped the way one understands the world. The capacity for reflexivity is crucial because it informs clinical decisions, which can lead to improvements in service delivery and patient outcomes. In this article, we present a scoping study that explored educational strategies designed to enhance reflexivity among clinicians and/or health profession students. We reviewed articles and grey literature that address the question: What is known about strategies for enhancing reflexivity among clinicians and students in health professional training programs? We searched multiple databases using keywords including: reflexivity, reflective, allied health professionals, pedagogy, learning, and education. The search strategy was iterative and involved three reviews. Each abstract was independently reviewed by two team members. Sixty-eight texts met the inclusion criteria. There was great diversity among the educational strategies and among health professions. Commonalities across strategies were identified related to reflective writing, experiential learning, classroom-based activities, continuing education, and online learning. We also summarize the 19 texts that evaluated educational strategies to enhance reflexivity. Further research and education is urgently needed for more equitable and socially-just health care. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1603140

  14. A scoping study of fission product transport from failed fuel during N Reactor postulated accidents

    International Nuclear Information System (INIS)

    Hagrman, D.L.

    1987-11-01

    This report presents a scoping study of cesium, iodine, and tellurium behavior during a cold leg manifold break in the N Reactor. More detail about fission product behavior than has previously been available is provided and key parameters that control this behavior are identified. The LACE LA1 test and evidence from the Power Burst Facility Severe Fuel Damage tests are used to test the key model applied to determine aerosol behavior. Recommendations for future analysis are also provided. The primary result is that most of the cesium, iodine, and tellurium remains in the molten uranium fuel. Only 0.0035 of the total inventory is calculated to be released. Condensation of most of the species of cesium and iodine that are released is calculated, with 0.998 of the released cesium and iodine condensing in the spacers and upstream end of the connector tubes. Most of the tellurium that is released condenses but the chemical reaction of tellurium vapor with surfaces is also a major factor in the behavior of this element

  15. Mass Market Demand Response and Variable Generation Integration Issues: A Scoping Study

    Energy Technology Data Exchange (ETDEWEB)

    Cappers, Peter; Mills, Andrew; Goldman, Charles; Wiser, Ryan; Eto, Joseph H.

    2011-09-10

    This scoping study focuses on the policy issues inherent in the claims made by some Smart Grid proponents that the demand response potential of mass market customers which is enabled by widespread implementation of Advanced Metering Infrastructure (AMI) through the Smart Grid could be the “silver bullet” for mitigating variable generation integration issues. In terms of approach, we will: identify key issues associated with integrating large amounts of variable generation into the bulk power system; identify demand response opportunities made more readily available to mass market customers through widespread deployment of AMI systems and how they can affect the bulk power system; assess the extent to which these mass market Demand Response (DR) opportunities can mitigate Variable Generation (VG) integration issues in the near-term and what electricity market structures and regulatory practices could be changed to further expand the ability for DR to mitigate VG integration issues over the long term; and provide a qualitative comparison of DR and other approaches to mitigate VG integration issues.

  16. Scoping studies for small steady-state tokamaks for divertor testing

    International Nuclear Information System (INIS)

    Galambos, J.D.; Peng, Y.K.M.; Nelson, B.E.; Hirshman, S.P.; Fogarty, P.J.

    1991-01-01

    A prime uncertainty in next-generation devices is the divertor performance. For the International Thermonuclear Experimental Reactor (ITER), the divertor limit often plays a more critical role in the operational scenario definition than do beta limit and energy confinement constraints. Hence, it is desirable to test the divertors in an environment as close as possible to that expected in next-step burning plasma experiments. Initial global scoping studies are done for small, steady-state, copper coil, beam-driven tokamaks that are dedicated to divertor testing. The usual ITER global physics models (beta limit, energy confinement, and analytic divertor heat load calculation) are incorporated, and for performance criteria we require that the divertor heat load and plasma collisionality in the edge region be similar to those expected in ITER. The smallest, lowest-cost devices satisfying these constraints tend to have major radius below 1 m, plasma current of 0.5 to 1 MA, and low aspect ratio and costs of a few tens of millions of dollars. Injection powers of about 4 to 5 MW are needed to sustain the plasma current, maintain plasma power balance, and provide the required divertor heat load. 6 refs., 5 tabs

  17. Using Meta-Analysis to Inform the Design of Subsequent Studies of Diagnostic Test Accuracy

    Science.gov (United States)

    Hinchliffe, Sally R.; Crowther, Michael J.; Phillips, Robert S.; Sutton, Alex J.

    2013-01-01

    An individual diagnostic accuracy study rarely provides enough information to make conclusive recommendations about the accuracy of a diagnostic test; particularly when the study is small. Meta-analysis methods provide a way of combining information from multiple studies, reducing uncertainty in the result and hopefully providing substantial…

  18. Toward complete and accurate reporting of studies of diagnostic accuracy: The STARD initiative

    NARCIS (Netherlands)

    Bossuyt, Patrick M.; Reitsma, Johannes B.; Bruns, David E.; Gatsonis, Constantine A.; Glasziou, Paul P.; Irwig, Les M.; Lijmer, Jeroen G.; Moher, David; Rennie, Drummond; de Vet, Henrica C. W.

    2003-01-01

    Rationale and Objectives. To comprehend the results of diagnostic accuracy studies, readers must understand the design, conduct, and analysis of such studies. The authors sought to develop guidelines for improving the accuracy and completeness of reporting of studies of diagnostic accuracy in order

  19. A methodology for the preliminary scoping of future changes in ecosystem services, with an illustration from the future midwestern landscapes study

    Science.gov (United States)

    The product is a white paper defining a methodology for the preliminary scoping of future changes in ecosystem services, with an Illustration from the Future Midwestern Landscapes Study. The scoping method develops a hierarchy of relevant societal values, identifies the ecosyste...

  20. Studies of atomic motion and atomic diagnostics in optical lattices

    Science.gov (United States)

    Grondalski, John Paul

    2001-06-01

    We present a detailed theoretical and numerical study of polarization gradient cooling for alkali atoms with large ground state angular momenta (Fg >= 2) moving in a one dimensional (1D) lin⊥lin optical lattice in order to clarify the physical picture of laser cooling in steady- state. Using a basis of Wannier states we find that the semiclassical picture of laser cooling depends strongly on coherences between the Zeeman sublevels of the atomic ground state. We find that atoms with ground state angular momenta Fg = 2, tend to diffuse throughout the lattice, while atoms with higher ground state angular momentum tend to remain localized at specific lattice sites. In the far-off resonance case, the lattice is essentially dissipation free allowing for studies of quantum-state control. We examine the creation and manipulation of mesoscopic coherent superpositions of Cesium atoms in magneto-optical double-potential wells created by a far- off-resonance 1D lin-θ-lin lattice. A robust set of dynamically varied lattice parameters that lead to a tunneling situation. Tunneling oscillations computed numerically agree with experiment except for an observed decay in tunneling oscillations. We consider the addition of a time-periodic drive to the double-well system, for which certain parameters of the drive, it is possible to coherently suppress tunneling. When a small amount of noise is added to the system in the form of random periodic δ-function ``kicks'' the quantum interference is destroyed. However, increasing the strength of the noise appears to have a stabilizing effect on the coherent suppression of tunneling. High resolution spatial information about atomic samples trapped in optical lattices can be obtained directly without the use of external probe lasers which necessarily disturb the system and whose resolution is limited by the wavelength of the probe laser. We explore the use of first and second order same-time atomic spatial correlation functions as a

  1. Study and conception of tools to help fulfill the use of the AnemoScope; Etudes et conception des outils aidant a completer l'utilisation d'AnemoScope

    Energy Technology Data Exchange (ETDEWEB)

    Vagliani, R.; Ilinca, A. [Quebec Univ., Rimouski, PQ (Canada). Laboratoire de Recherche en Energie Eolienne

    2009-08-15

    This paper presented the laboratory work of a research study on wind engineering. It described and interpreted all the tools that were created to facilitate the study. In particular, it demonstrated how data from the AnemoScope Wind Energy Simulation Toolkit can be retrieved. AnemoScope combines mesoscale and microscale wind models with advanced visualization for computer analysis. It allows users to determine the ideal locations to install wind turbines by providing the science and technology to perform pinpoint wind-energy studies. This paper also demonstrated how to retrieve real data from Environment Canada as well as topographical data from the Geobase Internet site and combine them into a Global Mapper software. The information provided can be used to effectively compare results with actual data from AnemoScope with those provided from Environment Canada based on topography. 10 refs, 15 tabs, 33 figs.

  2. Diagnostic value of acoustic radiation force impulse imaging for assessing superficial lymph nodes: A diagnostic accuracy study.

    Science.gov (United States)

    Zhang, Fengjuan; Zhao, Xinming; Ji, Xiaohui; Han, Ruoling; Li, Ping; Du, Min

    2017-10-01

    The aim of this study was to assess the diagnostic value of acoustic radiation force impulse (ARFI) imaging for differentiating superficial lymph nodes.Virtual touch tissue imaging (VTI) grade and shear wave velocity (SWV) were analyzed and compared in 97 patients (65 women, 32 men; mean age, 49 y; range, 23-72 y) with 97 lymph nodes [23 chronic nonspecific reactive lymph nodes (CLNs), 38 metastatic lymph nodes (MLNs), and 36 blood and lymphatic system diseases lymph nodes (BLLNs)]. The elastography characteristics in patients with CLNs, MLNs, and BLLNs were compared using the nonparametric Kruskal-Wallis test and Mann-Whitney U test for continuous variables and categorical variables. The diagnostic performance of VTI grade and SWV were evaluated using the area under the receiver operating characteristic curve (AUC).The median of SWV of MLNs was significantly higher (2.90 m/s) than those of CLNs (2.15 m/s) and BLLNs (2.52 m/s). The VTI grade of MLNs was significantly higher than those of CLNs (P accuracy, and AUC were 81.58%, 95.65%, 86.89%, and 0.904, respectively, at a cutoff level of grade IV for VTI grade in differentiating MLNs from CLNs, whereas those of SWV were 57.89%, 86.96%, 68.85%, and 0.752, respectively, at a cutoff level of 2.76 m/s.The diagnostic performance of VTI grade was significantly higher than that of SWV in differentiating MLNs from CLNs. The diagnostic performance of VTI grade and SWV were lower intermediate in differentiating MLNs from BLLNs and in differentiating BLLNs from CLNs, and there was no significant difference between VTI grade and SWV. ARFI imaging may be a feasible method for differentiating MLNs from CLNs.

  3. A clinicopathological study of various oral cancer diagnostic techniques

    Directory of Open Access Journals (Sweden)

    G Ulaganathan

    2017-01-01

    Full Text Available Oral cancer is one of the most commonly occurring malignant tumors in the head and neck regions with high incident rate and mortality rate in the developed countries than in the developing countries. Generally, the survival rate of cancer patients may increase when diagnosed at early stage, followed by prompt treatment and therapy. Recently, cancer diagnosis and therapy design for a specific cancer patient have been performed with the advanced computer-aided techniques. The responses of the cancer therapy could be continuously monitored to ensure the effectiveness of the treatment process that hardly requires diagnostic result as quick as possible to improve the quality and patient care. This paper gives an overview of oral cancer occurrence, different types, and various diagnostic techniques. In addition, a brief introduction is given to various stages of immunoanalysis including tissue image preparation, whole slide imaging, and microscopic image analysis.

  4. Beam property studies in the PLS diagnostic beamline

    CERN Document Server

    Ko, I S; Seon, D K; Kim, C B; Lee, T Y

    1999-01-01

    A diagnostic beamline has been operated in the Pohang Light Source (PLS) storage ring for the diagnostics of electron and photon beam properties. It consists of two 1:1 imaging systems: a visible-light imaging system and a soft X-ray imaging system. We have measured the transverse and the longitudinal structures of beams by using a streak camera to obtain a visible image. Accurate transverse beam size have been measured to be 186 mu m horizontally and 43.1 mu m vertically by using soft X-ray images with minimum diffraction errors. The corresponding emittances are 11.7 nm-rad horizontally and 0.59 nm-rad vertically. By comparing the measured data with the design values, we confirmed that the PLS storage ring has reached its designed performance within an error of 3.3 % in the transverse direction.

  5. Diagnostic approach to urinary tract infections in male general practice patients: a national surveillance study.

    NARCIS (Netherlands)

    Heijer, C.D.J. den; Dongen, M.C.J.M. van; Donker, G.A.; Stobberingh, E.E.

    2012-01-01

    Background: Diagnostic urinary tract infection (UTI) studies have primarily been performed among female patients. Aim: To create a diagnostic algorithm for male general practice patients suspected of UTI. Design and setting: Surveillance study in the Dutch Sentinel General Practice Network. Method:

  6. Diagnostic study on the relation between ozone and vorticity potential

    Energy Technology Data Exchange (ETDEWEB)

    Abdel Basset, H. [Department of Astronomy and Meteorology, Faculty of Science, Al Azhar University, Nasr City, Cairo (Egypt); Gahein, A. [Egyptian Meteorological Authority, Cairo (Egypt)

    2003-04-01

    A diagnostic analysis of a Mediterranean system and the associated tropopause folding for the period 27 February to 10 March, 1987 is presented. Geopotential height, potential vorticity (PV) and relative humidity distributions were diagnosed. The analysis indicates clear correlation between the development of the cut-off low and the tropopause folding. A series of vertical cross-sections at the ends of the jet streaks demonstrated that a fold could be captured using potential vorticity and relative humidity. Q-vectors were employed to investigate vertical motion in the vicinity of the fold and showed the exact positions of descent corresponding to the fold along the entire length of the jet streak. The analysis also shows that the strong correlation between total ozone and column integrated vorticity potential holds well for all levels. As both quantities are integrals through the atmosphere, this result is consistent with, but does not prove, a high independent linear dependence between ozone and PV. More case studies are needed to assure the high linear dependence between ozone and PV. The maximum transport of ozone from the stratosphere to the troposphere is coinciding with the maximum developing system, and also with the maximum values of PV. [Spanish] Se presenta un analisis diagnostico de un Sistema mediterraneo y del pliegue de la tropopausa asociado durante el periodo del 27 de febrero al 10 de marzo de 1987. Se diagnosticaron la altitud neopotencial, el potencial de vorticidad y la distribucion de la humedad relativa. El analisis indica una correlacion clara entre el desarrollo de la baja segregada y el pliegue de la tropopausa. Una serie de cortes verticales en los extremos de las trazas del chorro demostraron que el pliegue puede ser capturado utilizando el potencial de vorticidad y la humedad relativa. Para investigar la movilidad vertical en la vecindad del pliegue se utilizaron vectores Q, y se demostraron las posiciones exactas de descenso

  7. Nuclear power plant diagnostics study at the Midland Training Simulator

    International Nuclear Information System (INIS)

    Reifman, J.; Rank, P.; Lee, J.C.; Wehe, D.K.

    1991-01-01

    This paper discusses the implementation of two advanced diagnostic concepts for nuclear power plant diagnostics, the systematic generation and updating of a rule-based system and the simulation filter, at the Midland Nuclear Power Plant Unit 2 Training Simulator. The authors use an entropy minimax pattern recognition algorithm for the systematic construction of the diagnostic rule base. By extracting information from a transient database constructed with the Midland Simulator, the algorithm searches for trends in plant parameters, forming patterns or rules that describe the behavior of the transients. The rules are updated in an incremental manner within the context of the entropy minimax algorithm. The simulation filter is a nonlinear parameter estimation algorithm based on the extended Kalman filter. The authors use the simulation filter to improve the results of crude simulation models by optimally estimating system states given a set of measurements and results from a nonlinear simulation program. The Midland Simulator results of the Three Mile Island accident are significantly improved with the use of the simulation filter

  8. Collaborative research networks in health: a pragmatic scoping study for the development of an imaging network.

    Science.gov (United States)

    Robinson, Tracy Elizabeth; Rankin, Nicole; Janssen, Anna; Mcgregor, Deborah; Grieve, Stuart; Shaw, Timothy

    2015-12-09

    Collaborative research networks are often touted as a solution for enhancing the translation of knowledge, but questions remain about how to evaluate their impact on health service delivery. This pragmatic scoping study explored the enabling factors for developing and supporting a collaborative imaging network in a metropolitan university in Australia. An advisory group was established to provide governance and to identify key informants and participants. Focus group discussions (n = 2) and semi-structured interviews (n = 22) were facilitated with representatives from a broad range of disciplines. In addition, a survey, a review of relevant websites (n = 15) and a broad review of the literature were undertaken to elicit information on collaborative research networks and perceived needs and factors that would support their involvement in a multi-disciplinary collaborative research network. Findings were de-identified and broad themes were identified. Participants identified human factors as having priority for developing and sustaining a collaborative research network. In particular, leadership, a shared vision and a communication plan that includes social media were identified as crucial for sustaining an imaging network in health research. It is important to develop metrics that map relationships between network members and the role that communication tools can contribute to this process. This study confirms that human factors remain significant across a range of collaborative endeavours. The use of focus group discussions, interviews, and literature and website reviews means we can now strongly recommend the primacy of human factors. More work is needed to identify how the network operates and what specific indicators or metrics help build the capacity of clinicians and scientists to participate in translational research.

  9. Advanced practice nurses' scope of practice: a qualitative study of advanced clinical competencies.

    Science.gov (United States)

    Nieminen, Anna-Lena; Mannevaara, Bodil; Fagerström, Lisbeth

    2011-12-01

    To describe and explore Advanced Practice Nurses' clinical competencies and how these are expressed in clinical practice. Discussion concerning advanced clinical practice has been ongoing in the USA since the 1960s and in the UK since the late 1980s. Approximately 24 countries, excluding the USA, have implemented the role of Advance Practice Nurse (APN). In the Nordic countries, especially Sweden and Finland, APNs have been introduced in some organizations but their competency domains have not yet been clearly defined. The study's theoretical framework emanates from Aristotle's three-dimensional view of knowledge that is epistêmê, technê, and phronesis. Between October 2005 and January 2006, focus group interviews of Clinical Nurse Specialists who provide expert functions in pediatric, internal medicine, and surgical units (n = 26) and APN students (n = 8) were conducted. The data material was analyzed using inductive content analysis. Grouped into five main themes, the study results indicate that APNs possess advanced level clinical competencies in: (A) assessment of patients' caring needs and nursing care activities, (B) the caring relationship, (C) multi-professional teamwork, (D) development of competence and nursing care, and (E) leadership in a learning and caring culture. Clinical competencies consist of advanced skills, which typify an expanding role that offers new possibilities for holistic patient care practice. APNs' scope of practice is characterized by responsibility and competence in making autonomous judgments based on expanded clinical competence. On an advanced level, clinical competence consists not merely of advanced skills for assessing and meeting the needs of patients but also the creation of safe and trustful relationships with patients and collaboration with colleagues. APNs can realize advanced skills in their actions through their manner of knowing, doing, and being. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011

  10. What the Study of Scope Can Tell Us about Second Language Learning

    Science.gov (United States)

    O'Grady, William; Lee, Miseon; Kwak, Hye-Young

    2009-01-01

    This paper, designed specifically for language teachers, focuses on a phenomenon in second language learning that is largely independent of instructional effects, curricular materials, and classroom activities. Experimental work suggests that scope, the relationship between two or more logical operators (such as quantifiers or negatives), is…

  11. A study of diagnostics expert system for accelerator applications

    International Nuclear Information System (INIS)

    Tyagi, Y.; Banerji, Anil; Kotaiah, S.

    2003-01-01

    Knowledge based techniques are proving to be useful in a number of problem domains which typically requires human expertise. Expert systems employing knowledge based techniques are a recent product of artificial intelligence. Methods developed in the artificial intelligence area can be applied with success for certain classes of problems in accelerator. Accelerators are complex devices with thousands of components. The number of possible faults or problems that can appear is enormous. A diagnostics expert system can provide great help in finding and diagnosing problems in Indus-II accelerator sub-systems. (author)

  12. Studying stellar rotation and convection theoretical background and seismic diagnostics

    CERN Document Server

    Belkacem, Kévin; Neiner, Coralie; Lignières, Francois; Green, John

    2013-01-01

    This volume synthesizes the results of work carried out by several international teams of the SIROCO (Seismology for Rotation and Convection) collaboration. It provides the theoretical background required to interpret the huge quantity of high-quality observational data recently provided by space experiments such as CoRoT and Kepler. Asteroseismology allows astrophysicists to test, to model and to understand stellar structure and evolution as never before. The chapters in this book address the two groups of topics summarized as "Stellar Rotation and Associated Seismology" as well as "Stellar Convection and Associated Seismology". The book offers the reader solid theoretical background knowledge and adapted seismic diagnostic techniques.

  13. Protection study of a diagnostic system for electron beam at the output of an accelerator

    International Nuclear Information System (INIS)

    Rahmani, Kaouther; Yaacoubi, Imen

    2009-01-01

    The aim of this work is the determination of the conception of a protection system dedicated to protect a diagnostic system in the CNSTN. According to this study, the suitable material for the protection against the electrons in the plexiglas and the supermalloy to protect the future diagnostic system against the magnetic field. (Author)

  14. Distress in suspected lung cancer patients following rapid and standard diagnostic programs : a prospective observational study

    NARCIS (Netherlands)

    Brocken, Pepijn; van der Heijden, Erik H. F. M.; Oud, Karen T. M.; Bootsma, Gerben; Groen, Harry J. M.; Donders, A. Rogier T.; Dekhuijzen, P. N. Richard; Prins, Judith B.

    ObjectiveTimeliness may influence emotional distress during the diagnostic phase of suspected lung cancer patients. We performed a prospective observational study to compare distress and quality of life (QoL) in two medical centres with a Rapid Outpatient Diagnostic Program (RODP) and two using

  15. Identification and diagnostic evaluation of possible dementia in general practice. A prospective study

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Rishøj, Susanne; Waldemar, Gunhild

    2005-01-01

    OBJECTIVE: To investigate the rate of diagnostic evaluation of dementia for patients in whom a suspicion of dementia was raised, and to investigate reasons why a diagnostic evaluation was not always being performed. DESIGN: A prospective study among elderly patients aged 65+, and a follow-up stud...

  16. Irritable bowel syndrome--prognosis and diagnostic safety. A 5-year follow-up study

    DEFF Research Database (Denmark)

    Svendsen, J H; Munck, Lars K; Andersen, J R

    1985-01-01

    The irritable bowel syndrome is the commonest diagnosis in gastroenterological clinics, although diagnostic criteria and investigatory programs vary. To elucidate the diagnostic safety and prognosis of the syndrome, a retrospective study was conducted. One hundred and twelve consecutive patients...... with irritable bowel syndrome as the final and only abdominal diagnosis in the period 1977-79 were followed up in 1984. Seventeen patients died during the follow-up period; two of these were considered diagnostic failures (chronic pancreatitis and pancreatic cancer). Of the remaining 95 patients, 93 were...... available for the follow-up study. Three diagnostic failures were found (gallbladder stones, kidney stone, thyrotoxicosis). The diagnostic failure rate was accordingly 4.5% (5/110). Half of the patients had unchanged or aggravated symptoms at the follow-up study, independent of treatment. The only predictor...

  17. Dimensions of lay health worker programmes: results of a scoping study and production of a descriptive framework.

    Science.gov (United States)

    South, Jane; Meah, Angela; Bagnall, Anne-Marie; Jones, Rebecca

    2013-03-01

    Approaches that engage and support lay health workers in the delivery of health improvement activities have been widely applied across different health issues and populations. The lack of a common terminology, inconsistency in the use of role descriptors and poor indexing of lay health worker roles are all barriers to the development of a shared evidence base for lay health worker interventions. The aim of the paper is to report results from a scoping study of approaches to involve lay people in public health roles and to present a framework for categorisation of the different dimensions of lay health worker programmes. Our scoping study comprised a systematic scoping review to map the literature on lay health worker interventions and to identify role dimensions and common models. The review, which was limited to interventions relevant to UK public health priorities, covered a total of 224 publications. The scoping study also drew on experiential evidence from UK practice. Research-based and practice-based evidence confirmed the variety of role descriptors in use and the complexity of role dimensions. Five common models that define the primary role of the lay health worker were identified from the literature. A framework was later developed that grouped features of lay health worker programmes into four dimensions: intervention, role, professional support/service and the community. More account needs to be taken of the variations that occur between lay health worker programmes. This framework, with the mapping of key categories of difference, may enable better description of lay health worker programmes, which will in turn assist in building a shared evidence base. More research is needed to examine the transferability of the framework within different contexts.

  18. Tracer Equivalent Latitude: A Diagnostic Tool for Isentropic Transport Studies.

    Science.gov (United States)

    Allen, Douglas R.; Nakamura, Noboru

    2003-01-01

    Area equivalent latitude based on potential vorticity (PV) is a widely used diagnostic for isentropic transport in the stratosphere and upper troposphere. Here, an alternate method for calculating equivalent latitude is explored, namely, a numerical synthesis of a PV-like tracer from a long-term integration of the advection-diffusion equation on isentropic surfaces. It is found that the tracer equivalent latitude (TrEL) behaves much like the traditional PV equivalent latitude (PVEL) despite the simplified governing physics; this is evidenced by examining the kinematics of the Arctic lower stratospheric vortex. Yet in some cases TrEL performs markedly better as a coordinate for long-lived trace species such as ozone. These instances include analysis of lower stratospheric ozone during the Stratospheric Aerosol and Gas Experiment (SAGE) III Ozone Loss and Validation Experiment (SOLVE) campaign and three-dimensional reconstruction of total column ozone during November-December 1999 from fitted ozone-equivalent latitude relationship. It is argued that the improvement is due to the tracer being free from the diagnostic errors and certain diabatic processes that affect PV. The sensitivity of TrEL to spatial and temporal resolution, advection scheme, and driving winds is also examined.

  19. eHealth and mHealth initiatives in Bangladesh: a scoping study.

    Science.gov (United States)

    Ahmed, Tanvir; Lucas, Henry; Khan, Azfar Sadun; Islam, Rubana; Bhuiya, Abbas; Iqbal, Mohammad

    2014-06-16

    The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential. This scoping study applies a combination of research tools to explore 26 eHealth and mHealth initiatives in Bangladesh. A screening matrix was developed by modifying the framework of Arksey & O'Malley, further complemented by case study and SWOT analysis to identify common traits among the selected interventions. The WHO health system building blocks approach was then used for thematic analysis of these traits. Findings suggest that most eHealth and mHealth initiatives have proliferated within the private sector, using mobile phones. The most common initiatives include tele-consultation, prescription and referral. While a minority of projects have a monitoring and evaluation framework, less than a quarter have undertaken evaluation. Most of the initiatives use a health management information system (HMIS) to monitor implementation. However, these do not provide for effective sharing of information and interconnectedness among the various actors. There are extremely few individuals with eHealth training in Bangladesh and there is a strong demand for capacity building and experience sharing, especially for implementation and policy making. There is also a lack of research evidence on how to design interventions to meet the needs of the population and on potential benefits. This study concludes that Bangladesh needs considerable preparation and planning to sustain eHealth and mHealth initiatives successfully

  20. Assessing Leg length Discrepancy Using a Biplane Low Dose Imaging System. A Comparative Diagnostic Study

    DEFF Research Database (Denmark)

    Jensen, Janni; Mussmann, Bo Redder; Torfing, Trine

    study was to evaluate the diagnostic accuracy of leg length (LL) measurements performed on low dose pre-view images acquired using a new bi-planar imaging system. The administered radiation dose from the pre-view image is approximately 20,17μGycm2 vs. 2670μGycm2 when acquiring the diagnostic image....... Materials and Methods. Pre-view and diagnostic images from 22 patients were retrospectively collected (44 images) and included in the study. All images were anonymized and interpreted independently by two senior musculoskeletal radiologists. Three sets of measurements were performed on both the pre......-view- and the diagnostic images, the mechanical axis lines of the femur and the tibia as well as the anatomical line of the entire extremity. Variance within and between the two raters was assessed by the intra-class correlation coefficient (ICC) and comparisons between LL measurements in the pre-view and the diagnostic...

  1. Heavy Section Steel Technology Program. Part I. Program scope, fracture, materials and thermal shock studies

    International Nuclear Information System (INIS)

    Whitman, G.D.

    1975-01-01

    A brief summary of the scope of HSST projects is presented. A major emphasis throughout the course of this work is the verification of methods of fracture prediction which can be utilized in an assessment of pressure vessel integrity. The utility of small specimens which are appropriate for surveillance purposes continues to be investigated in both the unirradiated and post-irradiated conditions. 11 references

  2. A quality measurement study of a diagnostic x-ray

    International Nuclear Information System (INIS)

    Nishitani, Motohiro; Fujimoto, Nobuhisa; Yamada, Katsuhiko

    1982-01-01

    It is important to check periodically the quality and quantity of the X-rays emitted, in order to obtain the best possible performance from your diagnostic X-ray apparatus. The best way of checking the exact quality of the X-ray is to measure the spectrum of the X-ray, but it is not an easy task to carry out. The second way is to plot the attenuation curve of the X-rays. We have developed a method to plot the attenuation curve by a single exposure, utilizing J.r. Greening's empirical formula. The output of the three cavity ionization chambers, one with 7 mmAl filter, another with a 3 mmAl and the third without any filter, exposed to the same X-ray, were put into a microcomputer. The programming was arranged to display the attenuation curve of the X-rays, effective energy of the X-rays, the 1st HVL and the 2nd HVL on the CRT. The attenuation curves of the X-rays, emitted at a tube voltage at between 60 and 140 kV obtained by this method, agreed with the experimental results with an error of +-4 %. The effective energy obtained by this method agreed with the experimental data with an error of +-1 %. (author)

  3. Published diagnostic models safely excluded colorectal cancer in an independent primary care validation study

    NARCIS (Netherlands)

    Elias, Sjoerd G; Kok, Liselotte; Witteman, Ben J M; Goedhard, Jelle G; Romberg-Camps, Mariëlle J L; Muris, Jean W M; de Wit, Niek J; Moons, Karel G M

    OBJECTIVE: To validate published diagnostic models for their ability to safely reduce unnecessary endoscopy referrals in primary care patients suspected of significant colorectal disease. STUDY DESIGN AND SETTING: Following a systematic literature search, we independently validated the identified

  4. [X-ray endoscopic semiotics and diagnostic algorithm of radiation studies of preneoplastic gastric mucosa changes].

    Science.gov (United States)

    Akberov, R F; Gorshkov, A N

    1997-01-01

    The X-ray endoscopic semiotics of precancerous gastric mucosal changes (epithelial dysplasia, intestinal epithelial rearrangement) was examined by the results of 1574 gastric examination. A diagnostic algorithm was developed for radiation studies in the diagnosis of the above pathology.

  5. Exploring Chemistry Student Teachers’ Diagnostic Competence—A Qualitative Cross-Level Study

    Directory of Open Access Journals (Sweden)

    Yannik Tolsdorf

    2017-12-01

    Full Text Available Diagnostic competence is an important skill of professional teachers and is a part of Pedagogical Content Knowledge (PCK. Because increasing heterogeneity and diversity characterize our schools, diagnostic competence plays a prominent role in teacher pre- and in-service courses. At our university, two modules are focused on examining student teachers’ diagnostic competence in chemistry. The present paper describes a cross-level case study analyzing three groups of student teachers in different phases of their university teacher training program. The study is based on a qualitative research study with a total of 108 participants. The results show both positive and negative developments in teacher trainees’ diagnostic competence. They show that attitudes and beliefs about heterogeneity can be changed from a rather negative viewpoint to a more positive one. The results will be presented and discussed below. Suggestions for further development will be given.

  6. [Critical reading of articles about diagnostic tests (part I): Are the results of the study valid?].

    Science.gov (United States)

    Arana, E

    2015-01-01

    In the era of evidence-based medicine, one of the most important skills a radiologist should have is the ability to analyze the diagnostic literature critically. This tutorial aims to present guidelines for determining whether primary diagnostic articles are valid for clinical practice. The following elements should be evaluated: whether the study can be applied to clinical practice, whether the technique was compared to the reference test, whether an appropriate spectrum of patients was included, whether expectation bias and verification bias were limited, the reproducibility of the study, the practical consequences of the study, the confidence intervals for the parameters analyzed, the normal range for continuous variables, and the placement of the test in the context of other diagnostic tests. We use elementary practical examples to illustrate how to select and interpret the literature on diagnostic imaging and specific references to provide more details. Copyright © 2014 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  7. Irritable bowel syndrome--prognosis and diagnostic safety. A 5-year follow-up study

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Munck, L K; Andersen, J R

    1985-01-01

    with irritable bowel syndrome as the final and only abdominal diagnosis in the period 1977-79 were followed up in 1984. Seventeen patients died during the follow-up period; two of these were considered diagnostic failures (chronic pancreatitis and pancreatic cancer). Of the remaining 95 patients, 93 were......The irritable bowel syndrome is the commonest diagnosis in gastroenterological clinics, although diagnostic criteria and investigatory programs vary. To elucidate the diagnostic safety and prognosis of the syndrome, a retrospective study was conducted. One hundred and twelve consecutive patients...

  8. Towards complete and accurate reporting of studies of diagnostic accuracy: The STARD initiative

    International Nuclear Information System (INIS)

    Bossuyt, P.M.; Reitsma, J.B.; Bruns, D.E.; Gatsonis, C.A.; Glasziou, P.P.; Irwig, L.M.; Lijmer, J.G.; Moher, D.; Rennie, D.; Vet, H.C.W. de

    2003-01-01

    AIM: To improve the accuracy and completeness of reporting of studies of diagnostic accuracy in order to allow readers to assess the potential for bias in a study and to evaluate the general isability of its results. METHODS: The standards for reporting of diagnostic accuracy (STARD) steering committee searched the literature to identify publications on the appropriate conduct and reporting of diagnostic studies and extracted potential items into an extensive list. Researchers, editors, and members of professional organisations shortened this list during a 2 day consensus meeting with the goal of developing a checklist and a generic flow diagram for studies of diagnostic accuracy. RESULTS: The search for published guidelines about diagnostic research yielded 33 previously published checklists, from which we extracted a list of 75 potential items. At the consensus meeting, participants shortened the list to a 25-item checklist, by using evidence whenever available. A prototype of a flow diagram provides information about the method of recruitment of patients, the order of test execution and the numbers of patients undergoing the test under evaluation, the reference standard, or both. CONCLUSIONS: Evaluation of research depends on complete and accurate reporting. If medical journals adopt the checklist and the flow diagram, the quality of reporting of studies of diagnostic accuracy should improve to the advantage of clinicians, researchers, reviewers, journals, and the public

  9. The Impact of Diagnostic Code Misclassification on Optimizing the Experimental Design of Genetic Association Studies

    Directory of Open Access Journals (Sweden)

    Steven J. Schrodi

    2017-01-01

    Full Text Available Diagnostic codes within electronic health record systems can vary widely in accuracy. It has been noted that the number of instances of a particular diagnostic code monotonically increases with the accuracy of disease phenotype classification. As a growing number of health system databases become linked with genomic data, it is critically important to understand the effect of this misclassification on the power of genetic association studies. Here, I investigate the impact of this diagnostic code misclassification on the power of genetic association studies with the aim to better inform experimental designs using health informatics data. The trade-off between (i reduced misclassification rates from utilizing additional instances of a diagnostic code per individual and (ii the resulting smaller sample size is explored, and general rules are presented to improve experimental designs.

  10. Diagnostic time in digital pathology: A comparative study on 400 cases

    Directory of Open Access Journals (Sweden)

    Aleksandar Vodovnik

    2016-01-01

    Full Text Available Background: Numerous validation studies in digital pathology confirmed its value as a diagnostic tool. However, a longer time to diagnosis than traditional microscopy has been seen as a significant barrier to the routine use of digital pathology. As a part of our validation study, we compared a digital and microscopic diagnostic time in the routine diagnostic setting. Materials and Methods: One senior staff pathologist reported 400 consecutive cases in histology, nongynecological, and fine needle aspiration cytology (20 sessions, 20 cases/session, over 4 weeks. Complex, difficult, and rare cases were excluded from the study to reduce the bias. A primary diagnosis was digital, followed by traditional microscopy, 6 months later, with only request forms available for both. Microscopic slides were scanned at ×20, digital images accessed through the fully integrated laboratory information management system (LIMS and viewed in the image viewer on double 23” displays. A median broadband speed was 299 Mbps. A diagnostic time was measured from the point slides were made available to the point diagnosis was made or additional investigations were deemed necessary, recorded independently in minutes/session and compared. Results: A digital diagnostic time was 1841 and microscopic 1956 min; digital being shorter than microscopic in 13 sessions. Four sessions with shorter microscopic diagnostic time included more cases requiring extensive use of magnifications over ×20. Diagnostic time was similar in three sessions. Conclusions: A diagnostic time in digital pathology can be shorter than traditional microscopy in the routine diagnostic setting, with adequate and stable network speeds, fully integrated LIMS and double displays as default parameters. This also related to better ergonomics, larger viewing field, and absence of physical slide handling, with effects on both diagnostic and nondiagnostic time. Differences with previous studies included a design

  11. Diagnostic stability among chronic patients with functional psychoses: an epidemiological and clinical study

    Directory of Open Access Journals (Sweden)

    Jakobsen Klaus D

    2007-08-01

    Full Text Available Abstract Background Diagnostic stability and illness course of chronic non-organic psychoses are complex phenomena and only few risk factors or predictors are known that can be used reliably. This study investigates the diagnostic stability during the entire course of illness in patients with non-organic psychoses and attempts to identify non-psychopathological risk factors or predictors. Method 100 patients with functional psychosis were initially characterised using the Operational Criteria Checklist for Psychotic Illness and Affective Illness (OPCRIT, medical records and health registers. To study the stability of diagnoses (i.e. shifts per time, we used registry data to define four measures of diagnostic variation that were subsequently examined in relation to four possible measures of time (i.e. observation periods or hospitalisation events. Afterwards, we identified putative co-variables and predictors of the best measures of diagnostic stability. Results All four measures of diagnostic variation are very strongly associated with numbers-of-hospitalisations and less so with duration-of-illness, duration-of-hospitalisation and with year-of-first-admission. The four measures of diagnostic variation corrected for numbers-of-hospitalisations were therefore used to study the diagnostic stability. Conventional predictors of illness course – e.g. age-of-onset and premorbid-functioning – are not significantly associated with stability. Only somatic-comorbidity is significantly associated with two measures of stability, while family-history-of-psychiatric-illness and global-assessment-of-functioning (GAF scale score show a trend. However, the traditional variables age-of-first-admission, civil-status, first-diagnosis-being-schizophrenia and somatic-comorbidity are able to explain two-fifth of the variation in numbers-of-hospitalisations. Conclusion Diagnostic stability is closely linked with the contact between patient and the healthcare system

  12. Enantioselective Decarboxylative Alkylation Reactions: Catalyst Development, Substrate Scope, and Mechanistic Studies

    Science.gov (United States)

    Behenna, Douglas C.; Mohr, Justin T.; Sherden, Nathaniel H.; Marinescu, Smaranda C.; Harned, Andrew M.; Tani, Kousuke; Seto, Masaki; Ma, Sandy; Novák, Zoltán; Krout, Michael R.; McFadden, Ryan M.; Roizen, Jennifer L.; Enquist, John A.; White, David E.; Levine, Samantha R.; Petrova, Krastina V.; Iwashita, Akihiko; Virgil, Scott C.; Stoltz, Brian M.

    2012-01-01

    α-Quaternary ketones are accessed through novel enantioselective alkylations of allyl and propargyl electrophiles by unstabilized prochiral enolate nucleophiles in the presence of palladium complexes with various phosphinooxazoline (PHOX) ligands. Excellent yields and high enantiomeric excesses are obtained from three classes of enolate precursors: enol carbonates, enol silanes, and racemic β-ketoesters. Each of these substrate classes functions with nearly identical efficiency in terms of yield and enantioselectivity. Catalyst discovery and development, the optimization of reaction conditions, the exploration of reaction scope, and applications in target-directed synthesis are reported. Experimental observations suggest that these alkylation reactions occur through an unusual inner-sphere mechanism involving binding of the prochiral enolate nucleophile directly to the palladium center. PMID:22083969

  13. Enantioselective Decarboxylative Alkylation Reactions: Catalyst Development, Substrate Scope, and Mechanistic Studies

    KAUST Repository

    Behenna, Douglas C.

    2011-11-14

    α-Quaternary ketones are accessed through novel enantioselective alkylations of allyl and propargyl electrophiles by unstabilized prochiral enolate nucleophiles in the presence of palladium complexes with various phosphinooxazoline (PHOX) ligands. Excellent yields and high enantiomeric excesses are obtained from three classes of enolate precursor: enol carbonates, enol silanes, and racemic β-ketoesters. Each of these substrate classes functions with nearly identical efficiency in terms of yield and enantioselectivity. Catalyst discovery and development, the optimization of reaction conditions, the exploration of reaction scope, and applications in target-directed synthesis are reported. Experimental observations suggest that these alkylation reactions occur through an unusual inner-sphere mechanism involving binding of the prochiral enolate nucleophile directly to the palladium center.

  14. Experimental design: Case studies of diagnostics optimization for W7-X

    International Nuclear Information System (INIS)

    Dreier, H.; Dinklage, A.; Fischer, R.; Hartfuss, H.-J.; Hirsch, M.; Kornejew, P.; Pasch, E.; Turkin, Yu.

    2005-01-01

    The preparation of diagnostics for Wendelstein 7-X is accompanied by diagnostics simulations and optimization. Starting from the physical objectives, the design of diagnostics should incorporate predictive modelling (e.g. transport modelling) and simulations of respective measurements. Although technical constraints are governing design considerations, it appears that several design parameters of different diagnostics can be optimized. However, a general formulation for fusion diagnostics design in terms of optimization is lacking. In this paper, first case studies of Bayesian experimental design aiming at applications on W7-X diagnostics preparation are presented. The information gain of a measurement is formulated as a utility function which is expressed in terms of the Kullback-Leibler divergence. Then, the expected range of data is to be included and the resulting expected utility represents the objective for optimization. Bayesian probability theory gives a framework allowing us for an appropriate formulation of the design problem in terms of probability distribution functions. Results are obtained for the information gain from interferometry and for the design of polychromators for Thomson scattering. For interferometry, studies of the choice of line-of-sights for optimum signal and for the reproduction of gradient positions are presented for circular, elliptical and W7-X geometries. For Thomson scattering, the design of filter transmissions for density and temperature measurements are discussed. (author)

  15. Agreement between Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and the proposed DSM-V attention deficit hyperactivity disorder diagnostic criteria: an exploratory study.

    Science.gov (United States)

    Ghanizadeh, Ahmad

    2013-01-01

    There is no empirical literature about the American Psychiatry Association proposed new diagnostic criteria for attention deficit hyperactivity disorder (ADHD). This study examined the agreement between ADHD diagnosis derived from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and DSM-V diagnostic criteria. It also reports sensitivity, specificity, and agreement for ADHD diagnosis. A clinical sample of 246 children and adolescents were interviewed face to face using both ADHD diagnostic criteria for DSM-V and DSM-IV by interviewing clinician. Comorbid psychiatric disorders were screened using DSM-IV criteria. The rate of ADHD diagnosis using DSM-V was significantly higher than the rate detected by using DSM-IV diagnostic criteria. The sensitivity of DSM-V diagnostic criteria was 100%, while its specificity was 71.1%. The kappa agreement between DSM-IV and DSM-V was 0.75. In addition, positive predictive value was 85.1%. All the four newly added symptoms to ADHD diagnostic criteria are statistically more common in the children with ADHD than those in the comparison group. However, these symptoms are also very common in the children without ADHD. It is expected that the rate of ADHD would increase using the proposed ADHD DSM-V criteria. Moreover, the newly added symptoms have a low specificity for ADHD diagnosis. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Out-of-hours primary care - a population-based study of the diagnostic scope of telephone contacts

    DEFF Research Database (Denmark)

    Moth, Grete; Huibers, Linda; Christensen, Morten Bondo

    2016-01-01

    det primære sundhedsvæsen, bl.a. almen praksis og lægevagten. Denne undersøgelse bidrager til at dække dette videnshul. Resultaterne kan bl.a. anvendes ved efter- og videreuddannelse af vagtlæger og give input til den sundhedspolitiske debat om, hvordan lægevagten bedst organiseres og bruges optimalt....

  17. The science of systematic reviewing studies of diagnostic tests

    NARCIS (Netherlands)

    Oosterhuis, W. P.; Niessen, R. W.; Bossuyt, P. M.

    2000-01-01

    BACKGROUND: Systematic reviews have gradually replaced single studies as the highest level of documented effectiveness of health care interventions. Systematic reviewing is a new scientific method, concerned with the development and application of methods for identifying relevant literature,

  18. Diagnostic criteria for depression in Parkinson's disease: a study of symptom patterns using latent class analysis.

    Science.gov (United States)

    Starkstein, Sergio; Dragovic, Milan; Jorge, Ricardo; Brockman, Simone; Merello, Marcelo; Robinson, Robert G; Bruce, David; Wilson, Mark

    2011-10-01

    Although major depression is one of the most frequent psychiatric disorders among patients with Parkinson's disease, diagnostic criteria have yet to be validated. The main aim of our study was to validate depressive symptoms using latent class analysis for use as diagnostic criteria for major depression in Parkinson's disease. We examined a consecutive series of 259 patients with Parkinson's disease admitted to 2 movement disorders clinics for regular follow-ups. All patients were assessed with a comprehensive psychiatric interview that included structured assessments for depression, anxiety, and apathy. The main finding was that all 9 Diagnostic and Statistical Manual (4th edition) diagnostic criteria for major depression (ie, depressed mood, diminished interest or pleasure, weight or appetite changes, sleep changes, psychomotor changes, loss of energy, feelings of worthlessness or inappropriate guilt, poor concentration, and suicidal ideation) identified a patient class (severe depression group) with high statistical significance. Latent class analysis also demonstrated a patient class with minimal depressive symptoms (no-depression group), and a third patient class with intermediate depressive symptoms (moderate depression). Anxiety and apathy were both significant comorbid conditions of moderate and severe depression. Taken together, our findings support the use of the full Diagnostic and Statistical Manual (4th edition) criteria for major depression for use in clinical practice and research in Parkinson's disease and suggest that anxiety may be included as an additional diagnostic criterion. Copyright © 2011 Movement Disorder Society.

  19. Compounding diagnostic delays: a qualitative study of point-of-care testing in South Africa.

    Science.gov (United States)

    Engel, Nora; Davids, Malika; Blankvoort, Nadine; Pai, Nitika Pant; Dheda, Keertan; Pai, Madhukar

    2015-04-01

    Successful point-of-care (POC) testing (completion of test-and-treat cycle in one patient encounter) has immense potential to reduce diagnostic and treatment delays, and improve patient and public health outcomes. We explored what tests are done and how in public/private, rural/urban hospitals and clinics in South Africa and whether they can ensure successful POC testing. This qualitative research study examined POC testing across major diseases in Cape Town, Durban and Eastern Cape. We conducted 101 semi-structured interviews and seven focus group discussions with doctors, nurses, community health workers, patients, laboratory technicians, policymakers, hospital managers and diagnostic manufacturers. In South Africa, diagnostics are characterised by a centralised system. Most tests conducted on the spot can be made to work successfully as POC tests. The majority of public/private clinics and smaller hospitals send samples via couriers to centralised laboratories and retrieve results the same way, via internet, fax or phone. The main challenge to POC testing lies in transporting samples and results, while delays risk patient loss from diagnostic/treatment pathways. Strategies to deal with associated delays create new problems, such as artificially prolonged turnaround times, strains on human resources and quality of testing, compounding additional diagnostic and treatment delays. For POC testing to succeed, particular characteristics of diagnostic ecosystems and adaptations of professional practices to overcome associated challenges must be taken into account. © 2014 John Wiley & Sons Ltd.

  20. Psychological Autopsy Studies as Diagnostic Tools: Are They Methodologically Flawed?

    Science.gov (United States)

    Hjelmeland, Heidi; Dieserud, Gudrun; Dyregrov, Kari; Knizek, Birthe L.; Leenaars, Antoon A.

    2012-01-01

    One of the most established "truths" in suicidology is that almost all (90% or more) of those who kill themselves suffer from one or more mental disorders, and a causal link between the two is implied. Psychological autopsy (PA) studies constitute one main evidence base for this conclusion. However, there has been little reflection on the…

  1. Studies on Halip/eetus Cobb, 1913. A diagnostic species ...

    African Journals Online (AJOL)

    1993-05-07

    May 7, 1993 ... This last part of a series on Haliplectus Cobb, 1913 includes a species compendium of the genus and a brief comparative ... kompendium van die genus en 'n kort vergelykende studie van verskiliende bevolkings van H. bickneri. Chitwood, 1956. ... The following approach was used in the construction of.

  2. Diagnostic strategies for acute abdominal pain: The OPTIMA study

    NARCIS (Netherlands)

    Laméris, W.

    2010-01-01

    In het kader van de OPTIMA-studie deed Wytze Laméris onderzoek naar de diagnostiek bij acute buikpijn op de spoedeisende hulp. Hij keek onder meer naar de toegevoegde waarde van beeldvormend onderzoek, zoals thoraxfoto's, CT-scans van de buik en echo. Het blijkt dat een echo in eerste instantie

  3. Diagnostics of children's school readiness in scientific studies abroad

    Directory of Open Access Journals (Sweden)

    Nazarenko V.V.

    2012-06-01

    Full Text Available The article considers the problem of children's school readiness as it is represented in contemporary studies of foreign scholars. It displays a variety of approaches to estimation of school readiness as well as the ways of measuring the levels of child development as relating to school readiness, namely those of them which are in common practice in education.

  4. Scoping Studies to Evaluate the Benefits of an Advanced Dry Feed System on the Use of Low-Rank Coal

    Energy Technology Data Exchange (ETDEWEB)

    Rader, Jeff; Aguilar, Kelly; Aldred, Derek; Chadwick, Ronald; Conchieri,; Dara, Satyadileep; Henson, Victor; Leininger, Tom; Liber, Pawel; Nakazono, Benito; Pan, Edward; Ramirez, Jennifer; Stevenson, John; Venkatraman, Vignesh

    2012-11-30

    This report describes the development of the design of an advanced dry feed system that was carried out under Task 4.0 of Cooperative Agreement DE-FE0007902 with the US DOE, “Scoping Studies to Evaluate the Benefits of an Advanced Dry Feed System on the use of Low- Rank Coal.” The resulting design will be used for the advanced technology IGCC case with 90% carbon capture for sequestration to be developed under Task 5.0 of the same agreement. The scope of work covered coal preparation and feeding up through the gasifier injector. Subcomponents have been broken down into feed preparation (including grinding and drying), low pressure conveyance, pressurization, high pressure conveyance, and injection. Pressurization of the coal feed is done using Posimetric1 Feeders sized for the application. In addition, a secondary feed system is described for preparing and feeding slag additive and recycle fines to the gasifier injector. This report includes information on the basis for the design, requirements for down selection of the key technologies used, the down selection methodology and the final, down selected design for the Posimetric Feed System, or PFS.

  5. Tracking with virtual slides: a tool to study diagnostic error in histopathology.

    Science.gov (United States)

    Treanor, Darren; Lim, Chee Hooi; Magee, Derek; Bulpitt, Andy; Quirke, Phil

    2009-07-01

    To determine the reasons for diagnostic error by virtual slides which allow unsupervised study of diagnosis and error. Software was developed to produce visualizations of the diagnostic track followed by pathologists as they viewed virtual slides. These showed the diagnostic path in four dimensions (x, y, time and zoom), areas studied for >1000 ms, and included pathologists' comments about the areas viewed. The system was used to study two trainee and two expert pathologists diagnosing 60 Barrett's oesophageal biopsy specimens. Comparisons of the diagnostic tracks showed the reason for errors. Forty-six cases had an expert consensus diagnosis. The trainees made errors in 21 and 15 cases, respectively, of which 11 and nine were clinically significant. Errors were made across the whole spectrum of diagnoses from negative to intramucosal carcinoma. Detailed examination of the tracks showed that in all errors there was incorrect interpretation of information; in three errors there was an additional failure to identify diagnostic features. Tracking with virtual slides is a useful tool in studying diagnosis and error, which has the potential for use in training and assessment.

  6. Scope Definition on End-of-Life Chain Performance Assessment: Recycling Rate and French E-Waste Chain Case Study

    OpenAIRE

    ARDUIN, Rachel Horta; LEAL, Jorge Martinez; GRIMAUD, Guilhem; CHARBUILLET, Carole; Pompidou, Stéphane; LARATTE, Bertrand; PERRY, Nicolas

    2017-01-01

    International audience; Efficiency indicators have been frequently used to assess end-of-life chain performance. While legislations give a standard definition, sometimes stakeholders redefine them to fit their own scopes and objectives. It is therefore necessary to fully understand the indicators calculation scope in order to accurately interpret the results during a decision-making process. This work discusses the influence of scope definition when establishing performance rates using the Fr...

  7. Renal colic at emergency departments. Epidemiologic, diagnostic and etiopathogenic study.

    Science.gov (United States)

    Pérez, José A Hermida; Palmes, M de la Paz Pérez; Ferrer, Juan Francisco Loro; Urdangarain, Otto Ochoa; Nuñez, Abdel Buduen

    2010-04-01

    To investigate epidemiologic, etiopathogenic and clinical factors associated with emergency renal colic (RC). METHODS ANDS RESULTS: We performed a prospective cross-sectional multicenter case-control study of 146 patients treated for RC at emergency departments. Data collected included age, sex, localization/severity of pain, symptoms, personal/family medical history, urine analysis, etiopathogenic factors, chemical composition of the lithiasis, and x-ray studies. Comparative statistical analysis was performed using SPSS 12.2 software. RC was more frequent in men; maximum incidence was between 31-50 years for both sex, with 36.3% in men and 21.23% in women; 60.27% of patients rated pain as severe; 140 RC patients (95.89%) had urologic antecedents vs. 15 (10.27%) controls without RC (ppain; 23.28% of RC patients had family history for urinary lithiasis vs. 6.16% controls (pLithiasis was observed by KUB x-ray in 42.10% of RC patients vs. 57.89% controls, most frequent calculi composition was calcium oxalate monohydrate and dehydrate (61,2%). The incidence of urinary lithiasis and RC in our health care area shows a male predominance. The characteristic pain of RC is severe and appears suddenly. It starts in the back (lumbar region), below the ribs, radiating towards the groin and external genitals (testicles in man or major lips in woman) on the same side. Nausea and vomiting are frequent. Family history of urinary lithiasis and low water intake are risk factors that need to be investigated. Occupations associated with a sedentary life style or with a hot, dry workplace show a higher incidence of lithiasis. A hot, dry climate favours the formation of urinary lithiasis and the highest incidence of lithiasis is in the summer, during the months of July and August. The most frequent component of urolithiasis in our study, as well as in other studies, was calcium oxalate monohydrate and dihydrate.

  8. Metabolomics diagnostic approach to mustard airway diseases: a preliminary study

    Directory of Open Access Journals (Sweden)

    BiBi Fatemeh Nobakht Mothlagh Ghoochani

    2018-01-01

    Full Text Available Objective(s: This study aims to evaluate combined proton nuclear magnetic resonance (1H NMR spectroscopy and gas chromatography-mass spectrometry (GC-MS metabolic profiling approaches, for discriminating between mustard airway diseases (MADs and healthy controls and for providing biochemical information on this disease. Materials and Methods: In the present study, analysis of serum samples collected from 17 MAD subjects and 12 healthy controls was performed using NMR. Of these subjects, 14 (8 patients and 6 controls were analyzed by GC-MS. Then, their spectral profiles were subjected to principal component analysis (PCA and orthogonal partial least squares regression discriminant analysis (OPLS-DA. Results: A panel of twenty eight metabolite biomarkers was generated for MADs, sixteen  NMR-derived metabolites (3-methyl-2-oxovaleric acid, 3-hydroxyisobutyrate, lactic acid, lysine, glutamic acid, proline, hydroxyproline, dimethylamine, creatine, citrulline, choline, acetic acid, acetoacetate, cholesterol, alanine, and lipid (mainly VLDL and twelve GC-MS-derived metabolites (threonine, phenylalanine, citric acid, myristic acid, pentadecanoic acid, tyrosine, arachidonic acid, lactic acid, propionic acid, 3-hydroxybutyric acid, linoleic acid, and oleic acid. This composite biomarker panel could effectively discriminate MAD subjects from healthy controls, achieving an area under receiver operating characteristic curve (AUC values of 1 and 0.79 for NMR and GC-MS, respectively. Conclusion: In the present study, a robust panel of twenty-eight biomarkers for detecting MADs was established. This panel is involved in three metabolic pathways including aminoacyl-tRNA biosynthesis, arginine, and proline metabolism, and synthesis and degradation of ketone bodies, and could differentiate MAD subjects from healthy controls with a higher accuracy.

  9. Scoping studies of vapor behavior during a severe accident in a metal-fueled reactor

    International Nuclear Information System (INIS)

    Spencer, B.W.; Marchaterre, J.F.

    1985-01-01

    Scoping calculations have been performed examining the consequences of fuel melting and pin failures for a reactivity-insertion type accident in a sodium-cooled, pool-type reactor fueled with a metal alloy fuel. The principal gas and vapor species released are shown to be Xe, Cs,and bond sodium contained within the fuel porosity. Fuel vapor pressure is insignificant, and there is no energetic fuel-coolant interaction for the conditions considered. Condensation of sodium vapor as it expands into the upper sodium pool in a jet mixing regime may occur as rapidly as the vapor emerges from the disrupted core (although reactor-material experiments are needed to confirm these high condensation rates). If the predictions of rapid direct-contact condensation can be verified experimentally for the sodium system, the implication is that the ability of vapor expansion to perform appreciable work on the system is largely eliminated. Furthermore, the ability of an expanding vapor bubble to transport fuel and fission product species to the cover gas region where they may be released to the containment is also largely eliminated. The radionuclide species except for fission gas are largely retained within the core and sodium pool

  10. Renewable Resource Integration Project - Scoping Study of Strategic Transmission, Operations, and Reliability Issues

    Energy Technology Data Exchange (ETDEWEB)

    Eto, Joseph; Budhraja, Vikram; Ballance, John; Dyer, Jim; Mobasheri, Fred; Eto, Joseph

    2008-07-01

    California is on a path to increase utilization of renewable resources. California will need to integrate approximately 30,000 megawatts (MW) of new renewable generation in the next 20 years. Renewable resources are typically located in remote locations, not near the load centers. Nearly two/thirds or 20,000 MW of new renewable resources needed are likely to be delivered to Los Angeles Basin transmission gateways. Integration of renewable resources requires interconnection to the power grid, expansion of the transmission system capability between the backbone power grid and transmission gateways, and increase in delivery capacity from transmission gateways to the local load centers. To scope the transmission, operations, and reliability issues for renewables integration, this research focused on the Los Angeles Basin Area transmission gateways where most of new renewables are likely. Necessary actions for successful renewables integration include: (1) Expand Los Angeles Basin Area transmission gateway and nomogram limits by 10,000 to 20,000 MW; (2) Upgrade local transmission network for deliverability to load centers; (3) Secure additional storage, demand management, automatic load control, dynamic pricing, and other resources that meet regulation and ramping needed in real time operations; (4) Enhance local voltage support; and (5) Expand deliverability from Los Angeles to San Diego and Northern California.

  11. Advanced diagnostics for laser plasma interaction studies and some recent experiments

    International Nuclear Information System (INIS)

    Chaurasia, S.; Munda, D.S.; Dhareshwar, L.J.

    2008-10-01

    The complete characterization of Laser plasma interaction studies related to inertial confinement fusion laser and Equation of state (EOS) studies needs many diagnostics to explain the several physical phenomena occurring simultaneously in the laser produced plasma. This involves many on ion emission are important to understand physical phenomena which are responsible for generation of laser plasma as well as its interaction with an intense laser. In this report we describe the development of various x-ray diagnostics which are used in determining temporal, spatial and spectral properties of x-rays radiated from laser produced plasma. Diagnostics which have been used in experiments for investigation of laser-produced plasma as a source of ions are also described. Techniques using an optical streak camera and VISAR which are being used in the Equation of States (EOS) studies of various materials, which are important for material science, astrophysics as well as ICF is described in details. (author)

  12. Diagnostic studies of ion beam formation in inductively coupled plasma

    Energy Technology Data Exchange (ETDEWEB)

    Jacobs, Jenee L. [Iowa State Univ., Ames, IA (United States)

    2015-01-01

    This dissertation describes a variety of studies focused on the plasma and the ion beam in inductively coupled plasma mass spectrometry (ICP-MS). The ability to use ICP-MS for measurements of trace elements in samples requires the analytes to be efficiently ionized. Updated ionization efficiency tables are discussed for ionization temperatures of 6500 K and 7000 K with an electron density of 1 x 1015 cm-3. These values are reflective of the current operating parameters of ICP-MS instruments. Calculations are also discussed for doubly charged (M2+) ion formation, neutral metal oxide (MO) ionization, and metal oxide (MO+) ion dissociation for similar plasma temperature values. Ionization efficiency results for neutral MO molecules in the ICP have not been reported previously.

  13. Issues concerning a diagnostic study of an action plan for the San Juan river basin

    Science.gov (United States)

    Yamaguchi, Hiromi; Futamura, Hisanori; Nakayama, Mikiyasu

    2004-11-01

    An action plan is being formulated for the San Juan River basin, shared by Costa Rica and Nicaragua in Central America. The action plan is assumed to be a planning tool designed to ensure the availability of the goods and services that water resources provide for the conservation of ecosystems and for social and economic development. Development of the action plan comprises two phases, namely elaboration of the diagnostic study and drafting of the action plan. The diagnostic study was published in 1997. After examining previous cases in international water systems, for which the diagnostic study was developed as the precursor of an action plan, the author felt that the existing diagnostic study for the San Juan River basin still had room for improvements, in particular in the following aspects: (a) inventory of past, ongoing and future projects; (b) impacts of reserved areas on the basin as a whole; (c) instruments to promote public participation; (d) support by central decision makers; (e) mechanisms for information transparency. These aspects, which need enhancements, seem to suggest that more emphasis should be put on the soft aspects of the sciences. While the diagnostic study addresses issues of natural environment in detail, both data and analysis of human environments are in low profile. The lesson gained from the Zambezi River basin project is that lack of a proper strategy and political commitments by the central decision makers (of the riparian states) will lead to an impasse in implementation of the project, due mainly to paucity of support within basin countries. Lack of support by the general public may also lead to a failure in the implementation phase. These aspects should have been sufficiently addressed in the diagnostic study, so that appropriate actions (to be listed in the action plan) should be elaborated for implementation.

  14. A diagnostic study of monsoon energetics for two contrasting years

    Directory of Open Access Journals (Sweden)

    S. S. V. S. Ramakrishna

    2010-12-01

    Full Text Available In the present study we made an attempt to explain the behavior of the southwest monsoon for two contrasting years, from the view point of energetics. As a test case we selected 2002 and 2003, which were weak and strong monsoon years, respectively, based on rainfall. The energy terms Kψ, Kχ and APE and the conversion terms f∇ψ. ∇χ, −ω'T' are calculated at 850 hPa level and also vertically integrated from 1000 hPa to 100 hPa. The results indicate that, the year of high energy (both KΨ, Kχ i.e. 2002, does not give a good amount of rainfall compared to the good year i.e. 2003. The break period during the year 2002 has been clearly explained using the block diagrams. Periods of highest rainfall coincide with the positive conversions of f∇ψ. ∇χ and −ω'T'. Vertically integrated moisture fluxes during the break period of 2002, 2003 are also analyzed. The main reservoirs (sources and sinks for the monsoon energy are also identified using block diagrams. Negative correlation between daily rainfall and energy terms in the year 2002 indicates its unusual behavior both in terms of energetics as well as precipitation. Positive correlations in the year 2003 represent strong monsoonal behavior. We calculated the climatology of the total kinetic energy at 850 hPa, vertically integrated (1000–100 hPa for 30 years (1980–2009 and rainfall for 103 years (1901–2003 which clearly indicates that the monsoon is indeed a season of high energy for the South Asian region. Also the east- west direct thermal circulations are strongly related to the good and bad monsoon years.

  15. The High Scope Approach To Early Learning

    OpenAIRE

    French, Geraldine

    2012-01-01

    Learning Objectives: After studying this chapter the reader should be able to: • Describe the historical origins, the longitudinal research, and the theoretical underpinnings of the HighScope approach. • Identify the teaching strategies adopted by HighScope educators. • Appreciate the curriculum content. • Understand the HighScope approach to the assessment of children’s learning. • Consider some criticisms of the HighScope research and approach to early learning. This ...

  16. Pre-diagnostic alcohol consumption and postmenopausal breast cancer survival: a prospective patient cohort study

    NARCIS (Netherlands)

    Vrieling, A.; Buck, K.; Heinz, J.; Obi, N.; Benner, A.; Flesch-Janys, D.; Chang-Claude, J.

    2012-01-01

    Study results on the association of alcohol consumption with breast cancer survival are inconsistent, partly due to the use of different survival outcomes. We assessed the association of pre-diagnostic alcohol consumption with survival and recurrence in a prospective cohort study in Germany

  17. Lack of uniform diagnostic criteria for cervical radiculopathy in conservative intervention studies: A systematic review

    NARCIS (Netherlands)

    E.J. Thoomes (Erik); G.G.M. Scholten-Peeters (Gwendolijne); A.J. de Boer (Alice); R.A. Olsthoorn (Remy); K. Verkerk (Karin); C.-W.C. Lin (Chung-Wei Christine); A.P. Verhagen (Arianne)

    2012-01-01

    textabstractPurpose: Cervical radiculopathy (CR) is a common diagnosis. It is unclear if intervention studies use uniform definitions and criteria for patient selection. Our objective was to assess the uniformity of diagnostic criteria and definitions used in intervention studies to select patients

  18. Lack of uniform diagnostic criteria for cervical radiculopathy in conservative intervention studies: a systematic review

    NARCIS (Netherlands)

    Thoomes, Erik J; Scholten-Peeters, Gwendolijne G M; de Boer, Alice J; Olsthoorn, Remy A; Verkerk, Karin; Lin, Christine; Verhagen, Arianne P

    PURPOSE: Cervical radiculopathy (CR) is a common diagnosis. It is unclear if intervention studies use uniform definitions and criteria for patient selection. Our objective was to assess the uniformity of diagnostic criteria and definitions used in intervention studies to select patients with CR.

  19. Consensus based reporting standards for diagnostic test accuracy studies for paratuberculosis in ruminants.

    NARCIS (Netherlands)

    Gardner, I.A.; Nielsen, S.S.; Whittington, R.J.; Collins, M.T.; Bakker, D.; Harris, B.; Sreevatsan, S.; Lombard, J.E.; Sweeney, R.; Smith, D.R.; Gavalchin, J.; Eda, S.

    2011-01-01

    The Standards for Reporting of Diagnostic Accuracy (STARD) statement (www.stard-statement.org) was developed to encourage complete and transparent reporting of key elements of test accuracy studies in human medicine. The statement was motivated by widespread evidence of bias in test accuracy studies

  20. Search strategies to identify diagnostic accuracy studies in MEDLINE and EMBASE

    NARCIS (Netherlands)

    Beynon, Rebecca; Leeflang, Mariska M. G.; McDonald, Steve; Eisinga, Anne; Mitchell, Ruth L.; Whiting, Penny; Glanville, Julie M.

    2013-01-01

    A systematic and extensive search for as many eligible studies as possible is essential in any systematic review. When searching for diagnostic test accuracy (DTA) studies in bibliographic databases, it is recommended that terms for disease (target condition) are combined with terms for the

  1. Commercial production and distribution of fresh fruits and vegetables: A scoping study on the importance of produce pathways to dose

    Energy Technology Data Exchange (ETDEWEB)

    Marsh, T.L.; Anderson, D.M.; Farris, W.T.; Ikenberry, T.A.; Napier, B.A.; Wilfert, G.L.

    1992-09-01

    This letter report summarizes a scoping study that examined the potential importance of fresh fruit and vegetable pathways to dose. A simple production index was constructed with data collected from the Washington State Department of Agriculture (WSDA), the United States Bureau of the Census, and the United States Department of Agriculture (USDA). Hanford Environmental Dose Reconstruction (HEDR) Project staff from Battelle, Pacific Northwest Laboratories, in cooperation with members of the Technical Steering Panel (TSP), selected lettuce and spinach as the produce pathways most likely to impact dose. County agricultural reports published in 1956 provided historical descriptions of the predominant distribution patterns of fresh lettuce and spinach from production regions to local population centers. Pathway rankings and screening dose estimates were calculated for specific populations living in selected locations within the HEDR study area.

  2. A centralised public information resource for randomised trials: a scoping study to explore desirability and feasibility

    Directory of Open Access Journals (Sweden)

    Entwistle Vikki A

    2005-05-01

    Full Text Available Abstract Background There are currently several concerns about the ways in which people are recruited to participate in randomised controlled trials, the low acceptance rates among people invited to participate, and the experiences of trial participants. An information resource about on-going clinical trials designed for potential and current participants could help overcome some of these problems. Methods We carried out a scoping exercise to explore the desirability and feasibility of establishing such a resource. We sought the views of a range of people including people who were considering taking part in a trial, current trial participants, people who had been asked but refused to participate in a trial, consumer group representatives and researchers who design and conduct trials. Results There was broad-based support for the concept of a centralised information resource for members of the public about on-going and recently completed clinical trials. Such an information resource could be based on a database containing standardised information for each trial relating to the purpose of the trial; the interventions being compared; the implications of participation for participants; and features indicative of scientific quality and ethical probity. The usefulness of the database could be enhanced if its search facility could allow people to enter criteria such as a disease and geographic area and be presented with all the trials relevant to them, and if optional display formats could allow them to view information in varying levels of detail. Access via the Internet was considered desirable, with complementary supported access via health information services. The development of such a resource is technically feasible, but the collation of the required information would take a significant investment of resources. Conclusion A centralised participant oriented information resource about clinical trials could serve several purposes. A more detailed

  3. Pediatric restless legs syndrome diagnostic criteria: an update by the International Restless Legs Syndrome Study Group.

    Science.gov (United States)

    Picchietti, Daniel L; Bruni, Oliviero; de Weerd, Al; Durmer, Jeffrey S; Kotagal, Suresh; Owens, Judith A; Simakajornboon, Narong

    2013-12-01

    Specific diagnostic criteria for pediatric restless legs syndrome (RLS) were published in 2003 following a workshop at the National Institutes of Health. Due to substantial new research and revision of the adult RLS diagnostic criteria, a task force was chosen by the International Restless Legs Syndrome Study Group (IRLSSG) to consider updates to the pediatric diagnostic criteria. A committee of seven pediatric RLS experts developed a set of 15 consensus questions to review, conducted a comprehensive literature search, and extensively discussed potential revisions. The committee recommendations were approved by the IRLSSG executive committee and reviewed by the IRLSSG membership. The pediatric RLS diagnostic criteria were simplified and integrated with the newly revised adult RLS criteria. Specific recommendations were developed for pediatric application of the criteria, including consideration of typical words used by children to describe their symptoms. Pediatric aspects of differential diagnosis, comorbidity, and clinical significance were then defined. In addition, the research criteria for probable and possible pediatric RLS were updated and criteria for a related condition, periodic limb movement disorder (PLMD), were clarified. Revised diagnostic criteria for pediatric RLS have been developed, which are intended to improve clinical practice and promote further research. Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

  4. How to find lessons from the public health literature: Example of a scoping study protocol on the neighborhood environment

    Directory of Open Access Journals (Sweden)

    Mélanie Levasseur

    2016-01-01

    Full Text Available Background: As key determinants of many favorable health and quality of life outcomes, it is important to identify factors associated with mobility and social participation. Although several investigations have been carried out on mobility, social participation and neighborhood environment, there is no clear integration of these results. This paper presents a scoping study protocol that aims to provide a comprehensive understanding of how the physical and social neighborhood environment is associated with or influences mobility and social participation in older adults. Methods: The rigorous methodological framework for scoping studies is used to synthesize and disseminate current knowledge on the associations or influence of the neighborhood environment on mobility and social participation in aging. Nine databases from public health and other fields are searched with 51 predetermined keywords. Using content analysis, all data are exhaustively analyzed, organized, and synthesized independently by two research assistants. Discussion: A comprehensive synthesis of empirical studies provides decision-makers, clinicians and researchers with current knowledge and best practices regarding neighborhood environments with a view to enhancing mobility and social participation. Such a synthesis represents an original contribution and can ultimately support decisions and development of innovative interventions and clear guidelines for the creation of age-supportive environments. Improvements in public health and clinical interventions might be the new innovation needed to foster health and quality of life for aging population. Finally, the aspects of the associations or influence of the neighborhood environment on mobility and social participation not covered by previous research are identified. Conclusions: Among factors that impact mobility and social participation, the neighborhood environment is important since interventions targeting it may have a

  5. Market scope

    International Nuclear Information System (INIS)

    2002-01-01

    Nova Scotia's Energy Strategy is aimed at opening the electricity market to wholesale competition, allowing eligible wholesale customers (such as municipal distribution utilities) to buy their electricity from competitive sources. The Nova Scotia Electricity Marketplace Governance Committee (EMGC) is concerned that this will not promote long-term competition because these eligible customers form only a very small fraction (1.6 per cent) of the total electricity demand in the province. This report examines the possible extensions of competition beyond the minimum specified in the Energy Strategy. It also identifies approaches that the EMGC may consider, including other potential levels of competition and their associated issues. The report discussed the issue of implementing wholesale competition as it relates to unbundling of the transmission tariff from the cost of energy supply and from the cost of distribution in retail marketing. The stages of expanding the market scope were also described with reference to large industrial customers, medium industrial and large commercial customers, and small commercial and residential customers. The report states that it is unlikely that the transition to an open access transmission market will need to be reversed, as it is likely to be an essential component of any further development. The EMGC feels it could minimize future transition costs and promote future evolution of competition by recommending for an institutional and market structure that is compatible with a broader competitive market

  6. Letter Report: Yucca Mountain Environmental Monitoring Systems Initiative - Air Quality Scoping Study for Pahranagat National Wildlife Refuge, Lincoln County, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    J. Englebrecht; I. Kavouras; D. Campbell; S. Campbell; S. Kohl; D. Shafer

    2008-08-01

    The Desert Research Institute (DRI) is performing a scoping study as part of the U.S. Department of Energy's Yucca Mountain Environmental Monitoring Systems Initiative (EMSI). The main objective is to obtain baseline air quality information for Yucca Mountain and an area surrounding the Nevada Test Site (NTS). Air quality and meteorological monitoring and sampling equipment housed in a mobile trailer (shelter) is collecting data at eight sites outside the NTS, including Ash Meadows National Wildlife Refuge (NWR), Pahranagat NWR, Beatty, Rachel, Caliente, Crater Flat, and Tonopah Airport, and at four sites on the NTS (Engelbrecht et al., 2007a-d). The trailer is stationed at any one site for approximately eight weeks at a time. This letter report provides a summary of air quality and meteorological data on completion of the site's sampling program.

  7. Study of a loss of coolant accident of a PWR reactor through a Full Scope Simulator and computational code RELAP

    International Nuclear Information System (INIS)

    Soares, Alexandre de Souza

    2014-01-01

    The present paper proposes a study of a loss of coolant accident of a PWR reactor through a Full Scope Simulator and computational code RELAP. To this end, it considered a loss of coolant accident with 160 cm 2 breaking area in cold leg of 20 circuit of the reactor cooling system of nuclear power plant Angra 2, with the reactor operating in stationary condition, to 100% power. It considered that occurred at the same time the loss of External Power Supply and the availability of emergency cooling system was not full. The results obtained are quite relevant and with the possibility of being used in the planning of future activities, given that the construction of Angra 3 is underway and resembles the Angra 2. (author)

  8. Gear noise, vibration, and diagnostic studies at NASA Lewis Research Center

    Science.gov (United States)

    Zakrajsek, J. J.; Oswald, F. B.; Townsend, D. P.; Coy, J. J.

    1990-01-01

    The NASA Lewis Research Center and the U.S. Army Aviation Systems Command are involved in a joint research program to advance the technology of rotorcraft transmissions. This program consists of analytical as well as experimental efforts to achieve the overall goals of reducing weight, noise, and vibration, while increasing life and reliability. Recent analytical activities are highlighted in the areas of gear noise, vibration, and diagnostics performed in-house and through NASA and U.S. Army sponsored grants and contracts. These activities include studies of gear tooth profiles to reduce transmission error and vibration as well as gear housing and rotordynamic modeling to reduce structural vibration and transmission and noise radiation, and basic research into current gear failure diagnostic methodologies. Results of these activities are presented along with an overview of near-term research plans in the gear noise, vibration, and diagnostics area.

  9. Diagnostic Value of Neurological Studies in Diagnosing Syncope: A Systematic Review.

    Science.gov (United States)

    Pournazari, Payam; Oqab, Zardasht; Sheldon, Robert

    2017-12-01

    Syncope is common and approaches to establishing etiology remain a matter of clinical and financial importance. Patients often undergo comprehensive neurologic investigations despite a lack of compelling indications. The aim was to determine the prevalence of use and diagnostic yield of electroencephalography (EEG), head computed tomography (CT), head magnetic resonance imaging (MRI), and carotid Doppler ultrasound (CUS) examinations. We conducted a systematic search in EMBASE, PubMed, and Cochrane from 1970 to 2015 for studies reporting on the use of EEG, CT, MRI, and CUS in diagnosing the cause of syncope. The inclusion criteria were: (1) observational and randomized trials; (2) frequency of use of investigations; and (3) diagnostic yield. Diagnostic studies of the more general transient loss of consciousness were excluded. Of 149 screened studies, 15 studies having 6944 patients met the criteria. No studies met all 6 prespecified quality descriptors. The mean prevalence of test use were: EEG, 17.0%; CT, 57.3%; MRI, 10.5%; and CUS, 17.8%. The articles reported the likelihoods of a test providing diagnostic information for syncope etiology were: EEG, 1.35%; CT, 1.18%; MRI, 3.74%; and CUS, 2.4%. Only 2 new and informative results were noted in 6334 tests. Neurologic investigations for assessment of patients deemed to have syncope are used widely and are widely ineffective. Neurologic investigations should be obtained only with a very high degree of clinical suspicion. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  10. IASP diagnostic criteria for complex regional pain syndrome: a preliminary empirical validation study. International Association for the Study of Pain.

    Science.gov (United States)

    Galer, B S; Bruehl, S; Harden, R N

    1998-03-01

    To assess the ability of the International Association for the Study of Pain Complex Regional Pain Syndrome (CRPS) diagnostic criteria and associated features to discriminate between CRPS patients and patients with painful diabetic neuropathy. Prospective assessment of signs and symptoms in a series of CRPS and diabetic neuropathy patients. University of Washington Multidisciplinary Pain Center. A consecutive series of 18 CRPS patients and 30 diabetic neuropathy patients. Patients completed a 10-item patient history questionnaire assessing symptoms of CRPS prior to medical evaluation. The evaluating physician completed a 10-item patient examination questionnaire assessing objective signs of CRPS. The analyses conducted were designed to test the ability of CRPS signs and symptoms and associated features to discriminate between CRPS patients and diabetic neuropathy patients. Data analysis suggested that CRPS decision rules may lead to overdiagnosis of the disorder. Diagnosis based on self-reported symptoms can be diagnostically useful in some circumstances. The addition of trophic tissue changes, range of motion changes, and "burning" quality of pain did not improve diagnostic accuracy, but the addition of motor neglect signs did. Test of a CRPS scoring system resulted in improved accuracy relative to current criteria and decision rules. Poorly understood disorders lacking prototypical signs/symptoms and diagnostic laboratory testing must rely on the development of reliable diagnostic guidelines. The results of this study should assist in the further refinement of the CRPS diagnostic criteria.

  11. Scope of FNAC in the diagnosis of soft tissue tumors-A study from a tertiary cancer referral center in India

    Directory of Open Access Journals (Sweden)

    Rekhi Bharat

    2007-10-01

    Full Text Available Abstract Background Fine needle aspiration cytology (FNAC forms one of the first diagnostic tools in the evaluation of tumors. Its role in diagnosing soft tissue tumors (STT has been fairly documented, as well as debated. Present study was aimed at evaluating its scope in diagnosing 127 cases of soft tissue tumors. Methods Conventional Pap and MGG staining was available in all the cases. Immunocytochemistry (ICC was performed in 15 cases. Histopathological details were available in 115 cases. Results 50% cases were referred for a primary diagnosis, while 26.8% & 22.8% cases were evaluated for recurrent and metastatic lesions, respectively. Extremities were the commonest sites. On FNAC, 101 cases (79.5% were labeled as malignant, whereas 10 cases (7.9% were labeled as benign. The remaining 16 cases (11% were not categorized and were labeled as 'unsure/not specified'. Histopathological confirmation in 115 cases, gave a diagnostic accuracy of 98%, with a positive predictive value of 98% in malignant cases and a negative predictive value of 100% in benign cases. Two cases were false positive. Among the various cytological categories, 60 cases (47.2% were of spindle cell type, followed by 32 (25.2% of round cell type and 14 cases (11% of lipomatous type. Other 12 cases (9.4% were of pleomorphic type; 7 (5.5% cases of epithelioid type and remaining 2 cases were of myxoid type. All the round cell, pleomorphic and myxoid type of tumors were sarcomas, whereas 73.3% cases of spindle cell type were labeled as 'malignant'. Exact cytological sub typing was offered in 58 cases, with rhabdomyosarcoma (RMS as the most frequently sub typed tumor. The two false positive malignant cases were of fibromatosis and a pigmented schwannoma, on biopsy. Out of 28 metastatic lesions, lymph nodes were the commonest site for metastasis, with epithelioid tumors that formed highest percentage of metastatic cases. Conclusion FNAC is fairly specific and sensitive in STT

  12. MODIFIED ALVARADO SCORING AS A DIAGNOSTIC TOOL IN ACUTE APPENDICITIS- A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    V. K. Arun Kumar

    2017-02-01

    Full Text Available BACKGROUND Acute Appendicitis commonest community-acquired intra-abdominal infections. Acute appendicitis and its associated complications are significant source of morbidity and sometimes mortality. The Modified Alvarado Scoring System (MASS has been reported to be a cheap and quick diagnostic tool in patients with acute appendicitis. Diagnostic accuracy have been observed if the scores were applied to various populations and clinical settings. The purpose of this study was to evaluate the diagnostic value of Modified Alvarado Scoring System in patients with acute appendicitis in our setting. The aim of the study is to evaluate the efficacy of the modified Alvarado score as a diagnostic tool in Acute Appendicitis, as the diagnosis of appendicitis depends on the onset of symptoms and the subjective interpretation of the physical examination. MATERIALS AND METHODS This was a prospective study carried out in Pondicherry Institute of Medical Science during the period of November 2013 to May 2015. This study was done on 50 patients diagnosed with Acute Appendicitis and admitted in General Surgery. RESULTS In this study, there were a total of 50 patients who were taken up for surgery based on clinical and radiological diagnosis. Our study demonstrates that modified Alvarado score applied to all adult patients of acute appendicitis in adults with a sensitivity of 60% and a specificity of 40% only. Showing it wasn’t efficient in diagnosing acute appendicitis. The positive predictive value shown by our study was 80% which is marginally lower than that explained in literature which reports 87.5%. Negative appendicectomy rate in this study is 12%. CONCLUSION Alvarado score is a non-invasive, safe diagnostic procedure, which is simple, fast reliable and repeatable; it can be used in all conditions, without expensive and complicated supportive diagnostic methods. Alvarado score increases the diagnostic certainty of clinical examination in diagnosis of

  13. Adjusting for Differential-verification Bias in Diagnostic-accuracy Studies A Bayesian Approach

    NARCIS (Netherlands)

    de Groot, Joris A. H.; Dendukuri, Nandini; Janssen, Kristel J. M.; Reitsma, Johannes B.; Bossuyt, Patrick M. M.; Moons, Karel G. M.

    2011-01-01

    In studies of diagnostic accuracy, the performance of an index test is assessed by verifying its results against those of a reference standard. If verification of index-test results by the preferred reference standard can be performed only in a subset of subjects, an alternative reference test could

  14. Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studies

    NARCIS (Netherlands)

    Whiting, Penny F.; Weswood, Marie E.; Rutjes, Anne W. S.; Reitsma, Johannes B.; Bossuyt, Patrick N. M.; Kleijnen, Jos

    2006-01-01

    BACKGROUND: A quality assessment tool for diagnostic accuracy studies, named QUADAS, has recently been developed. Although QUADAS has been used in several systematic reviews, it has not been formally validated. The objective was to evaluate the validity and usefulness of QUADAS. METHODS: Three

  15. 75 FR 36425 - Guidance for Industry and Food and Drug Administration Staff; In Vitro Diagnostic Studies...

    Science.gov (United States)

    2010-06-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2007-D-0076] (formerly Docket No. 2007D-0387) Guidance for Industry and Food and Drug Administration Staff; In Vitro Diagnostic Studies--Frequently Asked Questions; Availability AGENCY: Food and Drug Administration, HHS...

  16. Diagnostic dilemmas in Fabry disease: a case series study on GLA mutations of unknown clinical significance

    NARCIS (Netherlands)

    Smid, B. E.; Hollak, C. E. M.; Poorthuis, B. J. H. M.; van den Bergh Weerman, M. A.; Florquin, S.; Kok, W. E. M.; Lekanne Deprez, R. H.; Timmermans, J.; Linthorst, G. E.

    2015-01-01

    Fabry disease' (FD) phenotype is heterogeneous: alpha-galactosidase A gene mutations (GLA) can lead to classical or non-classical FD, or no FD. The aim of this study is to describe pitfalls in diagnosing non-classical FD and assess the diagnostic value of plasma globotriaosylsphingosine. This is a

  17. CASE STUDY OF RADON DIAGNOSTICS AND MITIGATION IN A NEW YORK STATE SCHOOL

    Science.gov (United States)

    The paper discusses a case study of radon diagnostics and mitigation performed by EPA in a New York State school building. esearch focused on active subslab depressurization (ASD) in the basement and, to a lesser degree, the potential for radon reduction in the basement and slab-...

  18. Distress in suspected lung cancer patients following rapid and standard diagnostic programs: a prospective observational study.

    Science.gov (United States)

    Brocken, Pepijn; van der Heijden, Erik H F M; Oud, Karen T M; Bootsma, Gerben; Groen, Harry J M; Donders, A Rogier T; Dekhuijzen, P N Richard; Prins, Judith B

    2015-04-01

    Timeliness may influence emotional distress during the diagnostic phase of suspected lung cancer patients. We performed a prospective observational study to compare distress and quality of life (QoL) in two medical centres with a Rapid Outpatient Diagnostic Program (RODP) and two using conventional Stepwise Diagnostic Approach (SDA) on the basis of trained nurse-led care. Outpatients with radiological suspicion of lung cancer completed the Hospital Anxiety and Depression Scale (HADS), European Organization for Research and Treatment of Cancer 30-item Quality of Life Questionnaire (QLQ-C30) and its 13-item Lung Cancer specific module (QLQ-LC13) upon first visit, 2 days later, thereafter weekly for 5 weeks and after 3 months. The 72 SDA patients and 121 RODP patients had a mean pre-diagnostic HADS-total score of 13.5 (SD 7.6); 63.4% had a score ≥10. Baseline QLQ-C30 global QoL was 61.6 (SD 22.7) exceeding reference values for lung cancer patients. Generalized least square models showed a significant centre by time interaction effect: during the first 6 weeks, HADS-total scores decreased in RODP patients (13.8-11.9) but sustained in SDA patients (13.1-13.6), whereas QoL showed no relevant changes. Times to diagnosis and discussion of therapy plan for RODP patients were 7 and 11 days shorter, respectively. Suspected lung cancer patients had high baseline distress levels. A decrease over time was found in RODP compared with SDA patients. QoL did not change relevantly. Albeit observational, these data indicate that patients experience less distress in rapid diagnostic programs than in stepwise diagnostic evaluation. Copyright © 2014 John Wiley & Sons, Ltd.

  19. Evaluating radiographers' diagnostic accuracy in screen-reading mammograms: what constitutes a quality study?

    International Nuclear Information System (INIS)

    Debono, Josephine C; Poulos, Ann E

    2015-01-01

    The aim of this study was to first evaluate the quality of studies investigating the diagnostic accuracy of radiographers as mammogram screen-readers and then to develop an adapted tool for determining the quality of screen-reading studies. A literature search was used to identify relevant studies and a quality evaluation tool constructed by combining the criteria for quality of Whiting, Rutjes, Dinnes et al. and Brealey and Westwood. This constructed tool was then applied to the studies and subsequently adapted specifically for use in evaluating quality in studies investigating diagnostic accuracy of screen-readers. Eleven studies were identified and the constructed tool applied to evaluate quality. This evaluation resulted in the identification of quality issues with the studies such as potential for bias, applicability of results, study conduct, reporting of the study and observer characteristics. An assessment of the applicability and relevance of the tool for this area of research resulted in adaptations to the criteria and the development of a tool specifically for evaluating diagnostic accuracy in screen-reading. This tool, with further refinement and rigorous validation can make a significant contribution to promoting well-designed studies in this important area of research and practice

  20. Second International Diagnostic Accuracy Study for the Serological Detection of West Nile Virus Infection

    Science.gov (United States)

    Papa, Anna; Sambri, Vittorio; Teichmann, Anette; Niedrig, Matthias

    2013-01-01

    Background In recent decades, sporadic cases and outbreaks in humans of West Nile virus (WNV) infection have increased. Serological diagnosis of WNV infection can be performed by enzyme-linked immunosorbent assay (ELISA), immunofluorescence assay (IFA) neutralization test (NT) and by hemagglutination-inhibition assay. The aim of this study is to collect updated information regarding the performance accuracy of WNV serological diagnostics. Methodology/Principal findings In 2011, the European Network for the Diagnostics of Imported Viral Diseases-Collaborative Laboratory Response Network (ENIVD-CLRN) organized the second external quality assurance (EQA) study for the serological diagnosis of WNV infection. A serum panel of 13 samples (included sera reactive against WNV, plus specificity and negative controls) was sent to 48 laboratories involved in WNV diagnostics. Forty-seven of 48 laboratories from 30 countries participated in the study. Eight laboratories achieved 100% of concurrent and correct results. The main obstacle in other laboratories to achieving similar performances was the cross-reactivity of antibodies amongst heterologous flaviviruses. No differences were observed in performances of in-house and commercial test used by the laboratories. IFA was significantly more specific compared to ELISA in detecting IgG antibodies. The overall analytical sensitivity and specificity of diagnostic tests for IgM detection were 50% and 95%, respectively. In comparison, the overall sensitivity and specificity of diagnostic tests for IgG detection were 86% and 69%, respectively. Conclusions/Significance This EQA study demonstrates that there is still need to improve serological tests for WNV diagnosis. The low sensitivity of IgM detection suggests that there is a risk of overlooking WNV acute infections, whereas the low specificity for IgG detection demonstrates a high level of cross-reactivity with heterologous flaviviruses. PMID:23638205

  1. Second international diagnostic accuracy study for the serological detection of West Nile virus infection.

    Directory of Open Access Journals (Sweden)

    Andrea Sanchini

    Full Text Available BACKGROUND: In recent decades, sporadic cases and outbreaks in humans of West Nile virus (WNV infection have increased. Serological diagnosis of WNV infection can be performed by enzyme-linked immunosorbent assay (ELISA, immunofluorescence assay (IFA neutralization test (NT and by hemagglutination-inhibition assay. The aim of this study is to collect updated information regarding the performance accuracy of WNV serological diagnostics. METHODOLOGY/PRINCIPAL FINDINGS: In 2011, the European Network for the Diagnostics of Imported Viral Diseases-Collaborative Laboratory Response Network (ENIVD-CLRN organized the second external quality assurance (EQA study for the serological diagnosis of WNV infection. A serum panel of 13 samples (included sera reactive against WNV, plus specificity and negative controls was sent to 48 laboratories involved in WNV diagnostics. Forty-seven of 48 laboratories from 30 countries participated in the study. Eight laboratories achieved 100% of concurrent and correct results. The main obstacle in other laboratories to achieving similar performances was the cross-reactivity of antibodies amongst heterologous flaviviruses. No differences were observed in performances of in-house and commercial test used by the laboratories. IFA was significantly more specific compared to ELISA in detecting IgG antibodies. The overall analytical sensitivity and specificity of diagnostic tests for IgM detection were 50% and 95%, respectively. In comparison, the overall sensitivity and specificity of diagnostic tests for IgG detection were 86% and 69%, respectively. CONCLUSIONS/SIGNIFICANCE: This EQA study demonstrates that there is still need to improve serological tests for WNV diagnosis. The low sensitivity of IgM detection suggests that there is a risk of overlooking WNV acute infections, whereas the low specificity for IgG detection demonstrates a high level of cross-reactivity with heterologous flaviviruses.

  2. Cervical vertebral maturation method and mandibular growth peak: a longitudinal study of diagnostic reliability.

    Science.gov (United States)

    Perinetti, Giuseppe; Primozic, Jasmina; Sharma, Bhavna; Cioffi, Iacopo; Contardo, Luca

    2018-03-28

    The capability of the cervical vertebral maturation (CVM) method in the identification of the mandibular growth peak on an individual basis remains undetermined. The diagnostic reliability of the six-stage CVM method in the identification of the mandibular growth peak was thus investigated. From the files of the Oregon and Burlington Growth Studies (data obtained between early 1950s and middle 1970s), 50 subjects (26 females, 24 males) with at least seven annual lateral cephalograms taken from 9 to 16 years were identified. Cervical vertebral maturation was assessed according to the CVM code staging system, and mandibular growth was defined as annual increments in Co-Gn distance. A diagnostic reliability analysis was carried out to establish the capability of the circumpubertal CVM stages 2, 3, and 4 in the identification of the imminent mandibular growth peak. Variable durations of each of the CVM stages 2, 3, and 4 were seen. The overall diagnostic accuracy values for the CVM stages 2, 3, and 4 were 0.70, 0.76, and 0.77, respectively. These low values appeared to be due to false positive cases. Secular trends in conjunction with the use of a discrete staging system. In most of the Burlington Growth Study sample, the lateral head film at age 15 was missing. None of the CVM stages 2, 3, and 4 reached a satisfactorily diagnostic reliability in the identification of imminent mandibular growth peak.

  3. Scrotal infrared digital thermography in assessment of varicocele--pilot study to assess diagnostic criteria.

    Science.gov (United States)

    Kulis, T; Kolaric, D; Karlovic, K; Knezevic, M; Antonini, S; Kastelan, Z

    2012-05-01

    The aim of this study was to assess scrotal thermography in diagnostics of varicocele and suggest potential diagnostic criteria. Twelve patients with clinically diagnosed varicocele were examined with scrotal infrared digital thermography, physical examination and ultrasound/doppler. The main outcome measure was evaluation of thermography diagnostic criteria for varicocele. Mean temperature at left pampiniform plexus was ≥ 34 °C in 83%, and at right pampiniform plexus in all cases was ≤ 34 °C. In 92% of patients, temperature at the left testicle was ≥ 32 °C, whereas at the right testicle it was >32 °C in 50% patients. Temperatures between left and right pampiniform plexus and between left and right testicle were significantly different with P thermography presents feasible, short and low cost diagnostic method for varicocele. Further study on a larger number of patients and healthy participants is needed to evaluate sensitivity and specificity of this method. © 2011 Blackwell Verlag GmbH.

  4. A microcosting study of diagnostic tests for the detection of coronary artery disease in the Netherlands

    Energy Technology Data Exchange (ETDEWEB)

    Tan, S.S. [Erasmus MC University Medical Center, Institute for Medical Technology Assessment, P.O. Box 1738, 3000 DR Rotterdam (Netherlands)], E-mail: s.s.tan@erasmusmc.nl; Oppe, M. [Erasmus MC University Medical Center, Institute for Medical Technology Assessment, P.O. Box 1738, 3000 DR Rotterdam (Netherlands)], E-mail: m.oppe@erasmusmc.nl; Zoet-Nugteren, S.K. [Ikazia Hospital Rotterdam, Department of Cardiology, P.O. Box 5009, 3008 AA Rotterdam (Netherlands)], E-mail: sk.zoet@ikazia.nl; Niezen, R.A. [Medical Center Rijnmond-Zuid, Department of Radiology, P.O. Box 9100, 3007 AC Rotterdam (Netherlands)], E-mail: niezenr@mcrz.nl; Kofflard, M.J.M. [Albert Schweitzer Hospital, Department of Cardiology, P.O. Box 444, 3300 AK Dordrecht (Netherlands)], E-mail: m.j.m.kofflard@asz.nl; Ten Cate, F.J. [Erasmus MC University Medical Center, Department of Cardiology, P.O. Box 2040, 3000 CA Rotterdam (Netherlands)], E-mail: f.j.tencate@erasmusmc.nl; Roijen, L. Hakkaart-van [Erasmus MC University Medical Center, Institute for Medical Technology Assessment, P.O. Box 1738, 3000 DR Rotterdam (Netherlands)], E-mail: l.hakkaart-vanroijen@erasmusmc.nl

    2009-10-15

    Objective: The primary aim of the present study was to calculate the actual costs of four diagnostic tests for the detection of coronary artery disease in the Netherlands using a microcosting methodology. As a secondary objective, the cost effectiveness of eight diagnostic strategies was examined, using microcosting and reimbursement fees subsequently as the cost estimate. Design: A multicenter, retrospective cost analysis from a hospital perspective. Setting: The study was conducted in three general hospitals in the Netherlands for 2006. Interventions: Exercise electrocardiography (exECG), stress echocardiography (sECHO), single-photon emission computed tomography (SPECT) and coronary angiography (CA). Results: The actual costs of exECG, sECHO, SPECT and CA were Euro 33, 216, 614 and 1300 respectively. For all diagnostic tests, labour and indirect cost components (overheads and capital) together accounted for over 75% of the total costs. Consumables played a relatively important role in SPECT (14%). Hotel and nutrition were only applicable to SPECT and CA. Diagnostic services were solely performed for CA, but their costs were negligible (2%). Using microcosting estimates, exECG-sECHO-SPECT-CA was the most and CA the least cost effective strategy ( Euro 397 and 1302 per accurately diagnosed patient). Using reimbursement fees, exECG-sECHO-CA was most and SPECT-CA least cost effective ( Euro 147 and 567 per accurately diagnosed patient). Conclusions: The use of microcosting estimates instead of reimbursement fees led to different conclusions regarding the relative cost effectiveness of alternative strategies.

  5. Expediting citation screening using PICo-based title-only screening for identifying studies in scoping searches and rapid reviews.

    Science.gov (United States)

    Rathbone, John; Albarqouni, Loai; Bakhit, Mina; Beller, Elaine; Byambasuren, Oyungerel; Hoffmann, Tammy; Scott, Anna Mae; Glasziou, Paul

    2017-11-25

    Citation screening for scoping searches and rapid review is time-consuming and inefficient, often requiring days or sometimes months to complete. We examined the reliability of PICo-based title-only screening using keyword searches based on the PICo elements-Participants, Interventions, and Comparators, but not the Outcomes. A convenience sample of 10 datasets, derived from the literature searches of completed systematic reviews, was used to test PICo-based title-only screening. Search terms for screening were generated from the inclusion criteria of each review, specifically the PICo elements-Participants, Interventions and Comparators. Synonyms for the PICo terms were sought, including alternatives for clinical conditions, trade names of generic drugs and abbreviations for clinical conditions, interventions and comparators. The MeSH database, Wikipedia, Google searches and online thesauri were used to assist generating terms. Title-only screening was performed by five reviewers independently in Endnote X7 reference management software using OR Boolean operator. Outcome measures were recall of included studies and the reduction in screening effort. Recall is the proportion of included studies retrieved using PICo title-only screening out of the total number of included studies in the original reviews. The percentage reduction in screening effort is the proportion of records not needing screening because the method eliminates them from the screen set. Across the 10 reviews, the reduction in screening effort ranged from 11 to 78% with a median reduction of 53%. In nine systematic reviews, the recall of included studies was 100%. In one review (oxygen therapy), four of five reviewers missed the same included study (median recall 67%). A post hoc analysis was performed on the dataset with the lowest reduction in screening effort (11%), and it was rescreened using only the intervention and comparator keywords and omitting keywords for participants. The reduction in

  6. Expediting citation screening using PICo-based title-only screening for identifying studies in scoping searches and rapid reviews

    Directory of Open Access Journals (Sweden)

    John Rathbone

    2017-11-01

    Full Text Available Abstract Background Citation screening for scoping searches and rapid review is time-consuming and inefficient, often requiring days or sometimes months to complete. We examined the reliability of PICo-based title-only screening using keyword searches based on the PICo elements—Participants, Interventions, and Comparators, but not the Outcomes. Methods A convenience sample of 10 datasets, derived from the literature searches of completed systematic reviews, was used to test PICo-based title-only screening. Search terms for screening were generated from the inclusion criteria of each review, specifically the PICo elements—Participants, Interventions and Comparators. Synonyms for the PICo terms were sought, including alternatives for clinical conditions, trade names of generic drugs and abbreviations for clinical conditions, interventions and comparators. The MeSH database, Wikipedia, Google searches and online thesauri were used to assist generating terms. Title-only screening was performed by five reviewers independently in Endnote X7 reference management software using OR Boolean operator. Outcome measures were recall of included studies and the reduction in screening effort. Recall is the proportion of included studies retrieved using PICo title-only screening out of the total number of included studies in the original reviews. The percentage reduction in screening effort is the proportion of records not needing screening because the method eliminates them from the screen set. Results Across the 10 reviews, the reduction in screening effort ranged from 11 to 78% with a median reduction of 53%. In nine systematic reviews, the recall of included studies was 100%. In one review (oxygen therapy, four of five reviewers missed the same included study (median recall 67%. A post hoc analysis was performed on the dataset with the lowest reduction in screening effort (11%, and it was rescreened using only the intervention and comparator keywords and

  7. Analisis Pengaruh Lokasi, Harga, Kualitas Pendidikan dan Fasilitas Terhadap Minat dan Dampaknya Pada Keputusan Orang Tua Murid Memilih Jasa Pendidikan (Studi Pada Orang Tua Siswa di SD. High/Scope Indonesia Medan)

    OpenAIRE

    Purba, Mery Lani

    2011-01-01

    Mery Lani Purba, 2011, The Analysis of Location, Price, Education Quality, and Facilities Influence toward Interest and the Impact of Parents’ Decision to Chose Education Services (Study on Parents in SD. High/Scope Indonesia Medan), under the guidance of Prof. Dr. Paham Ginting, MS (chairman), Dr. Endang Sulistya Rini, SE, M.Si (members). SD. High/Scope Indonesia Medan is the one of international private elementary schools in Medan. SD. High/Scope Indonesia Medan is a franchise business ...

  8. A prospective study of the diagnostic utility of sputum Gram stain in pneumonia.

    Science.gov (United States)

    Anevlavis, Stavros; Petroglou, Niki; Tzavaras, Athanasios; Maltezos, Efstratios; Pneumatikos, Ioannis; Froudarakis, Marios; Anevlavis, Eleftherios; Bouros, Demosthenes

    2009-08-01

    Sputum Gram stain and culture have been said to be unreliable indicators of the microbiological diagnosis of bacterial pneumonia. The etiological diagnosis of pneumonia is surrounded by great degree of uncertainty. This uncertainty should be and can be calculated and incorporated in the diagnosis and treatment. To determine the diagnostic accuracy and diagnostic value of sputum Gram stain in etiological diagnosis and initial selection of antimicrobial therapy of bacterial community acquired pneumonia (CAP). DESIGN-METHOD: Prospective study of 1390 patients with CAP admitted January 2002-June 2008, to our institutions. Of the 1390 patients, 178 (12.8%) fulfilled the criteria for inclusion into this study (good-quality sputa and presence of the same microorganism in blood and sputum cultures which was used as gold standard for assessing the diagnostic accuracy and diagnostic value of sputum Gram stain). The sensitivity of sputum Gram stain was 0.82 for Pneumococcal pneumonia, 0.76 for Staphylococcal pneumonia, 0.79 for Haemophilus influenzae pneumonia and 0.78 for Gram-negative bacilli pneumonia. The specificity of sputum Gram stain was 0.93 for Pneumococcal pneumonia, 0.96 for Staphylococcal pneumonia, 0.96 for H. influenzae pneumonia and 0.95 for Gram-negative bacilli pneumonia. The positive likelihood ratio (LR+) was 11.58 for Pneumococcal pneumonia, 19.38 for Staphylococcal pneumonia, 16.84 for H. influenzae pneumonia, 14.26 for Gram-negative bacilli pneumonia. The negative likelihood ratio (LR-) was 0.20 for Pneumococcal pneumonia, 0.25 for Staphylococcal pneumonia, 0.22 for H. influenzae pneumonia, and 0.23 for Gram-negative bacilli pneumonia. Sputum Gram stain is a dependable diagnostic test for the early etiological diagnosis of bacterial CAP that helps in choosing orthological and appropriate initial antimicrobial therapy.

  9. What the New Deal can learn from the Human Security Approach : Scoping study on human security: a multi-level grounded approch towards the New Deal

    NARCIS (Netherlands)

    Terpstra, Niels; Willems, Rens; Frerks, Georg; Chang Pico, Tomás

    2014-01-01

    This scoping study analyses the experiences with the implementation of the Human Security Approach in practice as elucidated in the literature, and aims at highlighting lessons that are of relevance to the successful design and implementation of the New Deal. The first chapter of this report

  10. Estimating the Cost of Preeclampsia in the Healthcare System: Cross-Sectional Study Using Data From SCOPE Study (Screening for Pregnancy End Points).

    Science.gov (United States)

    Fox, Aimée; McHugh, Sheena; Browne, John; Kenny, Louise C; Fitzgerald, Anthony; Khashan, Ali S; Dempsey, Eugene; Fahy, Ciara; O'Neill, Ciaran; Kearney, Patricia M

    2017-12-01

    To estimate the cost of preeclampsia from the national health payer's perspective using secondary data from the SCOPE study (Screening for Pregnancy End Points). SCOPE is an international observational prospective study of healthy nulliparous women with singleton pregnancies. Using data from the Irish cohort recruited between November 2008 and February 2011, all women with preeclampsia and a 10% random sample of women without preeclampsia were selected. Additional health service use data were extracted from the consenting participants' medical records for maternity services which were not included in SCOPE. Unit costs were based on estimates from 3 existing Irish studies. Costs were extrapolated to a national level using a prevalence rate of 5% to 7% among nulliparous pregnancies. Within the cohort of 1774 women, 68 developed preeclampsia (3.8%) and 171 women were randomly selected as controls. Women with preeclampsia used higher levels of maternity services. The average cost of a pregnancy complicated by preeclampsia was €5243 per case compared with €2452 per case for an uncomplicated pregnancy. The national cost of preeclampsia is between €6.5 and €9.1 million per annum based on the 5% to 7% prevalence rate. Postpartum care was the largest contributor to these costs (€4.9-€6.9 million), followed by antepartum care (€0.9-€1.3 million) and peripartum care (€0.6-€0.7 million). Women with preeclampsia generate significantly higher maternity costs than women without preeclampsia. These cost estimates will allow policy-makers to efficiently allocate resources for this pregnancy-specific condition. Moreover, these estimates are useful for future research assessing the cost-effectiveness of preeclampsia screening and treatment. © 2017 American Heart Association, Inc.

  11. Study on Fault Diagnostics of a Turboprop Engine Using Inverse Performance Model and Artificial Intelligent Methods

    Science.gov (United States)

    Kong, Changduk; Lim, Semyeong

    2011-12-01

    Recently, the health monitoring system of major gas path components of gas turbine uses mostly the model based method like the Gas Path Analysis (GPA). This method is to find quantity changes of component performance characteristic parameters such as isentropic efficiency and mass flow parameter by comparing between measured engine performance parameters such as temperatures, pressures, rotational speeds, fuel consumption, etc. and clean engine performance parameters without any engine faults which are calculated by the base engine performance model. Currently, the expert engine diagnostic systems using the artificial intelligent methods such as Neural Networks (NNs), Fuzzy Logic and Genetic Algorithms (GAs) have been studied to improve the model based method. Among them the NNs are mostly used to the engine fault diagnostic system due to its good learning performance, but it has a drawback due to low accuracy and long learning time to build learning data base if there are large amount of learning data. In addition, it has a very complex structure for finding effectively single type faults or multiple type faults of gas path components. This work builds inversely a base performance model of a turboprop engine to be used for a high altitude operation UAV using measured performance data, and proposes a fault diagnostic system using the base engine performance model and the artificial intelligent methods such as Fuzzy logic and Neural Network. The proposed diagnostic system isolates firstly the faulted components using Fuzzy Logic, then quantifies faults of the identified components using the NN leaned by fault learning data base, which are obtained from the developed base performance model. In leaning the NN, the Feed Forward Back Propagation (FFBP) method is used. Finally, it is verified through several test examples that the component faults implanted arbitrarily in the engine are well isolated and quantified by the proposed diagnostic system.

  12. Scope, Breadth, and Differences in Online Physician Ratings Related to Geography, Specialty, and Year: Observational Retrospective Study.

    Science.gov (United States)

    Liu, Jessica Janine; Matelski, John Justin; Bell, Chaim M

    2018-03-07

    Physician ratings websites have emerged as a novel forum for consumers to comment on their health care experiences. Little is known about such ratings in Canada. We investigated the scope and trends for specialty, geographic region, and time for online physician ratings in Canada using a national data source from the country's leading physician-rating website. This observational retrospective study used online ratings data from Canadian physicians (January 2005-September 2013; N=640,603). For specialty, province, and year of rating, we assessed whether physicians were likely to be rated favorably by using the proportion of ratings greater than the overall median rating. In total, 57,412 unique physicians had 640,603 individual ratings. Overall, ratings were positive (mean 3.9, SD 1.3). On average, each physician had 11.2 (SD 10.1) ratings. By comparing specialties with Canadian Institute of Health Information physician population numbers over our study period, we inferred that certain specialties (obstetrics and gynecology, family practice, surgery, and dermatology) were more commonly rated, whereas others (pathology, radiology, genetics, and anesthesia) were less represented. Ratings varied by specialty; cardiac surgery, nephrology, genetics, and radiology were more likely to be rated in the top 50th percentile, whereas addiction medicine, dermatology, neurology, and psychiatry were more often rated in the lower 50th percentile of ratings. Regarding geographic practice location, ratings were more likely to be favorable for physicians practicing in eastern provinces compared with western and central Canada. Regarding year, the absolute number of ratings peaked in 2007 before stabilizing and decreasing by 2013. Moreover, ratings were most likely to be positive in 2007 and again in 2013. Physician-rating websites are a relatively novel source of provider-level patient satisfaction and are a valuable source of the patient experience. It is important to understand the

  13. The Use of Social Media in Recruitment for Medical Research Studies: A Scoping Review

    Science.gov (United States)

    2016-01-01

    Background Recruiting an adequate number of participants into medical research studies is challenging for many researchers. Over the past 10 years, the use of social media websites has increased in the general population. Consequently, social media websites are a new, powerful method for recruiting participants into such studies. Objective The objective was to answer the following questions: (1) Is the use of social media more effective at research participant recruitment than traditional methods? (2) Does social media recruit a sample of research participants comparable to that recruited via other methods? (3) Is social media more cost-effective at research participant recruitment than traditional methods? Methods Using the MEDLINE, PsycINFO, and EMBASE databases, all medical research studies that used social media and at least one other method for recruitment were identified. These studies were then categorized as either interventional studies or observational studies. For each study, the effectiveness of recruitment, demographic characteristics of the participants, and cost-effectiveness of recruitment using social media were evaluated and compared with that of the other methods used. The social media sites used in recruitment were identified, and if a study stated that the target population was “difficult to reach” as identified by the authors of the study, this was noted. Results Out of 30 studies, 12 found social media to be the most effective recruitment method, 15 did not, and 3 found social media to be equally effective as another recruitment method. Of the 12 studies that found social media to be the best recruitment method, 8 were observational studies while 4 were interventional studies. Of the 15 studies that did not find social media to be the best recruitment method, 7 were interventional studies while 8 were observational studies. In total, 8 studies stated that the target population was “hard-to-reach,” and 6 of these studies found social

  14. Health Systems Integration of Sexual and Reproductive Health and HIV Services in Sub-Saharan Africa: A Scoping Study

    Science.gov (United States)

    Kendall, Tamil; Langer, Ana; Bärnighausen, Till

    2014-01-01

    Objective: Both sexual and reproductive health (SRH) services and HIV programs in sub-Saharan Africa are typically delivered vertically, operating parallel to national health systems. The objective of this study was to map the evidence on national and international strategies for integration of SRH and HIV services in sub-Saharan Africa and to develop a research agenda for future health systems integration. Methods: We examined the literature on national and international strategies to integrate SRH and HIV services using a scoping study methodology. Current policy frameworks, national HIV strategies and research, and gray literature on integration were mapped. Five countries in sub-Saharan Africa with experience of integrating SRH and HIV services were purposively sampled for detailed thematic analysis, according to the health systems functions of governance, policy and planning, financing, health workforce organization, service organization, and monitoring and evaluation. Results: The major international health policies and donor guidance now support integration. Most integration research has focused on linkages of SRH and HIV front-line services. Yet, the common problems with implementation are related to delayed or incomplete integration of higher level health systems functions: lack of coordinated leadership and unified national integration policies; separate financing streams for SRH and HIV services and inadequate health worker training, supervision and retention. Conclusions: Rigorous health systems research on the integration of SRH and HIV services is urgently needed. Priority research areas include integration impact, performance, and economic evaluation to inform the planning, financing, and coordination of integrated service delivery. PMID:25436826

  15. Studies on neutron noise diagnostics of control rod vibrations by neural networks

    International Nuclear Information System (INIS)

    Roston, G.; Kozma, R.; Kitamura, M.; Garis, N.S.; Pazsit, I.

    1996-01-01

    This work is focussed on the study of a neutron noise based technique for the diagnostics of reactor core internal, in particular, excessively vibrating control rods. The use of a combination of physical models and neural networks offers an alternative way of performing the inversion procedure. The application of a neural network technique to determine the rod position from the detector spectra is much faster, more effective and simpler to use than the conventional method. (author). 5 refs., 1 fig., 1 tab

  16. Does the Reporting Quality of Diagnostic Test Accuracy Studies, as Defined by STARD 2015, Affect Citation?

    Science.gov (United States)

    Choi, Young Jun; Chung, Mi Sun; Koo, Hyun Jung; Park, Ji Eun; Yoon, Hee Mang; Park, Seong Ho

    2016-01-01

    To determine the rate with which diagnostic test accuracy studies that are published in a general radiology journal adhere to the Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015, and to explore the relationship between adherence rate and citation rate while avoiding confounding by journal factors. All eligible diagnostic test accuracy studies that were published in the Korean Journal of Radiology in 2011-2015 were identified. Five reviewers assessed each article for yes/no compliance with 27 of the 30 STARD 2015 checklist items (items 28, 29, and 30 were excluded). The total STARD score (number of fulfilled STARD items) was calculated. The score of the 15 STARD items that related directly to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 was also calculated. The number of times each article was cited (as indicated by the Web of Science) after publication until March 2016 and the article exposure time (time in months between publication and March 2016) were extracted. Sixty-three articles were analyzed. The mean (range) total and QUADAS-2-related STARD scores were 20.0 (14.5-25) and 11.4 (7-15), respectively. The mean citation number was 4 (0-21). Citation number did not associate significantly with either STARD score after accounting for exposure time (total score: correlation coefficient = 0.154, p = 0.232; QUADAS-2-related score: correlation coefficient = 0.143, p = 0.266). The degree of adherence to STARD 2015 was moderate for this journal, indicating that there is room for improvement. When adjusted for exposure time, the degree of adherence did not affect the citation rate.

  17. Dose the reporting quality of diagnostic test accuracy studies, as defined by STARD 2015, affect citation?

    International Nuclear Information System (INIS)

    Choi, Young Jun; Chung, Mi Sun; Koo, Hyun Jung; Park, Ji Eun; Yoon, Hee Mang; Park, Seong Ho

    2016-01-01

    To determine the rate with which diagnostic test accuracy studies that are published in a general radiology journal adhere to the Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015, and to explore the relationship between adherence rate and citation rate while avoiding confounding by journal factors. All eligible diagnostic test accuracy studies that were published in the Korean Journal of Radiology in 2011–2015 were identified. Five reviewers assessed each article for yes/no compliance with 27 of the 30 STARD 2015 checklist items (items 28, 29, and 30 were excluded). The total STARD score (number of fulfilled STARD items) was calculated. The score of the 15 STARD items that related directly to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 was also calculated. The number of times each article was cited (as indicated by the Web of Science) after publication until March 2016 and the article exposure time (time in months between publication and March 2016) were extracted. Sixty-three articles were analyzed. The mean (range) total and QUADAS-2-related STARD scores were 20.0 (14.5–25) and 11.4 (7–15), respectively. The mean citation number was 4 (0–21). Citation number did not associate significantly with either STARD score after accounting for exposure time (total score: correlation coefficient = 0.154, p = 0.232; QUADAS-2-related score: correlation coefficient = 0.143, p = 0.266). The degree of adherence to STARD 2015 was moderate for this journal, indicating that there is room for improvement. When adjusted for exposure time, the degree of adherence did not affect the citation rate

  18. The Nature and Scope of Social Studies Education for the 21 st ...

    African Journals Online (AJOL)

    Social studies is an innovative concept with an eclectic field involving the arts, sciences, technology and social sciences. To be a successful teacher, one needs to orient oneself towards seeing social studies as man in his environment concerned with the problem of human survival irrespective of the inevitable changing life ...

  19. The Scope of Planning Studies in the Seventh Form Geography Syllabus.

    Science.gov (United States)

    Memon, P. A.

    1987-01-01

    Examines the use of planning studies in the new seventh-form geography syllabus. Focuses on relationships of planning to geography. Recommends that a syllabus should emphasize student application of knowledge and critical thinking techniques in geography to the management of social issues. Provides guidelines on how such studies may be organized.…

  20. Application of visually based, computerised diagnostic decision support system in dermatological medical education: a pilot study.

    Science.gov (United States)

    Chou, Wan-Yi; Tien, Peng-Tai; Lin, Fang-Yu; Chiu, Pin-Chi

    2017-05-01

    Medical education has shifted from memory-based practice to evidence-based decisions. The question arises: how can we ensure that all students get correct and systematic information? Visually based, computerised diagnostic decision support system (VCDDSS, VisualDx) may just fit our needs. A pilot study was conducted to investigate its role in medical education and clinical practice. This was a prospective study, including one consultant dermatologist, 51 medical students and 13 dermatology residents, conducted in the dermatology teaching clinic at China Medical University Hospital from 30 December 2014 to 21 April 2015. Clinical diagnoses of 13 patients were made before and after using VCDDSS. Questionnaires were filled out at the end. The consultant dermatologist's diagnosis was defined as the standard answer; the Sign test was used to analyse diagnostic accuracy and the Fisher exact test to analyse questionnaires. There was an 18.75% increase in diagnostic accuracy after use of VCDDSS (62.5-81.25%; p value system in clinical practice, medical education, residency training, and patient education in the future. Further large-scale studies should be planned to confirm its application. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. Assessing adaptability and reactive scope: Introducing a new measure and illustrating its use through a case study of environmental stress in forest-living baboons.

    Science.gov (United States)

    MacLarnon, A M; Sommer, V; Goffe, A S; Higham, J P; Lodge, E; Tkaczynski, P; Ross, C

    2015-05-01

    In order to maintain regulatory processes, animals are expected to be adapted to the range of environmental stressors usually encountered in their environmental niche. The available capacity of their stress responses is termed their reactive scope, which is utilised to a greater or lesser extent to deal with different stressors. Typically, non-invasive hormone assessment is used to measure the physiological stress responses of wild animals, but, for methodological reasons, such measurements are not directly comparable across studies, limiting interpretation. To overcome this constraint, we propose a new measure of the relative strength of stress responses, 'demonstrated reactive scope', and illustrate its use in a study of ecological correlates (climate, food availability) of faecal glucocorticoid (fGC) levels in two forest-living troops of baboons. Results suggest the wild-feeding troop experiences both thermoregulatory and nutritional stress, while the crop-raiding troop experiences only thermoregulatory stress. This difference, together with the crop-raiding troop's lower overall physiological stress levels and lower demonstrated fGC reactive scope, may reflect nutritional stress-buffering in this troop. The relatively high demonstrated fGC reactive scope levels of both troops compared with other baboons and primate species, may reflect their extreme habitat, on the edge of the geographic range for baboons. Demonstrated reactive scope provides a means of gauging the relative strengths of stress responses of individuals, populations, or species under different conditions, enhancing the interpretive capacity of non-invasive studies of stress hormone levels in wild populations, e.g. in terms of animals' adaptive flexibility, the magnitude of their response to anthropogenic change, or the severity of impact of environmental conditions. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Nutrient loading and eutrophication of coastal waters of the South Asian Seas: a scoping study

    OpenAIRE

    2015-01-01

    This study looked at nutrient pollution and how it is affecting coastal and marine ecosystems in Bangladesh, India, Maldives, Pakistan and Sri Lanka. Causes it addressed included: agricultural practices; aquaculture; domestic sewage; industrial actions; and the burning of fossil fuels.

  3. Diagnostic approach to urinary tract infections in male general practice patients: a national surveillance study

    Science.gov (United States)

    den Heijer, Casper DJ; van Dongen, Martien CJM; Donker, Gé A; Stobberingh, Ellen E

    2012-01-01

    Background Diagnostic urinary tract infection (UTI) studies have primarily been performed among female patients. Aim To create a diagnostic algorithm for male general practice patients suspected of UTI. Design and setting Surveillance study in the Dutch Sentinel General Practice Network. Method Clinical information and dipstick results were collected from 603 patients. Algorithm-predicted care was compared with care as usual in terms of sensitivity (antibiotic recommended when UTI was confirmed) and specificity (no antibiotic recommended when no UTI was observed). Results Complete information was available from 490/603 (81%) males, of whom 66% (321/490) had a UTI. A diagnostic algorithm recommending antimicrobial prescription in the case of a positive nitrite test or a positive leukocyte esterase test in males aged ≥60 years, had a positive predictive value (PPV) of 83% (95% confidence interval [CI] = 78 to 87) and a negative predictive value (NPV) of 60% (95% CI = 52 to 66), respectively (area under the ROC curve: 0.78, 95% CI = 0.74 to 0.82). When both dipstick results were positive in males aged ≥60 years, PPV increased to 90% (95% CI = 83 to 94), whereas NPV was highest in males Sensitivity and specificity of predicted UTI care and usual care did not differ (75% versus 79%, P = 0.30, and 70% versus 63%, P = 0.17, respectively). Conclusion UTI care provided to Dutch male GP patients is as accurate as predicted care from a diagnostic algorithm. The studied clinical information and dipstick tests are useful for ruling in UTI in males, but have limited value in ruling out this diagnosis. PMID:23211182

  4. Physical Impacts of Climate Change on the Western US Electricity System: A Scoping Study

    OpenAIRE

    Coughlin, Katie

    2008-01-01

    This paper presents an exploratory study of the possible physical impacts of climate change on the electric power system, and how these impacts could be incorporated into resource planning in the Western United States. While many aspects of climate change and energy have been discussed in the literature, there has not yet been a systematic review of the relationship between specific physical effects and the quantitative analyses that are commonly used in planning studies. The core of the prob...

  5. Diagnostic role of CT in patients with suspected sigmoid diverticulitis comparison with barium enema studies

    International Nuclear Information System (INIS)

    Cho, K.C.; Morehouse, H.T.; Thornhill, B.A.; Alterman, D.D.; Baker, S.R.

    1989-01-01

    The diagnostic values of CT and barium enema (BE) studies were evaluated prospectively in 48 hospitalized patients suspected of having sigmoid diverticulitis. Diverticulitis was correctly diagnosed on CT in 91% (20 of 22) and on BE studies in 80% (16 of 20). There were no false positives. On BE studies, there were two false negatives (10%) - one of these patients had a large abscess on CT - and in two others, the findings were equivocal. Of 26 patients without diverticulitis, alternative diagnoses were made possible in 17 patients by CT, but only in three patients by BE studies. Many extracolonic findings seen on CT were clinically unsuspected and required emergency surgery

  6. EEG Analysis during complex diagnostic tasks in Nuclear Power Plants - Simulator-based Experimental Study

    International Nuclear Information System (INIS)

    Ha, Jun Su; Seong, Poong Hyun

    2005-01-01

    In literature, there are a lot of studies based on EEG signals during cognitive activities of human-beings but most of them dealt with simple cognitive activities such as transforming letters into Morse code, subtraction, reading, semantic memory search, visual search, memorizing a set of words and so on. In this work, EEG signals were analyzed during complex diagnostic tasks in NPP simulator-based environment. Investigated are the theta, alpha, beta, and gamma band EEG powers during the diagnostic tasks. The experimental design and procedure are represented in section 2 and the results are shown in section 3. Finally some considerations are discussed and the direction for the further work is proposed in section 4

  7. Simulation study on unfolding methods for diagnostic X-rays and mixed gamma rays

    International Nuclear Information System (INIS)

    Hashimoto, Makoto; Ohtaka, Masahiko; Ara, Kuniaki; Kanno, Ikuo; Imamura, Ryo; Mikami, Kenta; Nomiya, Seiichiro; Onabe, Hideaki

    2009-01-01

    A photon detector operating in current mode that can sense X-ray energy distribution has been reported. This detector consists of a row of several segment detectors. The energy distribution is derived using an unfolding technique. In this paper, comparisons of the unfolding techniques among error reduction, spectrum surveillance, and neural network methods are discussed through simulation studies on the detection of diagnostic X-rays and gamma rays emitted by a mixture of 137 Cs and 60 Co. For diagnostic X-ray measurement, the spectrum surveillance and neural network methods appeared promising, while the error reduction method yielded poor results. However, in the case of measuring mixtures of gamma rays, the error reduction method was both sufficient and effective. (author)

  8. Interprofessional care in intensive care settings and the factors that impact it: results from a scoping review of ethnographic studies.

    Science.gov (United States)

    Paradis, Elise; Leslie, Myles; Gropper, Michael A; Aboumatar, Hanan J; Kitto, Simon; Reeves, Scott

    2013-12-01

    At the heart of safe cultures are effective interactions within and between interprofessional teams. Critical care clinicians see severely ill patients who require coordinated interprofessional care. In this scoping review, we asked: "What do we know about processes, relationships, organizational and contextual factors that shape the ability of clinicians to deliver interprofessional care in adult ICUs?" Using the 5-stage process established by Levac et al. (2010), we reviewed 981 abstracts to identify ethnographic articles that shed light on interprofessional care in the intensive care unit. The quality of selected articles is assessed using best practices in ethnographic research; their main insights evaluated in light of an interprofessional framework developed by Reeves et al (Interprofessional Teamwork for Health and Social Care. San Francisco, CA: Wiley-Blackwell; 2010). Overall, studies were of mixed quality, with an average (SD) score of 5.8 out of 10 (1.77). Insights into intensive care unit cultures include the importance of paying attention to workflow, the nefarious impact of hierarchical relationships, the mixed responses to protocols imposed from the top down, and a general undertheorization of sex and race. This review highlights several lessons for safe cultures and argues that more needs to be known about the context of critical care if quality and safety interventions are to succeed. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Study of prediction of fission product behaviors in severe accident. Scoping experiment and basic findings of Cs, Ba and Sr

    International Nuclear Information System (INIS)

    Yamawaki, Michio; Huang, Jintao; Tonegawa, Masahisa; Ono, Futaba; Yasumoto, Masaru; Yamaguchi, Kenji; Sugimoto, Jun.

    1998-02-01

    Fission product release experiment (VEGA: Verification Experiments for fission product Gas/Aerosol release) has been started at JAERI, aiming at accurate source term evaluation during severe accident. Behaviors of fission products released from fuels largely differ with species due to different vapor pressures, which depend on the chemical forms. In response with VEGA, a complementary and basic experiment has been initiated in order to clarify the fission product behaviors up to FP collection chamber by estimating with high accuracy the chemical forms and vapor pressure of released fission products under high temperature environment, and to develop analytical models to evaluate the fission product behaviors in reactor situations. In the present study, as a first step a scoping experiment has been conducted for the estimation of chemical forms and vapor pressure of fission products under high temperature conditions, by introducing oxide compounds of Cs, Ba, and Sr into Knudsen cell. Basic findings have been obtained for Cs, Ba, and Sr, which are important species for the source term evaluation. (author)

  10. The practice of Information Architecture in the scope of an Enterprise Content Management (ECM project: a study case

    Directory of Open Access Journals (Sweden)

    Livia Marangon Duffles Teixeira

    2017-10-01

    Full Text Available Introduction: the paper describes an ECM project in the scope of a Brazilian power supply company called Cía Energética de Minas Gerais (CEMIG, during the period of construction of new facilities for energy distribution. Such construction involved different teams of CEMIG working along with teams of outsourced companies, which conferred to the endeavor a complex character insofar as the multitude of convoluted activities involving various actors and roles. Objective: in order to manage the informational resources in a centralized way, the project concentrated in controlling deadlines and flows of document´s approval, since the phase of the engineering project design until the conclusion of the construction. Methodology: the methodology was grounded in essentials of Information Architecture (IA discipline, using punctual, categorized and organized surveys, which guide the development of a module of an ECM tool to meet the requirements. Results: the present paper, in addition to describe a study case of the ECM project, attests the relevant role of information professionals as a hallmark in IA based projects. Conclusions: it is clear from our findings the suitability of our methodological and professional choices, in addition to the proper results obtained with the use of the developed ECM tool.

  11. ïSCOPE: Safer care for older persons (in residential environments: A study protocol

    Directory of Open Access Journals (Sweden)

    Barnard Debbie

    2011-07-01

    Full Text Available Abstract Background The current profile of residents living in Canadian nursing homes includes elder persons with complex physical and social needs. High resident acuity can result in increased staff workload and decreased quality of work life. Aims Safer Care for Older Persons [in residential] Environments is a two year (2010 to 2012 proof-of-principle pilot study conducted in seven nursing homes in western Canada. The purpose of the study is to evaluate the feasibility of engaging front line staff to use quality improvement methods to integrate best practices into resident care. The goals of the study are to improve the quality of work life for staff, in particular healthcare aides, and to improve residents' quality of life. Methods/design The study has parallel research and quality improvement intervention arms. It includes an education and support intervention for direct caregivers to improve the safety and quality of their care delivery. We hypothesize that this intervention will improve not only the care provided to residents but also the quality of work life for healthcare aides. The study employs tools adapted from the Institute for Healthcare Improvement's Breakthrough Series: Collaborative Model and Canada's Safer Healthcare Now! improvement campaign. Local improvement teams in each nursing home (1 to 2 per facility are led by healthcare aides (non-regulated caregivers and focus on the management of specific areas of resident care. Critical elements of the program include local measurement, virtual and face-to-face learning sessions involving change management, quality improvement methods and clinical expertise, ongoing virtual and in person support, and networking. Discussion There are two sustainability challenges in this study: ongoing staff and leadership engagement, and organizational infrastructure. Addressing these challenges will require strategic planning with input from key stakeholders for sustaining quality improvement

  12. A Prospective Study of Medical Diagnostic Radiography and Risk of Thyroid Cancer

    Science.gov (United States)

    Neta, Gila; Rajaraman, Preetha; Berrington de Gonzalez, Amy; Doody, Michele M.; Alexander, Bruce H.; Preston, Dale; Simon, Steven L.; Melo, Dunstana; Miller, Jeremy; Freedman, D. Michal; Linet, Martha S.; Sigurdson, Alice J.

    2013-01-01

    Although diagnostic x-ray procedures provide important medical benefits, cancer risks associated with their exposure are also possible, but not well characterized. The US Radiologic Technologists Study (1983–2006) is a nationwide, prospective cohort study with extensive questionnaire data on history of personal diagnostic imaging procedures collected prior to cancer diagnosis. We used Cox proportional hazard regressions to estimate thyroid cancer risks related to the number and type of selected procedures. We assessed potential modifying effects of age and calendar year of the first x-ray procedure in each category of procedures. Incident thyroid cancers (n = 251) were diagnosed among 75,494 technologists (1.3 million person-years; mean follow-up = 17 years). Overall, there was no clear evidence of thyroid cancer risk associated with diagnostic x-rays except for dental x-rays. We observed a 13% increase in thyroid cancer risk for every 10 reported dental radiographs (hazard ratio = 1.13, 95% confidence interval: 1.01, 1.26), which was driven by dental x-rays first received before 1970, but we found no evidence that the relationship between dental x-rays and thyroid cancer was associated with childhood or adolescent exposures as would have been anticipated. The lack of association of thyroid cancer with x-ray procedures that expose the thyroid to higher radiation doses than do dental x-rays underscores the need to conduct a detailed radiation exposure assessment to enable quantitative evaluation of risk. PMID:23529772

  13. Study about diagnostic quality in a public-center of mammography of Santa Fe, Argentina

    International Nuclear Information System (INIS)

    Lescano, R.; Kiguen, J.; Gaitan, L.; Caspani, C.

    2001-01-01

    The objective is to apply a method that allows us to evaluate the diagnostic quality of a public-center of mammography and to validate it. The representative centers of a social class were grouped; this one is evaluated measuring the mechanics, electrics, dosimetrics and personal parameters of the process to get the mammography diagnostic. The original study and the respective report was submitted to the valuation of a panel of experts, who evaluated image, techniques and diagnostics. The equipment and techniques used are described in this case. The judgment of the ACR and the Argentine legislation are applied. The dosimetric results of the mammography practice serve to determine the local reference levels. The people who intervened in the diagnosis are evaluated, as well as the services that can influence it. Seeking the parametric sensibility in relationship with the succeeded and precocious diagnosis, the success of it is confirmed by the panel of experts. We conclude by indicating that the success percentage in the diagnosis is about 98,36%, that there is 100% of coincidence among the perception and the value of the study quality. The valuation of the image reaches 69,2% of the maximum score, and the placement technique, 73,9%. The parametric sensibilities of the principal variables are discussed. (author)

  14. Diagnostic accuracy research in glaucoma is still incompletely reported: An application of Standards for Reporting of Diagnostic Accuracy Studies (STARD 2015.

    Directory of Open Access Journals (Sweden)

    Manuele Michelessi

    Full Text Available Research has shown a modest adherence of diagnostic test accuracy (DTA studies in glaucoma to the Standards for Reporting of Diagnostic Accuracy Studies (STARD. We have applied the updated 30-item STARD 2015 checklist to a set of studies included in a Cochrane DTA systematic review of imaging tools for diagnosing manifest glaucoma.Three pairs of reviewers, including one senior reviewer who assessed all studies, independently checked the adherence of each study to STARD 2015. Adherence was analyzed on an individual-item basis. Logistic regression was used to evaluate the effect of publication year and impact factor on adherence.We included 106 DTA studies, published between 2003-2014 in journals with a median impact factor of 2.6. Overall adherence was 54.1% for 3,286 individual rating across 31 items, with a mean of 16.8 (SD: 3.1; range 8-23 items per study. Large variability in adherence to reporting standards was detected across individual STARD 2015 items, ranging from 0 to 100%. Nine items (1: identification as diagnostic accuracy study in title/abstract; 6: eligibility criteria; 10: index test (a and reference standard (b definition; 12: cut-off definitions for index test (a and reference standard (b; 14: estimation of diagnostic accuracy measures; 21a: severity spectrum of diseased; 23: cross-tabulation of the index and reference standard results were adequately reported in more than 90% of the studies. Conversely, 10 items (3: scientific and clinical background of the index test; 11: rationale for the reference standard; 13b: blinding of index test results; 17: analyses of variability; 18; sample size calculation; 19: study flow diagram; 20: baseline characteristics of participants; 28: registration number and registry; 29: availability of study protocol; 30: sources of funding were adequately reported in less than 30% of the studies. Only four items showed a statistically significant improvement over time: missing data (16, baseline

  15. Development of an Online Toolkit for Measuring Commercial Building Energy Efficiency Performance -- Scoping Study

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Na

    2013-03-13

    This study analyzes the market needs for building performance evaluation tools. It identifies the existing gaps and provides a roadmap for the U.S. Department of Energy (DOE) to develop a toolkit with which to optimize energy performance of a commercial building over its life cycle.

  16. Removal of Separable Organic From Tank 241-C-103 Scoping Study

    Energy Technology Data Exchange (ETDEWEB)

    KOCH, M.R.

    2000-05-16

    This study is based on previous evaluations/proposals for removing the floating organic layer in C-103. A practical method is described with assumptions, cost and schedule estimates, and risks. Proposed operational steps include bulk organic removal, phase separation, organic washing and offsite disposal, followed by an in-situ polishing process.

  17. Removal of Separable Organic From Tank 241-C-103 Scoping Study

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This study is based on previous evaluations/proposals for removing the floating organic layer in C-103. A practical method is described with assumptions, cost and schedule estimates, and risks. Proposed operational steps include bulk organic removal, phase separation, organic washing and offsite disposal, followed by an in-situ polishing process

  18. STABLE ISOTOPES IN ECOLOGICAL STUDIES: EXPANDING THE SCOPE OF MIXING MODELS

    Science.gov (United States)

    Stable isotopes are increasingly being used as tracers in ecological studies. One common application uses isotopic ratios to quantify the proportional contributions of multiple sources to a mixture. Examples include pollution sources for air or water bodies, food sources for an...

  19. A new adult appendicitis score improves diagnostic accuracy of acute appendicitis - a prospective study

    Science.gov (United States)

    2014-01-01

    Background The aim of the study was to construct a new scoring system for more accurate diagnostics of acute appendicitis. Applying the new score into clinical practice could reduce the need of potentially harmful diagnostic imaging. Methods This prospective study enrolled 829 adults presenting with clinical suspicion of appendicitis, including 392 (47%) patients with appendicitis. The collected data included clinical findings and symptoms together with laboratory tests (white cell count, neutrophil count and C-reactive protein), and the timing of the onset of symptoms. The score was constructed by logistic regression analysis using multiple imputations for missing values. Performance of the constructed score in patients with complete data (n = 725) was compared with Alvarado score and Appendicitis inflammatory response score. Results 343 (47%) of patients with complete data had appendicitis. 199 (58%) patients with appendicitis had score value at least 16 and were classified as high probability group with 93% specificity.Patients with score below 11 were classified as low probability of appendicitis. Only 4% of patients with appendicitis had a score below 11, and none of them had complicated appendicitis. In contrast, 207 (54%) of non-appendicitis patients had score below 11. There were no cases with complicated appendicitis in the low probability group. The area under ROC curve was significantly larger with the new score 0.882 (95% CI 0.858 – 0.906) compared with AUC of Alvarado score 0.790 (0.758 – 0.823) and Appendicitis inflammatory response score 0.810 (0.779 – 0.840). Conclusions The new diagnostic score is fast and accurate in categorizing patients with suspected appendicitis, and roughly halves the need of diagnostic imaging. PMID:24970111

  20. A Chinese literature overview on ultra-weak photon emission as promising technology for studying system-based diagnostics

    NARCIS (Netherlands)

    He, M.; Sun, M.; Wijk, E. van; Wietmarschen, H. van; Wijk, R. van; Wang, Z.; Wang, M.; Hankemeier, T.; Greef, J. van der

    2016-01-01

    To present the possibilities pertaining to linking ultra-weak photon emission (UPE) with Chinese medicine-based diagnostics principles, we conducted a review of Chinese literature regarding UPE with respect to a systems view of diagnostics. Data were summarized from human clinical studies and animal

  1. Diagnostic Accuracy of Fecal Calprotectin for Pediatric Inflammatory Bowel Disease in Primary Care: A Prospective Cohort Study

    NARCIS (Netherlands)

    Holtman, Gea A.; Lisman-van Leeuwen, Yvonne; Kollen, Boudewijn J.; Norbruis, Obbe F.; Escher, Johanna C.; Kindermann, Angelika; de Rijke, Yolanda B.; van Rheenen, Patrick F.; Berger, Marjolein Y.

    2016-01-01

    In specialist care, fecal calprotectin (FCal) is a commonly used noninvasive diagnostic test for ruling out inflammatory bowel disease (IBD) in children with chronic gastrointestinal symptoms. The aim of this study was to evaluate the diagnostic accuracy of FCal for IBD in symptomatic children in

  2. Diagnostic Accuracy of Fecal Calprotectin for Pediatric Inflammatory Bowel Disease in Primary Care : A Prospective Cohort Study

    NARCIS (Netherlands)

    Holtman, Gea A.; Lisman-van Leeuwen, Yvonne; Kollen, Boudewijn J.; Norbruis, Obbe F.; Escher, Johanna C.; Kindermann, Angelika; de Rijke, Yolanda B.; van Rheenen, Patrick F.; Berger, Marjolein Y.

    PURPOSE In specialist care, fecal calprotectin (FCal) is a commonly used noninvasive diagnostic test for ruling out inflammatory bowel disease (IBD) in children with chronic gastrointestinal symptoms. The aim of this study was to evaluate the diagnostic accuracy of FCal for IBD in symptomatic

  3. Nanopore wall-liquid interaction under scope of molecular dynamics study: Review

    Science.gov (United States)

    Tsukanov, A. A.; Psakhie, S. G.

    2017-12-01

    The present review is devoted to the analysis of recent molecular dynamics based on the numerical studies of molecular aspects of solid-fluid interaction in nanoscale channels. Nanopore wall-liquid interaction plays the crucial role in such processes as gas separation, water desalination, liquids decontamination, hydrocarbons and water transport in nano-fractured geological formations. Molecular dynamics simulation is one of the most suitable tools to study molecular level effects occurred in such multicomponent systems. The nanopores are classified by their geometry to four groups: nanopore in nanosheet, nanotube-like pore, slit-shaped nanopore and soft-matter nanopore. The review is focused on the functionalized nanopores in boron nitride nanosheets as novel selective membranes and on the slit-shaped nanopores formed by minerals.

  4. Hydrological and geological preliminary studies in the scope of the RMB project

    International Nuclear Information System (INIS)

    Ferreira, Vinicius V.M.; Barreto, Alberto A.; Aleixo, Bruna L.

    2011-01-01

    The RMB - Brazilian Multipurpose Reactor is a project that will contribute decisively in order to develop the science and the technology of the country. However, the licensing process of this facility is not a simple task, since it involves nuclear and environmental questions. The utilization of geoprocessing tools became in the last years an important technique to aid the development of several studies, and will be necessary also in this project. The objective of this work is to present the first hydrological and geological geoprocessing studies done in order to support the future environmental licensing process of the facility. The results show that further efforts should be done since there is a lack of many data needed for the next steps. (author)

  5. Study on the atmospheric component with the scope of analyses on the environmental impact

    International Nuclear Information System (INIS)

    Ferrara, V.; La Camera, F.

    1989-03-01

    This work has been carried out following a specific request from Italian National Department for Environment and shows technical approaches and methodologies of analyses and forecasts set up for environmental impact studies referred to 'atmospheric environment'. This work is presented according to the general items and objectives fixed by the same Department in the wider operative system for the application in Italy of environmental impact procedures. (author)

  6. A scoping review on the conduct and reporting of scoping reviews

    Directory of Open Access Journals (Sweden)

    Andrea C. Tricco

    2016-02-01

    Full Text Available Abstract Background Scoping reviews are used to identify knowledge gaps, set research agendas, and identify implications for decision-making. The conduct and reporting of scoping reviews is inconsistent in the literature. We conducted a scoping review to identify: papers that utilized and/or described scoping review methods; guidelines for reporting scoping reviews; and studies that assessed the quality of reporting of scoping reviews. Methods We searched nine electronic databases for published and unpublished literature scoping review papers, scoping review methodology, and reporting guidance for scoping reviews. Two independent reviewers screened citations for inclusion. Data abstraction was performed by one reviewer and verified by a second reviewer. Quantitative (e.g. frequencies of methods and qualitative (i.e. content analysis of the methods syntheses were conducted. Results After searching 1525 citations and 874 full-text papers, 516 articles were included, of which 494 were scoping reviews. The 494 scoping reviews were disseminated between 1999 and 2014, with 45 % published after 2012. Most of the scoping reviews were conducted in North America (53 % or Europe (38 %, and reported a public source of funding (64 %. The number of studies included in the scoping reviews ranged from 1 to 2600 (mean of 118. Using the Joanna Briggs Institute methodology guidance for scoping reviews, only 13 % of the scoping reviews reported the use of a protocol, 36 % used two reviewers for selecting citations for inclusion, 29 % used two reviewers for full-text screening, 30 % used two reviewers for data charting, and 43 % used a pre-defined charting form. In most cases, the results of the scoping review were used to identify evidence gaps (85 %, provide recommendations for future research (84 %, or identify strengths and limitations (69 %. We did not identify any guidelines for reporting scoping reviews or studies that assessed the quality of

  7. A scoping review on the conduct and reporting of scoping reviews.

    Science.gov (United States)

    Tricco, Andrea C; Lillie, Erin; Zarin, Wasifa; O'Brien, Kelly; Colquhoun, Heather; Kastner, Monika; Levac, Danielle; Ng, Carmen; Sharpe, Jane Pearson; Wilson, Katherine; Kenny, Meghan; Warren, Rachel; Wilson, Charlotte; Stelfox, Henry T; Straus, Sharon E

    2016-02-09

    Scoping reviews are used to identify knowledge gaps, set research agendas, and identify implications for decision-making. The conduct and reporting of scoping reviews is inconsistent in the literature. We conducted a scoping review to identify: papers that utilized and/or described scoping review methods; guidelines for reporting scoping reviews; and studies that assessed the quality of reporting of scoping reviews. We searched nine electronic databases for published and unpublished literature scoping review papers, scoping review methodology, and reporting guidance for scoping reviews. Two independent reviewers screened citations for inclusion. Data abstraction was performed by one reviewer and verified by a second reviewer. Quantitative (e.g. frequencies of methods) and qualitative (i.e. content analysis of the methods) syntheses were conducted. After searching 1525 citations and 874 full-text papers, 516 articles were included, of which 494 were scoping reviews. The 494 scoping reviews were disseminated between 1999 and 2014, with 45% published after 2012. Most of the scoping reviews were conducted in North America (53%) or Europe (38%), and reported a public source of funding (64%). The number of studies included in the scoping reviews ranged from 1 to 2600 (mean of 118). Using the Joanna Briggs Institute methodology guidance for scoping reviews, only 13% of the scoping reviews reported the use of a protocol, 36% used two reviewers for selecting citations for inclusion, 29% used two reviewers for full-text screening, 30% used two reviewers for data charting, and 43% used a pre-defined charting form. In most cases, the results of the scoping review were used to identify evidence gaps (85%), provide recommendations for future research (84%), or identify strengths and limitations (69%). We did not identify any guidelines for reporting scoping reviews or studies that assessed the quality of scoping review reporting. The number of scoping reviews conducted per year

  8. Interaction studies in Japanese primatology: their scope, uniqueness, and the future.

    Science.gov (United States)

    Nakamura, Michio

    2009-04-01

    This paper aims to review social interaction studies in Japanese primatology, in order to introduce their utility into the current framework of primatology and their potential for understanding primate sociality. In the first part, I introduce some of the achievements in the field of Japanese primatology. It is a well-known fact that Japanese primatology, in its initial phases, strongly focused on society and sociality in nonhuman primates with respect to human society and sociality. Although Jun'ichiro Itani's theory on the evolution of social structure significantly influenced some of the Japanese primatologists, it had a comparatively minor impact on the West. As Itani himself admitted, he only treated the so-called "hardware" of society and did not deal with its "software" comprehensively, although he understood its importance and even provided some insightful ideas. In the latter part of the paper, I introduce some of the studies that directly dealt with the social interactions of primates and that were written mostly in Japanese. As compared to works in standard primatology, many of these papers were descriptive. This is because interaction cannot be decomposed into individual behaviors; thus, we have to focus on interaction itself. Finally, I argue that we need to explore the methodology for describing the lively and dynamic aspects of primate sociality.

  9. A scoping study: demand side measures on the UK electrical system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    The study is intended to eventually bring about a number of improvements in the UK electrical system, particularly in regard to Demand Side Management (DSM). Among the benefits envisaged are (a) increased security of supply when the network is under stress; (b) reduction in costs; (c) simpler outage management; (d) carbon saving and (e) increased energy efficiency. So far, these potential benefits have attracted little attention in the residential and small business sectors of the market: suggested reasons for this are listed. Taking into account the experience of other countries, three options are presented for a UK DSM programme: they are (i) customer initiated; (ii) supplier initiated and (iii) distributor initiated. At present, all the suggested options need further study and to aid the development for small customers, five possible initiatives are suggested. This final report (95 pages) includes a detailed description of the research required and a tender process for a customer-initiated programme. The report was prepared by KEMA Limited under contract to the DTI.

  10. A scoping study: demand side measures on the UK electrical system

    International Nuclear Information System (INIS)

    2005-01-01

    The study is intended to eventually bring about a number of improvements in the UK electrical system, particularly in regard to Demand Side Management (DSM). Among the benefits envisaged are (a) increased security of supply when the network is under stress; (b) reduction in costs; (c) simpler outage management; (d) carbon saving and (e) increased energy efficiency. So far, these potential benefits have attracted little attention in the residential and small business sectors of the market: suggested reasons for this are listed. Taking into account the experience of other countries, three options are presented for a UK DSM programme: they are (i) customer initiated; (ii) supplier initiated and (iii) distributor initiated. At present, all the suggested options need further study and to aid the development for small customers, five possible initiatives are suggested. This final report (95 pages) includes a detailed description of the research required and a tender process for a customer-initiated programme. The report was prepared by KEMA Limited under contract to the DTI

  11. Exploring the scope of new arylamino alcohol derivatives: Synthesis, antimalarial evaluation, toxicological studies, and target exploration

    Directory of Open Access Journals (Sweden)

    Miguel Quiliano

    2016-12-01

    Full Text Available Synthesis of new 1-aryl-3-substituted propanol derivatives followed by structure-activity relationship, in silico drug-likeness, cytotoxicity, genotoxicity, in silico metabolism, in silico pharmacophore modeling, and in vivo studies led to the identification of compounds 22 and 23 with significant in vitro antiplasmodial activity against drug sensitive (D6 IC50 ≤ 0.19 μM and multidrug resistant (FCR-3 IC50 ≤ 0.40 μM and C235 IC50 ≤ 0.28 μM strains of Plasmodium falciparum. Adequate selectivity index and absence of genotoxicity was also observed. Notably, compound 22 displays excellent parasitemia reduction (98 ± 1%, and complete cure with all treated mice surviving through the entire period with no signs of toxicity. One important factor is the agreement between in vitro potency and in vivo studies. Target exploration was performed; this chemotype series exhibits an alternative antimalarial mechanism.

  12. Impact of contacting study authors to obtain additional data for systematic reviews: diagnostic accuracy studies for hepatic fibrosis.

    Science.gov (United States)

    Selph, Shelley S; Ginsburg, Alexander D; Chou, Roger

    2014-09-19

    Seventeen of 172 included studies in a recent systematic review of blood tests for hepatic fibrosis or cirrhosis reported diagnostic accuracy results discordant from 2 × 2 tables, and 60 studies reported inadequate data to construct 2 × 2 tables. This study explores the yield of contacting authors of diagnostic accuracy studies and impact on the systematic review findings. Sixty-six corresponding authors were sent letters requesting additional information or clarification of data from 77 studies. Data received from the authors were synthesized with data included in the previous review, and diagnostic accuracy sensitivities, specificities, and positive and likelihood ratios were recalculated. Of the 66 authors, 68% were successfully contacted and 42% provided additional data for 29 out of 77 studies (38%). All authors who provided data at all did so by the third emailed request (ten authors provided data after one request). Authors of more recent studies were more likely to be located and provide data compared to authors of older studies. The effects of requests for additional data on the conclusions regarding the utility of blood tests to identify patients with clinically significant fibrosis or cirrhosis were generally small for ten out of 12 tests. Additional data resulted in reclassification (using median likelihood ratio estimates) from less useful to moderately useful or vice versa for the remaining two blood tests and enabled the calculation of an estimate for a third blood test for which previously the data had been insufficient to do so. We did not identify a clear pattern for the directional impact of additional data on estimates of diagnostic accuracy. We successfully contacted and received results from 42% of authors who provided data for 38% of included studies. Contacting authors of studies evaluating the diagnostic accuracy of serum biomarkers for hepatic fibrosis and cirrhosis in hepatitis C patients impacted conclusions regarding

  13. Energy efficiency r d opportunities in the food and beverage sector, phase 1: Scoping study

    Energy Technology Data Exchange (ETDEWEB)

    1993-01-01

    Study to determine the energy efficiency research and development requirements of the food and beverage industry, and those new techniques that are perceived to be most important for competitiveness and the environment. Interviews were conducted with 76 organizations from across the country, along with eight provinces and 10 subsectors, including industrial companies and associations, R D centres, universities, federal and provincial ministries, electric and gas utilities, and equipment suppliers. The United States Department of Energy was also visited to determine their current focus and approach to the development and commercialization of new technologies. Companies were asked to define their energy efficiency R D wants and needs, and the new technologies most promising for their operations. Other organizations were asked about their capabilities and interests in conducting technology R D, and/or participating in the Industrial Targeted Program by cost-sharing activities or becoming involved in Steering Committee work.

  14. Advanced Turbine Systems (ATS). Phase 1: System scoping and feasibility studies

    Science.gov (United States)

    White, D. J.

    1993-04-01

    As part of this involvement, Solar intends to design and commercialize a unique gas turbine system that promises high cycle efficiencies and low exhaust emissions. This engine of approximately 12-MW will be targeted for the dispersed power markets both urban and rural. Goals of 50% thermal efficiency and 8 parts-per-million by volume (ppmv) nitrogen oxide emissions were established. Reliability, availability, and maintainability (RAM) will continue to be the most important factors in the competitive marketplace. The other major goal adopted was one of reducing the cost of power produced by 10%. This reduction is based on the cost of power (COP) associated with today's engines that lie in the same horsepower range as that targeted in this study. An advanced cycle based on an approximation of the Ericsson Cycle was adopted after careful studies of a number of different cycles. This advanced intercooled, recuperated engine when fired at 2450 F will be capable of meeting the 50% efficiency goal if the cooling air requirements do not exceed 7% of the total air flow rate. This latter qualification will probably dictate the use of ceramic parts for both the nozzle guide vanes and the turbine blades. Cooling of these parts will probably be required and the 7% cooling flow allowance is thought to be adequate for such materials. Analyses of the cost of power and RAM goals show that the installed cost of this advanced engine can be approximately 50% above today's costs. This cost is based on $4.00 per million Btu fuel and a COP reduction of 10% while maintaining the same RAM as today's engines.

  15. The Scope and Impact of Workplace Diversity in the United Arab Emirates – An Initial Study

    Directory of Open Access Journals (Sweden)

    Badreya Al-Jenaibi

    2011-07-01

    Full Text Available Managing workplace diversity has become a priority concern among organizations in the United Arab Emirates (UAE today. The UAE has one of the world's largest net migration rates, and the number of workers from India, the Philippines, Indonesia, Australia, the USA, among other countries, has increased significantly in recent decades (Burns, 2005. The UAE's cross-border mobility has resulted in the interaction of people with diverse language, customs and ethnic backgrounds. Although diversity has been shown to have a number of benefits, including enhanced employee creativity and competence, this recognition is often found more in theory than actual practice. Diversity can also lead to miscommunication, dysfunctional adaptation behaviors and the creation of barriers that reduce the benefits diversity can bring to the organization. Due to the nature of the UAE workplace, which is dominated by a foreign workforce, this study critically analyzes the benefits and challenges organizations face in the diverse workplaces of the United Arab Emirates. The study used a multi-method approach combining survey data from 450 surveys of foreign workers with qualitative data from interviews with native officials of organizations. It is an attempt to compare the views of UAE workplace experience from two different groups—non-native workers and native officials. The research found a generally favorable view toward workplace diversity from the perspective of surveyed employees. However, when asked more detailed questions about company policy, a significant segment of respondents expressed reservations about their employer’s ability to implement successful intercultural communication and diversity practices.

  16. Bayesian latent class models with conditionally dependent diagnostic tests: a case study.

    Science.gov (United States)

    Menten, Joris; Boelaert, Marleen; Lesaffre, Emmanuel

    2008-09-30

    In the assessment of the accuracy of diagnostic tests for infectious diseases, the true disease status of the subjects is often unknown due to the lack of a gold standard test. Latent class models with two latent classes, representing diseased and non-diseased subjects, are often used to analyze this type of data. In its basic format, latent class analysis requires the observed outcomes to be statistically independent conditional on the disease status. In most diagnostic settings, this assumption is highly questionable. During the last decade, several methods have been proposed to estimate latent class models with conditional dependence between the test results. A class of flexible fixed and random effects models were described by Dendukuri and Joseph in a Bayesian framework. We illustrate these models using the analysis of a diagnostic study of three field tests and an imperfect reference test for the diagnosis of visceral leishmaniasis. We show that, as observed earlier by Albert and Dodd, different dependence models may result in similar fits to the data while resulting in different inferences. Given this problem, selection of appropriate latent class models should be based on substantive subject matter knowledge. If several clinically plausible models are supported by the data, a sensitivity analysis should be performed by describing the results obtained from different models and using different priors. Copyright (c) 2008 John Wiley & Sons, Ltd.

  17. Prevalence and Diagnostic Approach to Sleep Apnea in Hemodialysis Patients: A Population Study

    Directory of Open Access Journals (Sweden)

    Valentina Forni Ogna

    2015-01-01

    Full Text Available Background. Previous observations found a high prevalence of obstructive sleep apnea (OSA in the hemodialysis population, but the best diagnostic approach remains undefined. We assessed OSA prevalence and performance of available screening tools to propose a specific diagnostic algorithm. Methods. 104 patients from 6 Swiss hemodialysis centers underwent polygraphy and completed 3 OSA screening scores: STOP-BANG, Berlin’s Questionnaire, and Adjusted Neck Circumference. The OSA predictors were identified on a derivation population and used to develop the diagnostic algorithm, which was validated on an independent population. Results. We found 56% OSA prevalence (AHI ≥ 15/h, which was largely underdiagnosed. Screening scores showed poor performance for OSA screening (ROC areas 0.538 [SE 0.093] to 0.655 [SE 0.083]. Age, neck circumference, and time on renal replacement therapy were the best predictors of OSA and were used to develop a screening algorithm, with higher discriminatory performance than classical screening tools (ROC area 0.831 [0.066]. Conclusions. Our study confirms the high OSA prevalence and highlights the low diagnosis rate of this treatable cardiovascular risk factor in the hemodialysis population. Considering the poor performance of OSA screening tools, we propose and validate a specific algorithm to identify hemodialysis patients at risk for OSA for whom further sleep investigations should be considered.

  18. Pain during diagnostic hysteroscopy: what is the role of the cervical canal? A pilot study.

    Science.gov (United States)

    Mazzon, Ivan; Favilli, Alessandro; Horvath, Stefano; Grasso, Mario; Di Renzo, Gian Carlo; Laurenti, Elena; Bini, Vittorio; Gerli, Sandro

    2014-12-01

    To evaluate whether a correlation exists between the pain perceived during diagnostic anesthesia-free hysteroscopy and the characteristics of the cervical canal. Prospective observational pilot study of 255 women undergoing diagnostic hysteroscopy. Data analysis included characteristics of the patient and the cervical canal, and the pain experience during the procedure, assessed by visual analog score (VAS). A multiple logistic regression was then carried out in order to exclude confounding factors. The degree of pain during hysteroscopy was equal to a median VAS score of 2 (range 0-10). Bivariate analysis between patients with VAS>3 and patients with VAS≤3 demonstrated a significant correlation between pain and the presence of synechiae in the cervical canal (P=0.022), the patient's age (P=0.003) and parity (P=0.001). Multivariate analysis revealed that the presence of cervical synechiae (P=0.0001) [OR=4.99 (95% CI 2.13-11.70)] and parity (P=0.014) [OR=0.42 (95% CI 0.21-0.83)] were significantly correlated with pain. There was no significant correlation with the different angles of the cervical canal. Cervical synechiae appear as a major factor influencing pain during hysteroscopy. While parity acts as a protective factor, the angle of the cervical canal does not seem to play an important role for pain during diagnostic hysteroscopy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. A study on enforcement effects of radiation safety control regulations for diagnostic X-ray equipment

    International Nuclear Information System (INIS)

    Sung, Mo IL; Park, Myeong Hwan; Kwon, Duk Moon; Lee, Joon IL

    1999-01-01

    The purposes of this study are to analyze the realities after enforcements of safety control regulations for diagnostic X-ray equipment and to suggest means for an improvement of low radiation safety control. A questionnaire survey for medical radiologic technologists was carried out to determine enforcement effects of the safety control regulations. The results of analysis from the survey are as follows. That is, most of he respondents realized the importance of the radiation safety control system, but about a half of them revealed that regulations were not well observed in accordance with their purposes. Only 43.9 percent of the respondents took an active part in quality control of radiation. And responsibility, sex, age, and knowledge for safety control were important indicators for observations of the regulations. Training for the safety control regulations are needed to ensure safety control and proper usage of diagnostic X-ray equipment. And management of organizations using diagnostic X-ray equipment have to understand and stress the importance of radiation safety control system. (author)

  20. Midazolam administration at a department of pediatric radiology: Conscious sedation for diagnostic imaging studies

    International Nuclear Information System (INIS)

    Madzik, J.; Marcinski, A.; Brzewski, M.; Jakubowska, A.; Roik, D.; Majkowska, Z.; Biejat, A.; Krzemien, G.

    2006-01-01

    The aims of the study were to evaluate the usefulness of midazolam administration for sedation prior to some diagnostic examinations in children and to present the requirements and rules for sedation in departments of pediatric radiology. From Oct. 2001 to Aug. 2005, two hundred children were investigated after conscious sedation with midazolam. The examinations were: voiding cystourethrography (129), voiding sonocystography (64), barium enema (3), ultrasonography (1), urography (1), X-ray of facial bone (1), and brain CT (1). The children's age-range was 4 months to 13 years 9 months. The decision for sedation was based on conversation with the child and/or parents, their experience with previous examinations, emotional status of the child, and exclusion of contraindications (renal insufficiency, hepatic failure, respiratory/circulatory insufficiency, allergy to benzodiazepines in anamnesis). Midazolam was given orally in a dose of 0.5 mg/kg body weight, 15-20 minutes before examination (already at the department of pediatric radiology). The parents were informed of the possible side effects and what to do after the procedure. All diagnostic procedures with conscious sedation were well tolerated by the children and accepted by the parents. The parents with experience from previous diagnostic procedures indicated that they would want their child to have midazolam again if the examination needed to be repeated. No significant complications were observed in the children receiving midazolam and few adverse effect on voiding during cystourethrography. In three children (2.5, 3, and 5 years old), paradoxical reactions occurred (psychomotor agitation) which disappeared spontaneously after some minutes and had no influence on the procedure. Application of midazolam for conscious sedation diminished anxiety and discomfort from diagnostic procedures and short anterograde amnesia protected the child's mind from painful experience. Conscious sedation should be widely used in

  1. Scoping study investigating stakeholder perceptions and use of school canteens in an Australian city.

    Science.gov (United States)

    Lawlis, Tanya; Eckley, Dionne; Jamieson, Maggie; Knox, Melissa

    2017-11-01

    To investigate stakeholder perceptions of healthy food availability in school canteens, the promotion of healthy foods and canteen policy compliance. This is a cross-sectional study of Catholic and independent primary and high schools comprising three investigative phases: (i) survey of 39 schools, (ii) survey of canteen managers and parents from 10 schools and (iii) an audit of school menus against National Healthy School Canteen Guidelines. Total participants included: 6 principals, no canteen mangers and 86 parents from two schools; 24 menus were audited. Schools are committed to supporting healthy eating, with participants agreeing canteens should follow the National Health School Canteen Guidelines. A total of 94% of parents (n = 81/86) indicated that their children buy food from the school canteen, with commonly purchased items mostly classified as 'red'. Despite this food choice, parents (n = 32/48) indicated they had a responsibility to encourage healthy eating. No school canteen menu comprised +50% 'green' foods and thus did not comply with the National Healthy School Canteen Guidelines. Despite the intense focus on school canteens to sell healthy food, little has changed in terms of student's food choices and the barriers to providing healthy options. The external environment and divided parental buy-in impact the canteen's ability to comply with guidelines. A holistic approach involving all stakeholder levels is required to successfully achieve a healthy school canteen environment and positively influence student's food habits and choices. © 2017 Dietitians Association of Australia.

  2. Energy and costs scoping study for plasma pyrolysis thermal processing system

    International Nuclear Information System (INIS)

    Sherick, K.E.; Findley, J.E.

    1992-01-01

    The purpose of this study was to provide information in support of an investigation of thermal technologies as possible treatment process for buried wastes at the INEL. Material and energy balances and a cost estimate were generated for a representative plasma torch-based thermal waste treatment system operating in a pyrolysis mode. Two waste streams were selected which are representative of INEL buried wastes, large in volume, and difficult to treat by other technologies. These streams were a solidified nitrate sludge waste stream and a waste/soil mix of other buried waste components. The treatment scheme selected includes a main plasma chamber operating under pyrolyzing conditions; a plasma afterburner to provide additional residence time at high temperature to ensure complete destruction of hazardous organics; an off-gas treatment system; and a incinerator and stack to oxidize carbon monoxide to carbon dioxide and vent the clean, oxidized gases to atmosphere. The material balances generated provide materials flow and equipment duty information of sufficient accuracy to generate initial rough-order-of-magnitude (ROM) system capital and operating cost estimates for a representative plasma thermal processing system

  3. Small- and Medium-Sized Commercial Building Monitoring and Controls Needs: A Scoping Study

    Energy Technology Data Exchange (ETDEWEB)

    Katipamula, Srinivas; Underhill, Ronald M.; Goddard, James K.; Taasevigen, Danny J.; Piette, M. A.; Granderson, J.; Brown, Rich E.; Lanzisera, Steven M.; Kuruganti, T.

    2012-10-31

    Buildings consume over 40% of the total energy consumption in the U.S. A significant portion of the energy consumed in buildings is wasted because of the lack of controls or the inability to use existing building automation systems (BASs) properly. Much of the waste occurs because of our inability to manage and controls buildings efficiently. Over 90% of the buildings are either small-size (<5,000 sf) or medium-size (between 5,000 sf and 50,000 sf); these buildings currently do not use BASs to monitor and control their building systems from a central location. According to Commercial Building Energy Consumption Survey (CBECS), about 10% of the buildings in the U.S. use BASs or central controls to manage their building system operations. Buildings that use BASs are typically large (>100,000 sf). Lawrence Berkeley National Laboratory (LBNL), Oak Ridge National Laboratory (ORNL) and Pacific Northwest National Laboratory (PNNL) were asked by the U.S. Department of Energy’s (DOE’s) Building Technologies Program (BTP) to identify monitoring and control needs for small- and medium-sized commercial buildings and recommend possible solutions. This study documents the needs and solutions for small- and medium-sized buildings.

  4. Economic crisis and communicable disease control in Europe: a scoping study among national experts.

    Science.gov (United States)

    Rechel, Boika; Suhrcke, Marc; Tsolova, Svetla; Suk, Jonathan E; Desai, Monica; McKee, Martin; Stuckler, David; Abubakar, Ibrahim; Hunter, Paul; Senek, Michaela; Semenza, Jan C

    2011-12-01

    The effects of the current global economic crisis on the spread and control of communicable diseases remain uncertain. This study aimed to explore experts' views about the impact of the current crisis and measures that have been undertaken by governments to mitigate an alleged adverse effect of the crisis on communicable diseases. An online survey was conducted during November 2009-February 2010 among experts from national agencies for communicable disease control from European Union (EU) and European Free Trade Association (EFTA) countries. There were few specific national policies and programmes aimed at mitigating the impact of the economic crisis. Prevention services were deemed particularly susceptible to budget cuts (68%) as a result of the economic crisis compared to primary care (28%), according to survey respondents. Services targeted at vulnerable and hard-to-reach population groups were perceived to be at particular risk of deterioration (67%) in contrast to travel medicine (11%), according to respondents. There is a need for sustainability of financial resources, public health workforce and infrastructures to ensure that the services and programmes for the surveillance and control of the spread of communicable disease are maintained and developed. There is also a need to explore and foster better linkage in data on socioeconomic circumstances and communicable disease outcomes. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  5. Exploring the scope of expanding advanced nursing practice in nurse-led clinics: a multiple-case study.

    Science.gov (United States)

    Shiu, Ann T Y; Lee, Diana T F; Chau, Janita P C

    2012-08-01

    This article is a report on a study to explore the development of expanding advanced nursing practice in nurse-led clinics in Hong Kong. Nurse-led clinics serviced by advanced practice nurses, a common international practice, have been adopted in Hong Kong since 1990s. Evaluations consistently show that this practice has good clinical outcomes and contributes to containing healthcare cost. However, similar to the international literature, it remains unclear as to what the elements of good advanced nursing practice are, and which directions Hong Kong should adopt for further development of such practice. A multiple-case study design was adopted with six nurse-led clinics representing three specialties as six case studies, and including two clinics each from continence, diabetes and wound care. Each case had four embedded units of analysis. They included non-participant observation of nursing activities (9 days), nurse interviews (N = 6), doctor interviews (N = 6) and client interviews (N = 12). The data were collected in 2009. Within- and cross-case analyses were conducted. The cross-case analysis demonstrated six elements of good advanced nursing practice in nurse-led clinics, and showed a great potential to expand the practice by reshaping four categories of current boundaries, including community-hospital, wellness-illness, public-private and professional-practice boundaries. From these findings, we suggest a model to advance the scope of advanced nursing practice in nurse-led clinics. The six elements may be applied as audit criteria for evaluation of advanced nursing practice in nurse-led clinics, and the proposed model provides directions for expanding such practice in Hong Kong and beyond. © 2011 Blackwell Publishing Ltd.

  6. STUDY ON PERCEPTION, ACCEPTANCE AND BARRIERS OF TELEMEDICINE AND E-HEALTH AMONGST PATIENTS AND ITS SCOPE IN PUBLIC HEALTH IN INDIA

    Directory of Open Access Journals (Sweden)

    Yogesh Kautish

    2017-10-01

    Full Text Available BACKGROUND With the fast moving pace of information technology and research, telemedicine solution has the potential to supplement/replace existing mode of face-to-face consultations and can become yet another way to see a healthcare professional in future. Telemedicine solutions uses smartphones, mobile applications, increasingly video conferencing and e-therapy solution for various diagnostic, therapeutic and counseling needs. Due to the improvements in information technology with availability of higher bandwidth and faster data transfers, this area is growing rapidly in healthcare services. The primary aim of this research is to analyse the perception and acceptance of telemedicine solution amongst the patients, the accessibility of technology by the masses, the enablers and barriers to successful implementation of telemedicine solution and its scope and future prospects in healthcare services in India. MATERIALS AND METHODS 150 patients >18 yrs. of age with no known physical/mental incapacities who visited the Medicine OPD were accessed using a structured questionnaire, the data was entered and coded into an MS Excel spreadsheet and the results were analysed. RESULTS Majority of the respondents (97.33% had access to technology with 91.33% used smartphones with apps. There was high acceptability for telemedicine- 90.67% for consultancy purposes, 88% for health education purposes and 85.33% for counseling and therapy sessions and ongoing clinical support. Confidentiality (mostly amongst females 46.15% and missed diagnosis (mostly amongst males 29.41% were major concerns. Medicine (84.67% and dermatology (80% were the most preferred branches of medicine. 88.67% felt that telemedicine has a huge future prospects, though 70% felt that they preferred FTF mode of consultation. 50% (73.08% <40 yrs. of age felt that telemedicine has the potential to replace existing mode of FTF consultation. CONCLUSION The research shows a huge acceptability of

  7. Homogenous Pd-catalyzed asymmetric hydrogenation of unprotected indoles: scope and mechanistic studies.

    Science.gov (United States)

    Duan, Ying; Li, Lu; Chen, Mu-Wang; Yu, Chang-Bin; Fan, Hong-Jun; Zhou, Yong-Gui

    2014-05-28

    An efficient palladium-catalyzed asymmetric hydrogenation of a variety of unprotected indoles has been developed that gives up to 98% ee using a strong Brønsted acid as the activator. This methodology was applied in the facile synthesis of biologically active products containing a chiral indoline skeleton. The mechanism of Pd-catalyzed asymmetric hydrogenation was investigated as well. Isotope-labeling reactions and ESI-HRMS proved that an iminium salt formed by protonation of the C═C bond of indoles was the significant intermediate in this reaction. The important proposed active catalytic Pd-H species was observed with (1)H NMR spectroscopy. It was found that proton exchange between the Pd-H active species and solvent trifluoroethanol (TFE) did not occur, although this proton exchange had been previously observed between metal hydrides and alcoholic solvents. Density functional theory calculations were also carried out to give further insight into the mechanism of Pd-catalyzed asymmetric hydrogenation of indoles. This combination of experimental and theoretical studies suggests that Pd-catalyzed hydrogenation goes through a stepwise outer-sphere and ionic hydrogenation mechanism. The activation of hydrogen gas is a heterolytic process assisted by trifluoroacetate of Pd complex via a six-membered-ring transition state. The reaction proceeds well in polar solvent TFE owing to its ability to stabilize the ionic intermediates in the Pd-H generation step. The strong Brønsted acid activator can remarkably decrease the energy barrier for both Pd-H generation and hydrogenation. The high enantioselectivity arises from a hydrogen-bonding interaction between N-H of the iminium salt and oxygen of the coordinated trifluoroacetate in the eight-membered-ring transition state for hydride transfer, while the active chiral Pd complex is a typical bifunctional catalyst, effecting both the hydrogenation and hydrogen-bonding interaction between the iminium salt and the coordinated

  8. Scoping study on SADC energy sector carbon market potential; SADC = Southern African Development Community

    Energy Technology Data Exchange (ETDEWEB)

    2010-10-22

    This study shows that, while there is a certain degree of institutional and project development capacity in the region and significant Clean Development Mechanism (CDM) potential, very little of this potential is currently being tapped. National institutional structures are mostly very new, understaffed, and working in isolation from each other. There are ongoing national CDM capacity building programmes in several SADC countries that will address barriers and develop projects at a national level, but there are also regional opportunities that these programmes will not address. For some of large scale project opportunities such as landfill gas, industrial energy use, fugitive emission and transport, a national approach is required because these projects depend on local industrial base, regulatory environment, and are also large enough that the carbon revenue can cover the transaction costs. There are a few key areas that should be addressed, however, at a regional level: Energy trade and power development: any low carbon power projects that are developed to serve regional energy needs and displace coal fired power can only receive carbon credits if the baseline is a regional power grid rather than just a national grid. This is also true for large scale energy efficiency projects in countries that have only hydropower - these would not receive any carbon credits unless there is justification for a regional grid definition that includes fossil fuel fired power stations.Small scale projects: While the total potential for small scale renewables may not be large in terms of tonnes of CO{sub 2} mitigated, the local development impacts of distributed renewable energy and energy efficiency projects are very large. For these projects to be implemented at a large enough scale to recoup the transaction costs of project development, a regional approach is critical. The CDM 'Programme of Activities' (PoA) approach is ideally suited for such regional small scale energy

  9. Gamma radiation grafted polymers for immobilization of Brucella antigen in diagnostic test studies

    Science.gov (United States)

    Docters, E. H.; Smolko, E. E.; Suarez, C. E.

    The radiation grafting process has a wide field of industrial applications, and in the recent years the immobilization of biocomponents in grafted polymeric materials obtained by means of ionizing radiations is a new and important contribution to biotechnology. In the present work, gamma preirradiation grafting method was employed to produce acrylics hydrogels onto polyethylene (PE), polyvinyl chloride (PVC) and polystyrene (PS). Two monomers were used to graft the previously mentioned polymers: methacrylic acid (MAAc) and acrylamide (AAm), and several working conditions were considered as influencing the degree of grafting. All this grafted polymers were used to study the possibility of a subsequent immobilization of Brucella antigen (BAg) in diagnostic test studies (ELISA).

  10. Study of an extrapolation chamber in a standard diagnostic radiology beam by Monte Carlo simulation

    International Nuclear Information System (INIS)

    Vedovato, Uly Pita; Silva, Rayre Janaina Vieira; Neves, Lucio Pereira; Santos, William S.; Perini, Ana Paula; Belinato, Walmir

    2016-01-01

    In this work, we studied the influence of the components of an extrapolation ionization chamber in its response. This study was undertaken using the MCNP-5 Monte Carlo code, and the standard diagnostic radiology quality for direct beams (RQR5). Using tally F6 and 2.1 x 10 9 simulated histories, the results showed that the chamber design and material not alter significantly the energy deposited in its sensitive volume. The collecting electrode and support board were the components with more influence on the chamber response. (author)

  11. National Energy Efficiency Evaluation, Measurement and Verification (EM&V) Standard: Scoping Study of Issues and Implementation Requirements

    Energy Technology Data Exchange (ETDEWEB)

    Schiller Consulting, Inc.; Schiller, Steven R.; Goldman, Charles A.; Galawish, Elsia

    2011-02-04

    This report is a scoping study that identifies issues associated with developing a national evaluation, measurement and verification (EM&V) standard for end-use, non-transportation, energy efficiency activities. The objectives of this study are to identify the scope of such a standard and define EM&V requirements and issues that will need to be addressed in a standard. To explore these issues, we provide and discuss: (1) a set of definitions applicable to an EM&V standard; (2) a literature review of existing guidelines, standards, and 'initiatives' relating to EM&V standards as well as a review of 'bottom-up' versus 'top-down' evaluation approaches; (3) a summary of EM&V related provisions of two recent federal legislative proposals (Congressman Waxman's and Markey's American Clean Energy and Security Act of 2009 and Senator Bingaman's American Clean Energy Leadership Act of 2009) that include national efficiency resource requirements; (4) an annotated list of issues that that are likely to be central to, and need to be considered when, developing a national EM&V standard; and (5) a discussion of the implications of such issues. There are three primary reasons for developing a national efficiency EM&V standard. First, some policy makers, regulators and practitioners believe that a national standard would streamline EM&V implementation, reduce costs and complexity, and improve comparability of results across jurisdictions; although there are benefits associated with each jurisdiction setting its own EM&V requirements based on their specific portfolio and evaluation budgets and objectives. Secondly, if energy efficiency is determined by the US Environmental Protection Agency to be a Best Available Control Technology (BACT) for avoiding criteria pollutant and/or greenhouse gas emissions, then a standard can be required for documenting the emission reductions resulting from efficiency actions. The third reason for a national

  12. Clinical Factors and Disease Course Related to Diagnostic Delay in Korean Crohn's Disease Patients: Results from the CONNECT Study.

    Directory of Open Access Journals (Sweden)

    Chang Mo Moon

    Full Text Available Diagnostic delay frequently occurs in Crohn's disease (CD patients because of diagnostic limitations. However, diagnostic delay and its related factors remain poorly defined. Therefore, we aimed to identify the predictors associated with diagnostic delay and to evaluate the impact of diagnostic delay on clinical course in a Korean CD patient cohort. We performed a multicenter retrospective analysis of 1,047 CD patients registered in the Crohn's Disease Clinical Network and Cohort study in Korea. The mean interval of diagnostic delay was 16.0 ± 33.1 months. Multivariate analysis showed that older age at diagnosis (≥40 years (p = 0.014, concomitant upper gastrointestinal (UGI disease (p = 0.012 and penetrating disease behavior at diagnosis (p = 0.001 were positively associated with long diagnostic delay (≥18 months. During the longitudinal follow-up, long diagnostic delay was independently predictive of further development of intestinal stenosis (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.07-1.93; p = 0.017, internal fistulas (HR, 1.62; 95% CI, 1.12-2.33; p = 0.011, and perianal fistulas (HR, 1.38; 95% CI, 1.06-1.80; p = 0.016. However, as for the risk of abscess formation, bowel perforation, and CD-related abdominal surgery, no significant association with diagnostic delay was observed. Older age at diagnosis, UGI involvement, and penetrating behavior are associated with long diagnostic delay in Korean CD patients. Moreover, diagnostic delay is associated with an increased risk of CD-related complications such as intestinal stenosis, internal fistulas, and perianal fistulas.

  13. The SCOPE Mission

    International Nuclear Information System (INIS)

    Fujimoto, M.; Tsuda, Y.; Saito, Y.; Shinohara, I.; Takashima, T.; Matsuoka, A.; Kojima, H.; Kasaba, Y.

    2009-01-01

    In order to reach the new horizon of the space physics research, the Plasma Universe, via in-situ measurements in the Earth's magnetosphere, SCOPE will perform formation flying observations combined with high-time resolution electron measurements. The simultaneous multi-scale observations by SCOPE of various plasma dynamical phenomena will enable data-based study of the key space plasma processes from the cross-scale coupling point of view. Key physical processes to be studied are magnetic reconnection under various boundary conditions, shocks in space plasma, collisionless plasma mixing at the boundaries, and physics of current sheets embedded in complex magnetic geometries. The SCOPE formation is made up of 5 spacecraft and is put into the equatorial orbit with the apogee at 30 Re (Re: earth radius). One of the spacecraft is a large mother ship which is equipped with a full suite of particle detectors including ultra-high time resolution electron detector. Among other 4 small spacecraft, one remains near (∼10 km) the mother ship and the spacecraft-pair will focus on the electron-scale physics. Others at the distance of 100∼3000 km(electron∼ion spatial scales) from the mother ship will monitor plasma dynamics surrounding the mother-daughter pair. There is lively on-going discussion on Japan-Europe international collaboration (ESA's Cross-Scale), which would certainly make better the coverage over the scales of interest and thus make the success of the mission, i.e., clarifying the multi-scale nature of the Plasma Universe, to be attained at an even higher level.

  14. Networked Microgrids Scoping Study

    Energy Technology Data Exchange (ETDEWEB)

    Starke, Michael R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-10-01

    While the utilization of a microgrid for local power reliability during grid outage and emergencies is a well-known benefit, the integration of microgrids with the broader electrical distribution system will allow for seamless interaction with distribution system operations, contributing to resource and economic optimization, enhanced reliability and resiliency, and improved power quality. By virtue of integration with the distribution system, multiple microgrids should be networked and collectively known as networked microgrids. As a follow-up to the work conducted by Oak Ridge National Laboratory on a microgrid controller [the Complete System-level Efficient and Interoperable Solution for Microgrid Integrated Controls (CSEISMIC)], the main goal of this work is to identify the next steps for bringing microgrid research to the utility industry, particularly as a resource for enhancing efficiency, reliability, and resilience. Various R&D needs for the integration of microgrids into the distribution system have been proposed, including interconnection types, communications, control architectures, quantification of benefits, functional requirements, and various operational issues.

  15. Effect of patient age awareness on diagnostic agreement of chronic or aggressive periodontitis between clinicians; a pilot study.

    Science.gov (United States)

    Oshman, Sarah; El Chaar, Edgard; Lee, Yoonjung Nicole; Engebretson, Steven

    2016-07-25

    The aim of this pilot study was to test whether diagnostic agreement of aggressive and chronic periodontitis amongst Board Certified Periodontists, is influenced by knowledge of a patient's age. In 1999 at the International World Workshop age was removed as a diagnostic criteria for aggressive periodontitis. The impact of this change on the diagnostic reliability amongst clinicians has not yet been assessed. Nine periodontal case reports were twice presented to sixteen board certified periodontists, once with age withheld and again with patient age provided. Participants were instructed to choose a diagnosis of Chronic Periodontitis or Aggressive Periodontitis. Diagnostic agreement was calculated using the Fleiss Kappa test. Including the patients' age in case report information increased diagnostic agreement (the kappa statistic) from 0.49 (moderate agreement) to 0.61 (substantial agreement). These results suggest that knowledge of a patients' age influenced clinical diagnosis, when distinguishing between aggressive periodontitis and chronic periodontitis, which may in turn impact treatment decision-making.

  16. Diagnostic inaccuracy and subject exclusions render placebo and observational studies of acute otitis media inconclusive.

    Science.gov (United States)

    Pichichero, Michael E; Casey, Janet R

    2008-11-01

    Diagnostic accuracy and appropriate inclusion/exclusion criteria representative of children at greatest risk is of paramount importance in trials to evaluate placebo or observation as an option for acute otitis media (AOM) management. Twelve observational studies spanning the time frame 1958-2005 and 13 natural history studies spanning the time frame 1968-2006 were evaluated for the diagnostic criteria, inclusion criteria, and exclusion criteria applied within the study design. Although a bulging or full tympanic membrane (TM) with effusion is the best indication of a diagnosis of bacterial AOM based on tympanocentesis findings, few observational and natural history studies required a bulging TM. Examination of subject inclusion criteria showed that many subjects did not have AOM but rather had no middle ear disease at all or they had otitis media with effusion. Exclusion criteria of subjects were also remarkable. Frequently children bias in exclusion criteria among placebo/natural history trials in AOM. The current data favoring observation of children with AOM should be reconsidered until better studies are conducted.

  17. Exploratory study of the implications of research on the use of smart connected devices for prevention: a scoping review

    Directory of Open Access Journals (Sweden)

    Audrey Petit

    2016-07-01

    Full Text Available Abstract Background Smart devices and mobile applications are now an integral part of all aspects of everyday life. They are particularly numerous in the field of health, contributing to the movement called ehealth. What is the potential role of these devices as prevention supports? The purpose of this article is to provide an exploratory analysis of the use, efficacy and contribution to conventional prevention strategies. Methods To address this issue, we conducted a scoping-review on the basis of 105 publications from the fields of medicine and human sciences. Results Three dimensions of the use of smart devices in the field of health were identified: 1/a quantification tool allowing the users to measure their activities; 2/a tool of self-positioning in the community; 3/an interface between the medical world and the population, modifying the hierarchy of knowledge. However, few published studies have investigated the determinants of the efficacy of these devices and their impact on individual behaviours and professional health practices. Conclusion Based on the hypothesis of possible integration of these devices in prevention policies, it would be interesting to investigate two research issues: how and under what psycho-socio-environmental conditions can smart devices contribute to the adoption of positive health behaviours? To what degree does the use of smart devices modify the health care professional-patient relationship? Finding answers to these questions could help to define the real place of these devices in prevention strategies by determining their complementarity with respect to other prevention strategies, and the conditions of their efficacy on behaviours and inequalities.

  18. New biomarkers defining a novel early stage of Fabry nephropathy: A diagnostic test study.

    Science.gov (United States)

    Aguiar, Patrício; Azevedo, Olga; Pinto, Rui; Marino, Jacira; Baker, Robert; Cardoso, Carlos; Ducla Soares, José Luís; Hughes, Derralynn

    2017-06-01

    Renal involvement in Fabry disease is a major determinant of overall disease prognosis and early enzyme replacement therapy seems effective in preventing progression of kidney injury. Gb3 storage, glomerular sclerosis and tubulo-interstitial fibrosis may occur with minimal or no changes on standard renal tests, hence alternative markers of renal dysfunction are crucial. In this study we compared several biomarkers with albuminuria in the identification of incipient Fabry nephropathy and their diagnostic accuracy to identify chronic kidney disease (CKD) stage≥2. In this multicentre, prospective, cross-sectional and diagnostic test study, a cohort of 78 Fabry patients and 25 healthy controls was consecutively recruited. Patients were grouped by severity of nephropathy: 1) albuminuria300mg/g; 4) glomerular filtration rate (GFR)Fabry patients, even in the subgroup of patients without evidence of nephropathy. We also found inverse significant correlations between estimated GFR and collagen type IV (ρ=-0.289; p=0.003) or N-acetyl-β-glucosaminidase (ρ=-0.448; p<0.001), which were stronger than with albumin (ρ=-0.274; p=0.019). There was also better diagnostic accuracy of N-acetyl-β-glucosaminidase to predict CKD stage≥2. These results suggest that studied biomarkers may overcome the limitations of albuminuria as sensitive marker of early renal dysfunction and as marker for CKD progression risk. These biomarkers may also define novel early stages of nephropathy characterized by mesangial expansion and/or tubular damage. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Potential Child Abuse Screening in Emergency Department; a Diagnostic Accuracy Study

    Science.gov (United States)

    Dinpanah, Hossein; Akbarzadeh Pasha, Abazar

    2017-01-01

    Introduction: Designing a tool that can differentiate those at risk of child abuse with great diagnostic accuracy is of great interest. The present study was designed to evaluate the diagnostic accuracy of Escape instrument in triage of at risk cases of child abuse presenting to emergency department (ED). Method: The present diagnostic accuracy study performed on 6120 of the children under 16 years old presented to ED during 3 years, using convenience sampling. Confirmation by the child abuse team (pediatrician, a social worker, and a forensic physician) was considered as the gold standard. Screening performance characteristics of Escape were calculated using STATA 21. Results: 6120 children with the mean age of 2.19 ± 1.12 years were screened (52.7% girls). 137 children were suspected victims of child abuse. Based on child abuse team opinion, 35 (0.5%) children were confirmed victims of child abuse. Sensitivity, specificity, positive and negative likelihood ratio and positive and negative predictive values of this test with 95% CI were 100 (87.6 – 100), 98.3 (97.9 – 98.6), 25.5 (18.6 – 33.8), 100 (99.9 – 100), 0.34 (0.25 – 0.46), and 0 (0 – NAN), respectively. Area under the ROC curve was 99.2 (98.9 – 99.4). Conclusion: It seems that Escape is a suitable screening instrument for detection of at risk cases of child abuse presenting to ED. Based on the results of the present study, the accuracy of this screening tool is 99.2%, which is in the excellent range. PMID:28286815

  20. Preterm premature rupture of membrane assessment via transperineal ultrasonography: a diagnostic accuracy study.

    Science.gov (United States)

    Kalafat, Erkan; Yuce, Tuncay; Tanju, Ozge; Koc, Acar

    2016-11-01

    The objective of this study is to evaluate diagnostic accuracy of transperineal ultrasound assessment compared to speculum examination by using placental alfa-microglobulin (PAMG)-1 tests as reference. This was a prospective observational study conducted in Ankara University Hospital. Women with early and late preterm pregnancies with suspected rupture of membranes, i.e. women with a complaint of fluid leakage (105 in total) were enrolled. Prior to speculum examination, sagittal and transverse plane views of the fornices and cervix were obtained via transperineal ultrasonography and images were stored. Then the speculum examination for amniotic fluid pooling was performed. Definite diagnoses were made with PAGM-1 assays. After collection of the data, ultrasound images were analyzed by an observer blind to physical examination findings. Hypoechogenic fluid appearance around the cervix and in the fornices was considered positive for preterm premature rupture of membranes (PPROM). Results of physical and ultrasound examination were compared with PAMG-1 test as a reference method. The diagnostic performance of transperineal ultrasound was tested with accuracy parameters and receiver-operating characteristics (ROC) curves. Inter-rater reliability was analyzed with Cohen's kappa. In total, 103 pregnant women were evaluated. The prevalence of PPROM in our study population was 43.14%. At a 5 mm diagnostic threshold, the sensitivity and specificity values of transperineal assessment were 95.45% (95% CI: 84.50-99.31%) and 96.55% (95% CI: 88.07-99.48%), respectively, and they were comparable with speculum examination in a population of preterm pregnant women with suspected PPROM (p > 0.05). Interobserver reliability analysis with Cohen's kappa has shown good very good agreement with the kappa value of 0.93 (95% CI 0.87-1.00). Transperineal ultrasonography is a novel method that can be used to assess vaginal pooling of amniotic fluid. Ultrasonography offers similar

  1. Potential Child Abuse Screening in Emergency Department; a Diagnostic Accuracy Study.

    Science.gov (United States)

    Dinpanah, Hossein; Akbarzadeh Pasha, Abazar

    2017-01-01

    Designing a tool that can differentiate those at risk of child abuse with great diagnostic accuracy is of great interest. The present study was designed to evaluate the diagnostic accuracy of Escape instrument in triage of at risk cases of child abuse presenting to emergency department (ED). The present diagnostic accuracy study performed on 6120 of the children under 16 years old presented to ED during 3 years, using convenience sampling. Confirmation by the child abuse team (pediatrician, a social worker, and a forensic physician) was considered as the gold standard. Screening performance characteristics of Escape were calculated using STATA 21. 6120 children with the mean age of 2.19 ± 1.12 years were screened (52.7% girls). 137 children were suspected victims of child abuse. Based on child abuse team opinion, 35 (0.5%) children were confirmed victims of child abuse. Sensitivity, specificity, positive and negative likelihood ratio and positive and negative predictive values of this test with 95% CI were 100 (87.6 - 100), 98.3 (97.9 - 98.6), 25.5 (18.6 - 33.8), 100 (99.9 - 100), 0.34 (0.25 - 0.46), and 0 (0 - NAN), respectively. Area under the ROC curve was 99.2 (98.9 - 99.4). It seems that Escape is a suitable screening instrument for detection of at risk cases of child abuse presenting to ED. Based on the results of the present study, the accuracy of this screening tool is 99.2%, which is in the excellent range.

  2. Reliability studies of diagnostic methods in Indian traditional Ayurveda medicine: An overview

    Science.gov (United States)

    Kurande, Vrinda Hitendra; Waagepetersen, Rasmus; Toft, Egon; Prasad, Ramjee

    2013-01-01

    Recently, a need to develop supportive new scientific evidence for contemporary Ayurveda has emerged. One of the research objectives is an assessment of the reliability of diagnoses and treatment. Reliability is a quantitative measure of consistency. It is a crucial issue in classification (such as prakriti classification), method development (pulse diagnosis), quality assurance for diagnosis and treatment and in the conduct of clinical studies. Several reliability studies are conducted in western medicine. The investigation of the reliability of traditional Chinese, Japanese and Sasang medicine diagnoses is in the formative stage. However, reliability studies in Ayurveda are in the preliminary stage. In this paper, examples are provided to illustrate relevant concepts of reliability studies of diagnostic methods and their implication in practice, education, and training. An introduction to reliability estimates and different study designs and statistical analysis is given for future studies in Ayurveda. PMID:23930037

  3. Pressurized water reactor monitoring. Study of detection, diagnostic and estimation (least squares and filtering) methods

    International Nuclear Information System (INIS)

    Gillet, M.

    1986-07-01

    This thesis presents a study for the surveillance of the Primary circuit water inventory of a pressurized water reactor. A reference model is developed for the development of an automatic system ensuring detection and real-time diagnostic. The methods to our application are statistical tests and adapted a pattern recognition method. The estimation of the detected anomalies is treated by the least square fit method, and by filtering. A new projected optimization method with superlinear convergence is developed in this framework, and a segmented linearization of the model is introduced, in view of a multiple filtering. 46 refs [fr

  4. Substantia nigra fractional anisotropy is not a diagnostic biomarker of Parkinson's disease: A diagnostic performance study and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hirata, Fabiana C.C.; Vieira, Gilson; Lucato, Leandro T.; Leite, Claudia C.; Pastorello, Bruno F.; Otaduy, Maria C.G.; Chaim, Khallil T.; Campanholo, Kenia R. [University of Sao Paulo, LIM-44, Department of Radiology, Sao Paulo, SP (Brazil); Sato, Joao R. [University of Sao Paulo, LIM-44, Department of Radiology, Sao Paulo, SP (Brazil); Universidade Federal do ABC, Center of Mathematics, Computation and Cognition, Santo Andre (Brazil); Bor-Seng-Shu, Edson; Novaes, Natalia P. [Hospital Israelita Albert Einstein, Sao Paulo (Brazil); University of Sao Paulo, Department of Neurology, Sao Paulo (Brazil); Magalhaes Melo, Luciano; Goncalves, Marcia R.; Reis Barbosa, Egberto [University of Sao Paulo, Department of Neurology, Sao Paulo (Brazil); Pereira do Nascimento, Felipe Barjud; Amaro, Edson [University of Sao Paulo, LIM-44, Department of Radiology, Sao Paulo, SP (Brazil); Hospital Israelita Albert Einstein, Sao Paulo (Brazil); Jacobsen Teixeira, Manoel [University of Sao Paulo, Department of Neurosurgery, Sao Paulo (Brazil); Cardoso, Ellison Fernando [University of Sao Paulo, LIM-44, Department of Radiology, Sao Paulo, SP (Brazil); Hospital Israelita Albert Einstein, Sao Paulo (Brazil); Institute of Mathematics and Statistics University of Sao Paulo (IME-USP), Sao Paulo (Brazil)

    2017-06-15

    Our goal was to estimate the diagnostic accuracy of substantia nigra fractional anisotropy (SN-FA) for Parkinson's disease (PD) diagnosis in a sample similar to the clinical setting, including patients with essential tremor (ET) and healthy controls (HC). We also performed a systematic review and meta-analysis to estimate mean change in SN-FA induced by PD and its diagnostic accuracy. Our sample consisted of 135 subjects: 72 PD, 21 ET and 42 HC. To address inter-scanner variability, two 3.0-T MRI scans were performed. MRI results of this sample were pooled into a meta-analysis that included 1,432 subjects (806 PD and 626 HC). A bivariate model was used to evaluate diagnostic accuracy measures. In our sample, we did not observe a significant effect of disease on SN-FA and it was uninformative for diagnosis. The results of the meta-analysis estimated a 0.03 decrease in mean SN-FA in PD relative to HC (CI: 0.01-0.05). However, the discriminatory capability of SN-FA to diagnose PD was low: pooled sensitivity and specificity were 72 % (CI: 68-75) and 63 % (CI: 58-70), respectively. There was high heterogeneity between studies (I{sup 2} = 91.9 %). SN-FA cannot be used as an isolated measure to diagnose PD. (orig.)

  5. Diagnostic X-ray examinations and increased chromosome translocations: evidence from three studies.

    Science.gov (United States)

    Bhatti, Parveen; Yong, Lee C; Doody, Michele M; Preston, Dale L; Kampa, Diane M; Ramsey, Marilyn J; Ward, Elizabeth M; Edwards, Alan A; Ron, Elaine; Tucker, James D; Sigurdson, Alice J

    2010-11-01

    Controversy regarding potential health risks from increased use of medical diagnostic radiologic examinations has come to public attention. We evaluated whether chromosome damage, specifically translocations, which are a potentially intermediate biomarker for cancer risk, was increased after exposure to diagnostic X-rays, with particular interest in the ionizing radiation dose-response below the level of approximately 50 mGy. Chromosome translocation frequency data from three separately conducted occupational studies of ionizing radiation were pooled together. Studies 1 and 2 included 79 and 150 medical radiologic technologists, respectively, and study 3 included 83 airline pilots and 50 university faculty members (total = 155 women and 207 men; mean age = 62 years, range 34-90). Information on personal history of radiographic examinations was collected from a detailed questionnaire. We computed a cumulative red bone marrow (RBM) dose score based on the numbers and types of X-ray examinations reported with 1 unit approximating 1 mGy. Poisson regression analyses were adjusted for age and laboratory method. Mean RBM dose scores were 49, 42, and 11 for Studies 1-3, respectively (overall mean = 33.5, range 0-303). Translocation frequencies significantly increased with increasing dose score (P X-ray examinations, including dose scores of approximately 50 and lower, suggesting the possibility of long-term adverse health effects.

  6. A diagnosis of bipolar spectrum disorder predicts diagnostic conversion from unipolar depression to bipolar disorder: a 5-year retrospective study.

    Science.gov (United States)

    Woo, Young Sup; Shim, In Hee; Wang, Hee-Ryung; Song, Hoo Rim; Jun, Tae-Youn; Bahk, Won-Myong

    2015-03-15

    The major aims of this study were to identify factors that may predict the diagnostic conversion from major depressive disorder (MDD) to bipolar disorder (BP) and to evaluate the predictive performance of the bipolar spectrum disorder (BPSD) diagnostic criteria. The medical records of 250 patients with a diagnosis of MDD for at least 5 years were retrospectively reviewed for this study. The diagnostic conversion from MDD to BP was observed in 18.4% of 250 MDD patients, and the diagnostic criteria for BPSD predicted this conversion with high sensitivity (0.870) and specificity (0.917). A family history of BP, antidepressant-induced mania/hypomania, brief major depressive episodes, early age of onset, antidepressant wear-off, and antidepressant resistance were also independent predictors of this conversion. This study was conducted using a retrospective design and did not include structured diagnostic interviews. The diagnostic criteria for BPSD were highly predictive of the conversion from MDD to BP, and conversion was associated with several clinical features of BPSD. Thus, the BPSD diagnostic criteria may be useful for the prediction of bipolar diathesis in MDD patients. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Diagnostic value of immunoperoxidase staining and immunofluorescence in the study of kidney biopsy specimens.

    Science.gov (United States)

    Jafari, Mohammad; Monsef-Esfahani, Alireza; Solimani, Bahram

    2015-07-01

    This study aimed to determine diagnostic value of immunoperoxidase in comparison with immunofluorescence in the diagnostic assessment of kidney biopsy specimens. Forty-eight kidney biopsy specimens were used to compare a direct immunofluorescence technique with immunoperoxidase techniques on paraffin sections. The sensitivity and specificity were calculated. The kappa statistic for agreement between the two tests was categorized as poor (zero to 0.2), moderate (0.21 to 0.45), good (0.46 to 0.75), and almost perfect concordance (0.76 to 1.0). Compared with immunofluorescence, the immunoperoxidase technique presented a sensitivity of 88.55% and a specificity of 69.22%. Its sensitivity in the staining for IgG, IgM, and IgA was 93.75%, 95.45%, and 76.47%, respectively. The specificity of this test in the staining for IgG, IgM, and IgA was 54.54%, 57.14%, and 96.00%, respectively. The overall kappa value was 0.60 and it was 0.60 for assessing staining intensity. There was a moderate agreement between immunoperoxidase and immunofluorescence in the positive or negative staining for IgG and IgM, as well as a good agreement in the positive or negative staining for IgA. For the staining intensity, the two tests had a good concordance for IgG and IgA and a moderate concordance for IgM. Although immunoperoxidase method has a lower overall diagnostic performance as compared to immunofluorescence, given the good concordance between the two techniques, it can be an alternative method for immunofluorescence study of kidney biopsy specimens, particularly where immunofluorescence fails or is not available.

  8. Development of consensus statements for pregnancy screening in diagnostic nuclear medicine: a Delphi study.

    Science.gov (United States)

    James, Daphne J; Warren-Forward, Helen M

    2015-03-01

    Current radiation protection recommendations do not provide clear guidelines or advice on pregnancy screening strategies for diagnostic nuclear medicine procedures. Previous studies have reported on variations in current practice for pregnancy screening before diagnostic nuclear medicine procedures. The development of consensus statements aims to provide a consistent approach and assist nuclear medicine personnel to confidently question patients about their pregnancy status. The Delphi technique was chosen for the research design. A panel consisting of 10 experienced nuclear medicine personnel from Australia and New Zealand was recruited. Panel members were provided with a summary of existing research. Consensus agreement was predefined as 80%. Questionnaires were developed and distributed to the panel members, with iterative analysis and feedback between survey rounds. Three survey rounds were conducted online using SurveyMonkey between December 2013 and June 2014. The round 1 questionnaire was developed from the results of a previous survey. It consisted of 30 questions designed to gather the opinions of the expert panel. After analysis of the round 1 responses, consensus statements were developed for round 2 and revised in round 3. Consensus was achieved for 16 statements. The statements recommend using verbal questioning with patient signature, defining the age range for questioning as 12-55 y, providing advice on the use of pregnancy testing, and questioning potentially difficult groups such as teenagers. A flowchart was included for comment in round 3. This was the first Australian study to develop consensus statements and a flowchart to assist nuclear medicine personnel in consistently and confidently questioning patients about their pregnancy status before diagnostic procedures. Implementation of these statements into clinical practice guidelines should reduce the possibility of inadvertent fetal irradiation. © 2015 by the Society of Nuclear Medicine and

  9. Consensus-based reporting standards for diagnostic test accuracy studies for paratuberculosis in ruminants

    DEFF Research Database (Denmark)

    Gardner, Ian A.; Nielsen, Søren Saxmose; Whittington, Richard

    2011-01-01

    The Standards for Reporting of Diagnostic Accuracy (STARD) statement (www.stard-statement.org) was developed to encourage complete and transparent reporting of key elements of test accuracy studies in human medicine. The statement was motivated by widespread evidence of bias in test accuracy...... studies and the finding that incomplete or absent reporting of items in the STARD checklist was associated with overly optimistic estimates of test performance characteristics. Although STARD principles apply broadly, specific guidelines do not exist to account for unique considerations in livestock...... studies such as herd tests, potential use of experimental challenge studies, a more diverse group of testing purposes and sampling designs, and the widespread lack of an ante-mortem reference standard with high sensitivity and specificity. The objective of the present study was to develop a modified...

  10. Scoping Review of the Zika Virus Literature.

    Directory of Open Access Journals (Sweden)

    Lisa A Waddell

    Full Text Available The global primary literature on Zika virus (ZIKV (n = 233 studies and reports, up to March 1, 2016 has been compiled using a scoping review methodology to systematically identify and characterise the literature underpinning this broad topic using methods that are documented, updateable and reproducible. Our results indicate that more than half the primary literature on ZIKV has been published since 2011. The articles mainly covered three topic categories: epidemiology of ZIKV (surveillance and outbreak investigations 56.6% (132/233, pathogenesis of ZIKV (case symptoms/ outcomes and diagnosis 38.2% (89/233 and ZIKV studies (molecular characterisation and in vitro evaluation of the virus 18.5% (43/233. There has been little reported in the primary literature on ZIKV vectors (12/233, surveillance for ZIKV (13/233, diagnostic tests (12/233 and transmission (10/233. Three papers reported on ZIKV prevention/control strategies, one investigated knowledge and attitudes of health professionals and two vector mapping studies were reported. The majority of studies used observational study designs, 89.7% (209/233, of which 62/233 were case studies or case series, while fewer (24/233 used experimental study designs. Several knowledge gaps were identified by this review with respect to ZIKV epidemiology, the importance of potential non-human primates and other hosts in the transmission cycle, the burden of disease in humans, and complications related to human infection with ZIKV. Historically there has been little research on ZIKV; however, given its current spread through Australasia and the Americas, research resources are now being allocated to close many of the knowledge gaps identified in this scoping review. Future updates of this project will probably demonstrate enhanced evidence and understanding of ZIKV and its impact on public health.

  11. Scoping Review of the Zika Virus Literature

    Science.gov (United States)

    2016-01-01

    The global primary literature on Zika virus (ZIKV) (n = 233 studies and reports, up to March 1, 2016) has been compiled using a scoping review methodology to systematically identify and characterise the literature underpinning this broad topic using methods that are documented, updateable and reproducible. Our results indicate that more than half the primary literature on ZIKV has been published since 2011. The articles mainly covered three topic categories: epidemiology of ZIKV (surveillance and outbreak investigations) 56.6% (132/233), pathogenesis of ZIKV (case symptoms/ outcomes and diagnosis) 38.2% (89/233) and ZIKV studies (molecular characterisation and in vitro evaluation of the virus) 18.5% (43/233). There has been little reported in the primary literature on ZIKV vectors (12/233), surveillance for ZIKV (13/233), diagnostic tests (12/233) and transmission (10/233). Three papers reported on ZIKV prevention/control strategies, one investigated knowledge and attitudes of health professionals and two vector mapping studies were reported. The majority of studies used observational study designs, 89.7% (209/233), of which 62/233 were case studies or case series, while fewer (24/233) used experimental study designs. Several knowledge gaps were identified by this review with respect to ZIKV epidemiology, the importance of potential non-human primates and other hosts in the transmission cycle, the burden of disease in humans, and complications related to human infection with ZIKV. Historically there has been little research on ZIKV; however, given its current spread through Australasia and the Americas, research resources are now being allocated to close many of the knowledge gaps identified in this scoping review. Future updates of this project will probably demonstrate enhanced evidence and understanding of ZIKV and its impact on public health. PMID:27244249

  12. Group-as-a-whole as a context for studying individual behaviour: A group diagnostic intervention

    Directory of Open Access Journals (Sweden)

    Dirk J. Geldenhuys

    2012-06-01

    Motivation for the study: Team research and practice is not on a par with the complexities that teams actually experience. Traditional group interventions use humanistic and functionalistic paradigms that do not consider the unconscious functioning of groups. Interventions that use the system psychodynamic paradigm could address these dynamics because they study behaviour of individual group members in the context of the group-as-a-whole. Research design, approach and method: The researcher conducted action research in a publishing company. He used purposive sampling and analysed the data using qualitative content analysis. Main findings: The researcher found that the group-as-a-whole partly explains the behaviour of team members and that intervening from this perspective could improve negative relationships. Practical/managerial implications: Managers can use interventions that use the groupas- a-whole concept as a diagnostic intervention to study and possibly change the complex behavioural issues that team members experience. Contribution/value-add: The findings give one an understanding of the behaviour of individual group members when one views it from a systems psychodynamic stance. Furthermore, the researcher proposes a group diagnostic intervention that will allow some of the root causes of poor interpersonal behaviour to surface and group members to diagnose and take ownership of their own behaviour.

  13. Odontogenic tumors: A retrospective study of four Brazilian diagnostic pathology centers

    Science.gov (United States)

    da-Costa, Daniela O P.; Maurício, Almir S.; de-Faria, Paulo A S.; da-Silva, Licínio E.; Mosqueda-Taylor, Adalberto

    2012-01-01

    Objective: This article presents the results of a retrospective study of the frequency and classification of odontogenic tumors recorded at four centers of diagnostic pathology in Rio de Janeiro, Brazil. Study Design: All medical records and microscopic slides of odontogenic tumor specimens for the years 1997 to 2007 were retrieved from the files of four services of diagnostic pathology in Rio de Janeiro City. Diagnoses were re-evaluated and the tumors classified according to the latest (2005) World Health Organization Classification of Tumors. Results: A total of 201 odontogenic tumors were found among 15,758 oral biopsies (1.3%). The frequencies of these tumors at the four centers ranged from 0.5% at the National Cancer Institute to 3.3% in a private laboratory. Chi-square analysis revealed statistically significant differences (p<0.05) between the proportions of odontogenic tumors in the studied centers. Of these, 94.5% were benign and 5.5% were malignant. Keratocystic odontogenic tumor (32.3%) was the most frequent lesion, followed by ameloblastoma (29.8%) and odontoma (18.4%). Conclusions: Odontogenic tumors are uncommon in Brazil. Different pathology laboratories reported divergent frequencies of odontogenic tumors, which may reflect institutional specializations and the patient populations served. Key words:Odontogenic tumors, jaw neoplasms, epidemiology, WHO classification. PMID:22143740

  14. A study on the diagnostic accuracy of gastrofiberscopy in the diagnosis of various gastric diseases

    International Nuclear Information System (INIS)

    Chin, Soo Il; Park, Charn Il; Kim, Young Kun; Oh, In Hyuk

    1971-01-01

    Gastrofiberscopy as well as roentgenologic examination of stomach, is now considered to be one of the indispensable diagnostic method of gastric disease. In general it is agreed that the roentgenologic examination is convenient for observation of shape, contour, motor function and gross lesion of stomach white gastrofiberscopy is especially valuable in detection of mucosal changes or small lesions of stomach. For evaluation of gastrofiberscopy in the diagnosis of various gastric diseases, the diagnostic accuracy of gastrofiberscopy was studied in 964 cases who underwent the fiberscopic examination in SNUH during the period from March 1, 1968 till April 30, 1971. The following results were obtained. 1. Each fiberscopic diagnosis in the 964 cases was classified as follows: normal stomach 414 cases (42.9%), gastritis 74 cases (7.7%), gastric ulcer 134 cases (13.9%), healed ulcer 14 cases (1.5%), benign pyloric stenosis 15 cases (1.6%), suspicious duodenal ulcer 23 cases (2.4%), gastric polyp 6 cases (0.6%), leiomyoma 1 case (0.1%), bezoar 2 cases (0.2%), xanthoma 1 case (0.1%), gastric carcinoma 237 case (24.6%), extrinstic mass 1 case (0.1%), post-operative condition 9 cases (0.9%), unsatisfactory examination 31 cases (3.2%), indeterminate diagnosis 2 cases (0.2%). 2. In various gastric diseases, the coincidence rate of diagnosis between fiberscopic and roentgenologic examination was studied and the obtained results are as follows: in normal stomach 72.9% (302/414), gastric ulcer 69.4% (93/134), healed ulcer 42.9% (6/14), benign pyloric stenosis 86.7% (13/15), duodenal ulcer 100.0% (23/23), gastric polyp 66.7% (4/6), gastric carcinoma 87.8% (208/237), post operative condition 66.7% (6/9). The overall result shows that the diagnostic coincidence between the two methods was observed in 67.7% of the cases (653/964). 3. The diagnostic accuracy of fiberscopic examination was 85.7% (24/28) in the diagnosis of gastric ulcer, 75.0% (6/8) in the diagnosis of benign pyloric

  15. Formulation and acoustic studies of a new phase-shift agent for diagnostic and therapeutic ultrasound.

    Science.gov (United States)

    Sheeran, Paul S; Luois, Samantha; Dayton, Paul A; Matsunaga, Terry O

    2011-09-06

    Recent efforts in the area of acoustic droplet vaporization with the objective of designing extravascular ultrasound contrast agents has led to the development of stabilized, lipid-encapsulated nanodroplets of the highly volatile compound decafluorobutane (DFB). We developed two methods of generating DFB droplets, the first of which involves condensing DFB gas (boiling point from -1.1 to -2 °C) followed by extrusion with a lipid formulation in HEPES buffer. Acoustic droplet vaporization of micrometer-sized lipid-coated droplets at diagnostic ultrasound frequencies and mechanical indices were confirmed optically. In our second formulation methodology, we demonstrate the formulation of submicrometer-sized lipid-coated nanodroplets based upon condensation of preformed microbubbles containing DFB. The droplets are routinely in the 200-300 nm range and yield microbubbles on the order of 1-5 μm once vaporized, consistent with ideal gas law expansion predictions. The simple and effective nature of this methodology allows for the development of a variety of different formulations that can be used for imaging, drug and gene delivery, and therapy. This study is the first to our knowledge to demonstrate both a method of generating ADV agents by microbubble condensation and formulation of primarily submicrometer droplets of decafluorobutane that remain stable at physiological temperatures. Finally, activation of DFB nanodroplets is demonstrated using pressures within the FDA guidelines for diagnostic imaging, which may minimize the potential for bioeffects in humans. This methodology offers a new means of developing extravascular contrast agents for diagnostic and therapeutic applications. © 2011 American Chemical Society

  16. A Delphi study to develop practical diagnostic guidelines for visual stress (pattern-related visual stress).

    Science.gov (United States)

    Evans, Bruce J W; Allen, Peter M; Wilkins, Arnold J

    Visual stress (VS) is characterised by symptoms of visual perceptual distortions and eyestrain when viewing text, symptoms that are alleviated by individually prescribed coloured filters. A recent review supports the existence of VS and its treatment, but noted that controversy remains, in part due to inconsistencies in the diagnosis of the condition. The present paper reviews the diagnostic criteria for VS in the literature and reports a Delphi analysis of the criteria currently used in clinical practice. Twenty-six eyecare practitioners were invited to participate in a Delphi study. They were selected because they were frequent prescribers of precision tinted lenses. In the first round they were sent a list of the indicators for which there is literature to suggest a relevance in the diagnosis of VS. The practitioners were invited to rank the indicators and add any additional criteria they use in diagnosis. In the second round a revised list was circulated, including items added from the responses in the first round. The respondents included optometrists, orthoptists and opticians. In the first round the response rate was 85%. Ninety-one percent of those who participated in the first round also responded in the second round. Strong indicators in the second round included the symptom of words moving when reading, voluntary use of an overlay for a prolonged period, improved performance of ≥15% with an overlay on the Wilkins Rate of Reading test, and an abnormally high score on the Pattern Glare Test. The strongest diagnostic criteria are combined in a diagnostic tool. This is proposed as a guide for clinical practice and further research. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  17. Does improved access to diagnostic imaging results reduce hospital length of stay? A retrospective study

    Directory of Open Access Journals (Sweden)

    Hurlen Petter

    2010-09-01

    Full Text Available Abstract Background One year after the introduction of Information and Communication Technology (ICT to support diagnostic imaging at our hospital, clinicians had faster and better access to radiology reports and images; direct access to Computed Tomography (CT reports in the Electronic Medical Record (EMR was particularly popular. The objective of this study was to determine whether improvements in radiology reporting and clinical access to diagnostic imaging information one year after the ICT introduction were associated with a reduction in the length of patients' hospital stays (LOS. Methods Data describing hospital stays and diagnostic imaging were collected retrospectively from the EMR during periods of equal duration before and one year after the introduction of ICT. The post-ICT period was chosen because of the documented improvement in clinical access to radiology results during that period. The data set was randomly split into an exploratory part used to establish the hypotheses, and a confirmatory part. The data was used to compare the pre-ICT and post-ICT status, but also to compare differences between groups. Results There was no general reduction in LOS one year after ICT introduction. However, there was a 25% reduction for one group - patients with CT scans. This group was heterogeneous, covering 445 different primary discharge diagnoses. Analyses of subgroups were performed to reduce the impact of this divergence. Conclusion Our results did not indicate that improved access to radiology results reduced the patients' LOS. There was, however, a significant reduction in LOS for patients undergoing CT scans. Given the clinicians' interest in CT reports and the results of the subgroup analyses, it is likely that improved access to CT reports contributed to this reduction.

  18. Pain over speed bumps in diagnosis of acute appendicitis: diagnostic accuracy study.

    Science.gov (United States)

    Ashdown, Helen F; D'Souza, Nigel; Karim, Diallah; Stevens, Richard J; Huang, Andrew; Harnden, Anthony

    2012-12-14

    To assess the diagnostic accuracy of pain on travelling over speed bumps for the diagnosis of acute appendicitis. Prospective questionnaire based diagnostic accuracy study. Secondary care surgical assessment unit at a district general hospital in the UK. 101 patients aged 17-76 years referred to the on-call surgical team for assessment of possible appendicitis. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios for pain over speed bumps in diagnosing appendicitis, with histological diagnosis of appendicitis as the reference standard. The analysis included 64 participants who had travelled over speed bumps on their journey to hospital. Of these, 34 had a confirmed histological diagnosis of appendicitis, 33 of whom reported increased pain over speed bumps. The sensitivity was 97% (95% confidence interval 85% to 100%), and the specificity was 30% (15% to 49%). The positive predictive value was 61% (47% to 74%), and the negative predictive value was 90% (56% to 100%). The likelihood ratios were 1.4 (1.1 to 1.8) for a positive test result and 0.1 (0.0 to 0.7) for a negative result. Speed bumps had a better sensitivity and negative likelihood ratio than did other clinical features assessed, including migration of pain and rebound tenderness. Presence of pain while travelling over speed bumps was associated with an increased likelihood of acute appendicitis. As a diagnostic variable, it compared favourably with other features commonly used in clinical assessment. Asking about speed bumps may contribute to clinical assessment and could be useful in telephone assessment of patients.

  19. A Study on the Diagnostic Detection Ability of the Artificial Proximal Caries by Digora

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Kyung Ran; Choi, Eui Hwan; Kim, Jae Duck [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Chosun University, Kwangju (Korea, Republic of)

    1998-08-15

    Digora system is an intraoral indirect digital radiography system utilizing storage phosphor image plate. It has wide dynamic range which allows it to decrease the patient's exposure time and may increase diagnostic ability through image processing (such as edge enhancement, grey scale conversion, brightness change, and contrast enhancement). And also, it can transmit and storage image information. The purpose of this study was to evaluate the diagnostic ability of artificial proximal caries between Conventional radiograph and Digora images (unenhanced image, brightness and contrast controlled image, and edge enhanced image). ROC (Receiver Operating Characteristic) analysis, paired t-tests, and F-tests were done for the statistical evaluation of detectability. The following results were acquired: 1. In Grade I lesions, the mean ROC areas of Conventional radiograph, Digora unenhanced image, Digora controlled image, and Digora edge enhanced image were 0.953, 0.933, 0.965, 0.978 (p>0.05). 2. In Grade II lesions, the mean ROC areas of Conventional radiograph, Digora unenhanced image, Digora controlled image, and Digora edge enhanced image were 0.969, 0.964, 0.988, 0.994. Among theses areas, there was just statistical significance between Diagnostic abilities of Digora edge enhanced image and Conventional radiograph (p<0.05). 3. In the Interobserver variability, the ROC curve areas of Digora edge enhanced image was lowerest in these areas, regardless of the Carious lesion depths. In conclusion, intraoral indirect digital system, Digora system, has the potential possibility as an alternative of Conventional radiograph in the diagnosis of proximal caries.

  20. A Study on the Diagnostic Detection Ability of the Artificial Proximal Caries by Digora

    International Nuclear Information System (INIS)

    Oh, Kyung Ran; Choi, Eui Hwan; Kim, Jae Duck

    1998-01-01

    Digora system is an intraoral indirect digital radiography system utilizing storage phosphor image plate. It has wide dynamic range which allows it to decrease the patient's exposure time and may increase diagnostic ability through image processing (such as edge enhancement, grey scale conversion, brightness change, and contrast enhancement). And also, it can transmit and storage image information. The purpose of this study was to evaluate the diagnostic ability of artificial proximal caries between Conventional radiograph and Digora images (unenhanced image, brightness and contrast controlled image, and edge enhanced image). ROC (Receiver Operating Characteristic) analysis, paired t-tests, and F-tests were done for the statistical evaluation of detectability. The following results were acquired: 1. In Grade I lesions, the mean ROC areas of Conventional radiograph, Digora unenhanced image, Digora controlled image, and Digora edge enhanced image were 0.953, 0.933, 0.965, 0.978 (p>0.05). 2. In Grade II lesions, the mean ROC areas of Conventional radiograph, Digora unenhanced image, Digora controlled image, and Digora edge enhanced image were 0.969, 0.964, 0.988, 0.994. Among theses areas, there was just statistical significance between Diagnostic abilities of Digora edge enhanced image and Conventional radiograph (p<0.05). 3. In the Interobserver variability, the ROC curve areas of Digora edge enhanced image was lowerest in these areas, regardless of the Carious lesion depths. In conclusion, intraoral indirect digital system, Digora system, has the potential possibility as an alternative of Conventional radiograph in the diagnosis of proximal caries.

  1. Sensitivity analysis for publication bias in meta-analysis of diagnostic studies for a continuous biomarker.

    Science.gov (United States)

    Hattori, Satoshi; Zhou, Xiao-Hua

    2018-02-10

    Publication bias is one of the most important issues in meta-analysis. For standard meta-analyses to examine intervention effects, the funnel plot and the trim-and-fill method are simple and widely used techniques for assessing and adjusting for the influence of publication bias, respectively. However, their use may be subjective and can then produce misleading insights. To make a more objective inference for publication bias, various sensitivity analysis methods have been proposed, including the Copas selection model. For meta-analysis of diagnostic studies evaluating a continuous biomarker, the summary receiver operating characteristic (sROC) curve is a very useful method in the presence of heterogeneous cutoff values. To our best knowledge, no methods are available for evaluation of influence of publication bias on estimation of the sROC curve. In this paper, we introduce a Copas-type selection model for meta-analysis of diagnostic studies and propose a sensitivity analysis method for publication bias. Our method enables us to assess the influence of publication bias on the estimation of the sROC curve and then judge whether the result of the meta-analysis is sufficiently confident or should be interpreted with much caution. We illustrate our proposed method with real data. Copyright © 2017 John Wiley & Sons, Ltd.

  2. Diagnostic accuracy of proximal caries by digital radiographs: an in vivo and in vitro comparative study.

    Science.gov (United States)

    Li, Gang; Qu, Xin-min; Chen, Yan; Zhang, Jie; Zhang, Zu-yan; Ma, Xu-chen

    2010-03-01

    The aim of this study was to evaluate if the diagnostic accuracy of proximal dental caries in digital radiographs was similar when obtained in in vivo and in vitro conditions. Thirty-nine noncavitated teeth were collected from 11 subjects who had part of upper or lower jaws excised owing to cyst or neoplasm. Before operation, radiographs of the teeth involved were taken with the digital imaging system Digora Optime (Soredex, Helsinki, Finland), and after operation, the same extracted teeth were mounted in plaster blocks and exposed with the same digital imaging system. The teeth were subsequently sectioned for histologic validation of the lesions. Six observers evaluated all of the radiographs according to a 5-category scale. Receiver operating characteristic analysis was performed. Repeated-measure analysis of variance was used for the statistical analysis. There were no significant differences between digital radiographs taken in in vivo and in vitro conditions for diagnosis of proximal dental caries (P = .286). Detection accuracy of proximal dental caries obtained from an in vitro study can be considered to be representative of diagnostic accuracy of proximal dental caries obtained in the real clinical situation. Copyright 2010 Mosby, Inc. All rights reserved.

  3. Which diagnostic findings in disorders with excessive daytime sleepiness are really helpful? A retrospective study.

    Science.gov (United States)

    Kretzschmar, Ute; Werth, Esther; Sturzenegger, Christian; Khatami, Ramin; Bassetti, Claudio L; Baumann, Christian R

    2016-06-01

    Due to extensive clinical and electrophysiological overlaps, the correct diagnosis of disorders with excessive daytime sleepiness is often challenging. The aim of this study was to provide diagnostic measures that help discriminating such disorders, and to identify parameters, which don't. In this single-center study, we retrospectively identified consecutive treatment-naïve patients who suffered from excessive daytime sleepiness, and analyzed clinical and electrophysiological measures in those patients in whom a doubtless final diagnosis could be made. Of 588 patients, 287 reported subjective excessive daytime sleepiness. Obstructive sleep apnea is the only disorder that could be identified by polysomnography alone. The diagnosis of insufficient sleep syndrome relies on actigraphy as patients underestimate their sleep need and the disorder shares several clinical and electrophysiological properties with both narcolepsy type 1 and idiopathic hypersomnia. Sleep stage sequencing on MSLT appears helpful to discriminate between insufficient sleep syndrome and narcolepsy. Sleep inertia is a strong indicator for idiopathic hypersomnia. There are no distinctive electrophysiological findings for the diagnosis of restless legs syndrome. Altogether, EDS disorders are common in neurological sleep laboratories, but usually cannot be diagnosed based on PSG and MSLT findings alone. The diagnostic value of actigraphy recordings can hardly be overestimated. © 2016 European Sleep Research Society.

  4. Emergency Sonography Aids Diagnostic Accuracy of Torso Injuries: A Study in a Resource Limited Setting

    Directory of Open Access Journals (Sweden)

    Charles Edward Tunuka

    2014-01-01

    Full Text Available Introduction. Clinical evaluation of patients with torso trauma is often a diagnostic challenge. Extended focused assessment with sonography for trauma (EFAST is an emergency ultrasound scan that adds to the evaluation of intrathoracic abdominal and pericardial cavities done in FAST (focused assessment with sonography for trauma. Objective. This study compares EFAST (the index test with the routine standard of care (SoC investigations (the standard reference test for torso trauma injuries. Methods. A cross-sectional descriptive study was conducted over a 3-month period. Eligible patients underwent EFAST scanning and the SoC assessment. The diagnostic accuracy of EFAST was calculated using sensitivity and specificity scores. Results. We recruited 197 patients; the M : F ratio was 5 : 1, with mean age of 27 years (SD 11. The sensitivity of EFAST was 100%, the specificity was 97%, the PPV was 87%, and the NPV was 100%. It took 5 minutes on average to complete an EFAST scan. 168 (85% patients were EFAST-scanned. Most patients (82 (48% were discharged on the same day of hospitalization, while 7 (4% were still at the hospital after two weeks. The mortality rate was 18 (9%. Conclusion. EFAST is a reliable method of diagnosing torso injuries in a resource limited context.

  5. Bayesian bivariate meta-analysis of diagnostic test studies using integrated nested Laplace approximations.

    Science.gov (United States)

    Paul, M; Riebler, A; Bachmann, L M; Rue, H; Held, L

    2010-05-30

    For bivariate meta-analysis of diagnostic studies, likelihood approaches are very popular. However, they often run into numerical problems with possible non-convergence. In addition, the construction of confidence intervals is controversial. Bayesian methods based on Markov chain Monte Carlo (MCMC) sampling could be used, but are often difficult to implement, and require long running times and diagnostic convergence checks. Recently, a new Bayesian deterministic inference approach for latent Gaussian models using integrated nested Laplace approximations (INLA) has been proposed. With this approach MCMC sampling becomes redundant as the posterior marginal distributions are directly and accurately approximated. By means of a real data set we investigate the influence of the prior information provided and compare the results obtained by INLA, MCMC, and the maximum likelihood procedure SAS PROC NLMIXED. Using a simulation study we further extend the comparison of INLA and SAS PROC NLMIXED by assessing their performance in terms of bias, mean-squared error, coverage probability, and convergence rate. The results indicate that INLA is more stable and gives generally better coverage probabilities for the pooled estimates and less biased estimates of variance parameters. The user-friendliness of INLA is demonstrated by documented R-code. Copyright (c) 2010 John Wiley & Sons, Ltd.

  6. Precision medicine for hepatocelluar carcinoma using molecular pattern diagnostics: results from a preclinical pilot study.

    Science.gov (United States)

    Agarwal, Rahul; Cao, Yuan; Hoffmeier, Klaus; Krezdorn, Nicolas; Jost, Lukas; Meisel, Alejandro Rodriguez; Jüngling, Ruth; Dituri, Francesco; Mancarella, Serena; Rotter, Björn; Winter, Peter; Giannelli, Gianluigi

    2017-06-08

    The aim of this study was to design a road map for personalizing cancer therapy in hepatocellular carcinoma (HCC) by using molecular pattern diagnostics. As an exploratory study, we investigated molecular patterns of tissues of two tumors from individual HCC patients, which in previous experiments had shown contrasting reactions to the phase 2 transforming growth factor beta receptor 1 inhibitor galunisertib. Cancer-driving molecular patterns encompass - inter alias - altered transcription profiles and somatic mutations in coding regions differentiating tumors from their respective peritumoral tissues and from each other. Massive analysis of cDNA ends and all-exome sequencing demonstrate a highly divergent transcriptional and mutational landscape, respectively, for the two tumors, that offers potential explanations for the tumors contrasting responses to galunisertib. Molecular pattern diagnostics (MPDs) suggest alternative, individual-tumor-specific therapies, which in both cases deviate from the standard sorafenib treatment and from each other. Suggested personalized therapies use kinase inhibitors and immune-focused drugs as well as low-toxicity natural compounds identified using an advanced bioinformatics routine included in the MPD protocol. The MPD pipeline we describe here for the prediction of suitable drugs for treatment of two contrasting HCCs may serve as a blueprint for the design of therapies for various types of cancer.

  7. Radiation protection to the eye and thyroid during diagnostic cerebral angiography : a phantom study

    International Nuclear Information System (INIS)

    Shortt, C. P.; Malone, L.; Thornton, J.; Brennan, P.; Lee, M. J.

    2008-01-01

    Full text: We measured radiation doses to the eye and thyroid during diagnostic cerebral angiography to assess the effectiveness of bismuth and lead shields at dose reduction. Phantom head angiographic studies were performed with bismuth (study 1) and lead shields (study 2). In study 1 (12 phantoms), thermoluminescent dosimeters (TLD) were placed over the eyes and thyroid in three groups: (i) no shields (four phantoms); (ii) anterior bismuth shields (four phantoms) and (iii) anterior and posterior bismuth shields (four phantoms). In a second study (eight phantoms), lead shields were placed over the thyroid only and TLD dose measurements obtained in two groups: (i) no shielding (four phantoms) and (ii) thyroid lead shielding (four phantoms). A standard 4-vessel cerebral angiogram was performed on each phantom. Study 1 (bismuth shields) showed higher doses to the eyes compared with thyroid (mean 13.03 vs 5.98 mSv, P < 0.001) and a higher eye dose on the X-ray tube side. Overall, the use of bismuth shielding did not significantly reduce dose to either eyes or thyroid in the measured TLD positions. In study 2, a significant thyroid dose reduction was found with the use of lead shields (47%, mean 2.46 vs 4.62 mSv, P < 0.001). Considerable doses to the eyes and thyroid highlight the need for increased awareness of patient protection. Eye shielding is impractical and interferes with diagnostic capability. Thyroid lead shielding yields significant protection to the thyroid, is not in the field of view and should be used routinely.

  8. Radiation protection to the eye and thyroid during diagnostic cerebral angiography: a phantom study.

    LENUS (Irish Health Repository)

    Shortt, C P

    2008-08-01

    We measured radiation doses to the eye and thyroid during diagnostic cerebral angiography to assess the effectiveness of bismuth and lead shields at dose reduction. Phantom head angiographic studies were performed with bismuth (study 1) and lead shields (study 2). In study 1 (12 phantoms), thermoluminescent dosimeters (TLD) were placed over the eyes and thyroid in three groups: (i) no shields (four phantoms); (ii) anterior bismuth shields (four phantoms) and (iii) anterior and posterior bismuth shields (four phantoms). In a second study (eight phantoms), lead shields were placed over the thyroid only and TLD dose measurements obtained in two groups: (i) no shielding (four phantoms) and (ii) thyroid lead shielding (four phantoms). A standard 4-vessel cerebral angiogram was performed on each phantom. Study 1 (bismuth shields) showed higher doses to the eyes compared with thyroid (mean 13.03 vs 5.98 mSv, P < 0.001) and a higher eye dose on the X-ray tube side. Overall, the use of bismuth shielding did not significantly reduce dose to either eyes or thyroid in the measured TLD positions. In study 2, a significant thyroid dose reduction was found with the use of lead shields (47%, mean 2.46 vs 4.62 mSv, P < 0.001). Considerable doses to the eyes and thyroid highlight the need for increased awareness of patient protection. Eye shielding is impractical and interferes with diagnostic capability. Thyroid lead shielding yields significant protection to the thyroid, is not in the field of view and should be used routinely.

  9. Effectiveness of a clinical knowledge support system for reducing diagnostic errors in outpatient care in Japan: A retrospective study.

    Science.gov (United States)

    Shimizu, Taro; Nemoto, Takaaki; Tokuda, Yasuharu

    2018-01-01

    Clinical evidence has indicated the effectiveness of computer-based systems for preventing and reducing diagnostic errors. Our study aimed to evaluate the effectiveness of UpToDate, a computer-based clinical knowledge management system, for reducing diagnostic errors. We retrospectively identified 100 patients who visited an outpatient department in a community-based hospital from July 2014 to June 2015. Fifty patients (exposure group) were seen by UpToDate-equipped physicians and another 50 (control group) were seen by UpToDate-unequipped physicians. We extracted data on patient sex, age, primary diagnosis, and case difficulty that could potentially affect diagnostic outcomes. We compared the two groups regarding diagnostic error rate and performed logistic regression analysis to analyze the concurrent effects of various factors affecting diagnostic error. The diagnostic error rate was 2% in the exposure group, while the error rate was 24% in the control group. Multivariate logistic regression analysis showed that error rate reduction was significantly associated with exposure to UpToDate with an odds ratio of 15.21 (95% CI 1.86-124.36). Our results demonstrated the effectiveness of UpToDate for the prevention and reduction of diagnostic error. Copyright © 2017. Published by Elsevier B.V.

  10. Sample size re-estimation in paired comparative diagnostic accuracy studies with a binary response.

    Science.gov (United States)

    McCray, Gareth P J; Titman, Andrew C; Ghaneh, Paula; Lancaster, Gillian A

    2017-07-14

    The sample size required to power a study to a nominal level in a paired comparative diagnostic accuracy study, i.e. studies in which the diagnostic accuracy of two testing procedures is compared relative to a gold standard, depends on the conditional dependence between the two tests - the lower the dependence the greater the sample size required. A priori, we usually do not know the dependence between the two tests and thus cannot determine the exact sample size required. One option is to use the implied sample size for the maximal negative dependence, giving the largest possible sample size. However, this is potentially wasteful of resources and unnecessarily burdensome on study participants as the study is likely to be overpowered. A more accurate estimate of the sample size can be determined at a planned interim analysis point where the sample size is re-estimated. This paper discusses a sample size estimation and re-estimation method based on the maximum likelihood estimates, under an implied multinomial model, of the observed values of conditional dependence between the two tests and, if required, prevalence, at a planned interim. The method is illustrated by comparing the accuracy of two procedures for the detection of pancreatic cancer, one procedure using the standard battery of tests, and the other using the standard battery with the addition of a PET/CT scan all relative to the gold standard of a cell biopsy. Simulation of the proposed method illustrates its robustness under various conditions. The results show that the type I error rate of the overall experiment is stable using our suggested method and that the type II error rate is close to or above nominal. Furthermore, the instances in which the type II error rate is above nominal are in the situations where the lowest sample size is required, meaning a lower impact on the actual number of participants recruited. We recommend multinomial model maximum likelihood estimation of the conditional

  11. Self-report and subjective history in the diagnosis of painful neck conditions: A systematic review of diagnostic accuracy studies.

    Science.gov (United States)

    Mizer, Adam; Bachmann, Alexa; Gibson, Jessie; Donaldson, Megan Burrowbridge

    2017-10-01

    Rising healthcare costs and inherent risks with over-utilizing diagnostic imaging require a quality subjective examination to improve effectiveness and time management of physical examinations. This systematic review investigates the diagnostic accuracy of subjective history and self-report items to determine if there is significant alteration in the probability of identifying specific painful neck conditions. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. 1) Written in the English language 2) Cervical pain with/without referred upper extremity or head pain 3) Subjective history or self-report items 4) Study designs that reported diagnostic statistics or allowed calculation of sensitivities, specificities, diagnostic odds ratios, and likelihood ratios 5) used a reference standard that has a sensitivity or specificity ≥75% or a diagnostic tool that is strongly supported in the literature where this data is not available. Quality Assessment of Studies of Diagnostic Accuracy II was performed to evaluate risk of bias. Five studies with 830 total patients met the inclusion criteria. Conditions commonly reported in the literature included: cervical radiculopathy, cervical myelopathy, degenerative joint disease, and cervicogenic headache. Individual history questions show minimal diagnostic value in identifying cervical conditions without the physical examination. The value of the subjective history report is important and requires further investigation for specific neck conditions. Clustering symptoms may provide more insight than individual history items in future studies. The diagnostic value of history for neck conditions may be underrepresented due to the lack of studies that isolate subjective examination from the physical examination. 3a. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Analysis and modification of a single-mesh gear fatigue rig for use in diagnostic studies

    Science.gov (United States)

    Zakrajsek, James J.; Townsend, Dennis P.; Oswald, Fred B.; Decker, Harry J.

    1992-01-01

    A single-mesh gear fatigue rig was analyzed and modified for use in gear mesh diagnostic research. The fatigue rig allowed unwanted vibration to mask the test-gear vibration signal, making it difficult to perform diagnostic studies. Several possible sources and factors contributing to the unwanted components of the vibration signal were investigated. Sensor mounting location was found to have a major effect on the content of the vibration signal. In the presence of unwanted vibration sources, modal amplification made unwanted components strong. A sensor location was found that provided a flatter frequency response. This resulted in a more useful vibration signal. A major network was performed on the fatigue rig to reduce the influence of the most probable sources of the noise in the vibration signal. The slave gears were machined to reduce weight and increase tooth loading. The housing and the shafts were modified to reduce imbalance, looseness, and misalignment in the rotating components. These changes resulted in an improved vibration signal, with the test-gear mesh frequency now the dominant component in the signal. Also, with the unwanted sources eliminated, the sensor mounting location giving the most robust representation of the test-gear meshing energy was found to be at a point close to the test gears in the load zone of the bearings.

  13. Preliminary study of diagnostic workstation with different matrix size for detection of small pulmonary nodules

    International Nuclear Information System (INIS)

    Wu Jie; Wang Xuejian; Wang Bo; Tong Juan; Wei Yuqing; Shen Guiquan; Wang Limei; Cao Jun; Sui He

    2004-01-01

    Objective: To assess the influence in detecting small pulmonary nodules (SPNs) on soft-copy images displayed with different matrix sizes. Methods: Seventy-six chest compute radiographs were selected for the study. Of the 76 test images, 36 pulmonary nodules smaller than 20 mm in diameter were proven by CT, which were further divided into two groups: 1.0-2.0 cm and Z values and standard error of three kinds of view system for individual observers. Results: For 1.0-2.0 cm group, the mean A Z values were 0.7936 for DRCS with 2-fold magnification and window technique, 0.8225 for 1 K monitor with 2-fold magnification and window technique, and 0.8367 for 2 K monitor without magnification; for Z values increased slightly as the display matrix size improved, but there were no significant differences among the three sets in the detection of SPNs in the ROC analyses. Conclusion: It is acceptable to detect small pulmonary nodules of 1.0-2.0 cm in diameter on 1 K monitor and DRCS with magnification. High resolution diagnostic workstation is recommended for detecting small pulmonary nodules <1.0 cm in diameter. Reasonable equipment for the detection of subtle abnormality may result in better cost-efficacy and diagnostic accuracy

  14. A diagnostic study of thoracic myelopathy due to ossification of ligamentum flavum.

    Science.gov (United States)

    Feng, Fabo; Sun, Chuiguo; Chen, ZhongQiang

    2015-05-01

    We set out to establish a magnetic resonance imaging (MRI) and computed tomography (CT)-based diagnostic method for determining the responsible segments in thoracic myelopathy due to ossification of the ligamentum flavum (OLF). Forty-four patients who underwent surgery for treatment of myelopathy due to OLF between June 2005 and May 2013 were enrolled in this study as the myelopathy group. Forty-four patients who were identified through CT and MRI scans to have OLF but had no definite neurologic deficits prior to the examination were included as the control group. MRI and CT examination were reviewed, and the degree of spinal canal compromise was graded on axial T2-weighted MRI. Anteroposterior spinal canal diameter was measured at the maximally stenosed level on axial and sagittal CT. The canal grade and the cross-section area-occupying ratio were measured and calculated on the CT scans. The diagnostic coincidence rates for the indices were then compared. Cases of Grade IV were all in the myelopathy group while cases of Grade II were all in the control group. The canal grade (paramedian) was the most relevant continuous variable with the largest JOA score (r = 0.685, P compression on T2-weighted MRI.

  15. Gearbox Tooth Cut Fault Diagnostics Using Acoustic Emission and Vibration Sensors — A Comparative Study

    Directory of Open Access Journals (Sweden)

    Yongzhi Qu

    2014-01-01

    Full Text Available In recent years, acoustic emission (AE sensors and AE-based techniques have been developed and tested for gearbox fault diagnosis. In general, AE-based techniques require much higher sampling rates than vibration analysis-based techniques for gearbox fault diagnosis. Therefore, it is questionable whether an AE-based technique would give a better or at least the same performance as the vibration analysis-based techniques using the same sampling rate. To answer the question, this paper presents a comparative study for gearbox tooth damage level diagnostics using AE and vibration measurements, the first known attempt to compare the gearbox fault diagnostic performance of AE- and vibration analysis-based approaches using the same sampling rate. Partial tooth cut faults are seeded in a gearbox test rig and experimentally tested in a laboratory. Results have shown that the AE-based approach has the potential to differentiate gear tooth damage levels in comparison with the vibration-based approach. While vibration signals are easily affected by mechanical resonance, the AE signals show more stable performance.

  16. Experimental studies of laser-ablated zirconium carbide plasma plumes: Fuel corrosion diagnostic development

    International Nuclear Information System (INIS)

    Wantuck, P.J.; Butt, D.P.; Sappey, A.D.

    1992-01-01

    Understanding the corrosion behavior of nuclear fuel materials, such as refractory carbides, in a high temperature hydrogen environment is critical for several proposed nuclear thermal propulsion (NTP) concepts. Monitoring the fuel corrosion products is important not only for understanding corrosion characteristics, but to assess the performance of an actual, operating nuclear propulsion system as well. In this paper, we describe an experimental study initiated to develop, test, and subsequently utilize non-intrusive, laser-based diagnostics to characterize the gaseous product species which are expected to evolve during the exposure of representative fuel samples to hydrogen. Laser ablation is used to produce high temperature, vapor plumes from solid solution, uranium-free, zirconium carbide (ZrC) forms for probing by other laser diagnostic methods; predominantly laser-induced fluorescence (LIF). We discuss the laser ablation technique, results of plume emission measurements, as well as the use of planar LIF to image both the ZrC plumes and actual NTP fuel corrosion constituents

  17. Non-Destructive Testing for Building Diagnostics and Monitoring: Experience Achieved with Case Studies

    Directory of Open Access Journals (Sweden)

    Tavukçuoğlu Ayşe

    2018-01-01

    Full Text Available Building inspection on site, in other words in-situ examinations of buildings is a troublesome work that necessitates the use of non-destructive investigation (NDT techniques. One of the main concerns of non-destructive testing studies is to improve in-situ use of NDT techniques for diagnostic and monitoring studies. The quantitative infrared thermography (QIRT and ultrasonic pulse velocity (UPV measurements have distinct importance in that regard. The joint use of QIRT and ultrasonic testing allows in-situ evaluation and monitoring of historical structures and contemporary ones in relation to moisture, thermal, materials and structural failures while the buildings themselves remain intact. For instances, those methods are useful for detection of visible and invisible cracks, thermal bridges and damp zones in building materials, components and functional systems as well as for soundness assessment of materials and thermal performance assessment of building components. In addition, those methods are promising for moisture content analyses in materials and monitoring the success of conservation treatments or interventions in structures. The in-situ NDT studies for diagnostic purposes should start with the mapping of decay forms and scanning of building surfaces with infrared images. Quantitative analyses are shaped for data acquisition on site and at laboratory from representative sound and problem areas in structures or laboratory samples. Laboratory analyses are needed to support in-situ examinations and to establish the reference data for better interpretation of in situ data. Advances in laboratory tests using IRT and ultrasonic testing are guiding for in-situ materials investigations based on measurable parameters. The knowledge and experience on QIRT and ultrasonic testing are promising for the innovative studies on today’s materials technologies, building science and conservation/maintenance practices. Such studies demand a multi

  18. On the optimal scope of negligence

    NARCIS (Netherlands)

    Dari-Mattiacci, G.

    2005-01-01

    This article studies the optimal scope of negligence, considering which of the parties’ precautionary measures should be included in the determination of negligence and which instead should be omitted. The analysis shows that the optimal scope of negligence balances the gains derived from improved

  19. Establishment of diagnostic reference levels in computed tomography for paediatric patients in Sudan: a pilot study

    International Nuclear Information System (INIS)

    Sulieman, A.

    2015-01-01

    Paediatric patients are recognised to be at higher risk of developing radiation-induced cancer than adults. The purpose of this pilot study was to evaluate the radiation doses to paediatric patients during computed tomography (CT) procedures in order to propose local diagnostic reference levels (DRLs). A total of 296 patients (aged 6-10 y) were investigated in 8 hospitals equipped with 64-, 16- and dual-slice CT machines. The mean dose length product values were 772, 446 and 178 mGy cm for head, abdomen and chest, respectively. Imaging protocols were not adapted to the patient's weight in certain CT machines. The results confirmed that paediatric patients are exposed to an unnecessary radiation dose. The established DRLs were higher than those available in other countries. This study showed the need for harmonisation of the practice in CT departments and radiation dose optimisation. (authors)

  20. Economic growth constraints in Vietnam: A study using the growth diagnostic approach

    Directory of Open Access Journals (Sweden)

    Nguyen Duc Thanh

    2016-04-01

    Full Text Available Recent studies have clearly pointed out a decreasing trend of Vietnam’s economic growth in the short and the medium terms. This paper presents a study applying the growth diagnostic method for Vietnam to determine growth constrains. The binding growth constrains of Vietnam are found to include a poor business environment; an underdeveloped infrastructure, especially the transportation network market; failures related to information externalities, learning externalities and coordination failures. Notably, the energy infrastructure could be a vital constraint in a near future, but is not a binding constraint at present. The inefficiency of financial intermediaries and the government’s over-investment could become a binding constraint when the economy returns to its high growth path.

  1. Group-as-a-whole as a context for studying individual behaviour: A group diagnostic intervention

    Directory of Open Access Journals (Sweden)

    Dirk J. Geldenhuys

    2012-01-01

    Full Text Available Orientation: Traditionalists view group interventions from three perspectives: singletons, dyads and whole groups. The focus of this research was on interventions from the third perspective, that of the whole group, using a systems psychodynamic stance. Research purpose: The purpose of the research was to use group-as-a-whole to study individual behaviour in organisations.Motivation for the study: Team research and practice is not on a par with the complexities that teams actually experience. Traditional group interventions use humanistic and functionalistic paradigms that do not consider the unconscious functioning of groups. Interventions that use the system psychodynamic paradigm could address these dynamics because they study behaviour of individual group members in the context of the group-as-a-whole. Research design, approach and method: The researcher conducted action research in a publishing company. He used purposive sampling and analysed the data using qualitative content analysis.Main findings: The researcher found that the group-as-a-whole partly explains the behaviour of team members and that intervening from this perspective could improve negative relationships.Practical/managerial implications: Managers can use interventions that use the groupas- a-whole concept as a diagnostic intervention to study and possibly change the complex behavioural issues that team members experience.Contribution/value-add: The findings give one an understanding of the behaviour of individual group members when one views it from a systems psychodynamic stance. Furthermore, the researcher proposes a group diagnostic intervention that will allow some of the root causes of poor interpersonal behaviour to surface and group members to diagnose and take ownership of their own behaviour.

  2. Suitability of small diagnostic peripheral-blood samples for cell-therapy studies.

    Science.gov (United States)

    Stephanou, Coralea; Papasavva, Panayiota; Zachariou, Myria; Patsali, Petros; Epitropou, Marilena; Ladas, Petros; Al-Abdulla, Ruba; Christou, Soteroulla; Antoniou, Michael N; Lederer, Carsten W; Kleanthous, Marina

    2017-02-01

    Primary hematopoietic stem and progenitor cells (HSPCs) are key components of cell-based therapies for blood disorders and are thus the authentic substrate for related research. We propose that ubiquitous small-volume diagnostic samples represent a readily available and as yet untapped resource of primary patient-derived cells for cell- and gene-therapy studies. In the present study we compare isolation and storage methods for HSPCs from normal and thalassemic small-volume blood samples, considering genotype, density-gradient versus lysis-based cell isolation and cryostorage media with different serum contents. Downstream analyses include viability, recovery, differentiation in semi-solid media and performance in liquid cultures and viral transductions. We demonstrate that HSPCs isolated either by ammonium-chloride potassium (ACK)-based lysis or by gradient isolation are suitable for functional analyses in clonogenic assays, high-level HSPC expansion and efficient lentiviral transduction. For cryostorage of cells, gradient isolation is superior to ACK lysis, and cryostorage in freezing media containing 50% fetal bovine serum demonstrated good results across all tested criteria. For assays on freshly isolated cells, ACK lysis performed similar to, and for thalassemic samples better than, gradient isolation, at a fraction of the cost and hands-on time. All isolation and storage methods show considerable variation within sample groups, but this is particularly acute for density gradient isolation of thalassemic samples. This study demonstrates the suitability of small-volume blood samples for storage and preclinical studies, opening up the research field of HSPC and gene therapy to any blood diagnostic laboratory with corresponding bioethics approval for experimental use of surplus material. Copyright © 2017 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  3. Acute undifferentiated fever in India: a multicentre study of aetiology and diagnostic accuracy.

    Science.gov (United States)

    Mørch, Kristine; Manoharan, Anand; Chandy, Sara; Chacko, Novin; Alvarez-Uria, Gerardo; Patil, Suvarna; Henry, Anil; Nesaraj, Joel; Kuriakose, Cijoy; Singh, Ashita; Kurian, Siby; Gill Haanshuus, Christel; Langeland, Nina; Blomberg, Bjørn; Vasanthan Antony, George; Mathai, Dilip

    2017-10-04

    The objectives of this study were to determine the proportion of malaria, bacteraemia, scrub typhus, leptospirosis, chikungunya and dengue among hospitalized patients with acute undifferentiated fever in India, and to describe the performance of standard diagnostic methods. During April 2011-November 2012, 1564 patients aged ≥5 years with febrile illness for 2-14 days were consecutively included in an observational study at seven community hospitals in six states in India. Malaria microscopy, blood culture, Dengue rapid NS1 antigen and IgM Combo test, Leptospira IgM ELISA, Scrub typhus IgM ELISA and Chikungunya IgM ELISA were routinely performed at the hospitals. Second line testing, Dengue IgM capture ELISA (MAC-ELISA), Scrub typhus immunofluorescence (IFA), Leptospira Microscopic Agglutination Test (MAT), malaria PCR and malaria immunochromatographic rapid diagnostic test (RDT) Parahit Total™ were performed at the coordinating centre. Convalescence samples were not available. Case definitions were as follows: Leptospirosis: Positive ELISA and positive MAT. Scrub typhus: Positive ELISA and positive IFA. Dengue: Positive RDT and/or positive MAC-ELISA. Chikungunya: Positive ELISA. Bacteraemia: Growth in blood culture excluding those defined as contaminants. Malaria: Positive genus-specific PCR. Malaria was diagnosed in 17% (268/1564) and among these 54% had P. falciparum. Dengue was diagnosed in 16% (244/1564). Bacteraemia was found in 8% (124/1564), and among these Salmonella typhi or S. paratyphi constituted 35%. Scrub typhus was diagnosed in 10%, leptospirosis in 7% and chikungunya in 6%. Fulfilling more than one case definition was common, most frequent in chikungunya where 26% (25/98) also had positive dengue test. Malaria and dengue were the most common causes of fever in this study. A high overlap between case definitions probably reflects high prevalence of prior infections, cross reactivity and subclinical infections, rather than high prevalence of

  4. A novel diagnostic aid for intra-abdominal adhesion detection in cine-MR imaging: Pilot study and initial diagnostic impressions.

    Science.gov (United States)

    Randall, David; Joosten, Frank; ten Broek, Richard; Gillott, Richard; Bardhan, Karna Dev; Strik, Chema; Prins, Wiesje; van Goor, Harry; Fenner, John

    2017-07-14

    A non-invasive diagnostic technique for abdominal adhesions is not currently available. Capture of abdominal motion due to respiration in cine-MRI has shown promise, but is difficult to interpret. This article explores the value of a complimentary diagnostic aid to facilitate the non-invasive detection of abdominal adhesions using cine-MRI. An image processing technique was developed to quantify the amount of sliding that occurs between the organs of the abdomen and the abdominal wall in sagittal cine-MRI slices. The technique produces a 'sheargram' which depicts the amount of sliding which has occurred over 1-3 respiratory cycles. A retrospective cohort of 52 patients, scanned for suspected adhesions, made 281 cine-MRI sagittal slices available for processing. The resulting sheargrams were reported by two operators and compared to expert clinical judgement of the cine-MRI scans. The sheargram matched clinical judgement in 84% of all sagittal slices and 93-96% of positive adhesions were identified on the sheargram. The sheargram displayed a slight skew towards sensitivity over specificity, with a high positive adhesion detection rate but at the expense of false positives. Good correlation between sheargram and absence/presence of inferred adhesions indicates quantification of sliding motion has potential to aid adhesion detection in cine-MRI. Advances in Knowledge: This is the first attempt to clinically evaluate a novel image processing technique quantifying the sliding motion of the abdominal contents against the abdominal wall. The results of this pilot study reveal its potential as a diagnostic aid for detection of abdominal adhesions.

  5. Efficacy of various types of laryngoscope (direct, Pentax Airway Scope and GlideScope) for endotracheal intubation in various cervical immobilisation scenarios: a randomised cross-over simulation study

    Science.gov (United States)

    Kim, Jong Won; Lee, Kyeong Ryong; Hong, Dae Young; Baek, Kwang Je; Lee, Young Hwan; Park, Sang O

    2016-01-01

    Objective To compare the efficacy of direct laryngoscopy (DL), Pentax Airway Scope (PAWS) and GlideScope video laryngoscope (GVL) systems for endotracheal intubation (ETI) in various cervical immobilisation scenarios: manual in-line stabilisation (MILS), Philadelphia neck collar (PNC) (moderate limit of mouth opening) and Stifneck collar (SNC) (severe limit of mouth opening). Design Randomised cross-over simulation study. Setting and Participants 35 physicians who had >30 successful ETI experiences at a tertiary hospital in Seoul, Korea. Primary and secondary outcome measures Participants performed ETI using PAWS, GVL and DL randomly in simulated MILS, PNC and SNC scenarios in our simulation centre. The end points were successful ETI and the time to complete ETI. In addition, modified Cormack-Lehane (CL) classification and pressure to teeth were recorded. Results In MILS, there were no significant differences in the rate of success of ETI between the three devices: 33/35(94.3%) for DL vs 32/35(91.4%) for GVL vs 35/35(100.0%) for PAWS; p=0.230). PAWS achieved successful ETI more quickly (19.8 s) than DL (29.6 s) and GVL (35.4 s). For the PNC scenario, a higher rate of successful ETI was achieved with GVL 33/35 (94.3%) than PAWS 29/35 (82.9%) or DL 25/35 (71.4%) (p=0.040). For the SNC scenario, a higher rate of successful ETI was achieved with GVL 28/35(80.0%) than with DL 14/35(40.0%) and PAWS 7/35(20.0%) (p<0.001). For the PNC and SNC scenarios, GVL provided a relatively good view of the glottis, but a frequent pressure to teeth occurred. Conclusions All three devices are suitable for ETI in MILS. DL is not suitable in both neck collar scenarios. PAWS showed faster intubations in MILS, but was not suitable in the SNC scenario. GVL is most suitable in all cervical immobilisation scenarios, but may cause pressure to teeth more frequently. PMID:27797983

  6. Advance in study of intelligent diagnostic method for nuclear power plant

    International Nuclear Information System (INIS)

    Zhou Gang; Yang Li

    2008-01-01

    The advance of research on the application of three types of intelligent diagnostic approach based on neural network (ANN), fuzzy logic and expert system to the operation status monitoring and fault diagnosis of nuclear power plant (NPP) was reviewed. The research status and characters on status monitoring and fault diagnosis approaches based on neural network, fuzzy logic and expert system for nuclear power plant were analyzed. The development trend of applied research on intelligent diagnostic approaches for nuclear power plant was explored. The analysis results show that the research achievements on intelligent diagnostic approaches based on fuzzy logic and expert system for nuclear power plant are not much relatively. The research of intelligent diagnostic approaches for nuclear power plant concentrate on the aspect of operation status monitoring and fault diagnosis based on neural networks for nuclear power plant. The advancing tendency of intelligent diagnostic approaches for nuclear power plant is the combination of various intelligent diagnostic approaches, the combination of neural network diagnostic approaches and other diagnostic approaches as well as multiple neural network diagnostic approaches. (authors)

  7. Search strategies to identify diagnostic accuracy studies in MEDLINE and EMBASE.

    Science.gov (United States)

    Beynon, Rebecca; Leeflang, Mariska M G; McDonald, Steve; Eisinga, Anne; Mitchell, Ruth L; Whiting, Penny; Glanville, Julie M

    2013-09-11

    A systematic and extensive search for as many eligible studies as possible is essential in any systematic review. When searching for diagnostic test accuracy (DTA) studies in bibliographic databases, it is recommended that terms for disease (target condition) are combined with terms for the diagnostic test (index test). Researchers have developed methodological filters to try to increase the precision of these searches. These consist of text words and database indexing terms and would be added to the target condition and index test searches.Efficiently identifying reports of DTA studies presents challenges because the methods are often not well reported in their titles and abstracts, suitable indexing terms may not be available and relevant indexing terms do not seem to be consistently assigned. A consequence of using search filters to identify records for diagnostic reviews is that relevant studies might be missed, while the number of irrelevant studies that need to be assessed may not be reduced. The current guidance for Cochrane DTA reviews recommends against the addition of a methodological search filter to target condition and index test search, as the only search approach. To systematically review empirical studies that report the development or evaluation, or both, of methodological search filters designed to retrieve DTA studies in MEDLINE and EMBASE. We searched MEDLINE (1950 to week 1 November 2012); EMBASE (1980 to 2012 Week 48); the Cochrane Methodology Register (Issue 3, 2012); ISI Web of Science (11 January 2013); PsycINFO (13 March 2013); Library and Information Science Abstracts (LISA) (31 May 2010); and Library, Information Science & Technology Abstracts (LISTA) (13 March 2013). We undertook citation searches on Web of Science, checked the reference lists of relevant studies, and searched the Search Filters Resource website of the InterTASC Information Specialists' Sub-Group (ISSG). Studies reporting the development or evaluation, or both, of a

  8. A unification of models for meta-analysis of diagnostic accuracy studies without a gold standard.

    Science.gov (United States)

    Liu, Yulun; Chen, Yong; Chu, Haitao

    2015-06-01

    Several statistical methods for meta-analysis of diagnostic accuracy studies have been discussed in the presence of a gold standard. However, in practice, the selected reference test may be imperfect due to measurement error, non-existence, invasive nature, or expensive cost of a gold standard. It has been suggested that treating an imperfect reference test as a gold standard can lead to substantial bias in the estimation of diagnostic test accuracy. Recently, two models have been proposed to account for imperfect reference test, namely, a multivariate generalized linear mixed model (MGLMM) and a hierarchical summary receiver operating characteristic (HSROC) model. Both models are very flexible in accounting for heterogeneity in accuracies of tests across studies as well as the dependence between tests. In this article, we show that these two models, although with different formulations, are closely related and are equivalent in the absence of study-level covariates. Furthermore, we provide the exact relations between the parameters of these two models and assumptions under which two models can be reduced to equivalent submodels. On the other hand, we show that some submodels of the MGLMM do not have corresponding equivalent submodels of the HSROC model, and vice versa. With three real examples, we illustrate the cases when fitting the MGLMM and HSROC models leads to equivalent submodels and hence identical inference, and the cases when the inferences from two models are slightly different. Our results generalize the important relations between the bivariate generalized linear mixed model and HSROC model when the reference test is a gold standard. © 2014, The International Biometric Society.

  9. Near Infrared Imaging as a Diagnostic Tool for Detecting Enamel Demineralization: An in vivo Study

    Science.gov (United States)

    Lucas, Seth Adam

    Background and Objectives: For decades there has been an effort to develop alternative optical methods of imaging dental decay utilizing non-ionizing radiation methods. The purpose of this in-vivo study was to demonstrate whether NIR can be used as a diagnostic tool to evaluate dental caries and to compare the sensitivity and specificity of this method with that of conventional methods, including bitewing x-rays and visual inspection. Materials and Methods: 31 test subjects (n=31) from the UCSF orthodontic clinic undergoing orthodontic treatment with planned premolar extractions were recruited. Calibrated examiners performed caries detection examinations using conventional methods: bitewing radiographs and visual inspection. These findings were compared with the results from NIR examinations: transillumination and reflectance. To confirm the results found in the two different detection methods, a gold standard was used. After teeth were extracted, polarized light microscopy and transverse microradiography were performed. Results: A total of 87 premolars were used in the study. NIR identified the occlusal lesions with a sensitivity of 71% and a specificity of 77%, whereas, the visual examination had a sensitivity of only 40% and a specifity of 39%. For interproximal lesions halfway to DEJ, specificity remained constant, but sensitivity improved to 100% for NIR and 75% for x-rays. Conclusions: The results of this preliminary study demonstrate that NIR is just as effective at detecting enamel interproximal lesions as standard dental x-rays. NIR was more effective at detecting occlusal lesions than visual examination alone. NIR shows promise as an alternative diagnostic tool to the conventional methods of x-rays and visual examination and provides a non-ionizing radiation technique.

  10. Assessing FDG-PET diagnostic accuracy studies to develop recommendations for clinical use in dementia.

    Science.gov (United States)

    Boccardi, Marina; Festari, Cristina; Altomare, Daniele; Gandolfo, Federica; Orini, Stefania; Nobili, Flavio; Frisoni, Giovanni B

    2018-04-30

    FDG-PET is frequently used as a marker of synaptic damage to diagnose dementing neurodegenerative disorders. We aimed to adapt the items of evidence quality to FDG-PET diagnostic studies, and assess the evidence available in current literature to assist Delphi decisions for European recommendations for clinical use. Based on acknowledged methodological guidance, we defined the domains, specific to FDG-PET, required to assess the quality of evidence in 21 literature searches addressing as many Population Intervention Comparison Outcome (PICO) questions. We ranked findings for each PICO and fed experts making Delphi decisions for recommending clinical use. Among the 1435 retrieved studies, most lacked validated measures of test performance, an adequate gold standard, and head-to-head comparison of FDG-PET and clinical diagnosis, and only 58 entered detailed assessment. Only two studies assessed the accuracy of the comparator (clinical diagnosis) versus any kind of gold-/reference-standard. As to the index-test (FDG-PET-based diagnosis), an independent gold-standard was available in 24% of the examined papers; 38% used an acceptable reference-standard (clinical follow-up); and 38% compared FDG-PET-based diagnosis only to baseline clinical diagnosis. These methodological limitations did not allow for deriving recommendations from evidence. An incremental diagnostic value of FDG-PET versus clinical diagnosis or lack thereof cannot be derived from the current literature. Many of the observed limitations may easily be overcome, and we outlined them as research priorities to improve the quality of current evidence. Such improvement is necessary to outline evidence-based guidelines. The available data were anyway provided to expert clinicians who defined interim recommendations.

  11. Diagnostic accuracy of bedside tests for predicting difficult intubation in Indian population: An observational study

    Science.gov (United States)

    Dhanger, Sangeeta; Gupta, Suman Lata; Vinayagam, Stalin; Bidkar, Prasanna Udupi; Elakkumanan, Lenin Babu; Badhe, Ashok Shankar

    2016-01-01

    Background: Unanticipated difficult intubation can be challenging to anesthesiologists, and various bedside tests have been tried to predict difficult intubation. Aims: The aim of this study was to determine the incidence of difficult intubation in the Indian population and also to determine the diagnostic accuracy of bedside tests in predicting difficult intubation. Settings and Design: In this study, 200 patients belonging to age group 18–60 years of American Society of Anesthesiologists I and II, scheduled for surgery under general anesthesia requiring endotracheal intubation were enrolled. Patients with upper airway pathology, neck mass, and cervical spine injury were excluded from the study. Materials and Methods: An attending anesthesiologist conducted preoperative assessment and recorded parameters such as body mass index, modified Mallampati grading, inter-incisor distance, neck circumference, and thyromental distance (NC/TMD). After standard anesthetic induction, laryngoscopy was performed, and intubation difficulty assessed using intubation difficulty scale on the basis of seven variables. Statistical Analysis: The Chi-square test or student t-test was performed when appropriate. The binary multivariate logistic regression (forward-Wald) model was used to determine the independent risk factors. Results: Among the 200 patients, 26 patients had difficult intubation with an incidence of 13%. Among different variables, the Mallampati score and NC/TMD were independently associated with difficult intubation. Receiver operating characteristic curve showed a cut-off point of 3 or 4 for Mallampati score and 5.62 for NC/TMD to predict difficult intubation. Conclusion: The diagnostic accuracy of NC/TM ratio and Mallampatti score were better compared to other bedside tests to predict difficult intubation in Indian population. PMID:26957691

  12. Mammary carcinoma – current diagnostic methods and symptomatology in imaging studies

    International Nuclear Information System (INIS)

    Popiel, Monika; Mróz-Klimas, Danuta; Kasprzak, Renata; Furmanek, Mariusz

    2012-01-01

    Breast cancer is the most common neoplasm of the female population and its incidence is constantly rising. Social campaigns educating the public about the importance of the problem have been conducted for the past several years. Women are encouraged to self-examine on a monthly basis. Women aged 50–69 years can have an x-ray mammography performed once every 2 years as part of a prophylactic screening program. Ultrasound studies or MR mammography are adjuvant or, in some cases, alternative to x-ray mammography. Nuclear medicine techniques with application of oncophilic markers and receptor studies (this publication will not cover nuclear medicine methods) are not routinely used. Other techniques, such as computed tomography and conventional radiography are of no significance in the diagnostics of mammary cancer. However, together with isotopic methods, they are helpful in staging of the disease. X-ray mammography is, up to date, the only method with proven value in decreasing mortality. It is also the best available method for visualization of microcalicifications. Ultrasound examination is complementary to x-ray mammography as it is a cheap, easily available method of imaging mammary glands with higher glandular tissue content. It is also the most commonly used modality aiding in targeted biopsy of mammary gland. To date, MR mammography, characterized by the highest sensitivity in cancer diagnostics, remained a method reserved for “special tasks”. MR is used for prophylaxis mainly in a population of women with particularly high risk of the disease and in cases where x-ray and ultrasound examinations are insufficient. Picture of mammary carcinoma in imaging studies is heterogeneous. However, it most often presents as an irregularly demarcated mass. Moreover, each modality can aid in visualization of additional features of a lesion such as typical shape of microcalcifications in x-ray mammography, characteristic pattern of contrast enhancement in MR examination

  13. Potential Child Abuse Screening in Emergency Department; a Diagnostic Accuracy Study

    Directory of Open Access Journals (Sweden)

    Hossein Dinpanah

    2017-01-01

    Full Text Available Introduction: Designing a tool that can differentiate those at risk of child abuse with great diagnostic accuracyis of great interest. The present study was designed to evaluate the diagnostic accuracy of Escape instrumentin triage of at risk cases of child abuse presenting to emergency department (ED. Methods: The present diagnosticaccuracy study performed on 6120 of the children under 16 years old presented to ED during 3 years,using convenience sampling. Confirmation by the child abuse team (pediatrician, a socialworker, and a forensicphysician was considered as the gold standard. Screening performance characteristics of Escape were calculatedusing STATA 21. Results: 6120 children with the mean age of 2.19 § 1.12 years were screened (52.7% girls.137 children were suspected victims of child abuse. Based on child abuse team opinion, 35 (0.5% children wereconfirmed victims of child abuse. Sensitivity, specificity, positive and negative likelihood ratio and positive andnegative predictive values of this test with 95% CI were 100 (87.6 – 100, 98.3 (97.9 – 98.6, 25.5 (18.6 – 33.8, 100(99.9 – 100, 0.34 (0.25 – 0.46, and 0 (0 – NAN, respectively. Area under the ROC curve was 99.2 (98.9 – 99.4.Conclusion: It seems that Escape is a suitable screening instrument for detection of at risk cases of child abusepresenting to ED. Based on the results of the present study, the accuracy of this screening tool is 99.2%, which isin the excellent range.

  14. Science for Humanitarian Emergencies and Resilience (SHEAR) scoping study: Annex 3 - Early warning system and risk assessment case studies

    OpenAIRE

    Brown, Sarah; Cornforth, Rosalind; Boyd, Emily; Standley, Sarah; Allen, Mary; Clement, Kalonga; Gonzalo, Alcade; Erwin, Garzona; Michelle, Slaney; Haseeb, Irfanullah; Maliha, Shahjajan

    2014-01-01

    This report provides case studies of Early Warning Systems (EWSs) and risk assessments encompassing three main hazard types: drought; flood and cyclone. The case studies are taken from ten countries across three continents (focusing on Africa, South Asia and the Caribbean).\\ud The case studies have been developed to assist the UK Department for International Development (DFID) to prioritise areas for Early Warning System (EWS) related research under their ‘Science for Humanitarian Emergencies...

  15. Diagnostic x-ray in use in federal medical centre, case study Makurdi metropolis

    International Nuclear Information System (INIS)

    Onoja, R.A.; Fiase, J.O.

    2009-01-01

    Every year more than two thousand patients go for routine medical check-up at the Federal Medical Centre using diagnostic x-rays. This paper is based on a study to determine the entrance surface doses per radiograph of 108 patients that had diagnostic examinations at the Federal Medical Centre Makurdi. The examinations considered in this study are chest x-ray examinations, abdomen, skull and other extremities, for both adults and children. The results show that the mean entrance surface doses of PA chest x-ray for female range between 237-275μGy, for male is between 1183-297μGy, and for children range between 47-237μGy. The AP chest x-ray for female range between 1943-3440μGy, for male is between 1583-3484μGy and for children it ranges between 177-451μGy. The PA examination of the skull for adult female ranged between 117-787μGy, for male it ranged between 117-532μGy and children from 472-948μGy. Also for the AP examination for skull the adult female mean entrance surface doses range from 129-798μGy, for the male it range from 145-178μGy and for children 138-650μGy. The AP abdomen for adult female produces a mean entrance surface doses range between 620-682μGy, for the male is between 105-930μGy, and children it range between 144-398μGy. In the case of extremities AP examination are between the range of 173-468μGy for adult female, 300-595μGy for adult male and between 254-887μGy for the children. In the case of extremities PA examination mean entrance surface doses are between the range of 145-517μGy for adult female, 363-517μGy for adult male and between 130-566μGy for the children. The data shows that the entrance surface doses due to the x-ray examination for adult and children are within the ICRP guidance levels. These guidance levels of dose for diagnostic radiography for a typical adult patient are 10 mGy for AP abdomen, 0.4 mGy PA chest, 7 mGy for AP chest and 5 mGy for PA skull

  16. Searching for Real-World Effectiveness of Health Care Innovations: Scoping Study of Social Prescribing for Diabetes.

    Science.gov (United States)

    Pilkington, Karen; Loef, Martin; Polley, Marie

    2017-02-02

    provide an insight into the criteria for the success of social prescribing services. Our study revealed the varied models of social prescribing and nonmedical, community-based services available to people with type 2 diabetes and the extent of evaluation of these, which would not have been achieved by searching databases alone. The findings of this scoping study do not prove that social prescribing is an effective measure for people with type 2 diabetes in the United Kingdom, but can be used to inform future evaluation and contribute to the development of the evidence base for social prescribing. Accessing Web-based information provides a potential method for investigating how specific innovative health concepts, such as social prescribing, have been translated, implemented, and evaluated in practice. Several challenges were encountered including defining the concept, focusing on process plus intervention, and searching diverse, evolving Web-based sources. Further exploration of this approach will inform future research on the application of innovative health care concepts into practice. ©Karen Pilkington, Martin Loef, Marie Polley. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.02.2017.

  17. Pressurized water reactor monitoring. Study of detection, diagnostic and estimation methods (least error squares and filtering)

    International Nuclear Information System (INIS)

    Gillet, M.

    1986-07-01

    This thesis presents a study for the surveillance of the ''primary coolant circuit inventory monitoring'' of a pressurized water reactor. A reference model is developed in view of an automatic system ensuring detection and diagnostic in real time. The methods used for the present application are statistical tests and a method related to pattern recognition. The estimation of failures detected, difficult owing to the non-linearity of the problem, is treated by the least error squares method of the predictor or corrector type, and by filtering. It is in this frame that a new optimized method with superlinear convergence is developed, and that a segmented linearization of the model is introduced, in view of a multiple filtering [fr

  18. Towards the SocioScope: an Information System for the the Study of Social Dynamics through Digital Traces

    OpenAIRE

    Liu, Bing; Calabrese, Francesco; Vaccari, Andrea; Ratti, Carlo

    2009-01-01

    Over the past decade there has been an explosion in the deployment of pervasive systems like cell phone networks and content aggregators on the Internet that produce massive amounts of data as by-products of their interaction with users. This data is related to the actions and opinions of people and thereby to the overall dynamics of cities, how they function and evolve over time. Here we propose the implementation of a new information system, the SocioScope, that streamlines the operatio...

  19. [Tetra-saccharide glucose as a diagnostic biomarker for Pompe disease: a study with 35 patients].

    Science.gov (United States)

    Bobillo Lobato, Joaquín; Durán Parejo, Pilar; Tejero Díez, Pedro; Jiménez Jiménez, Luis M

    2013-08-04

    Pompe disease is a disorder originating from an acid alpha-glycosidase (AAG) enzyme deficiency. This disease produces an accumulation of lysosomal glycogen in different tissues, whereby the skeletal and heart muscles are especially involved. The established diagnosis is achieved through the identification of the AAG deficiency. There are also other secondary diagnostic biomarkers, such as tetra-saccharide glucose (Glc4), which shows high levels in the urine of these patients. In this study it is highlighted the usefulness of Glc4 as a diagnostic biomarker for Pompe disease in its different forms of presentation, using a high-performance liquid chromatography with ultraviolet detection (HPLC/UV) adapted to the study. A total of 75 individuals have been analyzed: 40 healthy controls and 35 patients diagnosed with Pompe disease. Twenty-four hour samples of urine were collected from all of the patients and their Glc4 levels were determined by means of HPLC/UV. The evaluation of the urinary Glc4 shows a high discrimination ability between healthy/sick individuals. In addition, the results obtained have allowed to establish the most appropriate level of decision or cut-off point for the identification of sick people. Glc4 urinary levels are found to be high in patients suffering from Pompe disease and even though increased levels are also found in other conditions, the existence of a AAG deficiency together with a compatible clinical symptoms, prove very helpful for a correct diagnosis of this serious disease. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  20. Challenges associated with transition to caregiver role following diagnostic disclosure of Alzheimer disease: a descriptive study.

    Science.gov (United States)

    Ducharme, Francine; Lévesque, Louise; Lachance, Lise; Kergoat, Marie-Jeanne; Coulombe, Renée

    2011-09-01

    The prevalence of Alzheimer's disease is rising. The large number of new cases identified each year means that many new families will set upon a long trajectory of caring for a relative with dementia. Diagnostic disclosure of Alzheimer's disease marks the official transition to the caregiver role, yet this early period of the caregiver career have rarely been studied. Based on Meleis's theoretical framework for role transition, the objectives of this study were to document the characteristics of the caregiving context during the transition to the caregiver role following diagnostic disclosure of Alzheimer's disease and to compare these characteristics by caregiver gender and kinship tie to the relative. A descriptive design was used. Data were collected using standardized measures selected in accordance with the role transition theoretical framework. The sample recruited in Quebec (Canada) cognition clinics comprised 122 caregivers of an elderly relative diagnosed with Alzheimer's disease in the past nine months. Findings reveal the context of care to be marked by several challenges for caregivers. The majority of caregivers receives little informal support, has poor knowledge of available formal services, and has difficulty planning ahead for the relative's future care needs. Caregivers themselves report a lack of preparedness to provide care. Compared with men caregivers, women seem to have more problems controlling disturbing thoughts about their new caregiver role and to experience more family conflicts and psychological distress. Compared with offspring caregivers, spouse caregivers are less able to respond to the relative's disruptive behaviors, make less use of problem-solving strategies, and report fewer family conflicts. The challenges faced by caregivers during the transition to the caregiver role are sensitive to nursing interventions. Pro-active interventions from the outset of the caregiving career, such as early assessment of caregiver needs for

  1. Ultrasonography has a diagnostic value in the assessment of cervical radiculopathy: A prospective pilot study.

    Science.gov (United States)

    Takeuchi, Mikinobu; Wakao, Norimitsu; Hirasawa, Atsuhiko; Murotani, Kenta; Kamiya, Mitsuhiro; Osuka, Koji; Takayasu, Masakazu

    2017-08-01

    This study investigated the diagnostic accuracy of the difference in the cross-sectional areas (CSAs) of affected cervical nerve roots (NRs) for diagnosing cervical radiculopathy (CR). In total, 102 CR patients and 219 healthy volunteers were examined with ultrasound. The CSA of the cervical NR at each level was measured on the affected side and the contralateral side in CR patients by blinded ultrasonographic technicians. The difference between the CSAs of CR patients and normal volunteers and the difference in the laterality of CSA at the same affected level (ΔCSA) were calculated for each cervical level. The CSAs of the affected NRs in CR patients were significantly larger than those of the unaffected NRs in CR patients and those of the control group at the C5, C6 and C7 levels (P<0.005). ΔCSA was also significantly larger in the CR group at all levels (P<0.001). A receiver operating characteristic analysis demonstrated that the threshold values were 9.6 mm 2 (CSA) for C5NR and 15 mm 2 for both C6NR and C7NR. This study revealed that the CSAs of affected NRs were enlarged and that the laterality of the CSA (ΔCSA) was greater in CR patients than in control patients. • Cervical radiculopathy is diagnosed through ultrasonographic measurement of the CSAs. • The CSAs of affected nerve roots were significantly enlarged. • The ΔCSA in the CR group was significantly higher than in the control group. • Diagnostic CSA and ΔCSA thresholds were identified.

  2. Association of hip pain with radiographic evidence of hip osteoarthritis: diagnostic test study

    Science.gov (United States)

    Nevitt, Michael C; Niu, Jingbo; Clancy, Mary M; Lane, Nancy E; Link, Thomas M; Vlad, Steven; Tolstykh, Irina; Jungmann, Pia M.; Felson, David T; Guermazi, Ali

    2015-01-01

    Study question Is there concordance between hip pain and radiographic hip osteoarthritis? Methods In this diagnostic test study, pelvic radiographs were assessed for hip osteoarthritis in two cohorts: the Framingham Osteoarthritis Study (community of Framingham, Massachusetts) and the Osteoarthritis Initiative (a multicenter longitudinal cohort study of osteoarthritis in the United States). Using visual representation of the hip joint, participants reported whether they had hip pain on most days and the location of the pain: anterior, groin, lateral, buttocks, or low back. In the Framingham study, participants with hip pain were also examined for hip pain with internal rotation. The authors analysed the agreement between radiographic hip osteoarthritis and hip pain, and for those with hip pain suggestive of hip osteoarthritis they calculated the sensitivity, specificity, positive predictive value, and negative predictive value of radiographs as the diagnostic test. Study answer and limitations In the Framingham study (n=946), only 15.6% of hips in patients with frequent hip pain showed radiographic evidence of hip osteoarthritis, and 20.7% of hips with radiographic hip osteoarthritis were frequently painful. The sensitivity of radiographic hip osteoarthritis for hip pain localised to the groin was 36.7%, specificity 90.5%, positive predictive value 6.0%, and negative predictive value 98.9%. Results did not differ much for hip pain at other locations or for painful internal rotation. In the Osteoarthritis Initiative study (n=4366), only 9.1% of hips in patients with frequent pain showed radiographic hip osteoarthritis, and 23.8% of hips with radiographic hip osteoarthritis were frequently painful. The sensitivity of definite radiographic hip osteoarthritis for hip pain localised to the groin was 16.5%, specificity 94.0%, positive predictive value 7.1%, and negative predictive value 97.6%. Results also did not differ much for hip pain at other locations. What this

  3. Evaluation of the appendix during diagnostic laparoscopy, the laparoscopic appendicitis score : a pilot study

    NARCIS (Netherlands)

    Hamminga, Jenneke T. H.; Hofker, H. Sijbrand; Broens, Paul M. A.; Kluin, Philip M.; Heineman, Erik; Haveman, Jan Willem

    Diagnostic laparoscopy is the ultimate diagnostic tool to evaluate the appendix. Still, according to the literature, this strategy results in a negative appendectomy rate of approximately 12-18 % and associated morbidity. Laparoscopic criteria for determining appendicitis are lacking. The goal of

  4. Study design for concurrent development, assessment, and implementation of new diagnostic imaging technology

    NARCIS (Netherlands)

    M.G.M. Hunink (Myriam); G.P. Krestin (Gabriel)

    2002-01-01

    textabstractWith current constraints on health care resources and emphasis on value for money, new diagnostic imaging technologies must be assessed and their value demonstrated. The state of the art in the field of diagnostic imaging technology assessment advocates a hierarchical

  5. Automated and dynamic scheduling for geodetic VLBI - A simulation study for AuScope and global networks

    Science.gov (United States)

    Iles, E. J.; McCallum, L.; Lovell, J. E. J.; McCallum, J. N.

    2018-02-01

    As we move into the next era of geodetic VLBI, the scheduling process is one focus for improvement in terms of increased flexibility and the ability to react with changing conditions. A range of simulations were conducted to ascertain the impact of scheduling on geodetic results such as Earth Orientation Parameters (EOPs) and station coordinates. The potential capabilities of new automated scheduling modes were also simulated, using the so-called 'dynamic scheduling' technique. The primary aim was to improve efficiency for both cost and time without losing geodetic precision, particularly to maximise the uses of the Australian AuScope VLBI array. We show that short breaks in observation will not significantly degrade the results of a typical 24 h experiment, whereas simply shortening observing time degrades precision exponentially. We also confirm the new automated, dynamic scheduling mode is capable of producing the same standard of result as a traditional schedule, with close to real-time flexibility. Further, it is possible to use the dynamic scheduler to augment the 3 station Australian AuScope array and thereby attain EOPs of the current global precision with only intermittent contribution from 2 additional stations. We thus confirm automated, dynamic scheduling bears great potential for flexibility and automation in line with aims for future continuous VLBI operations.

  6. Quantitative or qualitative transcriptional diagnostic signatures? A case study for colorectal cancer.

    Science.gov (United States)

    Guan, Qingzhou; Yan, Haidan; Chen, Yanhua; Zheng, Baotong; Cai, Hao; He, Jun; Song, Kai; Guo, You; Ao, Lu; Liu, Huaping; Zhao, Wenyuan; Wang, Xianlong; Guo, Zheng

    2018-01-29

    Due to experimental batch effects, the application of a quantitative transcriptional signature for disease diagnoses commonly requires inter-sample data normalization, which would be hardly applicable under common clinical settings. Many cancers might have qualitative differences with the non-cancer states in the gene expression pattern. Therefore, it is reasonable to explore the power of qualitative diagnostic signatures which are robust against experimental batch effects and other random factors. Firstly, using data of technical replicate samples from the MicroArray Quality Control (MAQC) project, we demonstrated that the low-throughput PCR-based technologies also exist large measurement variations for gene expression even when the samples were measured in the same test site. Then, we demonstrated the critical limitation of low stability for classifiers based on quantitative transcriptional signatures in applications to individual samples through a case study using a support vector machine and a naïve Bayesian classifier to discriminate colorectal cancer tissues from normal tissues. To address this problem, we identified a signature consisting of three gene pairs for discriminating colorectal cancer tissues from non-cancer (normal and inflammatory bowel disease) tissues based on within-sample relative expression orderings (REOs) of these gene pairs. The signature was well verified using 22 independent datasets measured by different microarray and RNA_seq platforms, obviating the need of inter-sample data normalization. Subtle quantitative information of gene expression measurements tends to be unstable under current technical conditions, which will introduce uncertainty to clinical applications of the quantitative transcriptional diagnostic signatures. For diagnosis of disease states with qualitative transcriptional characteristics, the qualitative REO-based signatures could be robustly applied to individual samples measured by different platforms.

  7. Neurofibromatosis type 2 (NF 2) or schwannomatosis?--Case report study and diagnostic criteria.

    Science.gov (United States)

    Radek, Maciej; Tomasik, Bartłomiej; Wojdyn, Maciej; Snopkowska-Wiaderna, Dorota; Błaszczyk, Maciej; Radek, Andrzej

    2016-01-01

    Neurofibromatosis type 2 (NF2) and schwannomatosis are entities that may, due to the similarity of clinical symptoms, cause diagnostic difficulties. Incidence rate of both diseases is similar and estimated between 1:25,000 and 1:40,000. The genes associated with the development of the aforementioned disorders are located on chromosome 22 and lay in proxmity. Schwannomatosis is characterized by an incomplete penetrance and the risk of its transmission to the offspring is significantly lower than in the case of NF 2. Schwannomatosis clinical characteristic is similar to the NF2, however vestibular schwannomas are not present. Therefore the imaging studies evaluated by an experienced radiologist play a key role in the diagnostic process. Forty two-year-old female hospitalized three times because of the tumors of the spinal canal was admitted to the Department of Neurosurgery and Peripheral Nerve Surgery in 2008 because of the cervical pain syndrome with concomitant headache. She was diagnosed with a schwannomatosis, recently distinguished, the third form of neurofibromatosis. MRI imaging revealed craniocervical junction tumor. Suboccipital craniectomy with concomitant C1-C2 laminectomy was done in order to remove the lesion. After the surgery the patient did not present any deficits in neurological examination and was discharged from hospital in good general condition. The patient was diagnosed with schwannomatosis, recently established neurofibromatosis entity which may resemble NF2 clinically. In patients after the age of 30, in whom we observe multiple schwannomas without the concomitant hearing impairment, the diagnosis of schwannomatosis is very likely. Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  8. A scoping study: children, policy and cultural shifts in homelessness services in South Australia: are children still falling through the gaps?

    Science.gov (United States)

    Parry, Yvonne Karen; Grant, Julian; Burke, Lynette

    2016-09-01

    Homeless families are the fastest growing segment of the homelessness population. Homelessness services are often the first to know when children are at risk of disengagement with health, welfare and education services. Changes to Australian policy to explicitly attend to the needs of children are attempts to address the complexity of, and provide better outcomes for, homeless children. There are mounting levels of evidence describing some of the needs of children who are homeless. Using the scoping study methodological framework, this review of academic and grey literature identified the extent to which service providers provide for the needs of homeless children. The literature search was conducted from September 2012 to April 2013 using ProQuest, Science Direct, Sage and OVID databases. Therefore, the objectives of this scoping study were to: (i) identify the specific needs of children in homelessness; (ii) describe recent changes in policy relating to care for children in homelessness services; (iii) explore the evidence on how service providers can enact care for children in homelessness services; (iv) identify the types of practice changes that are needed to optimise outcomes for children; and (v) identify the gaps in service delivery. This article describes the Australian policy changes and explores the potential impact of subsequent sector reforms on the internal practices in front-line homelessness services, in order to overcome structural and systemic barriers, and promote opportunities for children in homeless families. This scoping study literature review contributes to the understanding of the impact of policy change on front-line staff and suggests possible practice changes and future research options. © 2015 John Wiley & Sons Ltd.

  9. Converging farmers' and scientists' perspectives on researchable constraints on organic cocoa production in Ghana: results of a diagnostic study

    NARCIS (Netherlands)

    Ayenor, G.K.; Röling, N.G.; Padi, B.; Huis, van A.; Obeng-Ofori, D.; Atengdem, P.B.

    2004-01-01

    A diagnostic study was conducted to identify the major constraints on organic cocoa production at Brong-Densuso and surrounding communities in the Suhum-Kraboa-Coaltar District, astern Region, Ghana. The study followed a technographic study that highlighted cocoa as a public crop requiring broad

  10. SMASH: A Diagnostic Tool to Monitor Student Metacognition, Affect, and Study Habits in an Undergraduate Science Course

    Science.gov (United States)

    Metzger, Kelsey J.; Smith, Brittany A.; Brown, Ethan; Soneral, Paula A. G.

    2018-01-01

    This study describes the development and implementation of an iterative diagnostic and intervention routine designed to elicit and quantitatively describe aspects of student metacognition, affect, and study habits in a first-year undergraduate biology course. The Student Metacognition, Affect, and Study Habits (SMASH) inventory is a…

  11. Plasma Fluctuation Studies in the TCV Tokamak: Modeling of Shaping Effects and Advanced Diagnostic Development

    International Nuclear Information System (INIS)

    Marinoni, A.

    2009-10-01

    therefore also well suited to investigate inhomogeneous spatial regions, where the need for an excellent spatial resolution is greatest. Additionally, it was also designed as translatable to broaden the region of study, which can extend up to the magnetic axis, in selected configurations. The translatable design combined with the flexibility of TCV in terms of plasma positioning in the vacuum vessel allows the phase contrast system to measure fluctuations across virtually the whole plasma minor radius. The diagnostic is sensitive both to radial and poloidal wave numbers, depending on the configuration. A parallel project to the development and installation of the phase contrast imaging system was the installation of a prototype Doppler reflectometer operating in a homodyne configuration, both in X and in O mode polarization. The reflectometer was operated parasitically to assess its performance which proved to be excellent; it is now routinely available on TCV. The theoretical part of the thesis consisted of extensive modeling of the effect of plasma shape, in particular triangularity, on turbulent transport by means of linear and nonlinear gyrokinetic simulations. This was motivated by experiments on TCV that had shown a dramatic improvement in confinement, up to a factor of two, in inverting the sign of the triangularity from positive to negative. Negative triangularity was indeed found to have a stabilizing influence on ion scale instabilities, specifically on the so called trapped electron mode (TEM). Simulations were carried out on actual TCV shots and the variation of the heat flux with triangularity calculated by the nonlinear simulations is in fair agreement with the experimental results. Linear simulations and a simple analytical model explain, in agreement with nonlinear runs, the resulting stabilization as a result of a rather complex modification of the toroidal precessional drift of trapped particles exerted by negative triangularity. (author)

  12. The effect of image translation table on diagnostic efficacy of myocardial perfusion SPECT studies

    International Nuclear Information System (INIS)

    Siennicki, J.; Kovacevic-Kusmierek, K.; Bienkiewicz, M.; Plachcinska, A.; Kusmierek, J.; Chizynski, K.

    2010-01-01

    Background: The aim of this study was to determine which of the most popular colour scales used in the Xeleris processing system (GE) should preferably be used during a clinical interpretation of myocardial perfusion images, and to find out whether a colour scale saturation level affects the diagnostic efficacy of the study. Material And Methods: From among 100 patients in whom a myocardial perfusion scintigraphy had been performed, a subgroup of people referred for coronary angiography, with neither prior history nor ECG signs of a myocardial infarction has been selected retrospectively. This group consisted of 41 patients (14 females) in the age group 46 to 76 years. All patients underwent two-day myocardial perfusion SPECT imaging using 99mT c-MIBI as a radiopharmaceutical. Reconstructed slices were interpreted in 3 colour scales: white-red-yellow-green-blue-black with computer-assigned thresholds (French 100%), the same French scale but without a white colour (image maximum set manually to a border value between red and white - French w.w.), and a white-yellow-violet-pink-blue-black scale (GEcolor), by consensus of two experienced nuclear medicine specialists. A semiquantitative method for evaluation of perfusion images was applied, based on myocardium segmentation. Perfusion in each segment was scored using a five-point system. Study interpretation (normal/abnormal perfusion) was based on summed stress scores (SSS), being equal/above or below a given threshold value. The choice of optimal SSS threshold value was based on sensitivity and specificity of the study in detection of perfusion defects resulting from critical stenoses of main coronary arteries. Results: SSS values differed among colour scales (p < 0.00001). The lowest values were obtained for a French 100% scale (mean value = 5.0, SD = 8.0), the highest for French w.w. (mean values = 8.1, SD = 8.7), and for GE colour scale - mean value - 5.6, SD - 7.9. A French 100% scale gave high sensitivity (88

  13. Modelling multiple thresholds in meta-analysis of diagnostic test accuracy studies

    Directory of Open Access Journals (Sweden)

    Susanne Steinhauser

    2016-08-01

    Full Text Available Abstract Background In meta-analyses of diagnostic test accuracy, routinely only one pair of sensitivity and specificity per study is used. However, for tests based on a biomarker or a questionnaire often more than one threshold and the corresponding values of true positives, true negatives, false positives and false negatives are known. Methods We present a new meta-analysis approach using this additional information. It is based on the idea of estimating the distribution functions of the underlying biomarker or questionnaire within the non-diseased and diseased individuals. Assuming a normal or logistic distribution, we estimate the distribution parameters in both groups applying a linear mixed effects model to the transformed data. The model accounts for across-study heterogeneity and dependence of sensitivity and specificity. In addition, a simulation study is presented. Results We obtain a summary receiver operating characteristic (SROC curve as well as the pooled sensitivity and specificity at every specific threshold. Furthermore, the determination of an optimal threshold across studies is possible through maximization of the Youden index. We demonstrate our approach using two meta-analyses of B type natriuretic peptide in heart failure and procalcitonin as a marker for sepsis. Conclusions Our approach uses all the available information and results in an estimation not only of the performance of the biomarker but also of the threshold at which the optimal performance can be expected.

  14. Bivariate Random Effects Meta-analysis of Diagnostic Studies Using Generalized Linear Mixed Models

    Science.gov (United States)

    GUO, HONGFEI; ZHOU, YIJIE

    2011-01-01

    Bivariate random effect models are currently one of the main methods recommended to synthesize diagnostic test accuracy studies. However, only the logit-transformation on sensitivity and specificity has been previously considered in the literature. In this paper, we consider a bivariate generalized linear mixed model to jointly model the sensitivities and specificities, and discuss the estimation of the summary receiver operating characteristic curve (ROC) and the area under the ROC curve (AUC). As the special cases of this model, we discuss the commonly used logit, probit and complementary log-log transformations. To evaluate the impact of misspecification of the link functions on the estimation, we present two case studies and a set of simulation studies. Our study suggests that point estimation of the median sensitivity and specificity, and AUC is relatively robust to the misspecification of the link functions. However, the misspecification of link functions has a noticeable impact on the standard error estimation and the 95% confidence interval coverage, which emphasizes the importance of choosing an appropriate link function to make statistical inference. PMID:19959794

  15. Transscrotal Near Infrared Spectroscopy as a Diagnostic Test for Testis Torsion in Pediatric Acute Scrotum: A Prospective Comparison to Gold Standard Diagnostic Test Study.

    Science.gov (United States)

    Schlomer, Bruce J; Keays, Melise A; Grimsby, Gwen M; Granberg, Candace F; DaJusta, Daniel G; Menon, Vani S; Ostrov, Lauren; Sheth, Kunj R; Hill, Martinez; Sanchez, Emma J; Harrison, Clanton B; Jacobs, Micah A; Huang, Rong; Burgu, Berk; Hennes, Halim; Baker, Linda A

    2017-09-01

    A rapid test for testicular torsion in children may obviate the delay for testicular ultrasound. In this study we assessed testicular tissue percent oxygen saturation (%StO2) measured by transscrotal near infrared spectroscopy as a diagnostic test for pediatric testicular torsion. This was a prospective comparison to a gold standard diagnostic test study that evaluated near infrared spectroscopy %StO2 readings to diagnose testicular torsion. The gold standard for torsion diagnosis was standard clinical care. From 2013 to 2015 males with acute scrotum for more than 1 month and who were less than 18 years old were recruited. Near infrared spectroscopy %StO2 readings were obtained for affected and unaffected testes. Near infrared spectroscopy Δ%StO2 was calculated as unaffected minus affected reading. The utility of near infrared spectroscopy Δ%StO2 to diagnose testis torsion was described with ROC curves. Of 154 eligible patients 121 had near infrared spectroscopy readings. Median near infrared spectroscopy Δ%StO2 in the 36 patients with torsion was 2.0 (IQR -4.2 to 9.8) vs -1.7 (IQR -8.7 to 2.0) in the 85 without torsion (p=0.004). AUC for near infrared spectroscopy as a diagnostic test was 0.66 (95% CI 0.55-0.78). Near infrared spectroscopy Δ%StO2 of 20 or greater had a positive predictive value of 100% and a sensitivity of 22.2%. Tanner stage 3-5 cases without scrotal edema or with pain for 12 hours or less had an AUC of 0.91 (95% CI 0.86-1.0) and 0.80 (95% CI 0.62-0.99), respectively. In all children near infrared spectroscopy readings had limited utility in diagnosing torsion. However, in Tanner 3-5 cases without scrotal edema or with pain 12 hours or less, near infrared spectroscopy discriminated well between torsion and nontorsion. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. Differentiating between analytical and diagnostic performance evaluation with a focus on the method comparison study and identification of bias.

    Science.gov (United States)

    Flatland, Bente; Friedrichs, Kristen R; Klenner, Stefanie

    2014-12-01

    Prior to introduction of a new method to the diagnostic laboratory, analytical performance must be validated to ensure operation within the manufacturer's specifications and/or within predetermined quality requirements. In addition, the new method may require diagnostic performance assessment to ensure it differentiates between diseased and nondiseased individuals as intended. These 2 phases of assessment, while complementary, are not equivalent and require a different set of experiments, statistical analyses, and interpretation. Studies of analytical performance typically include a method comparison experiment, the purpose of which is to identify bias (inaccuracy) of the "test" (or "index") method (new method) relative to a "comparative method" (established method). Analysis of method comparison data is facilitated by commercial software programs that present the statistical significance of identified bias; however, the clinical relevance of any bias also should be considered. Studies of diagnostic performance should not be pursued until analytical performance is fully characterized and may not be required for well-established tests or for those for which results are nonspecific (ie, not referable to a specific disease or condition). Diagnostic performance assessment may include assessment of sensitivity, specificity, predictive values, odds ratios, and/or likelihood ratios. The purpose of this review is to clarify differences between the assessment of analytical and diagnostic performance, and to explore the method comparison study and bias assessment from a perspective not addressed in prior veterinary articles. © 2014 American Society for Veterinary Clinical Pathology.

  17. STARD-BLCM: Standards for the Reporting of Diagnostic accuracy studies that use Bayesian Latent Class Models

    DEFF Research Database (Denmark)

    Kostoulas, Polychronis; Nielsen, Søren S.; Branscum, Adam J.

    2017-01-01

    . In such cases, a valid alternative to classical test evaluation involves the use of latent class models that do not require a priori knowledge of disease status. Latent class models have been successfully implemented in a Bayesian framework for over 20 years. The objective of this work was to identify the STARD...... items that require modification and develop a modified version of STARD for studies that use Bayesian latent class analysis to estimate diagnostic test accuracy in the absence of a reference standard. Examples and elaborations for each of the modified items are provided. The new guidelines, termed STARD......-BLCM (Standards for Reporting of Diagnostic accuracy studies that use Bayesian Latent Class Models), will facilitate improved quality of reporting on the design, conduct and results of diagnostic accuracy studies that use Bayesian latent class models....

  18. Study of an experimental methodology for thermal properties diagnostic of building envelop

    Science.gov (United States)

    Yang, Yingying; Sempy, Alain; Vogt Wu, Tingting; Sommier, Alain; Dumoulin, Jean; Batsale, Jean Christophe

    2017-04-01

    The building envelope plays a critical role in determining levels of comfort and building efficiency. Its real thermal properties characterization is of major interest to be able to diagnose energy efficiency performance of buildings (new construction and retrofitted existing old building). Research and development on a possible methodology for energy diagnostic of the building envelop is a hot topic and necessary trend. Many kinds of sensors and instruments are used for the studies. The application of infrared (IR) thermography in non-destructive evaluation has been widely employed for qualitative evaluations for building diagnostics; meanwhile, the IR thermography technology also has a large potentiality for the evaluation of the thermal characteristics of the building envelope. Some promising recent research studies have been carried out with such contactless measurement technique. Nevertheless, research efforts are still required for in situ measurements under natural environmental conditions. In order to develop new solutions for non-intrusive evaluation of local thermal performance, enabling quantitative assessment of thermal properties of buildings and materials, experiments were carried out on a multi-layer pratical scale wall fixed on a caisson placed in a climatic chamber. Six halogen lamps (1.5 kW for each lamp) placed in front of objective wall were used to emulate sunny conditions. The radiative heat flux emitted was monitored and modulated with time according to typical weather data set encountered in France. Both steady state and transient regime heat transfer were studied during these experiments. Contact sensors (thermocouples, heat flux meters, Peltier sensors) and non-contact sensors (thermal IR camera, pyranometer) were used to measure the temperatures and heat flux density evolution. It has to be noticed that the Peltier sensors have been tuned and used with a specific processing to set them compliant for heat flux density measurements. The

  19. Development of a Cherenkov-type diagnostic system to study runaway electrons within the COMPASS tokamak

    Czech Academy of Sciences Publication Activity Database

    Rabinski, M.; Jakubowski, L.; Malinowski, K.; Sadowski, M. J.; Zebrowski, J.; Jakubowski, M.J.; Mirowski, R.; Weinzettl, Vladimír; Ficker, Ondřej; Mlynář, Jan; Pánek, Radomír; Papřok, Richard; Vlainic, Milos

    2017-01-01

    Roč. 12, October (2017), č. článku C10014. ISSN 1748-0221. [European Conference on Plasma Diagnostics (ECPD2017)/2./. Bordeaux, 18.04.2017-21.04.2017] R&D Projects: GA MŠk(CZ) LM2015045 Institutional support: RVO:61389021 Keywords : Nuclear instruments and methods for hot plasma diagnostics * Plasma diagnostics - probes Subject RIV: BL - Plasma and Gas Discharge Physics OBOR OECD: 2.11 Other engineering and technologies Impact factor: 1.220, year: 2016 http://iopscience.iop.org/article/10.1088/1748-0221/12/10/C10014

  20. Diagnostic usefulness of the cytological study of the transport buffer in transrectal prostate core biopsies.

    Science.gov (United States)

    López, J I; Cáceres, F; Pérez, A; Caamaño, V; Larrinaga, G; Lecumberri, D; Arruza, A

    2014-11-01

    To evaluate the diagnostic usefulness of the cytological study of the transport buffer in the diagnosis of prostate adenocarcinoma in transrectal core biopsies. A total of 256 consecutively biopsied patients have been included in the analysis, 100 of them diagnosed of prostate adenocarcinoma. The procedure included the cytological analysis of the transport buffer and conventional histology. Cytological evaluation was performed in a blind way by the same pathologist. Overall sensitivity, specificity, and positive and negative predictive values to detect malignancy in the cytological slides were 54%, 98%, 94% and 76%, respectively. When restricted the analysis to cases with Gleason score higher than 8, sensitivity and negative predictive value increased to 85% and 97%, respectively. Similarly, when the analysis focused exclusively to cases with more than 5mm of cancer in the biopsy, sensitivity and positive predictive value increased to 66% and 96%, respectively. This study shows that whilst specificity was maintained in 98%, sensitivity, and positive and negative predictive values significantly improved in high grade and high volume adenocarcinomas. Our findings confirm that the cytological study of the transport buffer may complement the histology in the diagnosis of prostate adenocarcinoma. Copyright © 2014 AEU. Published by Elsevier Espana. All rights reserved.

  1. Correlation of central venous pressure with venous blood gas analysis parameters; a diagnostic study

    Directory of Open Access Journals (Sweden)

    Sima Rahim-Taleghani

    2017-03-01

    Full Text Available Objective: This study was conducted to assess the correlation between central venous pressure (CVP and venous blood gas (VBG analysis parameters, to facilitate management of severe sepsis and septic shock in emergency department. Material and methods: This diagnostic study was conducted from January 2014 until June 2015 in three major educational medical centers, Tehran, Iran. For patients selected with diagnosis of septic shock, peripheral blood sample was taken for testing the VBG parameters and the anion gap (AG was calculated. All the mentioned parameters were measured again after infusion of 500 cc of normal saline 0.9% in about 1 h. Results: Totally, 93 patients with septic shock were enrolled, 63 male and 30 female. The mean age was 72.53 ± 13.03 and the mean Shock Index (SI before fluid therapy was 0.79 ± 0.30. AG and pH showed significant negative correlations with CVP, While HCO3 showed a significant positive correlation with CVP. These relations can be affected by the treatment modalities used in shock management such as fluid therapy, mechanical ventilation and vasopressor treatment. Conclusion: It is likely that there is a significant statistical correlation between VBG parameters and AG with CVP, but further research is needed before implementation of the results of this study. Keywords: Shock, Septic, Central venous pressure, Blood gas analysis, Emergency department, Emergency medicine

  2. Performance of physician-certified verbal autopsies: multisite validation study using clinical diagnostic gold standards

    Directory of Open Access Journals (Sweden)

    Flaxman Abraham D

    2011-08-01

    Full Text Available Abstract Background Physician review of a verbal autopsy (VA and completion of a death certificate remains the most widely used approach for VA analysis. This study provides new evidence about the performance of physician-certified verbal autopsy (PCVA using defined clinical diagnostic criteria as a gold standard for a multisite sample of 12,542 VAs. The study was also designed to analyze issues related to PCVA, such as the impact of a second physician reader on the cause of death assigned, the variation in performance with and without household recall of health care experience (HCE, and the importance of local information for physicians reading VAs. Methods The certification was performed by 24 physicians. The assignment of VA was random and blinded. Each VA was certified by one physician. Half of the VAs were reviewed by a different physician with household recall of health care experience included. The completed death certificate was processed for automated ICD-10 coding of the underlying cause of death. PCVA was compared to gold standard cause of death assignment based on strictly defined clinical diagnostic criteria that are part of the Population Health Metrics Research Consortium (PHMRC gold standard verbal autopsy study. Results For individual cause assignment, the overall chance-corrected concordance for PCVA against the gold standard cause of death is less than 50%, with substantial variability by cause and physician. Physicians assign the correct cause around 30% of the time without HCE, and addition of HCE improves performance in adults to 45% and slightly higher in children to 48%. Physicians estimate cause-specific mortality fractions (CSMFs with considerable error for adults, children, and neonates. Only for neonates for a cause list of six causes with HCE is accuracy above 0.7. In all three age groups, CSMF accuracy improves when household recall of health care experience is available. Conclusions Results show that physician

  3. Computerized Diagnostic Assistant for the Automatic Detection of Pneumothorax on Ultrasound: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Shane M. Summers, MD, RDMS

    2016-03-01

    Full Text Available Introduction: Bedside thoracic ultrasound (US can rapidly diagnose pneumothorax (PTX with improved accuracy over the physical examination and without the need for chest radiography (CXR; however, US is highly operator dependent. A computerized diagnostic assistant was developed by the United States Army Institute of Surgical Research to detect PTX on standard thoracic US images. This computer algorithm is designed to automatically detect sonographic signs of PTX by systematically analyzing B-mode US video clips for pleural sliding and M-mode still images for the seashore sign. This was a pilot study to estimate the diagnostic accuracy of the PTX detection computer algorithm when compared to an expert panel of US trained physicians. Methods: This was a retrospective study using archived thoracic US obtained on adult patients presenting to the emergency department (ED between 5/23/2011 and 8/6/2014. Emergency medicine residents, fellows, attending physicians, physician assistants, and medical students performed the US examinations and stored the images in the picture archive and communications system (PACS. The PACS was queried for all ED bedside US examinations with reported positive PTX during the study period along with a random sample of negatives. The computer algorithm then interpreted the images, and we compared the results to an independent, blinded expert panel of three physicians, each with experience reviewing over 10,000 US examinations. Results: Query of the PACS system revealed 146 bedside thoracic US examinations for analysis. Thirteen examinations were indeterminate and were excluded. There were 79 true negatives, 33 true positives, 9 false negatives, and 12 false positives. The test characteristics of the algorithm when compared to the expert panel were sensitivity 79% (95 % CI [63-89] and specificity 87% (95% CI [77-93]. For the 20 images scored as highest quality by the expert panel, the algorithm demonstrated 100% sensitivity

  4. Best practice guidelines for the use of next-generation sequencing applications in genome diagnostics: a national collaborative study of dutch genome diagnostic laboratories

    NARCIS (Netherlands)

    Weiss, Marjan M.; van der Zwaag, Bert; Jongbloed, Jan D. H.; Vogel, Maartje J.; Brüggenwirth, Hennie T.; Lekanne Deprez, Ronald H.; Mook, Olaf; Ruivenkamp, Claudia A. L.; van Slegtenhorst, Marjon A.; van den Wijngaard, Arthur; Waisfisz, Quinten; Nelen, Marcel R.; van der Stoep, Nienke

    2013-01-01

    Next-generation sequencing (NGS) methods are being adopted by genome diagnostics laboratories worldwide. However, implementing NGS-based tests according to diagnostic standards is a challenge for individual laboratories. To facilitate the implementation of NGS in Dutch laboratories, the Dutch

  5. Best practice guidelines for the use of next-generation sequencing applications in genome diagnostics: a national collaborative study of Dutch genome diagnostic laboratories.

    Science.gov (United States)

    Weiss, Marjan M; Van der Zwaag, Bert; Jongbloed, Jan D H; Vogel, Maartje J; Brüggenwirth, Hennie T; Lekanne Deprez, Ronald H; Mook, Olaf; Ruivenkamp, Claudia A L; van Slegtenhorst, Marjon A; van den Wijngaard, Arthur; Waisfisz, Quinten; Nelen, Marcel R; van der Stoep, Nienke

    2013-10-01

    Next-generation sequencing (NGS) methods are being adopted by genome diagnostics laboratories worldwide. However, implementing NGS-based tests according to diagnostic standards is a challenge for individual laboratories. To facilitate the implementation of NGS in Dutch laboratories, the Dutch Society for Clinical Genetic Laboratory Diagnostics (VKGL) set up a working group in 2012. The results of their discussions are presented here. We provide best practice guidelines and criteria for implementing and validating NGS applications in a clinical setting. We introduce the concept of "diagnostic yield" as the main performance characteristic for evaluating diagnostic tests. We recommend that the laboratory procedures, including the tested genes, should be recorded in a publicly available document describing the complete "diagnostic routing." We also propose that laboratories should use a list of "core disease genes" for specific genetic diseases. This core list contains the essential genes for each disease, and they should all be included in a diagnostic test to establish a reliable and accurate molecular diagnosis. The guidelines will ensure a clear and standardized quality of care provided by genetic diagnostic laboratories. The best practice guidelines and criteria that are presented here were adopted by the VKGL in January 2013. © 2013 WILEY PERIODICALS, INC.

  6. Developing the Evidence Base to Inform Best Practice: A Scoping Study of Breast and Cervical Cancer Reviews in Low- and Middle-Income Countries.

    Directory of Open Access Journals (Sweden)

    Margaret M Demment

    Full Text Available Breast and cervical cancers have emerged as major global health challenges and disproportionately lead to excess morbidity and mortality in low- and middle-income countries (LMICs when compared to high-income countries. The objective of this paper was to highlight key findings, recommendations, and gaps in research and practice identified through a scoping study of recent reviews in breast and cervical cancer in LMICs.We conducted a scoping study based on the six-stage framework of Arskey and O'Malley. We searched PubMed, Cochrane Reviews, and CINAHL with the following inclusion criteria: 1 published between 2005-February 2015, 2 focused on breast or cervical cancer 3 focused on LMIC, 4 review article, and 5 published in English.Through our systematic search, 63 out of the 94 identified cervical cancer reviews met our selection criteria and 36 of the 54 in breast cancer. Cervical cancer reviews were more likely to focus upon prevention and screening, while breast cancer reviews were more likely to focus upon treatment and survivorship. Few of the breast cancer reviews referenced research and data from LMICs themselves; cervical cancer reviews were more likely to do so. Most reviews did not include elements of the PRISMA checklist.Overall, a limited evidence base supports breast and cervical cancer control in LMICs. Further breast and cervical cancer prevention and control studies are necessary in LMICs.

  7. Value of systematic detection of physical child abuse at emergency rooms : A cross-sectional diagnostic accuracy study

    NARCIS (Netherlands)

    Sittig, Judith S.; Uiterwaal, Cuno S P M; Moons, Karel G M; Russel-Kampschoer, Ingrid M B; Nievelstein, Rutger A J; Nieuwenhuis, Edward E S; Van De Putte, Elise M.

    2016-01-01

    Objectives: The aim of our diagnostic accuracy study Child Abuse Inventory at Emergency Rooms (CHAIN-ER) was to establish whether a widely used checklist accurately detects or excludes physical abuse among children presenting to ERs with physical injury. Design: A large multicentre study with a

  8. Study on Unified Chaotic System-Based Wind Turbine Blade Fault Diagnostic System

    Science.gov (United States)

    Kuo, Ying-Che; Hsieh, Chin-Tsung; Yau, Her-Terng; Li, Yu-Chung

    At present, vibration signals are processed and analyzed mostly in the frequency domain. The spectrum clearly shows the signal structure and the specific characteristic frequency band is analyzed, but the number of calculations required is huge, resulting in delays. Therefore, this study uses the characteristics of a nonlinear system to load the complete vibration signal to the unified chaotic system, applying the dynamic error to analyze the wind turbine vibration signal, and adopting extenics theory for artificial intelligent fault diagnosis of the analysis signal. Hence, a fault diagnostor has been developed for wind turbine rotating blades. This study simulates three wind turbine blade states, namely stress rupture, screw loosening and blade loss, and validates the methods. The experimental results prove that the unified chaotic system used in this paper has a significant effect on vibration signal analysis. Thus, the operating conditions of wind turbines can be quickly known from this fault diagnostic system, and the maintenance schedule can be arranged before the faults worsen, making the management and implementation of wind turbines smoother, so as to reduce many unnecessary costs.

  9. Diagnostic Methods of Helicobacter pylori Infection for Epidemiological Studies: Critical Importance of Indirect Test Validation.

    Science.gov (United States)

    Miftahussurur, Muhammad; Yamaoka, Yoshio

    2016-01-01

    Among the methods developed to detect H. pylori infection, determining the gold standard remains debatable, especially for epidemiological studies. Due to the decreasing sensitivity of direct diagnostic tests (histopathology and/or immunohistochemistry [IHC], rapid urease test [RUT], and culture), several indirect tests, including antibody-based tests (serology and urine test), urea breath test (UBT), and stool antigen test (SAT) have been developed to diagnose H. pylori infection. Among the indirect tests, UBT and SAT became the best methods to determine active infection. While antibody-based tests, especially serology, are widely available and relatively sensitive, their specificity is low. Guidelines indicated that no single test can be considered as the gold standard for the diagnosis of H. pylori infection and that one should consider the method's advantages and disadvantages. Based on four epidemiological studies, culture and RUT present a sensitivity of 74.2-90.8% and 83.3-86.9% and a specificity of 97.7-98.8% and 95.1-97.2%, respectively, when using IHC as a gold standard. The sensitivity of serology is quite high, but that of the urine test was lower compared with that of the other methods. Thus, indirect test validation is important although some commercial kits propose universal cut-off values.

  10. Diagnostic accuracy of placental growth factor in women with suspected preeclampsia: a prospective multicenter study.

    Science.gov (United States)

    Chappell, Lucy C; Duckworth, Suzy; Seed, Paul T; Griffin, Melanie; Myers, Jenny; Mackillop, Lucy; Simpson, Nigel; Waugh, Jason; Anumba, Dilly; Kenny, Louise C; Redman, Christopher W G; Shennan, Andrew H

    2013-11-05

    Hypertensive disorders of pregnancy are a major contributor to death and disability for pregnant women and their infants. The diagnosis of preeclampsia by using blood pressure and proteinuria is of limited use because they are tertiary, downstream features of the disease. Placental growth factor (PlGF) is an angiogenic factor, a secondary marker of associated placental dysfunction in preeclampsia, with known low plasma concentrations in the disease. In a prospective multicenter study, we studied the diagnostic accuracy of low plasma PlGF concentration (preeclampsia between 20 and 35 weeks' gestation (and up to 41 weeks' gestation as a secondary analysis). The outcome was delivery for confirmed preeclampsia within 14 days. Of 625 women, 346 (55%) developed confirmed preeclampsia. In 287 women enrolled before 35 weeks' gestation, PlGF preeclampsia within 14 days; specificity was lower (0.55; 0.48-0.61). Area under the receiver operating characteristic curve for low PlGF (0.87, standard error 0.03) for predicting preeclampsia within 14 days was greater than all other commonly used tests, singly or in combination (range, 0.58-0.76), in women presenting with suspected preeclampsia (Ppreeclampsia, low PlGF has high sensitivity and negative predictive value for preeclampsia within 14 days, is better than other currently used tests, and presents an innovative adjunct to management of such women.

  11. [Maxillary sinusitis as a diagnostical adverse finding of the dental cone-beam computed tomography study].

    Science.gov (United States)

    Schreindorfer, Károly; Kiss, Ágnes; Marada, Gyula

    2017-11-01

    Cone-beam computed tomography is a frequently used diagnostical method in the head and neck region. The thickening of the maxillary sinus mucosa is often observed in these images. Determining the prevalence of teeth and roots that can be identified as cause of maxillary odontogenic sinusitis, and recording the average observed mucosa thickening on these images. The scans that give the base of the study have been performed by the Department of Dentistry of Medical University of Pécs between 2015-2016. The size of the voxels had been varied between 0.25 and 0.4 mm and the size of the image had been set up to 15×12 cm. The acquisition time had been set up to 27 seconds. 170 cases of the 260 revised records fulfilled the initial criterion conditions. The average mucosa thickness was 8.8 mm. During the present study, the upper first molars palatal and the second molars mesiobuccal roots were mainly associated with maxillary odontogenic sinusitis. Whether in the case of chronic maxillary sinusitis that is not or only temporarily responsive to conventional therapy, may it be justifiable to provide dental consultation and cone-beam computed tomography to exclude the dental origin of sinusitis. Orv Hetil. 2017; 158(44): 1747-1753.

  12. [Comparative study of diagnostic methods for visceral leishmaniasis in dogs from Ilha Solteira, SP].

    Science.gov (United States)

    de Assis, Juliana; de Queiroz, Nina Marí Gual Pimenta; da Silveira, Rita de Cássia Vieira; Nunes, Cáris Maroni; Oliveira, Trícia Maria Ferreira de Sousa; Junior, Antonio Carlos Faconti de Noronha; Neves, Maria Francisca; Machado, Rosangela Zacarias; Buzetti, Wilma Aparecida Starke

    2010-01-01

    The purpose of the present work was a comparative study of diagnostic methods for Canine Visceral Leishmaniasis (CVL) using serological methods, enzyme-linked immunosorbent assay (ELISA) and indirect fluorescent antibody test (IFAT), histochemical (HE) and immunohistochemical (IMHC) tests using spleen, lymph node and liver canine tissues. In addition, Polymerase Chain Reaction (PCR) was done in blood and in tissues in order to compare and confirm no conclusive and negative diagnosis by the methods above. For this study, 34 dogs were divided according to clinical signs in asymptomatic, oligosymptomatic and polisymptomatic Leishmania-infected dogs euthanized by Zoonotic Disease Control Center (CCZ) from Ilha Solteira, SP, Brazil. The positivism indexes of ELISA, IMHC, IFAT and HE were 65.0, 62.0, 56.0 and 56.0%, respectively with the highest numbers of positive dogs in polisymptomatic (92.0%) followed by oligosymptomatic (57.0%) and asymptomatic dogs (12.5%). Furthermore, PCR confirmed the positive results and detected DNA in tissues from 100% of negative dogs and 89.0% suspects raising the animal positivism index up to 97.0%. In conclusion, PCR was the most sensitive and a valuable method for a definitive CVL diagnosis.

  13. Concrete decontamination scoping tests

    International Nuclear Information System (INIS)

    Archibald, K.E.

    1995-01-01

    This report details the research efforts and scoping tests performed at the Idaho Chemical Process Plant using scabbling, chemical, and electro-osmotic decontamination techniques on radiologically contaminated concrete

  14. Diagnostic accuracy study of routine echocardiography for bicuspid aortic valve: a retrospective study and meta-analysis

    Science.gov (United States)

    Hillebrand, Mathias; Koschyk, Dietmar; ter Hark, Pia; Schüler, Helke; Rybczynski, Meike; Berger, Jürgen; Gulati, Amit; Bernhardt, Alexander M.; Detter, Christian; Girdauskas, Evaldas; Blankenberg, Stefan

    2017-01-01

    Background Transthoracic echocardiography (TTE) is the standard procedure to distinguish tricuspid aortic valve (TAV) from bicuspid aortic valve (BAV). Published studies assessed the accuracy of TTE for BAV under ideal conditions. Conversely, we aimed at assessing accuracy of TTE for BAV under routine conditions. Methods This retrospective, cross-sectional study of 216 adults included 132 men aged 62±14 years. Of these, 108 had BAV and 108 were age-matched individuals with TAV. All diagnoses were confirmed at surgery. We assessed TTE in two patient groups. First, in the (I) group of all 216 individuals, where we assessed accuracy for BAV according to the original diagnoses as documented by the primary investigators during original TTE examination. Second, we assessed accuracy for BAV according to expert re-evaluation in (II) all 158 TTE with availability of original recordings. Third, we performed a meta-analysis of published results on the accuracy of TTE for BAV according to PRISMA standards. Results Sensitivity, specificity and accuracy of (I) primary investigators was 46.3%, 97.2, and 71.8% as compared to (II) expert re-evaluation with 59.7%, 93%, and 77.8%, respectively. Sensitivity was significantly higher at re-evaluation (Pvalve calcification (P=0.003) predicted an inaccurate diagnosis of BAV. Conversely, meta-analysis of published TTE studies identified a pooled sensitivity of 87.7% and a pooled specificity of 88.3% for BAV. Conclusions The current study shows that TTE yields almost ideal diagnostic accuracy when ideal investigators examine ideal patients. However, the study also shows that TTE yields suboptimal diagnostic accuracy under routine conditions. TTE in non-tertiary care settings, concomitant aortic aneurysm, and presence of severe aortic valve calcification predict an inaccurate diagnosis of BAV. PMID:28890873

  15. Diagnostic accuracy study of routine echocardiography for bicuspid aortic valve: a retrospective study and meta-analysis.

    Science.gov (United States)

    Hillebrand, Mathias; Koschyk, Dietmar; Ter Hark, Pia; Schüler, Helke; Rybczynski, Meike; Berger, Jürgen; Gulati, Amit; Bernhardt, Alexander M; Detter, Christian; Girdauskas, Evaldas; Blankenberg, Stefan; von Kodolitsch, Yskert

    2017-08-01

    Transthoracic echocardiography (TTE) is the standard procedure to distinguish tricuspid aortic valve (TAV) from bicuspid aortic valve (BAV). Published studies assessed the accuracy of TTE for BAV under ideal conditions. Conversely, we aimed at assessing accuracy of TTE for BAV under routine conditions. This retrospective, cross-sectional study of 216 adults included 132 men aged 62±14 years. Of these, 108 had BAV and 108 were age-matched individuals with TAV. All diagnoses were confirmed at surgery. We assessed TTE in two patient groups. First, in the (I) group of all 216 individuals, where we assessed accuracy for BAV according to the original diagnoses as documented by the primary investigators during original TTE examination. Second, we assessed accuracy for BAV according to expert re-evaluation in (II) all 158 TTE with availability of original recordings. Third, we performed a meta-analysis of published results on the accuracy of TTE for BAV according to PRISMA standards. Sensitivity, specificity and accuracy of (I) primary investigators was 46.3%, 97.2, and 71.8% as compared to (II) expert re-evaluation with 59.7%, 93%, and 77.8%, respectively. Sensitivity was significantly higher at re-evaluation (PTTE at a non-tertiary care center (P=0.012), presence of aortic aneurysm (P=0.001) and presence of severe aortic valve calcification (P=0.003) predicted an inaccurate diagnosis of BAV. Conversely, meta-analysis of published TTE studies identified a pooled sensitivity of 87.7% and a pooled specificity of 88.3% for BAV. The current study shows that TTE yields almost ideal diagnostic accuracy when ideal investigators examine ideal patients. However, the study also shows that TTE yields suboptimal diagnostic accuracy under routine conditions. TTE in non-tertiary care settings, concomitant aortic aneurysm, and presence of severe aortic valve calcification predict an inaccurate diagnosis of BAV.

  16. Making Patent Scopes Exceed the Technological Scopes of Scientific Inventions

    DEFF Research Database (Denmark)

    Beukel, Karin

    This paper presents the results of a grounded theory study of the transformation of scientific discoveries into patented inventions. Using an algebraic interpretive approach, the narratives collected during interviews are analyzed as Bayesian inferences and the developed theory is tested. The fin...... for searching in new directions for solutions if challenges of exploitation with regard to the scientific invention arise.......This paper presents the results of a grounded theory study of the transformation of scientific discoveries into patented inventions. Using an algebraic interpretive approach, the narratives collected during interviews are analyzed as Bayesian inferences and the developed theory is tested....... The findings recast the relationship between science and patents as a process in which the way the transformation of the scientific invention is handled has an effect on the breadth of the patent scope. Unleashing patent scope surplus is dependent on processes related to abstraction and cognitive variety...

  17. A Genome-Wide Association Study to Identify Diagnostic Markers for Human Pathogenic Campylobacter jejuni Strains

    Directory of Open Access Journals (Sweden)

    Cody J. Buchanan

    2017-06-01

    Full Text Available Campylobacter jejuni is a leading human enteric pathogen worldwide and despite an improved understanding of its biology, ecology, and epidemiology, limited tools exist for identifying strains that are likely to cause disease. In the current study, we used subtyping data in a database representing over 24,000 isolates collected through various surveillance projects in Canada to identify 166 representative genomes from prevalent C. jejuni subtypes for whole genome sequencing. The sequence data was used in a genome-wide association study (GWAS aimed at identifying accessory gene markers associated with clinically related C. jejuni subtypes. Prospective markers (n = 28 were then validated against a large number (n = 3,902 of clinically associated and non-clinically associated genomes from a variety of sources. A total of 25 genes, including six sets of genetically linked genes, were identified as robust putative diagnostic markers for clinically related C. jejuni subtypes. Although some of the genes identified in this study have been previously shown to play a role in important processes such as iron acquisition and vitamin B5 biosynthesis, others have unknown function or are unique to the current study and warrant further investigation. As few as four of these markers could be used in combination to detect up to 90% of clinically associated isolates in the validation dataset, and such markers could form the basis for a screening assay to rapidly identify strains that pose an increased risk to public health. The results of the current study are consistent with the notion that specific groups of C. jejuni strains of interest are defined by the presence of specific accessory genes.

  18. Pulmonary actinomycosis: CT studies of diagnostic and post-treatment findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Su Jung; Song, Sun Wha; Bo, Seal Hwang; Park, Hyun Jin; Kim, Hyeon Sook; Kim, Ki Jun; Kim, Horrim; Park, Seog Hee [College of Medicine, the Catholic University of Korea, Uijeongbu (Korea, Republic of)

    2008-05-15

    To investigate the value of the computed tomography (CT) in the study of diagnostic and post-treatment findings of pulmonary actinomycosis. Clinical data and CT findings were retrospectively analyzed in 10 patients with histopathologically confirmed pulmonary actinomycosis. We analyzed the initial CT findings in search of patterns and distributions which suggest possible lung abnormalities and found the pleura, chest wall, and lymphadenopathy to be involved as part of the indicators of lung abnormalities. We analyzed follow-up CT findings for changes in the lungs after antibiotic therapy and recurrence after surgery. Of the 10 patients analyzed by CT for lung lesions, seven had been diagnosed with alcoholism and nine were male. The initial CTs (n = 10) indicated that all the pulmonary lesions were solitary without chest wall involvement. However, a transfissural extension was observed in 20% of the study population (n = 2). Furthermore, peripheral lung distribution and adjacent pleural thickening was observed in 70% of the study population (n = 7). Within the consolidation (n = 6) or mass (n = 4), a central low density with peripheral enhancement was seen in 70% of the study population (n = 7). A follow-up CT of the seven cases following antiobiotic therapy revealed that four cases showed minimal improvement or aggravation of their lung lesions, whereas three cases showed resolution or improvement. The improvement of the central low density was related to the improvement of consolidation or mass. Furthermore the presence of fibrosis was observed after the resolution of pulmonary lesions (n = 2). No relationship was found between the duration and response of antibiotic therapy. A follow-up CT (n = 4) subsequent to a lung resection revealed the onset of chest wall actinomycosis and a thickened pleura in one case. The results of this study highlight the value of the CT in pulmonary actinomycosis in order to diagnose and evaluate antibiotic responses, complications, or

  19. Search filters for finding prognostic and diagnostic prediction studies in Medline to enhance systematic reviews.

    Directory of Open Access Journals (Sweden)

    Geert-Jan Geersing

    Full Text Available BACKGROUND: The interest in prognostic reviews is increasing, but to properly review existing evidence an accurate search filer for finding prediction research is needed. The aim of this paper was to validate and update two previously introduced search filters for finding prediction research in Medline: the Ingui filter and the Haynes Broad filter. METHODOLOGY/PRINCIPAL FINDINGS: Based on a hand search of 6 general journals in 2008 we constructed two sets of papers. Set 1 consisted of prediction research papers (n = 71, and set 2 consisted of the remaining papers (n = 1133. Both search filters were validated in two ways, using diagnostic accuracy measures as performance measures. First, we compared studies in set 1 (reference with studies retrieved by the search strategies as applied in Medline. Second, we compared studies from 4 published systematic reviews (reference with studies retrieved by the search filter as applied in Medline. Next--using word frequency methods--we constructed an additional search string for finding prediction research. Both search filters were good in identifying clinical prediction models: sensitivity ranged from 0.94 to 1.0 using our hand search as reference, and 0.78 to 0.89 using the systematic reviews as reference. This latter performance measure even increased to around 0.95 (range 0.90 to 0.97 when either search filter was combined with the additional string that we developed. Retrieval rate of explorative prediction research was poor, both using our hand search or our systematic review as reference, and even combined with our additional search string: sensitivity ranged from 0.44 to 0.85. CONCLUSIONS/SIGNIFICANCE: Explorative prediction research is difficult to find in Medline, using any of the currently available search filters. Yet, application of either the Ingui filter or the Haynes broad filter results in a very low number missed clinical prediction model studies.

  20. Retrospective study of cumulative diagnostic radiation exposure during childhood in patients with spina bifida.

    Science.gov (United States)

    Smookler, Gregory; Deavenport-Saman, Alexis

    2015-10-01

    The Biological Effects of Ionizing Radiation Committee of the National Academy of Sciences in 2005 and other expert panels have warned that risk of cancer increases with higher doses of radiation. Children with spina bifida and hydrocephalus have far greater exposure to radiation than the average person, starting almost directly after birth and continuing throughout their lifetimes. The purpose of this study was to estimate the amount of ionizing radiation that patients with spina bifida and hydrocephalus are exposed to during childhood from diagnostic imaging. Thirty patients, ages 18 years or older, with spina bifida and hydrocephalus were randomly selected from a spina bifida clinic and their radiology records were reviewed. Descriptive analyses were conducted. The total radiation exposure was then calculated for the study group, and the mean effective dose per patient was determined. In the study group, during their first 18 years, each patient had a mean of 55.1 studies and a median of 45 radiologic studies, a mean of 9.6 brain CT scans, and a mean cumulative effective dose of 81.9 mSv (2.6 mSv/patient/year over 18 years) and a median cumulative effective dose of 77.2 mSV of accumulated radiation exposure (4.5 mSv/patient/year over 18 years). Clinicians should recognize that increased radiation exposure puts patients with spina bifida and hydrocephalus at higher risk for cancer. The population of children and adults with spina bifida and hydrocephalus should be surveyed for incidence of cancer. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Search filters for finding prognostic and diagnostic prediction studies in Medline to enhance systematic reviews.

    Science.gov (United States)

    Geersing, Geert-Jan; Bouwmeester, Walter; Zuithoff, Peter; Spijker, Rene; Leeflang, Mariska; Moons, Karel G M; Moons, Karel

    2012-01-01

    The interest in prognostic reviews is increasing, but to properly review existing evidence an accurate search filer for finding prediction research is needed. The aim of this paper was to validate and update two previously introduced search filters for finding prediction research in Medline: the Ingui filter and the Haynes Broad filter. Based on a hand search of 6 general journals in 2008 we constructed two sets of papers. Set 1 consisted of prediction research papers (n = 71), and set 2 consisted of the remaining papers (n = 1133). Both search filters were validated in two ways, using diagnostic accuracy measures as performance measures. First, we compared studies in set 1 (reference) with studies retrieved by the search strategies as applied in Medline. Second, we compared studies from 4 published systematic reviews (reference) with studies retrieved by the search filter as applied in Medline. Next--using word frequency methods--we constructed an additional search string for finding prediction research. Both search filters were good in identifying clinical prediction models: sensitivity ranged from 0.94 to 1.0 using our hand search as reference, and 0.78 to 0.89 using the systematic reviews as reference. This latter performance measure even increased to around 0.95 (range 0.90 to 0.97) when either search filter was combined with the additional string that we developed. Retrieval rate of explorative prediction research was poor, both using our hand search or our systematic review as reference, and even combined with our additional search string: sensitivity ranged from 0.44 to 0.85. Explorative prediction research is difficult to find in Medline, using any of the currently available search filters. Yet, application of either the Ingui filter or the Haynes broad filter results in a very low number missed clinical prediction model studies.

  2. The comparative study on diagnostic validity of cerebral aneurysm by computed tomography angiography versus digital subtraction angiography after subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Masih Saboori

    2011-01-01

    Full Text Available Background: In order to declare the preoperative diagnostic value of brain aneurysms, two radiological modalities, computed tomographic angiography and digital subtraction angiography were compared. Methods: In this descriptive analytic study, diagnostic value of computed tomographic angiography (CTA was com-pared with digital subtraction angiography (DSA. Sensitivity, specificity, positive and negative predictive values were calculated and compared between the two modalities. All data were analyzed with SPSS software, version 16. Results: Mean age of patients was 49.5 ± 9.13 years. 57.9 % of subjects were female. CTA showed 89% sensitivity and 100% specificity whereas DSA demonstrated 74% sensitivity and 100% specificity. Positive predictive value of both methods was 100%, but negative predictive value of CTA and DSA was 85% and 69%, respectively. Conclusions: Based on our data, CTA is a valuable diagnostic modality for detection of brain aneurysm and su-barachnoid hemorrhage.

  3. Ionization-potential depression and other dense plasma statistical property studies - Application to spectroscopic diagnostics.

    Science.gov (United States)

    Calisti, Annette; Ferri, Sandrine; Mossé, Caroline; Talin, Bernard

    2017-02-01

    The radiative properties of an emitter surrounded by a plasma, are modified through various mechanisms. For instance the line shapes emitted by bound-bound transitions are broadened and carry useful information for plasma diagnostics. Depending on plasma conditions the electrons occupying the upper quantum levels of radiators no longer exist as they belong to the plasma free electron population. All the charges present in the radiator environment contribute to the lowering of the energy required to free an electron in the fundamental state. This mechanism is known as ionization potential depression (IPD). The knowledge of IPD is useful as it affects both the radiative properties of the various ionic states and their populations. Its evaluation deals with highly complex n-body coupled systems, involving particles with different dynamics and attractive ion-electron forces. A classical molecular dynamics (MD) code, the BinGo-TCP code, has been recently developed to simulate neutral multi-component (various charge state ions and electrons) plasma accounting for all the charge correlations. In the present work, results on IPD and other dense plasma statistical properties obtained using the BinGo-TCP code are presented. The study focuses on aluminum plasmas for different densities and several temperatures in order to explore different plasma coupling conditions.

  4. [The diagnostic value of fine needle aspiration cytology in hematology: a study of 40 cases].

    Science.gov (United States)

    El Graoui, Omar; Marouane, Sophia; Zamiati, Soumaya; Faez, Saadia; Oukkach, Bouchra

    2013-01-01

    Fine-needle aspiration cytology (FNAC) is a simple and safe procedure that has proven to be accurate in the diagnosis of a variety of neoplasms. It is performed in an outpatient setting, and results are routinely available within 24 hours. To evaluate the diagnostic value of FNAC in the assessment of lymph nodes, we conducted a prospective study of patients with no history of previews malignancy, who underwent FNAC of an enlarged lymph node, during the period of January 2010 through June 2011. Cytologic findings were correlated with either histologic findings, clinical information, or both. Sensibility, specificity, and predictive values in differentiating between benign and malignant lymphadenopathy were high (81-92%). False negative results could be explained by the fact that pathology may be focal rather than widespread and therefore not seen on a cytologic smear. FNAC has become an integral part of the initial diagnosis and management of patients with persistent lymphadenopathy. However, the most important limitations are the high percentage of inadequate material (37%). Sensitivity and specificity are to be improved in our practice by improving the adequacy of the sampling, as well as the skill, experience, and familiarity of the cytopathologist.

  5. Performance of a Brazilian population sample in the Boston Diagnostic Aphasia Examination: a pilot study.

    Science.gov (United States)

    Radanovic, M; Mansur, L L

    2002-03-01

    Brazilian researchers and health professionals often face the challenge of having to use tests developed in foreign languages and standardized for populations of other countries, especially in the fields of Neuropsychology and Neurolinguistics. This fact promotes a feeling that some scoring systems may be inadequate for our sociocultural reality. In the present study, we describe the performance of a Brazilian population sample submitted to a translated and adapted version of the Boston Diagnostic Aphasia Examination (BDAE). Sixty normal volunteers (21 men and 39 women), all Portuguese native speakers, ranging in age from 15 to 78 years (average 43.7) and with an educational level of 2 to 16 years (average 9.9), were tested using a translated and adapted Portuguese version of the BDAE. Cut-off scores are suggested for our population and the performance of the Brazilian sample is compared to that of American and Colombian samples, with the results being closely similar in all tasks. We also performed a correlation analysis between age, gender and educational level and the influence of these variables on the performance of the subjects. We found no statistically significant differences between genders. Educational level correlated positively with performance, especially in the subtests involving reading and writing. There was a negative correlation between age and performance in two subtests (Visual Confrontation Naming and Sentences to Dictation), but a coexisting effect of educational level could not be ruled out.

  6. Head computed tomography scanning during pediatric neurocritical care: diagnostic yield and the utility of portable studies.

    Science.gov (United States)

    LaRovere, Kerri L; Brett, Molly S; Tasker, Robert C; Strauss, Keith J; Burns, Jeffrey P

    2012-04-01

    We report our use of portable head computed tomography (CT) and the diagnostic yield and radiation dose from head CT in the pediatric intensive care unit (PICU). 204 PICU patients underwent head CT during 2008-2009. Therapeutic interventions and resource intensity during CT were categorized. Severity of illness was summarized using the pediatric risk of mortality (PRISM-III) model. Estimates of patient radiation dose were based on dose measurements made in four anthropomorphic head phantoms. 242 (62%) out of 391 head CT studies were portable. New pathology was identified on 80 (40%) scans. CT findings prompted a change in management in 46 (23%) patients; 25 of these resulted in life-extending treatments and 21 had forgoing of life-sustaining treatments within 24 hours. 26 patients with PRISM score greater than 30% underwent CT; 23 (88%) of these were portable. More portable versus fixed examinations were performed in patients requiring extracorporeal membrane oxygenation, inhaled nitric oxide, high levels of positive end expiratory pressure, and those with high vasopressor scores (P change in management in 1/4 of higher acuity patients scanned. The estimated radiation dose from portable CT is within the current national guidelines.

  7. Central nervous system histoplasmosis: Multicenter retrospective study on clinical features, diagnostic approach and outcome of treatment.

    Science.gov (United States)

    Wheat, Joseph; Myint, Thein; Guo, Ying; Kemmer, Phebe; Hage, Chadi; Terry, Colin; Azar, Marwan M; Riddell, James; Ender, Peter; Chen, Sharon; Shehab, Kareem; Cleveland, Kerry; Esguerra, Eden; Johnson, James; Wright, Patty; Douglas, Vanja; Vergidis, Pascalis; Ooi, Winnie; Baddley, John; Bamberger, David; Khairy, Raed; Vikram, Holenarasipur R; Jenny-Avital, Elizabeth; Sivasubramanian, Geetha; Bowlware, Karen; Pahud, Barbara; Sarria, Juan; Tsai, Townson; Assi, Maha; Mocherla, Satish; Prakash, Vidhya; Allen, David; Passaretti, Catherine; Huprikar, Shirish; Anderson, Albert

    2018-03-01

    Central nervous system (CNS) involvement occurs in 5 to 10% of individuals with disseminated histoplasmosis. Most experience has been derived from small single center case series, or case report literature reviews. Therefore, a larger study of central nervous system (CNS) histoplasmosis is needed in order to guide the approach to diagnosis, and treatment.A convenience sample of 77 patients with histoplasmosis infection of the CNS was evaluated. Data was collected that focused on recognition of infection, diagnostic techniques, and outcomes of treatment.Twenty nine percent of patients were not immunosuppressed. Histoplasma antigen, or anti-Histoplasma antibodies were detected in the cerebrospinal fluid (CSF) in 75% of patients. One year survival was 75% among patients treated initially with amphotericin B, and was highest with liposomal, or deoxycholate formulations. Mortality was higher in immunocompromised patients, and patients 54 years of age, or older. Six percent of patients relapsed, all of whom had the acquired immunodeficiency syndrome (AIDS), and were poorly adherent with treatment.While CNS histoplasmosis occurred most often in immunocompromised individuals, a significant proportion of patients were previously, healthy. The diagnosis can be established by antigen, and antibody testing of the CSF, and serum, and antigen testing of the urine in most patients. Treatment with liposomal amphotericin B (AMB-L) for at least 1 month; followed by itraconazole for at least 1 year, results in survival among the majority of individuals. Patients should be followed for relapse for at least 1 year, after stopping therapy.

  8. Novel Optical Diagnostic Techniques for Studying Particle Deposition Upon Large Cylinders in a Sheared Suspension

    Science.gov (United States)

    Yoda, M.; Bailey, B. C.

    2000-01-01

    On a twelve-month voyage to Mars, one astronaut will require at least two tons of potable water and two tons of pure oxygen. Efficient, reliable fluid reclamation is therefore necessary for manned space exploration. Space habitats require a compact, flexible, and robust apparatus capable of solid-fluid mechanical separation over a wide range of fluid and particle densities and particle sizes. In space, centrifugal filtration, where particles suspended in fluid are captured by rotating fixed-fiber mat filters, is a logical candidate for mechanical separation. Non-colloidal particles are deposited on the fibers due to inertial impaction or direct interception. Since rotation rates are easily adjustable, inertial effects are the most practical way to control separation rates for a wide variety of multiphase mixtures in variable gravity environments. Understanding how fluid inertia and differential fluid-particle inertia, characterized by the Reynolds and Stokes numbers, respectively, affect deposition is critical in optimizing filtration in a microgravity environment. This work will develop non-intrusive optical diagnostic techniques for directly visualizing where and when non-colloidal particles deposit upon, or contact, solid surfaces: 'particle proximity sensors'. To model particle deposition upon a single filter fiber, these sensors will be used in ground-based experiments to study particle dynamics as in the vicinity of a large (compared with the particles) cylinder in a simply sheared (i.e., linearly-varying, zero-mean velocity profile) neutrally-buoyant, refractive-index matched solid-liquid suspension.

  9. Performance of a Brazilian population sample in the Boston Diagnostic Aphasia Examination: A pilot study

    Directory of Open Access Journals (Sweden)

    M. Radanovic

    2002-03-01

    Full Text Available Brazilian researchers and health professionals often face the challenge of having to use tests developed in foreign languages and standardized for populations of other countries, especially in the fields of Neuropsychology and Neurolinguistics. This fact promotes a feeling that some scoring systems may be inadequate for our sociocultural reality. In the present study, we describe the performance of a Brazilian population sample submitted to a translated and adapted version of the Boston Diagnostic Aphasia Examination (BDAE. Sixty normal volunteers (21 men and 39 women, all Portuguese native speakers, ranging in age from 15 to 78 years (average 43.7 and with an educational level of 2 to 16 years (average 9.9, were tested using a translated and adapted Portuguese version of the BDAE. Cut-off scores are suggested for our population and the performance of the Brazilian sample is compared to that of American and Colombian samples, with the results being closely similar in all tasks. We also performed a correlation analysis between age, gender and educational level and the influence of these variables on the performance of the subjects. We found no statistically significant differences between genders. Educational level correlated positively with performance, especially in the subtests involving reading and writing. There was a negative correlation between age and performance in two subtests (Visual Confrontation Naming and Sentences to Dictation, but a coexisting effect of educational level could not be ruled out.

  10. [Diagnostic and evolutionary profile of multiple myeloma in Senegal: monocentric study conducted from 2005 to 2016].

    Science.gov (United States)

    Fall, Seynabou; Dieng, Fatma; Diouf, Coumba; Djiba, Boundia; Ndao, Awa Cheikh; Ndiaye, Fatou Samba Diago

    2017-01-01

    Accessibility to innovative multiple myeloma therapies is limited in sub-Saharan Africa. This study aimed to describe the diagnostic and evolutionary features observed during treatment of our patients with myeloma. We conducted a retrospective, descriptive, analytical study (2005 - 2016) of patients with myeloma included in the study based on International Myeloma Working Group (IMWG) Criteria (2003,2014) at the Hopital Aristide Le Dantec (Senegal). We collected data from 136 medical records (69 men, 67 women) of patients with an average age of 59 years ± 10.1 years, who were less than 65 years of age in 69.1% of cases. Tell-tale signs included bone pain (96.3%), renal failure (36.8%), infection (23.5%), pathological fracture (17.6%), spinal cord compression (16.9%) and malignant hypercalcaemia (16.2%). Isotopic antiglobulin test showed that anti-IgG could be detected in 61.3% of cases and Kappa in 65% of cases. Patients were classified stage III (59.4%) and I-II (40.6%)of the index staging system. The median survival of patients under conventional traitement (Méphalan-Prédnisone: 67.6%, innovative: 5.9%) was 20 months (1-78 months). Survival rates are better in the absence of neurological and infectious complications and for patients with score I-II of the index Staging System. In our study, multiple myeloma was frequently diagnosed before age 65, at advanced stage of tumor mass. Early detection and access to adequate therapies could improve overall survival.

  11. Cone beam computed tomography and periapical lesions: a systematic review analysing studies on diagnostic efficacy by a hierarchical model.

    Science.gov (United States)

    Kruse, C; Spin-Neto, R; Wenzel, A; Kirkevang, L-L

    2015-09-01

    To evaluate using a systematic review approach the diagnostic efficacy of CBCT for periapical lesions, focusing on the evidence level of the included studies using a six-tiered hierarchical model. The MEDLINE bibliographic database was searched from 2000 to July 2013 for studies evaluating the potential of CBCT imaging in the diagnosis and planning of treatment for periapical lesions. The search strategy was limited to English language publications using the following combined terms in the search strategy: apical pathology or endodontic pathology or periapical or lesion or healing and CBCT or cone beam CT. The diagnostic efficacy level of the studies was assessed independently by four reviewers. The search identified 25 publications that qualitatively or quantitatively assessed the use of CBCT for the diagnosis of periapical lesions, in which the methodology/results comprised at least one of the following parameters: the methods, the imaging protocols or qualitative/quantitative information on how CBCT influenced the diagnosis and/or treatment plan. From the assessed studies, it can be concluded that although there is a tendency for a higher accuracy for periapical lesion detection using CBCT compared to two-dimensional imaging methods, no studies have been conducted that justify the standard use of CBCT in diagnosing periapical lesions. In addition, it should be considered that, at the present time, the efficacy of CBCT as the diagnostic imaging method for periapical lesions has been assessed merely at low diagnostic efficacy levels. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  12. STARD-BLCM: Standards for the Reporting of Diagnostic accuracy studies that use Bayesian Latent Class Models.

    Science.gov (United States)

    Kostoulas, Polychronis; Nielsen, Søren S; Branscum, Adam J; Johnson, Wesley O; Dendukuri, Nandini; Dhand, Navneet K; Toft, Nils; Gardner, Ian A

    2017-03-01

    The Standards for the Reporting of Diagnostic Accuracy (STARD) statement, which was recently updated to the STARD2015 statement, was developed to encourage complete and transparent reporting of test accuracy studies. Although STARD principles apply broadly, the checklist is limited to studies designed to evaluate the accuracy of tests when the disease status is determined from a perfect reference procedure or an imperfect one with known measures of test accuracy. However, a reference standard does not always exist, especially in the case of infectious diseases with a long latent period. In such cases, a valid alternative to classical test evaluation involves the use of latent class models that do not require a priori knowledge of disease status. Latent class models have been successfully implemented in a Bayesian framework for over 20 years. The objective of this work was to identify the STARD items that require modification and develop a modified version of STARD for studies that use Bayesian latent class analysis to estimate diagnostic test accuracy in the absence of a reference standard. Examples and elaborations for each of the modified items are provided. The new guidelines, termed STARD-BLCM (Standards for Reporting of Diagnostic accuracy studies that use Bayesian Latent Class Models), will facilitate improved quality of reporting on the design, conduct and results of diagnostic accuracy studies that use Bayesian latent class models. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  13. Assessment of the potential impact of a reminder system on the reduction of diagnostic errors: a quasi-experimental study

    Directory of Open Access Journals (Sweden)

    Taylor Paul M

    2006-04-01

    Full Text Available Abstract Background Computerized decision support systems (DSS have mainly focused on improving clinicians' diagnostic accuracy in unusual and challenging cases. However, since diagnostic omission errors may predominantly result from incomplete workup in routine clinical practice, the provision of appropriate patient- and context-specific reminders may result in greater impact on patient safety. In this experimental study, a mix of easy and difficult simulated cases were used to assess the impact of a novel diagnostic reminder system (ISABEL on the quality of clinical decisions made by various grades of clinicians during acute assessment. Methods Subjects of different grades (consultants, registrars, senior house officers and medical students, assessed a balanced set of 24 simulated cases on a trial website. Subjects recorded their clinical decisions for the cases (differential diagnosis, test-ordering and treatment, before and after system consultation. A panel of two pediatric consultants independently provided gold standard responses for each case, against which subjects' quality of decisions was measured. The primary outcome measure was change in the count of diagnostic errors of omission (DEO. A more sensitive assessment of the system's impact was achieved using specific quality scores; additional consultation time resulting from DSS use was also calculated. Results 76 subjects (18 consultants, 24 registrars, 19 senior house officers and 15 students completed a total of 751 case episodes. The mean count of DEO fell from 5.5 to 5.0 across all subjects (repeated measures ANOVA, p Conclusion The provision of patient- and context-specific reminders has the potential to reduce diagnostic omissions across all subject grades for a range of cases. This study suggests a promising role for the use of future reminder-based DSS in the reduction of diagnostic error.

  14. Multimodal MRI for early diabetic mild cognitive impairment: study protocol of a prospective diagnostic trial

    International Nuclear Information System (INIS)

    Yu, Ying; Sun, Qian; Yan, Lin-Feng; Hu, Yu-Chuan; Nan, Hai-Yan; Yang, Yang; Liu, Zhi-Cheng; Wang, Wen; Cui, Guang-Bin

    2016-01-01

    Type 2 diabetes mellitus (T2DM) is a risk factor for dementia. Mild cognitive impairment (MCI), an intermediary state between normal cognition and dementia, often occurs during the prodromal diabetic stage, making early diagnosis and intervention of MCI very important. Latest neuroimaging techniques revealed some underlying microstructure alterations for diabetic MCI, from certain aspects. But there still lacks an integrated multimodal MRI system to detect early neuroimaging changes in diabetic MCI patients. Thus, we intended to conduct a diagnostic trial using multimodal MRI techniques to detect early diabetic MCI that is determined by the Montreal Cognitive Assessment (MoCA). In this study, healthy controls, prodromal diabetes and diabetes subjects (53 subjects/group) aged 40-60 years will be recruited from the physical examination center of Tangdu Hospital. The neuroimaging and psychometric measurements will be repeated at a 0.5 year-interval for 2.5 years’ follow-up. The primary outcome measures are 1) Microstructural and functional alterations revealed with multimodal MRI scans including structure magnetic resonance imaging (sMRI), resting state functional magnetic resonance imaging (rs-fMRI), diffusion kurtosis imaging (DKI), and three-dimensional pseudo-continuous arterial spin labeling (3D-pCASL); 2) Cognition evaluation with MoCA. The second outcome measures are obesity, metabolic characteristics, lifestyle and quality of life. The study will provide evidence for the potential use of multimodal MRI techniques with psychometric evaluation in diagnosing MCI at prodromal diabetic stage so as to help decision making in early intervention and improve the prognosis of T2DM. This study has been registered to ClinicalTrials.gov (NCT02420470) on April 2, 2015 and published on July 29, 2015

  15. Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studies

    Directory of Open Access Journals (Sweden)

    Bossuyt Patrick NM

    2006-03-01

    Full Text Available Abstract Background A quality assessment tool for diagnostic accuracy studies, named QUADAS, has recently been developed. Although QUADAS has been used in several systematic reviews, it has not been formally validated. The objective was to evaluate the validity and usefulness of QUADAS. Methods Three reviewers independently rated the quality of 30 studies using QUADAS. We assessed the proportion of agreements between each reviewer and the final consensus rating. This was done for all QUADAS items combined and for each individual item. Twenty reviewers who had used QUADAS in their reviews completed a short structured questionnaire on their experience of QUADAS. Results Over all items, the agreements between each reviewer and the final consensus rating were 91%, 90% and 85%. The results for individual QUADAS items varied between 50% and 100% with a median value of 90%. Items related to uninterpretable test results and withdrawals led to the most disagreements. The feedback on the content of the tool was generally positive with only small numbers of reviewers reporting problems with coverage, ease of use, clarity of instructions and validity. Conclusion Major modifications to the content of QUADAS itself are not necessary. The evaluation highlighted particular difficulties in scoring the items on uninterpretable results and withdrawals. Revised guidelines for scoring these items are proposed. It is essential that reviewers tailor guidelines for scoring items to their review, and ensure that all reviewers are clear on how to score studies. Reviewers should consider whether all QUADAS items are relevant to their review, and whether additional quality items should be assessed as part of their review.

  16. Study of the apoptotic effect of urine as a diagnostic biomarker in patients with interstitial cystitis.

    Science.gov (United States)

    Di Capua-Sacoto, C; Sanchez-Llopis, A; O'Connor, E; Martinez, A; Ruiz-Cerdá, J L

    2016-11-01

    The main objective of the study was to assess the apoptotic effect of urine from patients with interstitial cystitis (IC) in cell cultures and to study its value as a diagnostic biomarker for IC. A prospective study was conducted between January 2010 and January 2015 and included 57 patients diagnosed with IC and 50 healthy patients from the Hospital Clinic of Barcelona and the La Paz University Hospital. The urine of these patients was exposed to cell cultures, and its ability to induce apoptosis in the cultures was analysed. Using flow cytometry, we then measured the degree of apoptosis, quantified by the percentage of cells of the cell cycle in phase sub G0. The cell cultures exposed to the urine of patients with IC had a sub G1 peak and a G2 phase, which was significantly greater than that of the control group, and a significantly lower percentage in the S phase than the control group. The mean apoptosis values in the urine cultures from patients with IC were significantly higher than those of the control group. Using a value >10% of the apoptosis test as a positive result, we observed a specificity of 96% and a positive predictive value of 92%. The urine of patients with IC exerts an apoptotic effect on tumour cell cultures that is significantly greater than that exerted by the urine of healthy control patients. A≥10% cutoff for the apoptosis test presented very low sensitivity (40%) but had a very high specificity (96%), thereby able to confirm the diagnosis of IC when positive. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Diagnostics vehicle’s condition using obd-ii and raspberry pi technology: study literature

    Science.gov (United States)

    Moniaga, J. V.; Manalu, S. R.; Hadipurnawan, D. A.; Sahidi, F.

    2018-03-01

    Transportation accident rate are still being a major challenge in many countries. There are many factors that could be cause transportation accident, especially in vehicle’s internal system problem. To overcome this problem, OBD-II technology has been created to diagnostics vehicle’s condition. OBD-II scanner plugged to OBD-II port or usually called Data Link Connector (DLC), and after that it sends the diagnostics to Raspberry Pi. Compared from another microcontrollers, Arduino, Raspberry Pi are chosen because it sustains the application to receive real-time diagnostics, process the diagnostics and send command to automobiles at the same time, rather than Arduino that must wait for another process finished to run another process. Outcome from this application is to enable automobile’s user to diagnostics their own vehicles. If there is found something unusual or a problem, the application can told the problem to user, so they could know what to fix before they use their vehicle safely.

  18. Comprehensive Diagnostic Assessment of Health Status of Patients with Asthma or COPD : A Delphi Panel Study among Dutch Experts

    NARCIS (Netherlands)

    van den Akker, Edmée F M M; van't Hul, Alex J.; Birnie, Erwin; Chavannes, Niels H.; Rutten-van Mölken, Maureen P M H; In't Veen, Johannes C C M

    2017-01-01

    A comprehensive diagnostic assessment is needed to improve understanding of the health status of patients with chronic obstructive pulmonary disease (COPD) or asthma. Therefore, this study investigated which components and subsequent instruments should be part of a holistic assessment in secondary

  19. Integrated diagnostics: Proceedings from the 9th biennial symposium of the International Society for Strategic Studies in Radiology

    NARCIS (Netherlands)

    G.P. Krestin (Gabriel); N. Grenier (Nicolas); H. Hricak (Hedvig); V.P. Jackson (V.); P.L. Khong (P.); J.C. Miller (Janet); A. Muellner (Ada); M. Schwaiger (M.); J.H. Thrall (James)

    2012-01-01

    textabstractThe International Society for Strategic Studies in Radiology held its 9th biennial meeting in August 2011. The focus of the programme was integrated diagnostics and massive computing. Participants discussed the opportunities, challenges, and consequences for the discipline of radiology

  20. 78 FR 24425 - Assay Migration Studies for In Vitro Diagnostic Devices; Guidance for Industry and Food and Drug...

    Science.gov (United States)

    2013-04-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2008-D-0642] Assay Migration Studies for In Vitro Diagnostic Devices; Guidance for Industry and Food and Drug Administration Staff; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food...

  1. Henoch-Schönlein purpura in children: An epidemiological study among Dutch paediatricians on incidence and diagnostic criteria

    NARCIS (Netherlands)

    Aalberse, J.; Dolman, K.; Ramnath, G.; Pereira, R.R.; Davin, J.C.

    2007-01-01

    Background: The aim of the present study on the occurrence of Henoch-Schönlein Purpura (HSP) in Dutch children is to give some insight into the epidemiology of HSP in the Netherlands, to record the diagnostic criteria used by Dutch paediatricians and to evaluate the accuracy of the latter using the

  2. 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…

  3. Developing a science of clinical utility in diagnostic classification systems field study strategies for ICD-11 mental and behavioral disorders.

    Science.gov (United States)

    Keeley, Jared W; Reed, Geoffrey M; Roberts, Michael C; Evans, Spencer C; Medina-Mora, María Elena; Robles, Rebeca; Rebello, Tahilia; Sharan, Pratap; Gureje, Oye; First, Michael B; Andrews, Howard F; Ayuso-Mateos, José Luís; Gaebel, Wolfgang; Zielasek, Juergen; Saxena, Shekhar

    2016-01-01

    The World Health Organization (WHO) Department of Mental Health and Substance Abuse has developed a systematic program of field studies to evaluate and improve the clinical utility of the proposed diagnostic guidelines for mental and behavioral disorders in the Eleventh Revision of the International Classification of Diseases and Related Health Problems (ICD-11). The clinical utility of a diagnostic classification is critical to its function as the interface between health encounters and health information, and to making the ICD-11 be a more effective tool for helping the WHO's 194 member countries, including the United States, reduce the global disease burden of mental disorders. This article describes the WHO's efforts to develop a science of clinical utility in regard to one of the two major classification systems for mental disorders. We present the rationale and methodologies for an integrated and complementary set of field study strategies, including large international surveys, formative field studies of the structure of clinicians' conceptualization of mental disorders, case-controlled field studies using experimental methodologies to evaluate the impact of proposed changes to the diagnostic guidelines on clinicians' diagnostic decision making, and ecological implementation field studies of clinical utility in the global settings in which the guidelines will ultimately be implemented. The results of these studies have already been used in making decisions about the structure and content of ICD-11. If clinical utility is indeed among the highest aims of diagnostic systems for mental disorders, as their developers routinely claim, future revision efforts should continue to build on these efforts. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  4. A prospective study to compare the diagnostic performance of breast elastography versus conventional breast ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Leong, L.C.H., E-mail: lester.leong.c.h@sgh.com.s [Singapore General Hospital (Singapore); Sim, L.S.J.; Lee, Y.S.; Ng, F.C.; Wan, C.M.; Fook-Chong, S.M.C.; Jara-Lazaro, A.R.; Tan, P.H. [Singapore General Hospital (Singapore)

    2010-11-15

    Aim: To compare the diagnostic performance of breast elastography versus conventional ultrasound in the assessment of breast lesions. Materials and methods: The study was approved by the hospital's institutional review board. A prospective study involving 99 consecutive women who gave informed consent were enrolled from September 2007 to March 2008. One hundred and ten breast lesions were evaluated separately by conventional ultrasound, elastography and combined conventional ultrasound with elastography. Ultrasound assessment was based on the BIRADS classification, whereas elastographic assessment was based on strain pattern and the elastographic size ratios. Histological diagnosis was used as the reference standard. The sensitivity, specificity, and accuracy of each technique were compared. Results: The mean age of the patients was 46.7 years. Twenty-six lesions were malignant and 84 were benign. Sensitivity, specificity, and accuracy were 88.5, 42.9 and 53.6%, respectively, for conventional ultrasound, 100, 73.8, and 80%, respectively, for elastography, and 88.5, 78.6, and 80.9%, respectively, for combined imaging. The specificity and accuracy of elastography and combined imaging were significantly better than that of conventional ultrasound (p<0.0001), whereas there was no statistically significant difference in the sensitivity between all three groups. Two-thirds (66.7%) of sonographic false-positive lesions had benign elastogram findings, which might have been spared from biopsy. Conclusion: This initial experience with ultrasound breast elastography showed that it was more specific and more accurate than conventional ultrasound. Combining elastography with ultrasound improved specificity and accuracy of ultrasound and can potentially reduce unnecessary breast biopsies.

  5. SimTCM: A human patient simulator with application to diagnostic accuracy studies of Chinese medicine.

    Science.gov (United States)

    Ferreira, Arthur de Sá; Pacheco, Antonio Guilherme

    2015-01-01

    The aim of this work is to develop and implement the SimTCM, an advanced computational model that incorporates relevant aspects from traditional Chinese medicine (TCM) theory as well as advanced statistical and epidemiological techniques for simulation and analysis of human patients. SimTCM presents five major attributes for simulation: representation of true and false profiles for any single pattern; variable count of manifestations for each manifestation profile; empirical distributions of patterns and manifestations in a disease-specific population; incorporation of uncertainty in clinical data; and the combination of the four examinations. The proposed model is strengthened by following international standards for reporting diagnostic accuracy studies, and incorporates these standards in its treatment of study population, sample size calculation, data collection of manifestation profiles, exclusion criteria and missing data handling, reference standards, randomization and blinding, and test reproducibility. Simulations using data from patients diagnosed with hypertension and post-stroke sensory-motor impairments yielded no significant differences between expected and simulated frequencies of patterns (P=0.22 or higher). Time for convergence of simulations varied from 9.90 s (9.80, 10.27) to 28.31 s (26.33, 29.52). The ratio iteration profile necessary for convergence varied between 1:1 and 5:1. This model is directly connected to forthcoming models in a large project to design and implement the SuiteTCM: ProntTCM, SciTCM, DiagTCM, StudentTCM, ResearchTCM, HerbsTCM, AcuTCM, and DataTCM. It is expected that the continuity of the SuiteTCM project enhances the evidence-based practice of Chinese medicine. The software is freely available for download at: http://suitetcm.unisuam.edu.br.

  6. 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)

  7. External validation of IASP diagnostic criteria for Complex Regional Pain Syndrome and proposed research diagnostic criteria. International Association for the Study of Pain.

    Science.gov (United States)

    Bruehl, S; Harden, R N; Galer, B S; Saltz, S; Bertram, M; Backonja, M; Gayles, R; Rudin, N; Bhugra, M K; Stanton-Hicks, M

    1999-05-01

    Recent work in our research consortium has raised internal validity concerns regarding the current IASP criteria for Complex Regional Pain Syndrome (CRPS), suggesting problems with inadequate sensitivity and specificity. The current study explored the external validity of these IASP criteria for CRPS. A standardized evaluation of signs and symptoms of CRPS was conducted by study physicians in 117 patients meeting IASP criteria for CRPS, and 43 patients experiencing neuropathic pain with established non-CRPS etiology (e.g. diabetic neuropathy, post-herpetic neuralgia). Multiple discriminant function analyses were used to test the ability of the IASP diagnostic criteria and decision rules, as well as proposed research modifications of these criteria, to discriminate between CRPS patients and those experiencing non-CRPS neuropathic pain. Current IASP criteria and decision rules (e.g. signs or symptoms of edema, or color changes or sweating changes satisfy criterion 3) discriminated significantly between groups (P IASP criteria for CRPS have inadequate specificity and are likely to lead to overdiagnosis. Proposed modifications to these criteria substantially improve their external validity and merit further evaluation.

  8. Gaseous laser targets and optical diagnostics for studying compressible hydrodynamic instabilities

    International Nuclear Information System (INIS)

    Edwards, J M; Robey, H; Mackinnon, A

    2001-01-01

    Explore the combination of optical diagnostics and gaseous targets to obtain important information about compressible turbulent flows that cannot be derived from traditional laser experiments for the purposes of V and V of hydrodynamics models and understanding scaling. First year objectives: Develop and characterize blast wave-gas jet test bed; Perform single pulse shadowgraphy of blast wave interaction with turbulent gas jet as a function of blast wave Mach number; Explore double pulse shadowgraphy and image correlation for extracting velocity spectra in the shock-turbulent flow interaction; and Explore the use/adaptation of advanced diagnostics

  9. Structured approach to design of diagnostic test evaluation studies for chronic progressive infections in animals

    DEFF Research Database (Denmark)

    Nielsen, Søren Saxmose; Toft, Nils; Gardner, Ian Andrew

    2011-01-01

    ) than originally intended. The objective of this paper is to outline a structured approach to the design and conduct of a DTE for diagnostic tests used for chronic infections in animals, and intended for different purposes. We describe the process from reflections about test purpose and the underlying......Diagnostic test evaluations (DTEs) for chronic infections are challenging because a protracted incubation period has to be considered in the design of the DTE, and the adverse effects of infection may be widespread and progressive over an animal's entire life. Frequently, the specific purpose...

  10. Exploratory Study of the Diagnostic Abilities of the Baptista Depression Scale Adult Version (EBADEP-A

    Directory of Open Access Journals (Sweden)

    Makilim Nunes Baptista

    2013-09-01

    Full Text Available This study’s objective was to analyze the diagnostic capabilities of a depression screening scale. For that, this scale was administered along with two diagnostic instruments, namely, the structured clinical interview from the DSM-IV (SCID-CV and the Hamilton Depression Scale (HAM-D, which are considered to be the gold standard for diagnosing depressive disorders. Participants were 22 subjects diagnosed by psychiatrists with Major Depressive Disorder. The EBADEP-A correctly identified cases of depression, showing a high correlation with the HAM-D, which indicates the scale correctly captures most depressive symptoms, even though it was initially used as a depression-screening tool.

  11. Suprathermal electron studies in Tokamak plasmas by means of diagnostic measurements and modeling

    International Nuclear Information System (INIS)

    Kamleitner, J.

    2015-01-01

    To achieve reactor-relevant conditions in a tokamak plasma, auxiliary heating systems are required and can be realized by waves injected in the plasma that heat ions or electrons. Electron cyclotron resonant heating (ECRH) is a very flexible and robust technique featuring localized power deposition and current drive (CD) capabilities. Its fundamental principles are well understood and the application of ECRH is a proven and established tool; electron cyclotron current drive (ECCD) is regularly used to develop advanced scenarios and control magneto-hydrodynamics (MHD) instabilities in the plasma by tailoring the current profile. There remain important open questions, such as the phase space dynamics, the observed radial broadening of the supra-thermal electron distribution function and discrepancies in predicted and experimental CD efficiency. A main goal is to improve the understanding of wave-particle interaction in plasmas and current drive mechanisms. This was accomplished by combined experimental and numerical studies, strongly based on the conjunction of hard X-ray (HXR) Bremsstrahlung measurements and Fokker-Planck modelling, characterizing the supra-thermal electron population. The hard X-ray tomographic spectrometer (HXRS) diagnostic was developed to perform these studies by investigating spatial HXR emission asymmetries in the co- and counter-current directions and within the poloidal plane. The system uses cadmium-telluride detectors and digital acquisition to store the complete time history of incoming photon pulses. An extensive study of digital pulse processing algorithms was performed and its application allows the HXRS to handle high count rates in a noisy tokamak environment. Numerical tools were developed to improve the time resolution by conditional averaging and to obtain local information with the general tomographic inversion package. The interfaces of the LUKE code and the well-established CQL3D Fokker-Planck code to the Tokamak a

  12. Suprathermal electron studies in Tokamak plasmas by means of diagnostic measurements and modeling

    Energy Technology Data Exchange (ETDEWEB)

    Kamleitner, J.

    2015-07-01

    To achieve reactor-relevant conditions in a tokamak plasma, auxiliary heating systems are required and can be realized by waves injected in the plasma that heat ions or electrons. Electron cyclotron resonant heating (ECRH) is a very flexible and robust technique featuring localized power deposition and current drive (CD) capabilities. Its fundamental principles are well understood and the application of ECRH is a proven and established tool; electron cyclotron current drive (ECCD) is regularly used to develop advanced scenarios and control magneto-hydrodynamics (MHD) instabilities in the plasma by tailoring the current profile. There remain important open questions, such as the phase space dynamics, the observed radial broadening of the supra-thermal electron distribution function and discrepancies in predicted and experimental CD efficiency. A main goal is to improve the understanding of wave-particle interaction in plasmas and current drive mechanisms. This was accomplished by combined experimental and numerical studies, strongly based on the conjunction of hard X-ray (HXR) Bremsstrahlung measurements and Fokker-Planck modelling, characterizing the supra-thermal electron population. The hard X-ray tomographic spectrometer (HXRS) diagnostic was developed to perform these studies by investigating spatial HXR emission asymmetries in the co- and counter-current directions and within the poloidal plane. The system uses cadmium-telluride detectors and digital acquisition to store the complete time history of incoming photon pulses. An extensive study of digital pulse processing algorithms was performed and its application allows the HXRS to handle high count rates in a noisy tokamak environment. Numerical tools were developed to improve the time resolution by conditional averaging and to obtain local information with the general tomographic inversion package. The interfaces of the LUKE code and the well-established CQL3D Fokker-Planck code to the Tokamak a

  13. Commercial production and distribution of fresh fruits and vegetables: A scoping study on the importance of produce pathways to dose. Hanford Environmental Dose Reconstruction Project

    Energy Technology Data Exchange (ETDEWEB)

    Marsh, T.L.; Anderson, D.M.; Farris, W.T.; Ikenberry, T.A.; Napier, B.A.; Wilfert, G.L.

    1992-09-01

    This letter report summarizes a scoping study that examined the potential importance of fresh fruit and vegetable pathways to dose. A simple production index was constructed with data collected from the Washington State Department of Agriculture (WSDA), the United States Bureau of the Census, and the United States Department of Agriculture (USDA). Hanford Environmental Dose Reconstruction (HEDR) Project staff from Battelle, Pacific Northwest Laboratories, in cooperation with members of the Technical Steering Panel (TSP), selected lettuce and spinach as the produce pathways most likely to impact dose. County agricultural reports published in 1956 provided historical descriptions of the predominant distribution patterns of fresh lettuce and spinach from production regions to local population centers. Pathway rankings and screening dose estimates were calculated for specific populations living in selected locations within the HEDR study area.

  14. Importance of diagnostic laparoscopy in the assessment of the diaphragm after left thoracoabdominal stab wound: A prospective cohort study.

    Science.gov (United States)

    Yücel, Metin; Özpek, Adnan; Tolan, Hüseyin Kerem; Başak, Fatih; Baş, Gürhan; Ünal, Ethem; Alimoğlu, Orhan

    2017-03-01

    Stab wounds in the left thoracoabdominal region may cause diaphragmatic injury. The aim of the present study was to determine incidence of diaphragmatic injury and role of diagnostic laparoscopy in detection of injury in patients with left thoracoabdominal stab wound. Total of 81 patients (75 male, 6 female; mean age 27.5±9.8 years; range 14 to 60 years) who presented with left thoracoabdominal stab wound between April 2009 and September 2014 were evaluated. Laparotomy was performed on patients who had hemodynamic instability, signs of peritonitis, or organ evisceration. Remaining patients were followed conservatively. After 48 hours, diagnostic laparoscopy was performed on patients without laparotomy indication to examine the left diaphragm for injury. Follow-up and treatment findings were prospectively evaluated. Thirteen patients underwent laparotomy while diagnostic laparoscopy was performed on remaining 68 patients. Left diaphragmatic injury was observed in 19 patients (23.5%) in the study group. Four injuries were diagnosed by laparotomy and 15 were diagnosed by laparoscopy. Presence of hemopneumothorax did not yield difference in incidence of diaphragmatic injury (p=0.131). No significant difference was detected in terms of diaphragmatic injury with respect to entry site of stab wound in the thoracoabdominal region (p=0.929). It is important to evaluate the diaphragm in left thoracoabdominal stab injuries, and diagnostic laparoscopy is still the safest and most feasible method.

  15. Australian diagnostic radiographers' attitudes and perceptions of imaging obese patients: A study of self, peers and students

    International Nuclear Information System (INIS)

    Aweidah, L.; Robinson, J.; Cumming, S.; Lewis, S.

    2016-01-01

    Introduction and Objective: Imaging obese patients poses a number of challenges for diagnostic radiographers through positioning, radiation exposure, communication and care. Furthermore, the increasing prevalence of obesity in Australian society ensures these imaging challenges are more frequent however little is known about this area. This study aims to explore the attitudes and perceptions of diagnostic radiographers toward imaging obese patients through a mixed methods study. Methods: Ethics approval was granted to interview and survey diagnostic radiographers about their attitudes and perceptions of imaging obese patients. Twelve diagnostic radiographers who are designated clinical educators (DR CEs) took part in a 30–45 min semi-structured interview as well as a 20 min computer-based Weight Implicit Association Test (Weight-IAT) and self-report questionnaire of explicit attitudes. An additional 25 experienced Diagnostic Radiographers who were associate supervisors completed the Weight-IAT/explicit questionnaire only. Results: Thematic analysis of the interviews revealed that DR CEs adopted an image-focussed or patient-focussed approach to obese patients. Key themes with a negative bias included blame, tolerance and insecurity of skill. Positively associated key themes were empathy and experience in radiography. The sample overall showed a significant negative implicit weight bias (P = 0.016) as measured by the Weight-IAT and there was no evidence of negative explicit attitudes. Conclusion: Australian diagnostic radiographers in this study exhibited significant negative implicit weight bias, with interview results highlighting attitudes of blame and frustration towards obese patients. DR CEs were more likely to be focussed on image acquisition rather than patient considerations, with fewer responses related to empathy and equity. - Highlights: • Mixed-methods study combining qualitative interviews and implicit–explicit bias towards imaging obese

  16. Diagnostic value of tumor markers for lung adenocarcinoma-associated malignant pleural effusion: a validation study and meta-analysis.

    Science.gov (United States)

    Feng, Mei; Zhu, Jing; Liang, Liqun; Zeng, Ni; Wu, Yanqiu; Wan, Chun; Shen, Yongchun; Wen, Fuqiang

    2017-04-01

    Pleural effusion is one of the most common complications of lung adenocarcinoma and is diagnostically challenging. This study aimed to investigate the diagnostic performance of carcinoembryonic antigen (CEA), cytokeratin fragment (CYFRA) 21-1, and cancer antigen (CA) 19-9 for lung adenocarcinoma-associated malignant pleural effusion (MPE) through a validation study and meta-analysis. Pleural effusion samples were collected from 81 lung adenocarcinoma-associated MPEs and 96 benign pleural effusions. CEA, CYFRA 21-1, and CA19-9 were measured by electrochemiluminescence immunoassay. The capacity of tumor markers was assessed with receiver operating characteristic curve analyses and the area under the curve (AUC) was calculated. Standard methods for meta-analysis of diagnostic studies were used to summarize the diagnostic performance of CEA, CYFRA 21-1, and CA19-9 for lung adenocarcinoma-associated MPE. The pleural levels of CEA, CYFRA 21-1, and CA19-9 were significantly increased in lung adenocarcinoma-associated MPE compared to benign pleural effusion. The cut-off points for CEA, CYFRA 21-1, and CA19-9 were optimally set at 4.55 ng/ml, 43.10 μg/ml, and 12.89 U/ml, and corresponding AUCs were 0.93, 0.85, and 0.81, respectively. The combination of CEA, CYFRA 21-1, and CA19-9 increased the sensitivity to 95.06%, with an AUC of 0.95. Eight studies were included in this meta-analysis. CEA showed the best diagnostic performance with pooled sensitivity, specificity, positive/negative likelihood ratio, and diagnostic odds ratio of 0.75, 0.96, 16.01, 0.23, and 81.49, respectively. The AUC was 0.93. CEA, CYFRA 21-1, and CA19-9 play a role in the diagnosis of lung adenocarcinoma-associated MPE. The combination of these tumor markers increases the diagnostic accuracy.

  17. Theoretical Study of Radiation from a Broad Range of Impurity Ions for Magnetic Fusion Diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Safronova, Alla [Univ. of Nevada, Reno, NV (United States)

    2014-03-14

    Spectroscopy of radiation emitted by impurities plays an important role in the study of magnetically confined fusion plasmas. The measurements of these impurities are crucial for the control of the general machine conditions, for the monitoring of the impurity levels, and for the detection of various possible fault conditions. Low-Z impurities, typically present in concentrations of 1%, are lithium, beryllium, boron, carbon, and oxygen. Some of the common medium-Z impurities are metals such as iron, nickel, and copper, and high-Z impurities, such as tungsten, are present in smaller concentrations of 0.1% or less. Despite the relatively small concentration numbers, the aforementioned impurities might make a substantial contribution to radiated power, and also influence both plasma conditions and instruments. A detailed theoretical study of line radiation from impurities that covers a very broad spectral range from less than 1 Å to more than 1000 Å has been accomplished and the results were applied to the LLNL Electron Beam Ion Trap (EBIT) and the Sustained Spheromak Physics Experiment (SSPX) and to the National Spherical Torus Experiment (NSTX) at Princeton. Though low- and medium-Z impurities were also studied, the main emphasis was made on the comprehensive theoretical study of radiation from tungsten using different state-of-the-art atomic structure codes such as Relativistic Many-Body Perturbation Theory (RMBPT). The important component of this research was a comparison of the results from the RMBPT code with other codes such as the Multiconfigurational Hartree–Fock developed by Cowan (COWAN code) and the Multiconfiguration Relativistic Hebrew University Lawrence Atomic Code (HULLAC code), and estimation of accuracy of calculations. We also have studied dielectronic recombination, an important recombination process for fusion plasma, for variety of highly and low charged tungsten ions using COWAN and HULLAC codes. Accurate DR rate coefficients are needed for

  18. Performance of the TB-LAMP diagnostic assay in reference laboratories: Results from a multicentre study.

    Science.gov (United States)

    Pham, Thu Hang; Peter, Jonathan; Mello, Fernanda C Q; Parraga, Tommy; Lan, Nguyen Thi Ngoc; Nabeta, Pamela; Valli, Eloise; Caceres, Tatiana; Dheda, Keertan; Dorman, Susan E; Hillemann, Doris; Gray, Christen M; Perkins, Mark D

    2018-03-01

    To evaluate the diagnostic performance of TB-LAMP, a manual molecular tuberculosis (TB) detection method, and provide comparison to the Xpert MTB/RIF assay. In a large multicentre study, two sputum samples were collected from participants with TB symptoms in reference laboratories in Peru, South Africa, Brazil, and Vietnam. Each sample was tested with TB-LAMP. The reference standard consisted of four direct smears, four cultures, and clinical and radiological findings. Individuals negative on conventional tests were followed up after 8 weeks. The Xpert MTB/RIF assay was performed on fresh or frozen samples as a molecular test comparison. A total of 1036 adults with suspected TB were enrolled. Among 375 culture-confirmed TB cases with 750 sputum samples, TB-LAMP detected 75.6% (95% confidence interval (CI) 71.8-79.4%), including 97.9% (95% CI 96.4-99.4%) of smear-positive TB samples and 46.6% (95% CI 40.6-52.7%) of smear-negative TB samples. Specificity in 477 culture-negative participants not treated for TB (954 sputum samples) was 98.7% (95% CI 97.9-99.6%). TB-LAMP test results were indeterminate in 0.3% of cases. TB-LAMP detects nearly all smear-positive and half of smear-negative TB cases and has a high specificity when performed in reference laboratories. Performance was similar to the Xpert MTB/RIF assay. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  19. Single Nanorod Devices for Battery Diagnostics: A Case Study on LiMn 2 O 4

    KAUST Repository

    Yang, Yuan

    2009-12-09

    This paper presents single nanostructure devices as a powerful new diagnostic tool for batteries with LiMn2O4 nanorod materials as an example. LiMn2O4 and Al-doped LiMn2O4 nanorods were synthesized by a two-step method that combines hydrothermal synthesis of β-MnO2 nanorods and a solid state reaction to convert them to LiMn2O4 nanorods. λ-MnO2 nanorods were also prepared by acid treatment of LiMn2O4 nanorods. The effect of electrolyte etching on these LiMn2O 4-related nanorods is investigated by both SEM and single-nanorod transport measurement, and this is the first time that the transport properties of this material have been studied at the level of an individual singlecrystalline particle. Experiments show that Al dopants reduce the dissolution of Mn3+ ions significantly and make the LiAl 0.1Mn1.9O4 nanorods much more stable than LiMn2O4 against electrolyte etching, which is reflected by the magnification of both size shrinkage and conductance decrease. These results correlate well with the better cycling performance of Al-doped LiMn 2O4 in our Li-ion battery tests: LiAl0.1Mn 1.9O4 nanorods achieve 96% capacity retention after 100 cycles at 1C rate at room temperature, and 80% at 60 °C, whereas LiMn 2O4 shows worse retention of 91% at room temperature, and 69% at 60 °C. Moreover, temperature-dependent I - V measurements indicate that the sharp electronic resistance increase due to charge ordering transition at 290 K does not appear in our LiMn2O4 nanorod samples, suggesting good battery performance at low temperature. © 2009 American Chemical Society.

  20. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Defensive Functioning Scale: a validity study.

    Science.gov (United States)

    Porcerelli, John H; Cogan, Rosemary; Markova, Tsveti; Miller, Kristen; Mickens, Lavonda

    2011-01-01

    We assess the convergent and predictive validity of the Defensive Functioning Scale (DFS) with measures of life events, including childhood abuse and adult partner victimization; dimensions of psychopathology, including axis I (depressive) and axis II (borderline personality disorder) symptoms; and quality of object relations. One hundred and ten women from a university-based urban primary care clinic completed a research interview from which defense mechanisms were assessed. The quality of object relations was also assessed from interview data. The women completed self-report measures assessing depression, borderline personality disorder symptoms, childhood physical and sexual abuse, and adult partner physical and sexual victimization. Inter-rater reliability of the scoring of the DFS levels was good. High adaptive defenses were positively correlated with the quality of object relations and pathological defenses were positively correlated with childhood and adult victimization and symptom measures. Although major image distorting defenses were infrequently used, they were robustly correlated with all study variables. In a stepwise multiple regression analysis, major image distorting defenses, depressive symptoms, and minor image distorting defenses significantly predict childhood victimization, accounting for 37% of the variance. In a second stepwise multiple regression analysis, borderline personality disorder symptoms and disavowal defenses combined to significantly predict adult victimization, accounting for 16% of the variance. The DFS demonstrates good convergent validity with axis I and axis II symptoms, as well as with measures of childhood and adult victimization and object relations. The DFS levels add nonredundant information to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition beyond axis I and axis II. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Electroretinographic assessment and diagnostic reappraisal of children with visual dysfunction: A prospective study

    Directory of Open Access Journals (Sweden)

    Vedantham Vasumathy

    2007-01-01

    Full Text Available Purpose: To assess the presence or absence of a retinal cause of visual impairment using electroretinography (ERG in children with no obvious discernable cause on ocular examination. Design: Prospective observational case series. Materials and Methods: A prospective study was carried out involving 120 children with the mean age 4.4±3.2 years with visual dysfunction. All children underwent ERG under general anesthesia using a special handheld mini-Ganzfeld (Kurbisfeld dome. Results: Fifty-two (43.3% children were male and 68 (56.7% were female. The clinical diagnosis was as follows: Leber′s congenital amaurosis (LCA (n=47, achromatopsia (n=25, congenital stationary night blindness (CSNB (n=9 and others (unclassifiable, n=39. The visual acuity ranged from perception of light (PL to PL with projection in children with LCA. In the rest (n=73, some sort of visually guided behavior was discernable. Following ERG, a diagnostic reappraisal resulted as follows: LCA (n=49, achromatopsia (n=28, CSNB (n=4, cone-rod dystrophy (n=22, rod-cone degeneration (n=7, normal (n=8 and others (unclassifiable, n=2. Except for the two unclassifiable cases, ERG was successful in the diagnosis or exclusion of retinal dysfunction in the rest. By Pearson Chi-square test, there was a statistically significant association between the clinical and ERG diagnosis ( P < 0.001. Conclusion: LCA was the commonest cause of visual dysfunction in our series. A statistically significant correlation between clinical and electrophysiological diagnosis was seen. ERG helped in firmly establishing the presence or absence of global retinal dysfunction in the majority (118/120 of pediatric patients with visual dysfunction.

  2. Evidence That a Psychopathology Interactome Has Diagnostic Value, Predicting Clinical Needs: An Experience Sampling Study

    Science.gov (United States)

    van Os, Jim; Lataster, Tineke; Delespaul, Philippe; Wichers, Marieke; Myin-Germeys, Inez

    2014-01-01

    Background For the purpose of diagnosis, psychopathology can be represented as categories of mental disorder, symptom dimensions or symptom networks. Also, psychopathology can be assessed at different levels of temporal resolution (monthly episodes, daily fluctuating symptoms, momentary fluctuating mental states). We tested the diagnostic value, in terms of prediction of treatment needs, of the combination of symptom networks and momentary assessment level. Method Fifty-seven patients with a psychotic disorder participated in an ESM study, capturing psychotic experiences, emotions and circumstances at 10 semi-random moments in the flow of daily life over a period of 6 days. Symptoms were assessed by interview with the Positive and Negative Syndrome Scale (PANSS); treatment needs were assessed using the Camberwell Assessment of Need (CAN). Results Psychotic symptoms assessed with the PANSS (Clinical Psychotic Symptoms) were strongly associated with psychotic experiences assessed with ESM (Momentary Psychotic Experiences). However, the degree to which Momentary Psychotic Experiences manifested as Clinical Psychotic Symptoms was determined by level of momentary negative affect (higher levels increasing probability of Momentary Psychotic Experiences manifesting as Clinical Psychotic Symptoms), momentary positive affect (higher levels decreasing probability of Clinical Psychotic Symptoms), greater persistence of Momentary Psychotic Experiences (persistence predicting increased probability of Clinical Psychotic Symptoms) and momentary environmental stress associated with events and activities (higher levels increasing probability of Clinical Psychotic Symptoms). Similarly, the degree to which momentary visual or auditory hallucinations manifested as Clinical Psychotic Symptoms was strongly contingent on the level of accompanying momentary paranoid delusional ideation. Momentary Psychotic Experiences were associated with CAN unmet treatment needs, over and above PANSS

  3. Dental flossing as a diagnostic method for proximal gingivitis: a validation study

    Directory of Open Access Journals (Sweden)

    Alessandra Pascotini GRELLMANN

    2016-01-01

    Full Text Available ABSTRACT This study evaluated the clinical diagnosis of proximal gingivitis by comparing two methods: dental flossing and the gingival bleeding index (GBI. One hundred subjects (aged at least 18 years, with 15% of positive proximal sites for GBI, without proximal attachment loss were randomized into five evaluation protocols. Each protocol consisted of two assessments with a 10-minute interval between them: first GBI/second floss, first floss/second GBI, first GBI/second GBI, first tooth floss/second floss, and first gum floss-second floss. The dental floss was slid against the tooth surface (TF and the gingival tissue (GF. The evaluated proximal sites should present teeth with established point of contact and probing depth ≤ 3mm. One trained and calibrated examiner performed all the assessments. The mean percentages of agreement and disagreement were calculated for the sites with gingival bleeding in both evaluation methods (GBI and flossing. The primary outcome was the percentage of disagreement between the assessments in the different protocols. The data were analyzed by one-way ANOVA, McNemar, chi-square and Tukey’s post hoc tests, with a 5% significance level. When gingivitis was absent in the first assessment (negative GBI, bleeding was detected in the second assessment by TF and GF in 41.7% (p < 0.001 and 50.7% (p < 0.001 of the sites, respectively. In the absence of gingivitis in the second assessment (negative GBI, TF and GF detected bleeding in the first assessment in 38.9% (p = 0.004 and 58.3% (p < 0.001 of the sites, respectively. TF and GF appears to be a better diagnostic indicator of proximal gingivitis than GBI.

  4. Diagnostic strategies for excluding pulmonary embolism in clinical outcome studies - A systematic review

    NARCIS (Netherlands)

    Kruip, Marieke J. H. A.; Leclercq, Monique G. L.; van der Heul, Cees; Prins, Martin H.; Büller, Harry R.

    2003-01-01

    Background: Pulmonary embolism is a common clinical disorder that is associated with high morbidity and mortality if untreated. It is important to confirm or rule out the diagnosis in patients with clinical suspicion of the disease. Purpose: To evaluate various diagnostic strategies for excluding

  5. Diagnostic Assessment and Treatment of Reading Difficulties: A Case Study of Dyslexia

    Science.gov (United States)

    Oviedo, Paula Outon; Gonzalez, Rebeca Abal

    2013-01-01

    Dyslexia is a specific learning disability in reading and writing, which requires adequate early intervention to prevent future school failure. We describe the diagnostic assessment of a 7-year-old boy labelled "dyslexic", the evaluation of his family, social, medical, developmental, and academic status as a preliminary for the design…

  6. Irritable bowel syndrome--prognosis and diagnostic safety. A 5-year follow-up study

    DEFF Research Database (Denmark)

    Svendsen, J H; Munck, Lars K; Andersen, J R

    1985-01-01

    with irritable bowel syndrome as the final and only abdominal diagnosis in the period 1977-79 were followed up in 1984. Seventeen patients died during the follow-up period; two of these were considered diagnostic failures (chronic pancreatitis and pancreatic cancer). Of the remaining 95 patients, 93 were...

  7. Reporting guidelines for diagnostic accuracy studies that use Bayesian latent class models (STARD-BLCM)

    DEFF Research Database (Denmark)

    Kostoulas, Polychronis; Nielsen, Søren S.; Branscum, Adam J.

    2017-01-01

    Evaluation of medical tests is usually based on comparing their results to those from a perfect reference (gold standard) procedure. The Standards for Reporting of Diagnostic Accuracy (STARD) initiative (http://www.equator-network.org/reporting-guidelines/stard/) developed reporting guidelines...

  8. Barriers and Opportunities to Broader Adoption of Integrated Demand Side Management at Electric Utilities: A Scoping Study

    Energy Technology Data Exchange (ETDEWEB)

    Potter, Jennifer [Hawaii Natural Energy Institute, Honolulu, HI (United States); Stuart, Elizabeth [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Analysis and Environmental Impacts Div.; Cappers, P [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Analysis and Environmental Impacts Div.

    2018-02-13

    Integrated demand-side management (IDSM) is a strategic approach to designing and delivering a portfolio of demand side management (DSM) programs to customers. IDSM typically delivers customer centric strategies with the goal of increasing the amount of DSM in the field, but doing so in a way that integrates various measures and technologies to improve their collective performance and/or penetration. Specifically, IDSM can be defined as the integrated or coordinated delivery of three or more of: (1) energy efficiency (EE), (2) demand response (DR), (3) distributed generation (DG), (4) storage, (5) electric vehicle (EV) technologies, and (6) time-based rate programs to residential and commercial electric utility customers. The electric industry’s limited experience deploying IDSM to date suggests that significant barriers may exist. A Berkeley Lab report “Barriers and Opportunities to Broader Adoption of Integrated Demand Side Management at Electric Utilities: A Scoping Study” explores recent electric utility experience with IDSM to provide an assessment of the barriers and potential benefits perceived or experienced by program administrators in their attempts to implement integrated programs. The research draws on surveys and interviews with eleven staff from a sample of eight DSM program administrators and program implementers who were currently implementing or had previously attempted to implement an IDSM program or initiative. Respondents provided their perspectives on drivers for IDSM and barriers to broader deployment. They also reported on actions they had undertaken to promote expanded delivery of IDSM and provided their assessments of the most important under-tapped opportunities for expanding IDSM efforts, both for program administrator and regulatory organizations.

  9. 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.

  10. High mortality during tuberculosis treatment does not indicate long diagnostic delays in Vietnam: a cohort study

    Directory of Open Access Journals (Sweden)

    Sy Dinh N

    2007-08-01

    Full Text Available Abstract Background Delay in tuberculosis diagnosis and treatment initiation may increase disease severity and mortality. In evaluations of tuberculosis control programmes high fatality rates during tuberculosis treatment, are used as an indicator of long delays in low HIV-prevalence settings. However, data for this presumed association between delay and fatality are lacking. We assessed the association between diagnostic delay and mortality of new smear-positive pulmonary tuberculosis patients in Vietnam. Methods Follow-up of a patient cohort included in a survey of diagnostic delay in 70 randomly selected districts. Data on diagnosis and treatment were extracted from routine registers. Patients who had died during the course of treatment were compared to those with reported cure, completed treatment or failure (survivors. Results Complete data were available for 1881/2093 (89.9% patients, of whom 82 (4.4% had died. Fatality was 4.5% for patients with ≤ 4 weeks delay, 5.0% for 5- ≤ 8 weeks delay (aOR 1.11, 95%CI 0.67–1.84 and 3.2% for > 9 weeks delay (aOR 0.69, 95%CI 0.37–1.30. Fatality tended to decline with increasing delay but this was not significant. Fatality was not associated with median diagnostic delay at district level (Spearman's rho = -0.08, P = 0.5. Conclusion Diagnostic delay is not associated with treatment mortality in Vietnam at individual nor district level, suggesting that high case fatality should not be used as an indicator of long diagnostic delay in national tuberculosis programmes.

  11. A SCOPING STUDY: Development of Probabilistic Risk Assessment Models for Reactivity Insertion Accidents During Shutdown In U.S. Commercial Light Water Reactors

    Energy Technology Data Exchange (ETDEWEB)

    S. Khericha

    2011-06-01

    This report documents the scoping study of developing generic simplified fuel damage risk models for quantitative analysis from inadvertent reactivity insertion events during shutdown (SD) in light water pressurized and boiling water reactors. In the past, nuclear fuel reactivity accidents have been analyzed both mainly deterministically and probabilistically for at-power and SD operations of nuclear power plants (NPPs). Since then, many NPPs had power up-rates and longer refueling intervals, which resulted in fuel configurations that may potentially respond differently (in an undesirable way) to reactivity accidents. Also, as shown in a recent event, several inadvertent operator actions caused potential nuclear fuel reactivity insertion accident during SD operations. The set inadvertent operator actions are likely to be plant- and operation-state specific and could lead to accident sequences. This study is an outcome of the concern which arose after the inadvertent withdrawal of control rods at Dresden Unit 3 in 2008 due to operator actions in the plant inadvertently three control rods were withdrawn from the reactor without knowledge of the main control room operator. The purpose of this Standardized Plant Analysis Risk (SPAR) Model development project is to develop simplified SPAR Models that can be used by staff analysts to perform risk analyses of operating events and/or conditions occurring during SD operation. These types of accident scenarios are dominated by the operator actions, (e.g., misalignment of valves, failure to follow procedures and errors of commissions). Human error probabilities specific to this model were assessed using the methodology developed for SPAR model human error evaluations. The event trees, fault trees, basic event data and data sources for the model are provided in the report. The end state is defined as the reactor becomes critical. The scoping study includes a brief literature search/review of historical events, developments of

  12. Revisiting the validity of measures of social cognitive bias in schizophrenia: Additional results from the Social Cognition Psychometric Evaluation (SCOPE) study.

    Science.gov (United States)

    Buck, Benjamin E; Pinkham, Amy E; Harvey, Philip D; Penn, David L

    2016-11-01

    The ongoing Social Cognition Psychometric Evaluation (SCOPE) study is in the process of forming a gold-standard battery of social cognition tests for use in clinical trials. Previous SCOPE phases have not acknowledged key differences between social cognition skills and biases, and psychometric validity analyses might provide important information if tailored to bias-related outcomes. This study aims to validate these measures with such bias-related outcomes. Two measures of social cognitive bias - the Ambiguous Intention Hostility Questionnaire (AIHQ; hostile attribution bias) and Trustworthiness Task (distrust bias) - were reviewed according to their relationships to (1) current and prospective symptom levels, (2) questionnaires of trait paranoia and hostility and informant-rated hostility, (3) interpersonal conflict, as well as (4) relationships to measures of trait paranoia, hostility, and interpersonal conflict above and beyond the influence of clinically rated symptoms. Results supported hypotheses that social cognitive bias provides information about cognition, symptoms, and functioning related to interpersonal conflict. Each bias demonstrated relationships to trait paranoia questionnaires, hostility, or interpersonal conflict outcomes, and these persisted above and beyond the influence of clinically rated symptoms. Hostile attribution bias also predicted change in symptom levels over a brief interval. Overall, the current bias-specific psychometric analysis provides support for continued study of social cognitive biases. Hostile attribution bias may play a role in important outcome variables given relationships to emotional discomfort and suspiciousness symptoms, trait paranoia and hostility, interpersonal conflict, as well as prospective hostility symptoms. Distrust bias may also impact real-world functioning, as it is related to hostility, suspiciousness, and positive symptoms, trait paranoia, and hostility. Relationships of social cognitive biases to

  13. Diagnostic and treatment delay among pulmonary tuberculosis patients in Ethiopia: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Yimer Solomon

    2005-12-01

    Full Text Available Abstract Background Delayed diagnosis and treatment of tuberculosis (TB results in severe disease and a higher mortality. It also leads to an increased period of infectivity in the community. The objective of this study was to determine the length of delays, and analyze the factors affecting the delay from onset of symptoms of pulmonary tuberculosis (PTB until the commencement of treatment. Methods In randomly selected TB management units (TBMUs, i.e. government health institutions which have diagnosing and treatment facilities for TB in Amhara Region, we conducted a cross sectional study from September 1-December 31/2003. Delay was analyzed from two perspectives, 1. Period between onset of TB symptoms to first visit to any health provider (health seeking period, and from the first health provider visit to initiation of treatment (health providers' delay, and 2. Period between onset of TB symptoms to first visit to a medical provider (patients' delay, and from this visit to commencement of anti-TB treatment (health systems' delay. Patients were interviewed on the same date of diagnosis using a semi-structured questionnaire. Logistics regression analysis was applied to analyze the risk factors of delays. Results A total of 384 new smear positive PTB patients participated in the study. The median total delay was 80 days. The median health-seeking period and health providers' delays were 15 and 61 days, respectively. Conversely, the median patients' and health systems' delays were 30 and 21 days, respectively. Taking medical providers as a reference point, we found that forty eight percent of the subjects delayed for more than one month. Patients' delays were strongly associated with first visit to non-formal health providers and self treatment (P Conclusion Delay in the diagnosis and treatment of PTB is unacceptably high in Amhara region. Health providers' and health systems' delays represent the major portion of the total delay. Accessing a

  14. From breathless to failure: symptom onset and diagnostic meaning in patients with heart failure-a qualitative study.

    Science.gov (United States)

    Taylor, C J; Hobbs, F D R; Marshall, T; Leyva-Leon, F; Gale, N

    2017-03-10

    To explore 2 key points in the heart failure diagnostic pathway-symptom onset and diagnostic meaning-from the patient perspective. Qualitative interview study. Participants were recruited from a secondary care clinic in central England following referral from primary care. Over age 55 years with a recent (failure confirmed by a cardiologist following initial presentation to primary care. Semistructured interviews were carried out with 16 participants (11 men and 5 women, median age 78.5 years) in their own homes. Data were audio-recorded and transcribed. Participants were asked to describe their diagnostic journey from when they first noticed something wrong up to and including the point of diagnosis. Data were analysed using the framework method. Participants initially normalis