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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

    International Nuclear Information System (INIS)

    Chancellor, Christopher John

    2016-01-01

    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. 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.

  5. 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

  6. 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.

  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. 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

  10. 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

  11. 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 M...

  12. ML-o-Scope: A Diagnostic Visualization System for Deep Machine Learning Pipelines

    Science.gov (United States)

    2014-05-16

    Huawei , Intel, Microsoft, NetApp, Pivotal, Splunk, Virdata, VMware, WANdisco and Yahoo!. ML-o-scope: a diagnostic visualization system for deep machine...Facebook, GameOnTalis, Guavus, HP, Huawei , Intel, Microsoft, NetApp, Pivotal, Splunk, Virdata, VMware, WANdisco and Yahoo!. References [1] Bruna, J., and

  13. 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.)

  14. Advanced and extended scope practice of diagnostic radiographers in Scotland: Exploring strategic imaging service imperatives.

    Science.gov (United States)

    Henderson, I; Mathers, S A; McConnell, J

    2017-08-01

    The development of diagnostic imaging services manifests features specific to the Scottish environment, in particular development of the radiographic workforce through implementing skills mix and role developments to enhance outcomes for patients. A component of a College of Radiographers Industry Partnership Scheme (CoRIPS) supported study, this research investigates perspectives of strategic service managers with Health Board responsibility for service delivery. A questionnaire survey was administered to strategic service managers across Scotland (N = 14), followed up with telephone interviews. There was a return rate of 57% (n = 8) for the questionnaires and n = 4 agreed to be interviewed. Data collected related to radiographer roles across their Board area; awareness and understanding of service development issues and features as well as perspective on opportunities and barriers in the context of Scottish Government policy, workforce logistics, attitudes and inter-professional relationships. The results indicate evidence of financial, logistical and political barriers to service evolution, offset by a sense of optimism that scope for beneficial change may be approaching. There are a range of significant initiatives in place and an appetite exists to pursue the development of radiographer roles and skill mix for the benefit of service users more generally. The difficulties in achieving change are well understood and there are basic issues related to finance and industrial relations. There are also however, cultural elements to contend with in the form of attitudes demonstrated by some radiographers and significantly, the radiological community whose influence on the practice of independently regulated radiographers seems incongruent. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

  15. 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.

  16. Tokamak Engineering Technology Facility scoping study

    International Nuclear Information System (INIS)

    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

  17. Trends of infodemiology studies: a scoping review.

    Science.gov (United States)

    Zeraatkar, Kimia; Ahmadi, Maryam

    2018-06-01

    The health care industry is rich in data and information. Web technologies, such as search engines and social media, have provided an opportunity for the management of user generated data in real time in the form of infodemiology studies. The aim of this study was to investigate infodemiology studies conducted during 2002-2016, and compare them based on developed, developing and in transition countries. This scoping review was conducted in 2017 with the help of the PRISMA guidelines. PubMed, Scopus, Science Direct, Web of Knowledge, Google Scholar, Wiley and Springer databases were searched between the years 2002 and 2016. Finally, 56 articles were included in the review and analysed. The initial infodemiology studies pertain to the quality assessment of the hospital's websites. Most of the studies were on developed countries, based on flu, and published in the Journal of Medical Internet Research. The infodemiology approach provides unmatched opportunities for the management of health data and information generated by the users. Using this potential will provide unique opportunities for the health information need assessment in real time by health librarians and thereby provide evidence based health information to the people. © 2018 Health Libraries Group.

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. SRP decontamination and decommissioning scoping study

    International Nuclear Information System (INIS)

    Martin, W.P.

    1986-06-01

    Of the approximately 3000 site facilities, 496 were judged to be radioactively contaminated thereby requiring Decontamination and Decommissioning (D and D) after shutdown. To enable projection of D and D timing for each of the 496 facilities, a plant shutdown schedule was developed. A 5-year ''cool-down'' period was added to the highly contaminated facilities to allow radioactive decay resulting in a reduction of cost, waste volume, and radiation exposure. D and D of all facilities is projected to be completed in FY 2045. Since essentially all of the plant facilities are scheduled to operate past FY 2000, only seventy-four of the 496 facilities are projected to be decommissioned prior to FY 2000. These facilities include currently excessed facilities and those scheduled for shutdown in the near future - seepage basins, HWCTR, R-Reactor, high level waste tanks, etc. The type of D and D chosen is the factor having the most significant effect on D and D costs and waste volumes. The two types of final D and D are Entombment and Dismantlement. Dismantlement can increase costs and waste volumes by a factor of 2 to 100 compared to Entombment. This point should be kept in mind when reviewing this scoping study as approximately 75% of the projects are estimated based upon the less costly Entombment option. The D and D estimates for the 496 facilities are summarized by plant area in Table 3 and by custodian group (Program/General Department) in Table 4. The total estimated D and D cost in constant FY 1986 dollars is approximately $800,000,000, with total solid waste volumes of 5,000,000 and 170,000 cubic feet, for low level waste (LLW) and transuranic waste (TRU), respectively. A 6% annual escalation factor increases the total project costs of 800,000,000, FY 1986 dollars to 7 billion dollars. 27 refs

  3. 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.

  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. 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.

  6. 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

  7. 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

  8. Studies on WWER core diagnostics

    International Nuclear Information System (INIS)

    Lunin, G.L.; Mitin, V.I.; Bulavin, V.V.

    1987-01-01

    The reliability and safety of nuclear power plants have decisive meaning under the situation that nuclear power generation steadily increases, and among various measures aiming at ensuring the reliability and safety in the operation of nuclear power plants, the countermeasures for protecting reactor core, main process equipment and high pressure circuits from damage have the important role, and the monitoring of condition and the organization of forecast, which are carried out continuously or periodically during the operation of nuclear power stations using the diagnostic expert system specially developed for the purpose, are included in them. Such monitoring enables the early detection of mechanical damage, increase of vibration, defects caused during operation and so on in reactor cores and primary and secondary circuits, and the continuous watching of defect developments. Also boiling in a core is detected, the place of abnormality occurrence is identified, and the intensity and characteristics of boiling are determined, thus the occurrence of dangerous condition is prevented. The developments of an in-core monitoring system and noise diagnostic systems are reported. (Kako, I.)

  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

    International Nuclear Information System (INIS)

    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. 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)

  12. 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.

  13. 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.

  14. Diagnostic colonoscopy: performance measurement study.

    Science.gov (United States)

    Kuznets, Naomi

    2002-07-01

    This is the fifth of a series of best practices studies undertaken by the Performance Measurement Initiative (PMI), the centerpiece of the Institute for Quality Improvement (IQI), a not-for-profit quality improvement subsidiary of the Accreditation Association for Ambulatory Health Care (AAAHC) (Performance Measurement Initiative, 1999a, 1999b, 2000a, 2000b). The IQI was created to offer clinical performance measurement and improvement opportunities to ambulatory health care organizations and others interested in quality patient care. The purpose of the study was to provide opportunities to initiate clinical performance measurement on key processes and outcomes for this procedure and use this information for clinical quality improvement. This article provides performance measurement information on how organizations that have demonstrated and validated differences in clinical practice can have similar outcomes, but at a dramatically lower cost. The intent of the article is to provide organizations with alternatives in practice to provide a better value to their patients.

  15. 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.

  16. 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

  17. 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)

  18. 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.

  19. Tokamak physics experiment: Diagnostic windows study

    International Nuclear Information System (INIS)

    Merrigan, M.; Wurden, G.A.

    1995-11-01

    We detail the study of diagnostic windows and window thermal stress remediation in the long-pulse, high-power Tokamak Physics Experiment (TPX) operation. The operating environment of the TPX diagnostic windows is reviewed, thermal loads on the windows estimated, and cooling requirements for the windows considered. Applicable window-cooling technology from other fields is reviewed and its application to the TPX windows considered. Methods for TPX window thermal conditioning are recommended, with some discussion of potential implementation problems provided. Recommendations for further research and development work to ensure performance of windows in the TPX system are presented

  20. Finnsjoen 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.

    1992-12-01

    The Finnsjoen study site was selected in 1977 to provide input to the KBS-1 and KBS-2 performance assessments. The site was later used as a test site for testing new instruments and new site characterization methods, as well as a research site for studying mainly groundwater flow and groundwater transport. All together, the Finnsjoen studies have involved 11 cored boreholes, down to max 700 m depth, and extensive borehole geophysical, geochemical and geohydraulic measurements, as well as rock stress measurements and tracer tests. This report presents the scope of the Finnsjoen studies together with main results. Conceptual uncertainties in assumptions and models are discussed with emphasis on the models used for the performance assessment SKB91. Of special interest for the Finnsjoen study site is the strong influence caused by a subhorizontal fracture zone on groundwater flow, transport and chemistry

  1. An overview of the fire risk scoping study

    International Nuclear Information System (INIS)

    Nowlen, S.P.; Lambright, J.A.; Nicolette, V.F.; Bohn, M.P.

    1989-01-01

    The Fire Risk Scoping Study was sponsored by the US Nuclear Regulatory Commission and performed at Sandia National Laboratories. The study was initiated as a result of previous USNRC-sponsored fire research efforts that had identified certain fire risk issues that had not been addressed in previously completed commercial nuclear power plant fire risk analyses. The specific objectives of this study were (1) to review and requantify fire risk scenarios from four fire probabilistic risk assessments in light of updated data bases made available as a result of USNRC-sponsored Fire Protection Research Program and updated computer fire modeling capabilities, (2) to identify potentially significant fire risk issues that have not been previously addressed in a fire risk context and to quantify the potential impact of those identified fire risk issues where possible, and (3) to review current fire regulations and plant implementation practices for relevance to the identified unaddressed fire risk issues. 9 refs., 3 tabs

  2. Low activation diagnostic equipment design studies

    International Nuclear Information System (INIS)

    Hopkins, G.R.; Cheng, E.T.; Fisher, R.K.

    1985-01-01

    The low activation fusion concept has been applied to the diagnostic equipment in a fusion reactor. The components where fabrication from low activation materials is feasible have been identified. Other systems where higher activation elements are required can have their activation reduced by design approaches which include shielding and operation only in low flux regions of the reactor. Some components will not operate in a high flux so activation is not a major concern. This low activation diagnostic equipment study completes a series of low activation studies where all the components in a fusion power reactor have now been evaluated. It is concluded that a completely low activation fusion reactor is feasible with all components meeting the functional requirements. This provides an environmentally benign energy source with a high confidence level in meeting safety criteria in operation, maintenance and waste disposal

  3. Sternoe study site. Scope of activities and main results

    International Nuclear Information System (INIS)

    Ahlbom, K.; Andersson, J.E.; Nordqvist, R.; Tiren, S.; Ljunggren, C.; Voss, C.

    1992-01-01

    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 programme will be to perform detailed characterization, 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 anyone of the previously investigated study sites will be selected as a site for detailed characterization. Other sites with geological and/or socio-economical characteristics judged more favourable 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 concerns the Sternoe study site. This site was one of the first sites to be investigated by SKB . The studies at Sternoe were made under severe time-constraints and with prototype borehole instrumentations. These limitations should be kept in mind when reading the report. (41 refs., 16 figs., 12 tabs.) (au)

  4. Studies on the diagnostic accuracy of lymphography

    International Nuclear Information System (INIS)

    Luening, M.; Stargardt, A.; Abet, L.

    1979-01-01

    Contradictory reports in the literature on the reliability of lymphography stimulated the authors to test the diagnostic accuracy, employing methods which are approximately analogous to practice, using carcinoma of the cervix as the model on which the study was carried out. Using 21 observers it was found that there was no correlation between their experience and on-target accuracy of the diagnosis. Good observers obtained an accuracy of 85% with good proportions between sensitivity in the recognition of detail, specificity and readiness to arrive at a decision on the basis of discriminatory ability. With the help of the concept of the ROC curves, the position taken up by the observers in respect of diagnostic decisions, and a complex manner of assessing the various characteristic factors determining diagnostic accuracy, are demonstrated. This form of test, which permits manipulation of different variants of diagnosis, is recommended, among other things, for performance control at the end of training and continuing education courses in other fields of x-ray diagnosis as well. (orig.) [de

  5. Gideaa study site. Scope of activities and main results

    International Nuclear Information System (INIS)

    Ahlbom, K.; Andersson, J.E.; Nordqvist, R.; Ljunggren, C.; Tiren, S.; Voss, C.

    1991-10-01

    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 programme will be to perform detailed characterization, 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 anyone of the study sites will be selected as a site for detailed characterization. Other site with geological and/or socio-economical characteristics judged more favourable 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 concerns the Gideaa study site. (au)

  6. Kamlunge study site. Scope of activities and main results

    International Nuclear Information System (INIS)

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

    1992-05-01

    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 programme will be to perform detailed characterization, 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 anyone of the study sites will be selected as a site for detailed characterization. Other sites with geological and/or socio-economical characteristics judged more favourable may very well be 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 concerns the Kamlunge study site. (79 refs.) (au)

  7. Scoping study into community-based renewable energy projects

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    This scoping study has been carried out by the Centre for Sustainable Energy (CSE), a charity which promotes energy efficiency and renewable energy. CSE have used their involvement in the development of the Energy Club (the first energy service company for householders in the UK) and the Bristol Environment and Energy Trust (a cross-sector organisation initiating environmental projects) as the basis of the study. This study is the first phase of a long term project to set up two small-scale renewable energy schemes to demonstrate the benefits of a community based approach. Specific objectives of the study were: to identify, quantify and cost, renewable energy resources for interested community organisations; to evaluate two routes for developing community based projects - Environment Trusts and Energy Clubs'; to organise a seminar with the objective of bringing together community interest groups with experts in renewable energy; to identify two communities with viable renewable projects for the next phase - full feasibility studies/pilot projects. (author)

  8. Fjaellveden study site. Scope of activities and main results

    International Nuclear Information System (INIS)

    Ahlbom, K.; Andersson, J.E.; Nordqvist, R.; Ljunggren, C.; Tiren, S.; Voss, C.

    1991-10-01

    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 programme will be to perform detailed characterization, 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 repository. Such an application is foreseen to be given to the authorities around the year 2003. It is presently not clear if anyone of the study sites will be selected as a site for detailed characterization. Other sites with geological and/or socio-economical characteristics judged more favourable 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 for complementary investigations. This report concerns the Fjaellveden study site. (au)

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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.

  14. 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

  15. 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

  16. A Scoping Review of Qualitative Studies about Children Experiencing Parental Separation

    Science.gov (United States)

    Birnbaum, Rachel; Saini, Michael

    2013-01-01

    This article explores a scoping review of qualitative studies about children's experiences and feelings during times of parental separation. The purpose of the review was to explore children's feelings and attitudes about their parents' separation and how their voices are heard during times of parental separation. The scoping review examined 44…

  17. Diagnostics

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  18. 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

  19. 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…

  20. Quality of reporting of diagnostic accuracy studies

    NARCIS (Netherlands)

    Smidt, N.; Rutjes, A.W.; Windt - Mens, van der D.A.W.M.; Ostelo, R.W.J.G.; Reitsma, J.B.; Bouter, L.M.; Vet, de H.C.W.

    2005-01-01

    PURPOSE: To evaluate quality of reporting in diagnostic accuracy articles published in 2000 in journals with impact factor of at least 4 by using items of Standards for Reporting of Diagnostic Accuracy (STARD) statement published later in 2003. MATERIALS AND METHODS: English-language articles on

  1. 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

  2. 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...

  3. Scoping study for a one-health response to knowledge gaps in ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Scoping study for a one-health response to knowledge gaps in antimicrobial ... A recent World Bank report finds that drug-resistant infections have the ... Going to Scale : Sustainable Land Management in the Highlands of Eastern Africa.

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

    NARCIS (Netherlands)

    Naaktgeboren, Christiana A; Ochodo, Eleanor A; Van Enst, Wynanda A; de Groot, Joris A H; Hooft, Lotty; Leeflang, Mariska M G; Bossuyt, Patrick M; Moons, Karel G M; Reitsma, Johannes B

    2016-01-01

    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

  5. The scope of costs in alcohol studies: Cost-of-illness studies differ from economic evaluations

    OpenAIRE

    van Gils, Paul F; Hamberg-van Reenen, Heleen H; van den Berg, Matthijs; Tariq, Luqman; de Wit, G Ardine

    2010-01-01

    Abstract Background Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic e...

  6. Molecular Diagnostics for the Study of Hypersonic Flows

    Science.gov (United States)

    2000-04-01

    UNCLASSIFIED Defense Technical Information Center Compilation Part Notice ADPO10744 TITLE: Molecular Diagnostics for the Study of Hypersonic Flows...following component part numbers comprise the compilation report: ADP010736 thru ADPO10751 UNCLASSIFIED 5-1 Molecular Diagnostics for the Study of

  7. 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

  8. NSTX Diagnostics for Fusion Plasma Science Studies

    International Nuclear Information System (INIS)

    Kaita, R.; Johnson, D.; Roquemore, L.; Bitter, M.; Levinton, F.; Paoletti, F.; Stutman, D.

    2001-01-01

    This paper will discuss how plasma science issues are addressed by the diagnostics for the National Spherical Torus Experiment (NSTX), the newest large-scale machine in the magnetic confinement fusion (MCF) program. The development of new schemes for plasma confinement involves the interplay of experimental results and theoretical interpretations. A fundamental requirement, for example, is a determination of the equilibria for these configurations. For MCF, this is well established in the solutions of the Grad-Shafranov equation. While it is simple to state its basis in the balance between the kinetic and magnetic pressures, what they are as functions of space and time are often not easy to obtain. Quantities like the plasma pressure and current density are not directly measurable. They are derived from data that are themselves complex products of more basic parameters. The same difficulties apply to the understanding of plasma instabilities. Not only are the needs for spatial and temporal resolution more stringent, but the wave parameters which characterize the instabilities are difficult to resolve. We will show how solutions to the problems of diagnostic design on NSTX, and the physics insight the data analysis provides, benefits both NSTX and the broader scientific community

  9. 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.

  10. Air Pollution Awareness in the Scope of the Community Service Practices Course: An Interdisciplinary Study

    Science.gov (United States)

    Aydin-Güç, Funda; Aygün, Müge; Ceylan, Derya; Çavus-Güngören, Seda; Durukan, Ümmü Gülsüm; Hacioglu, Yasemin; Yekeler, Ayse Dilek

    2018-01-01

    The aim of this study is to determine the effect of the interdisciplinary (the disciplines of Turkish, Social Science, Natural Sciences, Mathematics and Public Administration) activities performed in the scope of the Community Service Practices Course on the air pollution awareness (APW). This study has been performed as a multiple case study.…

  11. Malaria Laboratory Diagnostic Performance: Case studies of two ...

    African Journals Online (AJOL)

    Advantages of rapid diagnostic tests when compared with microscopy are simple to perform, fast, low ... The study was conducted to establish the performance of laboratory diagnosis of malaria in local Malawi .... Government of Malawi.

  12. The CRC Contribution to Research Training: Report of a Scoping Study for the Cooperative Research Centres Association

    Science.gov (United States)

    Palmer, Nigel

    2012-01-01

    This report summarises findings from a scoping study conducted for the Cooperative Research Centres Association (CRCA) by the Centre for the Study of Higher Education. The purpose of the scoping study is to inform the research training activities of Cooperative Research Centres (CRCs). While previous studies have focussed on the outcomes supported…

  13. "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…

  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. Diagnostic techniques in deflagration and detonation studies.

    Science.gov (United States)

    Proud, William G; Williamson, David M; Field, John E; Walley, Stephen M

    2015-12-01

    Advances in experimental, high-speed techniques can be used to explore the processes occurring within energetic materials. This review describes techniques used to study a wide range of processes: hot-spot formation, ignition thresholds, deflagration, sensitivity and finally the detonation process. As this is a wide field the focus will be on small-scale experiments and quantitative studies. It is important that such studies are linked to predictive models, which inform the experimental design process. The stimuli range includes, thermal ignition, drop-weight, Hopkinson Bar and Plate Impact studies. Studies made with inert simulants are also included as these are important in differentiating between reactive response and purely mechanical behaviour.

  16. Limited Scope Design Study for Multi-Sensor Towbody

    Science.gov (United States)

    2016-06-01

    ports 2 Leak sensors 1 Electrical Surface supply voltage 300 V nominal (250–425 Vdc) Towbody output voltages 48/24/12 Vdc Load power...shallow water (អ m) at thousands of current and former Department of Defense (DoD) sites encompassing millions of acres. This design study...addresses the munitions remediation in shallow water problem with a system that uses a Multi-Sensor Towbody (MuST) and surface vessel with support

  17. 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...

  18. 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

  19. Preliminary study on acceptability of scope of thermal discharge mixing zone for nuclear power plant

    International Nuclear Information System (INIS)

    Liu Yongye; Yang Yang; Wang Liang; Chen Xiaoqiu; Liu Senlin

    2012-01-01

    Based on the situation that the existing domestic temperature control standards are not performable, the preliminary study on the acceptability of the mixing zone scope of thermal discharge for nuclear power plant was conducted in this paper, taking a coastal power station SNP as a case. The following preliminary conclusions could be drawn from the results of cluster analysis of the SNP site under different results of mathematical modeling and physical model test: 1) The influence intensity of ecological function of the SNP site seawater is small and the scope of thermal discharge mixing zone is acceptable under SNP-1 (Unit 1 and 2) operating condition; 2) the influence intensity of ecological function of the SNP site seawater is small and the scope of thermal discharge mixing zone is acceptable in spring under SNP-1 (Unit 1 and 2) and SNP-2 (Unit 3 and 4) operating condition, while the influence intensity of ecological function of the SNP site seawater is large and the scope of mixing zone is unacceptable in autumn under the same operating condition. (authors)

  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. Study on the scope of fault tree method applicability

    International Nuclear Information System (INIS)

    Ito, Taiju

    1980-03-01

    In fault tree analysis of the reliability of nuclear safety system, including reliability analysis of nuclear protection system, there seem to be some documents in which application of the fault tree method is unreasonable. In fault tree method, the addition rule and the multiplication rule are usually used. The addition rule and the multiplication rule must hold exactly or at least practically. The addition rule has no problem but the multiplication rule has occasionally some problem. For unreliability, mean unavailability and instantaneous unavailability of the elements, holding or not of the multiplication rule has been studied comprehensively. Between the unreliability of each element without maintenance, the multiplication rule holds. Between the instantaneous unavailability of each element, with maintenance or not, the multiplication rule also holds. Between the unreliability of each subsystem with maintenance, however, the multiplication rule does not hold, because the product value is larger than the value of unreliability for a parallel system consisting of the two subsystems with maintenance. Between the mean unavailability of each element without maintenance, the multiplication rule also does not hold, because the product value is smaller than the value of mean unavailability for a parallel system consisting of the two elements without maintenance. In these cases, therefore, the fault tree method may not be applied by rote for reliability analysis of the system. (author)

  3. Concurrent and predictive evaluation of malnutrition diagnostic measures in hip fracture inpatients: a diagnostic accuracy study.

    Science.gov (United States)

    Bell, J J; Bauer, J D; Capra, S; Pulle, R C

    2014-03-01

    Differences in malnutrition diagnostic measures impact malnutrition prevalence and outcomes data in hip fracture. This study investigated the concurrent and predictive validity of commonly reported malnutrition diagnostic measures in patients admitted to a metropolitan hospital acute hip fracture unit. A prospective, consecutive level II diagnostic accuracy study (n=142; 8 exclusions) including the International Classification of Disease, 10th Revision, Australian Modification (ICD10-AM) protein-energy malnutrition criteria, a body mass index (BMI) Patients were predominantly elderly (median age 83.5, range 50-100 years), female (68%), multimorbid (median five comorbidities), with 15% 4-month mortality. Malnutrition prevalence was lowest when assessed by BMI (13%), followed by MNA-SF (27%), ICD10-AM (48%), albumin (53%) and geriatrician assessment (55%). Agreement between measures was highest between ICD10-AM and geriatrician assessment (κ=0.61) followed by ICD10-AM and MNA-SF measures (κ=0.34). ICD10-AM diagnosed malnutrition was the only measure associated with 48-h mobilisation (35.0 vs 55.3%; P=0.018). Reduced likelihood of home discharge was predicted by ICD-10-AM (20.6 vs 57.1%; P=0.001) and MNA-SF (18.8 vs 47.8%; P=0.035). Bivariate analysis demonstrated ICD10-AM (relative risk (RR)1.2; 1.05-1.42) and MNA-SF (RR1.2; 1.0-1.5) predicted 4-month mortality. When adjusted for age, usual place of residency, comorbidities and time to surgery only ICD-10AM criteria predicted mortality (odds ratio 3.59; 1.10-11.77). Albumin, BMI and geriatrician assessment demonstrated limited concurrent and predictive validity. Malnutrition prevalence in hip fracture varies substantially depending on the diagnostic measure applied. ICD-10AM criteria or the MNA-SF should be considered for the diagnosis of protein-energy malnutrition in frail, multi-morbid hip fracture inpatients.

  4. Research trends in studies of medical students' characteristics: a scoping review.

    Science.gov (United States)

    Jung, Sung Soo; Park, Kwi Hwa; Roh, HyeRin; Yune, So Jung; Lee, Geon Ho; Chun, Kyunghee

    2017-09-01

    The purpose of this study is to investigate domestic and international research trends in studies of medical students' characteristics by using the scoping review methods. This study adopted the scoping review to assess papers on the characteristics of medical students. The procedure of research was carried out according to the five steps of the scoping review. The full texts of 100 papers are obtained and are read closely, after which suitable 88 papers are extracted by us for this research. The review is mapped by the year of the study, source, location, author, research design, research subject, objective, and key results. The frequency is analyzed by using Microsoft Excel and SPSS. We found 70 papers (79.5%) on a single medical school, 15 (17.0%) on multiple medical schools, and three (3.4%) on mixed schools, including medical and nonmedical schools. Sixty-nine (79.5%) were cross-sectional studies and 18 (20.5%) were longitudinal studies. Eighty-two papers (93.2%) adopted questionnaire surveys. We summarized research trends of studies on medical students in Korea and overseas by topic, and mapped them into physical health, mental health, psychological characteristics, cognitive characteristics, social characteristics, and career. This study provides insights into the future directions of research for the characteristics of medical students.

  5. Research trends in studies of medical students’ characteristics: a scoping review

    Science.gov (United States)

    2017-01-01

    The purpose of this study is to investigate domestic and international research trends in studies of medical students’ characteristics by using the scoping review methods. This study adopted the scoping review to assess papers on the characteristics of medical students. The procedure of research was carried out according to the five steps of the scoping review. The full texts of 100 papers are obtained and are read closely, after which suitable 88 papers are extracted by us for this research. The review is mapped by the year of the study, source, location, author, research design, research subject, objective, and key results. The frequency is analyzed by using Microsoft Excel and SPSS. We found 70 papers (79.5%) on a single medical school, 15 (17.0%) on multiple medical schools, and three (3.4%) on mixed schools, including medical and nonmedical schools. Sixty-nine (79.5%) were cross-sectional studies and 18 (20.5%) were longitudinal studies. Eighty-two papers (93.2%) adopted questionnaire surveys. We summarized research trends of studies on medical students in Korea and overseas by topic, and mapped them into physical health, mental health, psychological characteristics, cognitive characteristics, social characteristics, and career. This study provides insights into the future directions of research for the characteristics of medical students. PMID:28870017

  6. Research trends in studies of medical students’ characteristics: a scoping review

    Directory of Open Access Journals (Sweden)

    Sung Soo Jung

    2017-09-01

    Full Text Available The purpose of this study is to investigate domestic and international research trends in studies of medical students’ characteristics by using the scoping review methods. This study adopted the scoping review to assess papers on the characteristics of medical students. The procedure of research was carried out according to the five steps of the scoping review. The full texts of 100 papers are obtained and are read closely, after which suitable 88 papers are extracted by us for this research. The review is mapped by the year of the study, source, location, author, research design, research subject, objective, and key results. The frequency is analyzed by using Microsoft Excel and SPSS. We found 70 papers (79.5% on a single medical school, 15 (17.0% on multiple medical schools, and three (3.4% on mixed schools, including medical and nonmedical schools. Sixty-nine (79.5% were cross-sectional studies and 18 (20.5% were longitudinal studies. Eighty-two papers (93.2% adopted questionnaire surveys. We summarized research trends of studies on medical students in Korea and overseas by topic, and mapped them into physical health, mental health, psychological characteristics, cognitive characteristics, social characteristics, and career. This study provides insights into the future directions of research for the characteristics of medical students.

  7. The use of oxygen-enriched air for biomass gasification: initial scoping study

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-07-01

    The article reports an initial scoping study which is aimed at assessing the potential impact of using non-cryogenic oxygen, or oxygen-enriched air, for biomass gasification with respect to cost, design and operation of stationary biomass-fuelled generators in the range 5 to 15 MW(e). The study is expected to lead to identification of options worthy of more detailed study. The format of the scoping study is as follows: (i) using data on performance and cost from the manufacturers, minimum cost-saving potential is assessed; (ii) the performance and component costs of various gasifier types and engine types are reviewed to identify possible savings in monetary cost; (iii) an assessment of the likely impact of low-cost fuels is made and (iv) areas for detailed investigation are highlighted.

  8. ["Nervous breakdown": a diagnostic characterization study].

    Science.gov (United States)

    Salmán, E; Carrasco, J L; Liebowitz, M; Díaz Marsá, M; Prieto, R; Jusino, C; Cárdenas, D; Klein, D

    1997-01-01

    An evaluation was made of the influence of different psychiatric co-morbidities on the symptoms of the disorder popularly known as "ataque de nervios" (nervous breakdown) among the US Hispanic population. Using a self-completed instrument designed specially for both traditional nervous breakdown and for panic symptoms, and structured or semi-structured psychiatric interviews for Axis I disorders, and evaluation was made of Hispanic subjects who sought treatment for anxiety in a clinic (n = 156). This study centered on 102 subjects who presented symptoms of "nervous breakdown" and comorbidity with panic disorder, other anxiety disorders, or affective disorder. Variations in co-morbidity with "nervous breakdown" enabled the identification of different patterns of "nervous breakdown" presenting symptoms. Individuals with "nervous breakdown" and panic disorder characteristically expressed a greater sense of asphyxiation, fear of dying, and growing fear (panic-like) during their breakdowns. Subjects with "nervous breakdown" and affective disorder had a greater sensation of anger and more tendency toward screaming and aggressive behavior such as breaking things during the breakdown (emotional anger). Finally, subjects with "nervous breakdown" and co-morbidity with another anxiety disorder had fewer "paniclike" or "emotional anger" symptoms. These findings suggest that: a) the widely used term "nervous breakdown" is a popular label for different patterns of loss of emotional control; b) the type of loss of emotional control is influenced by the associated psychiatric disorder; and c) the symptoms characteristics of the "nervous breakdown" can be useful clinical markers for associated psychiatric disorders. Future research is needed to determine whether the known Hispanic entity "ataque de nervios" is simply a popular description for different aspects of well-known psychiatric disorders, or if it reflects specific demographic, environmental, personality and/or clinical

  9. 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 s...

  10. Diagnostic overshadowing and other challenges involved in the diagnostic process of patients with mental illness who present in emergency departments with physical symptoms--a qualitative study.

    Science.gov (United States)

    Shefer, Guy; Henderson, Claire; Howard, Louise M; Murray, Joanna; Thornicroft, Graham

    2014-01-01

    We conducted a qualitative study in the Emergency Departments (EDs) of four hospitals in order to investigate the perceived scope and causes of 'diagnostic overshadowing'--the misattribution of physical symptoms to mental illness--and other challenges involved in the diagnostic process of people with mental illness who present in EDs with physical symptoms. Eighteen doctors and twenty-one nurses working in EDs and psychiatric liaisons teams in four general hospitals in the UK were interviewed. Interviewees were asked about cases in which mental illness interfered with diagnosis of physical problems and about other aspects of the diagnostic process. Interviews were transcribed and analysed thematically. Interviewees reported various scenarios in which mental illness or factors related to it led to misdiagnosis or delayed treatment with various degrees of seriousness. Direct factors which may lead to misattribution in this regard are complex presentations or aspects related to poor communication or challenging behaviour of the patient. Background factors are the crowded nature of the ED environment, time pressures and targets and stigmatising attitudes held by a minority of staff. The existence of psychiatric liaison team covering the ED twenty-four hours a day, seven days a week, can help reduce the risk of misdiagnosis of people with mental illness who present with physical symptoms. However, procedures used by emergency and psychiatric liaison staff require fuller operationalization to reduce disagreement over where responsibilities lie.

  11. 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

  12. Motivational intensity modulates attentional scope: evidence from behavioral and ERP studies.

    Science.gov (United States)

    Liu, Lei; Zhang, Guangnan; Zhou, Renlai; Wang, Zuowei

    2014-10-01

    Previous studies have found that affective states with high motivational intensity narrow attentional scope, whereas affective states with low motivational intensity broaden attentional scope. This conclusion, however, is based on fragmented evidence based on several separate studies. The present study tests this conclusion within a single study using both behavioral (Experiment 1) and neurophysiological (Experiment 2) measures. Experiment 1 showed that individuals had the global precedence effect in the neutral affective state. However, the global precedence effect was reduced for affective states with high motivational intensity, whereas the global precedence effect was not significantly enhanced for those with low motivational intensity. Experiment 2 replicated these results with event-related potential (ERP) recording. ERP results showed that affective states with high motivational intensity induced smaller N2 and greater late positive potential (LPP) amplitudes than low motivational intensity and neutral affective states. However, no differences were found between the low motivational intensity and neutral affective states. Furthermore, smaller LPP predicted the tendency a global attentional focus in the frontal and central areas and larger LPP predicted a narrowed focus in the frontal area. The findings suggested that high motivational intensity of affective states can affect attentional scope.

  13. 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.

  14. Diagnostics for studies of novel laser ion acceleration mechanisms

    Energy Technology Data Exchange (ETDEWEB)

    Senje, Lovisa; Aurand, Bastian; Wahlström, Claes-Göran [Department of Physics, Lund University, P. O. Box 118, S-221 00 Lund (Sweden); Yeung, Mark; Kuschel, Stephan; Rödel, Christian [Helmholtz-Institut Jena, D-07743 Jena (Germany); Wagner, Florian; Roth, Markus [Technische Universität Darmstadt, D-64289 Darmstadt (Germany); Li, Kun; Neumayer, Paul [ExtreMe Matter Institut, D-64291 Darmstadt (Germany); Dromey, Brendan; Jung, Daniel [Department of Physics and Astronomy, Queen' s University, Belfast BT7 1NN (United Kingdom); Bagnoud, Vincent [Helmholtz-Institut Jena, D-07743 Jena (Germany); GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt (Germany); Zepf, Matthew [Helmholtz-Institut Jena, D-07743 Jena (Germany); Department of Physics and Astronomy, Queen' s University, Belfast BT7 1NN (United Kingdom); Kuehl, Thomas [ExtreMe Matter Institut, D-64291 Darmstadt (Germany); GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt (Germany); Universität Mainz, D-55099 Mainz (Germany)

    2014-11-15

    Diagnostic for investigating and distinguishing different laser ion acceleration mechanisms has been developed and successfully tested. An ion separation wide angle spectrometer can simultaneously investigate three important aspects of the laser plasma interaction: (1) acquire angularly resolved energy spectra for two ion species, (2) obtain ion energy spectra for multiple species, separated according to their charge to mass ratio, along selected axes, and (3) collect laser radiation reflected from and transmitted through the target and propagating in the same direction as the ion beam. Thus, the presented diagnostic constitutes a highly adaptable tool for accurately studying novel acceleration mechanisms in terms of their angular energy distribution, conversion efficiency, and plasma density evolution.

  15. Diagnostics for studies of novel laser ion acceleration mechanisms

    International Nuclear Information System (INIS)

    Senje, Lovisa; Aurand, Bastian; Wahlström, Claes-Göran; Yeung, Mark; Kuschel, Stephan; Rödel, Christian; Wagner, Florian; Roth, Markus; Li, Kun; Neumayer, Paul; Dromey, Brendan; Jung, Daniel; Bagnoud, Vincent; Zepf, Matthew; Kuehl, Thomas

    2014-01-01

    Diagnostic for investigating and distinguishing different laser ion acceleration mechanisms has been developed and successfully tested. An ion separation wide angle spectrometer can simultaneously investigate three important aspects of the laser plasma interaction: (1) acquire angularly resolved energy spectra for two ion species, (2) obtain ion energy spectra for multiple species, separated according to their charge to mass ratio, along selected axes, and (3) collect laser radiation reflected from and transmitted through the target and propagating in the same direction as the ion beam. Thus, the presented diagnostic constitutes a highly adaptable tool for accurately studying novel acceleration mechanisms in terms of their angular energy distribution, conversion efficiency, and plasma density evolution

  16. School Psychologist Diagnostic Decision-Making: A Pilot Study

    Science.gov (United States)

    Barnard-Brak, Lucy; Stevens, Tara; Robinson, Eric; Holt, Ann

    2013-01-01

    The current study examined the diagnostic decision-making of school psychologists as a function of a student's disability and academic performance with three research questions using a randomly-selected sample of school psychologists from the state of Texas. Results from the first research question indicated that school psychologists significantly…

  17. 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

  18. 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.

  19. The scope of costs in alcohol studies: Cost-of-illness studies differ from economic evaluations

    Directory of Open Access Journals (Sweden)

    Tariq Luqman

    2010-07-01

    Full Text Available Abstract Background Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic evaluations report a small part of all societal costs. To determine the cost- effectiveness of an intervention it is necessary that all costs and benefits are included. The purpose of this study is to describe and quantify the difference in societal costs incorporated in economic evaluations and cost-of-illness studies on alcohol abuse. Method To investigate the economic costs attributable to alcohol in cost-of-illness studies we used the results of a recent systematic review (June 2009. We performed a PubMed search to identify economic evaluations on alcohol interventions. Only economic evaluations in which two or more interventions were compared from a societal perspective were included. The proportion of health care costs and the proportion of societal costs were estimated in both type of studies. Results The proportion of healthcare costs in cost-of-illness studies was 17% and the proportion of societal costs 83%. In economic evaluations, the proportion of healthcare costs was 57%, and the proportion of societal costs was 43%. Conclusions The costs included in economic evaluations performed from a societal perspective do not correspond with those included in cost-of-illness studies. Economic evaluations on alcohol abuse underreport true societal cost of alcohol abuse. When considering implementation of alcohol abuse interventions, policy makers should take into account that economic evaluations from the societal perspective might underestimate the total

  20. The scope of costs in alcohol studies: Cost-of-illness studies differ from economic evaluations.

    Science.gov (United States)

    van Gils, Paul F; Hamberg-van Reenen, Heleen H; van den Berg, Matthijs; Tariq, Luqman; de Wit, G Ardine

    2010-07-06

    Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic evaluations report a small part of all societal costs. To determine the cost- effectiveness of an intervention it is necessary that all costs and benefits are included. The purpose of this study is to describe and quantify the difference in societal costs incorporated in economic evaluations and cost-of-illness studies on alcohol abuse. To investigate the economic costs attributable to alcohol in cost-of-illness studies we used the results of a recent systematic review (June 2009). We performed a PubMed search to identify economic evaluations on alcohol interventions. Only economic evaluations in which two or more interventions were compared from a societal perspective were included. The proportion of health care costs and the proportion of societal costs were estimated in both type of studies. The proportion of healthcare costs in cost-of-illness studies was 17% and the proportion of societal costs 83%. In economic evaluations, the proportion of healthcare costs was 57%, and the proportion of societal costs was 43%. The costs included in economic evaluations performed from a societal perspective do not correspond with those included in cost-of-illness studies. Economic evaluations on alcohol abuse underreport true societal cost of alcohol abuse. When considering implementation of alcohol abuse interventions, policy makers should take into account that economic evaluations from the societal perspective might underestimate the total effects and costs of interventions.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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)

  7. Indications and new diagnostic techniques in micturating cystourethrographic studies

    International Nuclear Information System (INIS)

    Schuster, W.; Bruenger, J.

    1978-01-01

    Urological radiographic procedures on children are of great importance. The frequency of examinations is comparable to the number of Gl tract studies. In diagnosing chronically recurrent urinary tract infections, micturating cystourethrography is a valuable addition to excretory urography. Indications and performance of micturating cystourethrography at juvenile age are described. All measures reducing radiation exposure must be taken into consideration. New technological devices grant improved diagnostic information with a minimal radiation exposure for patients. (orig.) [de

  8. 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

  9. Overinterpretation and misreporting of diagnostic accuracy studies: evidence of "spin".

    Science.gov (United States)

    Ochodo, Eleanor A; de Haan, Margriet C; Reitsma, Johannes B; Hooft, Lotty; Bossuyt, Patrick M; Leeflang, Mariska M G

    2013-05-01

    To estimate the frequency of distorted presentation and overinterpretation of results in diagnostic accuracy studies. MEDLINE was searched for diagnostic accuracy studies published between January and June 2010 in journals with an impact factor of 4 or higher. Articles included were primary studies of the accuracy of one or more tests in which the results were compared with a clinical reference standard. Two authors scored each article independently by using a pretested data-extraction form to identify actual overinterpretation and practices that facilitate overinterpretation, such as incomplete reporting of study methods or the use of inappropriate methods (potential overinterpretation). The frequency of overinterpretation was estimated in all studies and in a subgroup of imaging studies. Of the 126 articles, 39 (31%; 95% confidence interval [CI]: 23, 39) contained a form of actual overinterpretation, including 29 (23%; 95% CI: 16, 30) with an overly optimistic abstract, 10 (8%; 96% CI: 3%, 13%) with a discrepancy between the study aim and conclusion, and eight with conclusions based on selected subgroups. In our analysis of potential overinterpretation, authors of 89% (95% CI: 83%, 94%) of the studies did not include a sample size calculation, 88% (95% CI: 82%, 94%) did not state a test hypothesis, and 57% (95% CI: 48%, 66%) did not report CIs of accuracy measurements. In 43% (95% CI: 34%, 52%) of studies, authors were unclear about the intended role of the test, and in 3% (95% CI: 0%, 6%) they used inappropriate statistical tests. A subgroup analysis of imaging studies showed 16 (30%; 95% CI: 17%, 43%) and 53 (100%; 95% CI: 92%, 100%) contained forms of actual and potential overinterpretation, respectively. Overinterpretation and misreporting of results in diagnostic accuracy studies is frequent in journals with high impact factors. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120527/-/DC1. © RSNA, 2013.

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

    Science.gov (United States)

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

    2014-08-01

    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.

  11. 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

  12. 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.

  13. A Prospective Observational Study of Technical Difficulty With GlideScope-Guided Tracheal Intubation in Children.

    Science.gov (United States)

    Zhang, Bin; Gurnaney, Harshad G; Stricker, Paul A; Galvez, Jorge A; Isserman, Rebecca S; Fiadjoe, John E

    2018-05-09

    The GlideScope Cobalt is one of the most commonly used videolaryngoscopes in pediatric anesthesia. Although visualization of the airway may be superior to direct laryngoscopy, users need to learn a new indirect way to insert the tracheal tube. Learning this indirect approach requires focused practice and instruction. Identifying the specific points during tube placement, during which clinicians struggle, would help with targeted education. We conducted this prospective observational study to determine the incidence and location of technical difficulties using the GlideScope, the success rates of various corrective maneuvers used, and the impact of technical difficulty on success rate. We conducted this observational study at our quaternary pediatric hospital between February 2014 and August 2014. We observed 200 GlideScope-guided intubations and documented key intubation-related outcomes. Inclusion criteria for patients were the number of advancement maneuvers required to intubate the trachea, the location where technical difficulty occurred, the types of maneuvers used to address difficulties, and the tracheal intubation success rate. We used a bias-corrected bootstrapping method with 300 replicates to determine the 95% confidence interval (CI) around the rate of difficulty with an intubation attempt. After excluding attempts by inexperienced clinicians, there were 225 attempts in 187 patients, 58% (131 of 225; bootstrap CI, 51.6%-64.6%]) of the attempts had technical difficulties. Technical difficulty was most likely to occur when inserting the tracheal tube between the plane of the arytenoid cartilages to just beyond the vocal cords: "zone 3." Clockwise rotation of the tube was the most common successful corrective maneuver in zone 3. The overall tracheal intubation success rate was 98% (CI, 95%-99%); however, the first attempt success rate was only 80% (CI, 74%-86%). Patients with technical difficulty had more attempts (median [interquartile range], 2 [1

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

    International Nuclear Information System (INIS)

    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 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

  15. 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.

  16. Rational diagnostic studies of hyperthyroidism - can they be rationalized

    International Nuclear Information System (INIS)

    Schuemichen, C.; Bernhard, G.; Aurnhammer, R.

    1983-01-01

    The value of various diagnostic tests for recognizing hyperthyroidism was assessed in 285 patients. The prevalence of hyperthyroidism was 33% altogether: 21.8% diffuse hyperthyroidism (Graves' disease and disseminated autonomy) and 11.2% autonomous adenoma. A negative TRH-test was found in 29.5% of the euthyroid patients, 11.4% in patients younger and 40.7% in patients older than 50 years. In one patient with thyrotoxicosis the TRH-test was positive in the beginning. In 29% of the patients with diffuse hyperthyroidism and in 50% of the patients with hyperthyroid autonomous adenoma only one hormone level was elevated (T 3 , T 4 or FT 4 ). The radioioine test contributed primarily to the final diagnosis in 1.6% of diffuse hyperthyroidism and in 6.2% of hyperthyroid autonomous adenoma. Because of its high sensitivity the TRH-test remains the basic test in the diagnosis of thyrotoxicosis. The diagnostic value of T 3 and FT 4 is equivalent with slight advantages of FT 4 . In order to lower costs, the total T 4 measurements can, and the radioiodine test has to be, omitted. However, it ought to be kept in mind that if only the TRH test and T 3 and FT 4 are included in the diagnostic study, the final diagnosis is not substantiated adequately in one third of the patients with thyrotoxicosis. (orig.) [de

  17. Greenhouse gas inventories for England, Scotland, Wales and Northern Ireland: 1990 and 1995. A scoping study

    Energy Technology Data Exchange (ETDEWEB)

    Salway, A.G.; Dore, C.; Watterson, J.; Murrells, T.

    1999-11-01

    This report presents the results of a scoping study to develop a methodology to produce desegregated greenhouse gas emission inventories for the devoved administrations of the UK. Separate greenhouse gas emission inventories were estimated for England, Scotland, Wales and Northern Ireland for the years 1990 and 1995. The gases reported are carbon dioxide, methane, nitrous oxide, hydrofluorocarbons, perfluorocarbons, and SF{sub 6}. The estimates are consistent with the 1997 UK Greenhouse Gas Inventory and hence the UNFCCC reporting guidelines. Some emissions mainly mobile and offshore sources could not be allocated to any region, so an extra unallocated category was used to report these. Where possible the same methodology was used to calculate the regional emissions as for the UK Inventory. The study showed that the distribution of regional greenhouse gas emissions expressed as global warming potentials in 1995 were: England 75.5%, Scotland, 11.4%; Wales 6.4%; Northern Ireland 3.1%: unallocated, 4%. Following this scoping study, it is intended to publish annually disaggregated inventories for each year from 1990 for England, Scotland, Wales and Northern Ireland, in addition to the UK Greenhouse Gas Inventory. 50 refs., 6 figs., 16 tabs., 2 apps.

  18. 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.

  19. The study of practices in planed diagnostic medical exposure

    International Nuclear Information System (INIS)

    Popescu, Irina-Anca; Perju, Nicoleta Ana-Maria; Cobzeanu, Camelia

    2011-01-01

    The exposure of population to ionizing radiations in medical diagnostic purposes represents a planed exposure procedure, medically justified, having a direct impact on patient health state. A justification of exposure, with a result that can confirm a clinical diagnostic, implies further important steps in treatment decisions. Optimization in patients radiological protection is the result of observing the reference levels recommendations, which maintains a reasonable individual exposure to ionizing radiation in medical purpose. In this paper we investigated the justification of 4189 exposures of patients who underwent planed diagnostic medical investigation over 36 months in a radiological unit. The most frequent investigation concerned the spinal column in 38.3% of total exposures-mainly at lumbar level (63.0% and 24.1%, respectively of total number of exposures), followed by limb bones (20.6%) and thorax (26.9%). Justification of practices included: rheumatic pains in 45.8% of exposures followed by traumatic injuries (20.6%), pleural and pulmonary pathology (19.3%), malignant processes (12.3%), ear-nose-throat investigations (1.1%) and car accidents (0.9%). The females over 40 years old were the group with the highest number of medical exposures, with 54.5% of total practices. This study revealed that the number of medical exposures justification is almost equal with non-justified examinations, confirming a not so good correlation between clinical diagnostic and the required radiological investigation. The percentages of justified versus non-justified practices indicated by specialist physicians and general practitioners were slightly equal - 59.3% vs. 40.7%, 56.9% vs. 43.1%, respectively. The analysis of data concluded that either specialist/general physicians must evaluate more rigorously the patients and all clinical signs in order to reduce as reasonable as possible the non-justified medical exposures to ionizing radiations, and thus to avoid financial and

  20. Awareness of Diagnostic Error among Japanese Residents: a Nationwide Study.

    Science.gov (United States)

    Nishizaki, Yuji; Shinozaki, Tomohiro; Kinoshita, Kensuke; Shimizu, Taro; Tokuda, Yasuharu

    2018-04-01

    Residents' understanding of diagnostic error may differ between countries. We sought to explore the relationship between diagnostic error knowledge and self-study, clinical knowledge, and experience. Our nationwide study involved postgraduate year 1 and 2 (PGY-1 and -2) Japanese residents. The Diagnostic Error Knowledge Assessment Test (D-KAT) and General Medicine In-Training Examination (GM-ITE) were administered at the end of the 2014 academic year. D-KAT scores were compared with the benchmark scores of US residents. Associations between D-KAT score and gender, PGY, emergency department (ED) rotations per month, mean number of inpatients handled at any given time, and mean daily minutes of self-study were also analyzed, both with and without adjusting for GM-ITE scores. Student's t test was used for comparisons with linear mixed models and structural equation models (SEM) to explore associations with D-KAT or GM-ITE scores. The mean D-KAT score among Japanese PGY-2 residents was significantly lower than that of their US PGY-2 counterparts (6.2 vs. 8.3, p ITE scores correlated with ED rotations (≥6 rotations: 2.14; 0.16-4.13; p = 0.03), inpatient caseloads (5-9 patients: 1.79; 0.82-2.76; p ITE scores (ß = 0.37, 95% CI: 0.34-0.41) and indirectly associated with ED rotations (ß = 0.06, 95% CI: 0.02-0.10), inpatient caseload (ß = 0.04, 95% CI: 0.003-0.08), and average daily minutes of study (ß = 0.13, 95% CI: 0.09-0.17). Knowledge regarding diagnostic error among Japanese residents was poor compared with that among US residents. D-KAT scores correlated strongly with GM-ITE scores, and the latter scores were positively associated with a greater number of ED rotations, larger caseload (though only up to 15 patients), and more time spent studying.

  1. Rett syndrome diagnostic criteria: lessons from the Natural History Study.

    Science.gov (United States)

    Percy, Alan K; Neul, Jeffrey L; Glaze, Daniel G; Motil, Kathleen J; Skinner, Steven A; Khwaja, Omar; Lee, Hye-Seung; Lane, Jane B; Barrish, Judy O; Annese, Fran; McNair, Lauren; Graham, Joy; Barnes, Katherine

    2010-12-01

    Analysis of 819 participants enrolled in the Rett syndrome (RTT) Natural History Study validates recently revised diagnostic criteria. 765 females fulfilled 2002 consensus criteria for classic (653/85.4%) or variant (112/14.6%) RTT. All participants classified as classic RTT fulfilled each revised main criterion; supportive criteria were not uniformly present. All variant RTT participants met at least 3 of 6 main criteria in the 2002, 2 of 4 main criteria in the current format, and 5 of 11 supportive criteria in both. This analysis underscores the critical role of main criteria for classic RTT; variant RTT requires both main and supportive criteria.

  2. Studies of neutron measurement methods for fusion plasma diagnostics

    International Nuclear Information System (INIS)

    Beimer, K.H.

    1986-03-01

    This thesis comprises several studies mainly devoted to neutron measurement systems for plasma diagnostics at JET (Joint European Torus). An in situ calibration of the U-235 fission chamber detectors located at JET is presented. These detectors are used for measuring the neutron yield from the thermonuclear reactions in the plasma. The energy spectrum of the neutrons from the reactions D(d,n) 3 He has been studied by means of a 3 He spectrometer. Especially, it was found that by measuring the width of the full energy peak in the response spectrum of the 3 He-spectrometer, the deuterium distribution in the deuterium targets used can be estimated. In order to measure different neutron energies it is necessary to obtain a detailed knowledge of the response of the spectrometer. Therefore, the response function to monoenergetic neutrons in the energy range 130-3030 keV was experimentally determined. Some work has been related to a design study of a 14 MeV spectrometer for neutron diagnostics. It is a combined proton-recoil and time-of-flight spectrometer for high resolution measurements. The main parts of it are the collimator, the scattering foil, and the detectors for the recoil protons and the scattered neutrons. The influence of proton straggling in the foil on the resolution and efficiency of the spectrometer has been studied. Furthermore, a three dimensional Monte Carlo code has been written and used for the design of the collimator. (author)

  3. An overview of the fire risk scoping study objectives, approach, findings and follow-on efforts

    International Nuclear Information System (INIS)

    Nowlen, S.P.; Lambright, J.A.; Nicolette, V.F.; Bohn, M.P.

    1989-01-01

    The Fire Risk Scoping Study was sponsored by the US Nuclear Regulatory Commission and performed at Sandia National Laboratories. The study was initiated as a result of previous USNRC-sponsored fire research efforts that had identified certain fire risk issues which had not been addressed in previously completed commercial nuclear power plant fire risk analyses. The specific objectives of this study were (1) to review and requantify fire risk scenarios from four fire probabilistic risk assessments (PRAs) in light of updated data bases made available as a result of USNRC sponsored Fire Protection Research Program and updated computer fire modeling capabilities, (2) to identify potentially significant fire risk issues that have not been previously addressed in a fire risk context and to quantify the potential impact of those identified fire risk issues where possible, and (3) to review current fire regulations and plant implementation practices for relevance to the identified unaddressed fire risk issues. 8 refs., 2 tabs

  4. Data Citation Policies of Data Providers within the scope of Longitudinal Studies in Life Course Research

    Energy Technology Data Exchange (ETDEWEB)

    Reinhold, A.; Rittberger, M.; Mahrholz, N.

    2016-07-01

    In this article, a small-scale case study analyzing the nature of data citation policies within the scope of longitudinal studies in life course research is presented. The sample consists of eight data providers from Europe, North-America and Australia and was evaluated with regard to eight criteria which potentially affect data citation behavior of researchers in the field, for example the wording of data citation obligations or sanctions for not citing research data in accordance to given requirements. The study demonstrates that research data providers follow a wide range of approaches to data citation, especially in terms of data citation location within a publication as well as disposal obligations for data-related publications. However, this diversity might lead to inconsistency in data citation behaviour and also to a general lack of comparability of data citation quantity and quality as relevant factors in research evaluation. (Author)

  5. 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)

  6. 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

  7. PROJECT SCOPE MANAGEMENT PROCESS

    Directory of Open Access Journals (Sweden)

    Yana Derenskaya

    2018-01-01

    Full Text Available The purpose of the article is to define the essence of project scope management process, its components, as well as to develop an algorithm of project scope management in terms of pharmaceutical production. Methodology. To carry out the study, available information sources on standards of project management in whole and elements of project scope management in particular are analysed. Methods of system and structural analysis, logical generalization are used to study the totality of subprocesses of project scope management, input and output documents, and to provide each of them. Methods of network planning are used to construct a precedence diagram of project scope management process. Results of the research showed that components of the project scope management are managing the scope of the project product and managing the content of project work. It is the second component is investigated in the presented work as a subject of research. Accordingly, it is defined that project scope management process is to substantiate and bring to the realization the necessary amount of work that ensures the successful implementation of the project (achievement of its goal and objectives of individual project participants. It is also determined that the process of managing the project scope takes into account the planning, definition of the project scope, creation of the structure of project work, confirmation of the scope and management of the project scope. Participants of these subprocesses are: customer, investor, and other project participants – external organizations (contractors of the project; project review committee; project manager and project team. It is revealed that the key element of planning the project scope is the formation of the structure of design work, the justification of the number of works, and the sequence of their implementation. It is recommended to use the following sequence of stages for creating the structure of project work

  8. Design of Diagnostics: Case Studies for Wendelstein 7-X

    International Nuclear Information System (INIS)

    Dreier, H.; Dinklage, A.; Fischer, R.; Hirsch, M.; Kornejew, P.; Pasch, E.

    2005-01-01

    The set of start-up diagnostics for Wendelstein 7-X is oriented to resolve physical issues of stellarator optimization [1]. The diagnostics philosophy of W7-X aims at extendable set-ups which are to be supplemented along the operation of the device. Planning diagnostics directly lead to the requirement to optimize their respective outcome. In many cases, the optimization is much restricted by technical constraints. But even in those cases, figures of robustness of the chosen design settings are beneficial for the diagnostic strategy. In this paper a framework for diagnostic design is presented employing the Bayesian probability theory. Part of the approach can be regarded as a virtual diagnostic, which describes the future experimental unit including its error statistics and is able to produce artificial data. The virtual diagnostic is fed with mock-up quantities of interest and hence it enables the designer to compare the outcome of the virtual diagnostic with its input. For the design of diagnostics in fusion experiments several figures of merit are possible, depend- ing on the optimization goal. Here physical questions like estimation of the density distribution or the density gradient are possible optimization targets as well as technical issues as the robustness of density measurements, e.g, for controlling purposes. Also the estimation of derived quantities - like gradients needed for modeling of the bootstrap current or of the radial electric field - might be considered to be the goal of a diagnostic design. (Author)

  9. 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.

  10. 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.

  11. 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

  12. 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

  13. 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

  14. Feasibility and cost efficiency of a diagnostic guideline for chronic polyneuropathy : a prospective implementation study

    NARCIS (Netherlands)

    Vrancken, A.F.J.E.; Kalmijn, S.; Buskens, E.; Franssen, H.; Wokke, J.H.J.; Notermans, N.C.

    2006-01-01

    Background: Extensive investigations are often performed to reveal the cause of chronic polyneuropathy. It is not known whether a restrictive diagnostic guideline improves cost efficiency without loss of diagnostic reliability. Methods: In a prospective multicentre study, a comparison was made

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.)

  20. 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...

  1. Comparative diagnostic study of staging in renal cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Masaharu; Mori, Masaki; Ito, Sachiko and others

    1986-04-01

    A comparative diagnostic study was carried out on 56 patients with pathologically proven renal cell carcinoma which had been staged by CT, US, angiography (AG) and lymphography (LG) between June, 1980, and May, 1985. The confirmation of the tumor extent was established by surgery and microscopic examination in all patients except three, in whom the extent of the tumor was determined at autopsy. CT and AG were performed in all cases. It was also studied how far various factors such as histologic architecture, cell type, grade, growth mode, tumor necrosis and bleeding were related with prognosis, and how to evaluate them in imaging modality. Concerning the T factor, there was no difference in diagnostic ability between images, and since prognosis of T4 was inferior to those of T2 and T3, diagnosis of T4 was seen to require particular attention. Drawing ability of N and V factors was poor in US. In LG, evaluation of regional lymph nodes was difficult, so this seems to be an unnecessary examination because CT can provide sufficient evaluation. By imaging modality, diagnosis of architecture and cell type was difficult. By AG, avascular to hypovascular tumors were of solid type, and there were many spindle or pleomorphic cell types and combination of tubular-granular types, while the papillary type was few. By macroscopic growth mode, the infiltrating type was poor in prognosis, and the presence or absence of halo was evaluated by CT and AG. Prognosis was favorable in cases having no necrosis in the tumor or accompanied by hemorrhage. For the purpose of diagnosis, CT was found to be sufficient, and it was concluded that AG may be used only for the purpose of renal arterial embolization as a preoperative treatment of low-stage cases subjected to nephrectomy. US is sufficient only if satisfying the role of screening. (J.P.N.).

  2. The Oncogenic Risks of Diagnostic CT Scam Studies in Children

    International Nuclear Information System (INIS)

    Brent, R.

    2004-01-01

    Brenner et al (2001) reported that estimates of the exposure to children from CT scans indicates that the exposures are both higher than from conventional radiographic studies and higher than is necessary to obtain quality examinations. utilizing the oncogenic risk data from the RERF study in Japan, Brenner et al estimated that the oncogenic risk in this population of CT exposed children exposed each year would result in an additional 500 cases of cancer. This risk estimate is supported by the RERF epidemiological data obtained from the populations exposed in Hiroshima and Nagasaki. the increased risks associated with the increased exposure from CT scans have raised concern and stimulated discussion. Although there is little doubt about the benefits of CT scans in improving the health care of children, there is concern about the estimated oncogenic risk, especially since the frequency of CT studies has been increasing. Applying the oncogenic risks of ionizing radiation from the RERF data may not be appropriate for all types of radiation exposure for accurately predicting the incidence of cancer in exposed children because of the impact of 1) partial versus whole-body irradiation, and 2) the protraction of the exposure. Other population of children who have been exposed to radiation and whose incidence of cancer has been studied will be presented and those studies indicate that the risk of cancer is much lower or not increased at all with exposures in the diagnostic range. finally, the dramatic impact of the use of CT scans in clinical pediatric practice saves lives and improves diagnostic accuracy. Therefore, it is crucial that a scholarly evaluation of the risks and benefits should be initiated. The radiology community and the manufacturers have already initiated programs to decrease the exposure significantly. But it is essential that well-planned, retrospective and prospective epidemiology studies should be initiated to study the oncogenic risks. If you want to

  3. 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

  4. 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....

  5. Knowledge Transfer on Complex Social Interventions in Public Health: A Scoping Study

    Science.gov (United States)

    Dagenais, Christian; Malo, Marie; Robert, Émilie; Ouimet, Mathieu; Berthelette, Diane; Ridde, Valéry

    2013-01-01

    Objectives Scientific knowledge can help develop interventions that improve public health. The objectives of this review are (1) to describe the status of research on knowledge transfer strategies in the field of complex social interventions in public health and (2) to identify priorities for future research in this field. Method A scoping study is an exploratory study. After searching databases of bibliographic references and specialized periodicals, we summarized the relevant studies using a predetermined assessment framework. In-depth analysis focused on the following items: types of knowledge transfer strategies, fields of public health, types of publics, types of utilization, and types of research specifications. Results From the 1,374 references identified, we selected 26 studies. The strategies targeted mostly administrators of organizations and practitioners. The articles generally dealt with instrumental utilization and most often used qualitative methods. In general, the bias risk for the studies is high. Conclusion Researchers need to consider the methodological challenges in this field of research in order to improve assessment of more complex knowledge transfer strategies (when they exist), not just diffusion/dissemination strategies and conceptual and persuasive utilization. PMID:24324593

  6. 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.

  7. Economic impact of university veterinary diagnostic laboratories: A case study.

    Science.gov (United States)

    Schulz, Lee L; Hayes, Dermot J; Holtkamp, Derald J; Swenson, David A

    2018-03-01

    Veterinary diagnostic laboratories (VDLs) play a significant role in the prevention and mitigation of endemic animal diseases and serve an important role in surveillance of, and the response to, outbreaks of transboundary and emerging animal diseases. They also allow for business continuity in livestock operations and help improve human health. Despite these critical societal roles, there is no academic literature on the economic impact of VDLs. We present a case study on the economic impact of the Iowa State University Veterinary Diagnostic Laboratory (ISUVDL). We use economic contribution analysis coupled with a stakeholder survey to estimate the impact. Results suggest that the ISUVDL is responsible for $2,162.46 million in direct output, $2,832.45 million in total output, $1,158.19 million in total value added, and $31.79 million in state taxes in normal years. In an animal health emergency this increases to $8,446.21 million in direct output, $11,063.06 million in total output, $4,523.70 million in total value added, and $124.15 million in state taxes. The ISUVDL receives $4 million annually as a direct state government appropriation for operating purposes. The $31.79 million in state taxes in normal years and the $124.15 million in state taxes in an animal health emergency equates to a 795% and 3104% return on investment, respectively. Estimates of the economic impact of the ISUVDL provide information to scientists, administrators, and policymakers regarding the efficacy and return on investment of VDLs. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Exploring the scope of practice and training of obstetricians and gynaecologists in England, Italy and Belgium: a qualitative study.

    Science.gov (United States)

    Risso-Gill, Isabelle; Kiasuwa, Regine; Baeten, Rita; Caldarelli, Ilenia; Mitro, Silva; Merriel, Abi; Amadio, Giulia; McKee, Martin; Legido-Quigley, Helena

    2014-09-01

    This study explores the scope of practice of Obstetrics and Gynaecology specialists in Italy, Belgium and England, in light of the growth of professional and patient mobility within the EU which has raised concerns about a lack of standardisation of medical speciality practice and training. Semi-structured qualitative interviews were conducted with 29 obstetricians and gynaecologists from England, Belgium and Italy, exploring training and scope of practice, following a common topic guide. Interviews were recorded, transcribed and coded following a common coding framework in the language of the country concerned. Completed coding frames, written summaries and key quotes were then translated into English and were cross-analysed among the researchers to identify emerging themes and comparative findings. Although medical and specialty qualifications in each country are mutually recognised, there were great differences in training regimes, with different emphases on theory versus practice and recognition of different subspecialties. However all countries shared concerns about the impact of the European Working Time Directive on trainees' skills development. Reflecting differences in models of care, the scope of practice of OBGYN varied among countries, with pronounced differences between the public and private sector within countries. Technological advances and the growth of co-morbidities resulting from ageing populations have created new opportunities and greater links with other specialties. In turn new ethical concerns around abortion and fertility have also arisen, with stark cultural differences between the countries. Variations exist in the training and scope of practice of OBGYN specialists among these three countries, which could have significant implications for the expectations of patients seeking care and specialists practising in other EU countries. Changes within the specialty and advances in technology are creating new opportunities and challenges

  9. The diagnostic and therapeutic impact of MRI: an observational multi-centre study

    Energy Technology Data Exchange (ETDEWEB)

    Hollingworth, William; Todd, Christopher J.; Bell, Matthew I.; Arafat, Qais; Girling, Simon; Karia, Kanti R.; Dixon, Adrian K

    2000-11-01

    AIM: To provide information about the diagnostic and therapeutic impact of magnetic resonance imaging (MRI) and to compare the findings across diagnostic groups. MATERIALS AND METHODS: A prospective, observational study of 2017 consecutive referrals for MRI of the head, spine or knee at four imaging centres. Clinicians completed questionnaires before MRI stating initial diagnoses, diagnostic confidence and treatment plans. After imaging, a second questionnaire evaluated clinicians' revised diagnosis and treatment plans in the light of imaging findings. Patients were grouped into nine diagnostic categories for analysis. Comparison between pre- and post-imaging was used to assess the diagnostic and therapeutic impact of MRI. RESULTS: In seven of nine diagnostic groups MRI findings were associated with a diagnostic impact. Diagnoses were revised or discarded following normal MR findings and diagnostic confidence was increased by confirmative MR findings. There was no statistically significant diagnostic impact for suspected pituitary or cerebello-pontine angle lesions. In five of nine diagnostic groups (knee meniscus, knee ligament, multiple sclerosis, lumbar and cervical spine) MRI findings had a clear impact on treatment plans. CONCLUSION: This study demonstrates that in most diagnostic categories, MRI influences diagnosis and treatment. However, experimental studies are needed to prove that these diagnostic and therapeutic impacts lead to improved health. Hollingworth (2000)

  10. The diagnostic and therapeutic impact of MRI: an observational multi-centre study

    International Nuclear Information System (INIS)

    Hollingworth, William; Todd, Christopher J.; Bell, Matthew I.; Arafat, Qais; Girling, Simon; Karia, Kanti R.; Dixon, Adrian K.

    2000-01-01

    AIM: To provide information about the diagnostic and therapeutic impact of magnetic resonance imaging (MRI) and to compare the findings across diagnostic groups. MATERIALS AND METHODS: A prospective, observational study of 2017 consecutive referrals for MRI of the head, spine or knee at four imaging centres. Clinicians completed questionnaires before MRI stating initial diagnoses, diagnostic confidence and treatment plans. After imaging, a second questionnaire evaluated clinicians' revised diagnosis and treatment plans in the light of imaging findings. Patients were grouped into nine diagnostic categories for analysis. Comparison between pre- and post-imaging was used to assess the diagnostic and therapeutic impact of MRI. RESULTS: In seven of nine diagnostic groups MRI findings were associated with a diagnostic impact. Diagnoses were revised or discarded following normal MR findings and diagnostic confidence was increased by confirmative MR findings. There was no statistically significant diagnostic impact for suspected pituitary or cerebello-pontine angle lesions. In five of nine diagnostic groups (knee meniscus, knee ligament, multiple sclerosis, lumbar and cervical spine) MRI findings had a clear impact on treatment plans. CONCLUSION: This study demonstrates that in most diagnostic categories, MRI influences diagnosis and treatment. However, experimental studies are needed to prove that these diagnostic and therapeutic impacts lead to improved health. Hollingworth (2000)

  11. 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

  12. 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.

  13. 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.

  14. Title: Studies on drug switchability showed heterogeneity in methodological approaches: a scoping review.

    Science.gov (United States)

    Belleudi, Valeria; Trotta, Francesco; Vecchi, Simona; Amato, Laura; Addis, Antonio; Davoli, Marina

    2018-05-16

    Several drugs share the same therapeutic indication, including those undergoing patent expiration. Concerns on the interchangeability are frequent in clinical practice, challenging the evaluation of switchability through observational research. To conduct a scoping review of observational studies on drug switchability to identify methodological strategies adopted to deal with bias and confounding. We searched PubMed, EMBASE, and Web of Science (updated 1/31/2017) to identify studies evaluating switchability in terms of effectiveness/safety outcomes or compliance. Three reviewers independently screened studies extracting all characteristics. Strategies to address confounding, particularly, previous drug use and switching reasons were considered. All findings were summarized in descriptive analyses. Thirty-two studies, published in the last 10 years, met the inclusion criteria. Epilepsy, cardiovascular and rheumatology were the most frequently represented clinical areas. 75% of the studies reported data on effectiveness/safety outcomes. The most frequent study design was cohort (65.6%) followed by case-control (21.9%) and self-controlled (12.5%). Case-control and case-crossover studies showed homogeneous methodological strategies to deal with bias and confounding. Among cohort studies, the confounding associated with previous drug use was addressed introducing variables in multivariate model (47.3%) or selecting only adherent patients (14.3%). Around 30% of cohort studies did not report reasons for switching. In the remaining 70%, clinical parameters or previous occurrence of outcomes were measured to identify switching connected with lack of effectiveness or adverse events. This study represents a starting point for researchers and administrators who are approaching the investigation and assessment of issues related to interchangeability of drugs. Copyright © 2018. Published by Elsevier Inc.

  15. Scope Definition

    DEFF Research Database (Denmark)

    Bjørn, Anders; Owsianiak, Mikołaj; Laurent, Alexis

    2018-01-01

    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....

  16. 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)

  17. Guidance on assessing the methodological and reporting quality of toxicologically relevant studies: A scoping review.

    Science.gov (United States)

    Samuel, Gbeminiyi O; Hoffmann, Sebastian; Wright, Robert A; Lalu, Manoj Mathew; Patlewicz, Grace; Becker, Richard A; DeGeorge, George L; Fergusson, Dean; Hartung, Thomas; Lewis, R Jeffrey; Stephens, Martin L

    2016-01-01

    Assessments of methodological and reporting quality are critical to adequately judging the credibility of a study's conclusions and to gauging its potential reproducibility. To aid those seeking to assess the methodological or reporting quality of studies relevant to toxicology, we conducted a scoping review of the available guidance with respect to four types of studies: in vivo and in vitro, (quantitative) structure-activity relationships ([Q]SARs), physico-chemical, and human observational studies. Our aims were to identify the available guidance in this diverse literature, briefly summarize each document, and distill the common elements of these documents for each study type. In general, we found considerable guidance for in vivo and human studies, but only one paper addressed in vitro studies exclusively. The guidance for (Q)SAR studies and physico-chemical studies was scant but authoritative. There was substantial overlap across guidance documents in the proposed criteria for both methodological and reporting quality. Some guidance documents address toxicology research directly, whereas others address preclinical research generally or clinical research and therefore may not be fully applicable to the toxicology context without some translation. Another challenge is the degree to which assessments of methodological quality in toxicology should focus on risk of bias - as in clinical medicine and healthcare - or be broadened to include other quality measures, such as confirming the identity of test substances prior to exposure. Our review is intended primarily for those in toxicology and risk assessment seeking an entry point into the extensive and diverse literature on methodological and reporting quality applicable to their work. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. 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)

  19. 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.

  20. 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

  1. The application of evolutionary medicine principles for sustainable malaria control: a scoping study.

    Science.gov (United States)

    Ocampo, Denise; Booth, Mark

    2016-07-22

    Current interventions against malaria have significantly reduced the number of people infected and the number of deaths. Concerns about emerging resistance of both mosquitoes and parasites to intervention have been raised, and questions remain about how best to generate wider knowledge of the underlying evolutionary processes. The pedagogical and research principles of evolutionary medicine may provide an answer to this problem. Eight programme managers and five academic researchers were interviewed by telephone or videoconference to elicit their first-hand views and experiences of malaria control given that evolution is a constant threat to sustainable control. Interviewees were asked about their views on the relationship between practit groups and academics and for their thoughts on whether or not evolutionary medicine may provide a solution to reported tensions. There was broad agreement that evolution of both parasites and vectors presents an obstacle to sustainable control. It was also widely agreed that through more efficient monitoring, evolution could be widely monitored. Interviewees also expressed the view that even well planned interventions may fail if the evolutionary biology of the disease is not considered, potentially making current tools redundant. This scoping study suggests that it is important to make research, including evolutionary principles, available and easily applicable for programme managers and key decision-makers, including donors and politicians. The main conclusion is that sharing knowledge through the educational and research processes embedded within evolutionary medicine has potential to relieve tensions and facilitate sustainable control of malaria and other parasitic infections.

  2. Evidence-based practice in speech-language pathology curricula: a scoping study.

    Science.gov (United States)

    Togher, Leanne; Yiannoukas, Corina; Lincoln, Michelle; Power, Emma; Munro, Natalie; Mccabe, Patricia; Ghosh, Pratiti; Worrall, Linda; Ward, Elizabeth; Ferguson, Alison; Harrison, Elisabeth; Douglas, Jacinta

    2011-12-01

    This scoping study investigated how evidence-based practice (EBP) principles are taught in Australian speech-language pathology (SLP) teaching and learning contexts. It explored how Australian SLP university programs: (1) facilitate student learning about the principles of EBP in academic and clinical settings, and (2) self-evaluate their curricula in relation to EBP. The research involved two surveys. Survey 1 respondents were 131 academic staff, program coordinators, and on-campus and off-campus clinical educators. This survey gathered information about EBP teaching and learning in SLP programs as well as future EBP curriculum plans. Survey 2 investigated how clinical educators incorporated EBP into the way they taught clinical decision-making to students. Surveys responses from 85 clinical educators were analysed using descriptive and non-parametric statistics and thematic grouping of open-ended qualitative responses. Both surveys revealed strengths and gaps in integrating EBP into Australian SLP curricula. Perceived strengths were that respondents were positive about EBP, most had EBP training and access to EBP resources. The perceived gaps included the academic staff's perceptions of students' understanding and application of EBP, respondents' understanding of research methodologies, communication and collaboration between academic staff and clinical educators, and a lack of explicit discussion by clinical educators and students of EBP in relation to clients.

  3. 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

  4. 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.

  5. 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.

  6. 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...

  7. International trade in services: A scoping study of services trade and estimates of benefits from services trade liberalisation

    OpenAIRE

    Ballingall, John; Stephenson, John

    2005-01-01

    This is a scoping study. It summarises the dynamics of services trade in the world economy and discusses some of the benefits of services trade liberalisation from a qualitative and quantitative view point. We place particular emphasis on the role and interests of developing and least developed countries in world services trade. The study also provides an overview of services trade in the New Zealand economy, and, in places, highlights aspects of services trade where New Zealand’s interests m...

  8. What's it like being you? Growing old(er) with Autism Spectrum Conditions – a scoping study

    OpenAIRE

    Elichaoff, Frauke

    2015-01-01

    The aim of this scoping study was to understand which issues are of salience for the experiences of adults with Autism Spectrum Conditions (ASCs) as they grow older, in order to determine themes for a follow up study using in-depth interviews. Four adults (two female, two male) on the high functioning end of the autism spectrum were interviewed with a purposely broad semi-structured interview schedule. The transcripts were analysed using Thematic Analysis to identify emerging themes. The them...

  9. Tokamak physics studies using x-ray diagnostic methods

    International Nuclear Information System (INIS)

    Hill, K.W.; Bitter, M.; von Goeler, S.

    1987-03-01

    X-ray diagnostic measurements have been used in a number of experiments to improve our understanding of important tokamak physics issues. The impurity content in TFTR plasmas, its sources and control have been clarified through soft x-ray pulse-height analysis (PHA) measurements. The dependence of intrinsic impurity concentrations and Z/sub eff/ on electron density, plasma current, limiter material and conditioning, and neutral-beam power have shown that the limiter is an important source of metal impurities. Neoclassical-like impurity peaking following hydrogen pellet injection into Alcator C and a strong effect of impurities on sawtooth behavior were demonstrated by x-ray imaging (XIS) measurements. Rapid inward motion of impurities and continuation of m = 1 activity following an internal disruption were demonstrated with XIS measurements on PLT using injected aluminum to enhance the signals. Ion temperatures up to 12 keV and a toroidal plasma rotation velocity up to 6 x 10 5 m/s have been measured by an x-ray crystal spectrometer (XCS) with up to 13 MW of 85-keV neutral-beam injection in TFTR. Precise wavelengths and relative intensities of x-ray lines in several helium-like ions and neon-like ions of silver have been measured in TFTR and PLT by the XCS. The data help to identify the important excitation processes predicted in atomic physics. Wavelengths of n = 3 to 2 silver lines of interest for x-ray lasers were measured, and precise instrument calibration techniques were developed. Electron thermal conductivity and sawtooth dynamics have been studied through XIS measurements on TFTR of heat-pulse propagation and compound sawteeth. A non-Maxwellian electron distribution function has been measured, and evidence of the Parail-Pogutse instability identified by hard x-ray PHA measurements on PLT during lower-hybrid current-drive experiments

  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. The High/Scope Preschool Curriculum Comparison Study through Age 23.

    Science.gov (United States)

    Schweinhart, Lawrence J.; Weikart, David P.

    1997-01-01

    Assessed the relative effects through age 23 on young participants born in poverty of the High/Scope, Direct Instruction, and traditional Nursery School preschool curriculum models. Found against using Direct Instruction in preschool programs and for using a well-defined curriculum model based on child-initiated learning activities. (Author)

  12. Curriculum Mapping in Higher Education: A Case Study and Proposed Content Scope and Sequence Mapping Tool

    Science.gov (United States)

    Arafeh, Sousan

    2016-01-01

    Best practice in curriculum development and implementation requires that discipline-based standards or requirements embody both curricular and programme scopes and sequences. Ensuring these are present and aligned in course/programme content, activities and assessments to support student success requires formalised and systematised review and…

  13. 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.

  14. 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…

  15. Use and evaluation of molecular diagnostics for pneumonia etiology studies

    NARCIS (Netherlands)

    Bhat, Niranjan; O'Brien, Katherine L.; Karron, Ruth A.; Driscoll, Amanda J.; Murdoch, David R.; Black, Robert E.; Bhutta, Zulfiqar A.; Campbell, Harry; Cherian, Thomas; Crook, Derrick W.; de Jong, Menno D.; Dowell, Scott F.; Graham, Stephen M.; Klugman, Keith P.; Lanata, Claudio F.; Madhi, Shabir A.; Martin, Paul; Nataro, James P.; Piazza, Franco M.; Qazi, Shamim A.; Zar, Heather J.

    2012-01-01

    Comprehensive microbiological testing will be a core function of the Pneumonia Etiology Research for Child Health (PERCH) project. The development stage of PERCH provided the time and resources necessary for us to conduct a comprehensive review of the current state of respiratory diagnostics. These

  16. 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

  17. Studying the effects of operators' problem solving behaviour when using a diagnostic expert system developed for the nuclear industry

    International Nuclear Information System (INIS)

    Holmstroem, C.B.O.; Volden, F.S.; Endestad, T.

    1992-01-01

    This paper describes an experiment with the purpose to also illustrate and discuss some of the methodological problems when empirically studying problem solving. The experiment which was the second in a series, conducted at the OECD Halden Reactor Project, aimed to assess the effect on nuclear power plant operators diagnostic behaviour when using a rule-based diagnostic expert system. The rule-based expert system used in the experiment is called DISKET (Diagnosis System Using Knowledge Engineering Technique) and was originally developed by the Japan Atomic Energy Research Institute (JAERI). The experiment was performed in the Halden man-machine laboratory using a full scope pressurized water reactor simulator. Existing data collection methods and experimental design principles includes possibilities but also limitations. This is discussed and experiences are presented. Operator performance in terms of quality of diagnosis is improved by the use of DISKET. The use of the DISKET system also influences operators problem solving behaviour. The main difference between the two experimental conditions can be characterized as while the DISKET users during the diagnosis process are following a strategy which is direct and narrowed, the non-DISKET users are using a much broader and less focused search when trying to diagnose a disturbance. (author)

  18. Results of an integration study of a diagnostics port plug in ITER

    International Nuclear Information System (INIS)

    Salasca, Sophie; Cantone, Bruno; Grosman, André; Esposito, Basilio; Moro, Fabio; Morocco, Daniele; Villari, Rosaria; Angelone, Maurizio; Rincon, Esther; Hidalgo, Carlos; Nagy, Daniel; Kocsis, Gabor; Varela, Paulo; Porempovics, Gabor; Perrollaz, Guillaume; Patel, Kunal; Krivchenkov, Yuri; Walsh, Michael

    2013-01-01

    Highlights: ► An extensive study on the integration of diagnostics in a port plug of ITER has been performed. ► It has shown that the diagnostic performances could not be reached if their number was not decreased. ► A design of Diagnostic Shield Modules has been validated through mechanical and thermal analyses. ► These analyses have confirmed that the highest loads are concentrated in the vicinity of the plasma. -- Abstract: Diagnostics in ITER are mandatory to characterize the parameters of plasma and study its interactions with plasma-facing components. Diagnostics components in the vicinity of the plasma are supported by metallic structures called port plugs. At the tokamak mid-plane, these components are installed in port plugs through intermediate structures called drawers. Apart from hosting the diagnostics, the port plugs act as shielding against neutrons and gammas, in order to limit the nuclear loads in crucial components (such as diagnostics and superconducting coils) as well as the dose levels in the controlled zones of the tokamak. The radiation shielding function of the port plugs is ensured through an optimized mixture of heavy metallic materials and water, forming shielding blocks surrounding the diagnostics and called Diagnostic Shield Modules (DSMs). These DSMs constitute the rear part of the drawers (the front part being composed of the Diagnostic First Wall). This paper presents the main results of a study performed in Europe on the integration of a particular diagnostics port plug, the Equatorial Port Plug 1 (EPP1). The paper first provides the results of the EPP1 diagnostics integration analysis. In a second step it focuses on the design of the EPP1 DSMs and summarizes the major results of a thorough set of analyses aiming at studying the DSMs behaviour under different loads, suggesting recommendations to improve their current design

  19. Study of the performance of diagnostic radiology instruments during calibration

    International Nuclear Information System (INIS)

    Freitas, Rodrigo N. de; Vivolo, Vitor; Potiens, Maria da Penha A.

    2008-01-01

    Full text: The instruments used in diagnostic radiology measurements represent 8 % of the tested instruments by the calibration laboratory of IPEN annually (approximately 1600 in 2007). Considering that the calibration of this kind of instrument is performed biannually it is possible to conclude that almost 300 instruments are being used to measure the air kerma in diagnostic radiology clinics to determine the in beam values (in front of the patient), attenuated measurements (behind the patient) and scattered radiation. This work presents the results of the calibration of the instruments used in mammography, computed tomography, dental and conventional diagnostic radiology dosimetry, performed during the period of 2005 to 2007. Their performances during the calibrations measurements were evaluated. Although at the calibration laboratory there are three available series of radiation quality to this type of calibration (RQR, N and M, according to standards IEC 61267 and ISO 4037-1.), the applications can be assorted (general radiology, computed tomography, mammography, radiation protection and fluoroscopy). Depending on its design and behaviour , one kind of instrument can be used for one or more type of applications. The instruments normally used for diagnostic radiology measurements are ionization chambers with volumes varying from 3 to 1800 cm 3 , and can be cylindrical, spherical or plane parallel plates kind. They usually are sensitive to photon particles, with energies greater than 15 keV and can be used up to 1200 keV. In this work they were tested in X radiation fields from 25 to 150 kV, in specific qualities depending on the utilization of the instrument. The calibration results of 390 instruments received from 2005 to 2007 were analyzed. About 20 instruments were not able to be calibrated due to bad functioning. The calibration coefficients obtained were between 0.88 and 1.24. The uncertainties were always less than ± 3.6% to instruments used in scattered

  20. 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:

  1. 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.

  2. 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.

  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. Transition radiation electron beam diagnostic study at ATF

    International Nuclear Information System (INIS)

    Qiu, X.Z.; Wang, X.J.; Batchelor, K.; Ben-Zvi, I.

    1995-01-01

    Recently we have started a program to develop transition radiation based electron beam diagnostics at the Accelerator Test Facility at Brookhaven National Laboratory. In this paper, we will discuss a technique to estimate the lower limit in electron beam divergence measurement with single foil transition radiation and two-foil transition radiation interferometer. Preliminary experimental data from 4.5 MeV electron beam will be presented

  5. Diagnostics for studies of novel laser ion acceleration mechanisms

    OpenAIRE

    Senje, Lovisa; Yeung, Mark; Aurand, Bastian; Kuschel, Stephan; Rödel, Christian; Wagner, Florian; Li, Kun; Dromey, Brendan; Bagnoud, Vincent; Neumayer, Paul; Roth, Markus; Wahlström, Claes-Göran; Zepf, Matthew; Kuehl, Thomas; Jung, Daniel

    2014-01-01

    Diagnostic for investigating and distinguishing different laser ion acceleration mechanisms has been developed and successfully tested. An ion separation wide angle spectrometer can simultaneously investigate three important aspects of the laser plasma interaction: (1) acquire angularly resolved energy spectra for two ion species, (2) obtain ion energy spectra for multiple species, separated according to their charge to mass ratio, along selected axes, and (3) collect laser radiation reflecte...

  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. eHealth and mHealth initiatives in Bangladesh: A scoping study

    Science.gov (United States)

    2014-01-01

    Background 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. Methods 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. Results 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. Conclusion This study concludes that Bangladesh needs considerable preparation and planning to sustain e

  8. 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

  9. 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

  10. 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

    of a diagnostic study on a single binary test and investigation of common statistical approaches in relation to these criteria. RESULTS: Three criteria for defining the overall success of a diagnostic study could be identified: a strong criterion, a liberal criterion, and a weak criterion. The strong criterion...... can be implemented by comparing the lower bounds of the confidence intervals for sensitivity and specificity with prespecified target values, as is typically done in many diagnostic studies. The liberal criterion allows a clinically meaningful compensation between sensitivity and specificity and can...... be implemented in different ways. If the liberal criterion is applied instead of the strong criterion, this can lead to a substantial reduction in the sample size required for a diagnostic study. The weak criterion is not very adequate for defining the success of a diagnostic study. CONCLUSION: When planning...

  11. 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)

  12. Feasibility and cost efficiency of a diagnostic guideline for chronic polyneuropathy: a prospective implementation study

    NARCIS (Netherlands)

    Vrancken, A. F. J. E.; Kalmijn, S.; Buskens, E.; Franssen, H.; Vermeulen, M.; Wokke, J. H. J.; Notermans, N. C.

    2006-01-01

    Extensive investigations are often performed to reveal the cause of chronic polyneuropathy. It is not known whether a restrictive diagnostic guideline improves cost efficiency without loss of diagnostic reliability. In a prospective multicentre study, a comparison was made between the workup in

  13. Microwave-plasma interactions studied via mode diagnostics in ALPHA

    Energy Technology Data Exchange (ETDEWEB)

    Friesen, T., E-mail: tim.friesen@cern.ch [University of Calgary, Department of Physics and Astronomy (Canada); Andresen, G. B. [Aarhus University, Department of Physics and Astronomy (Denmark); Ashkezari, M. D. [Simon Fraser University, Department of Physics (Canada); Baquero-Ruiz, M. [University of California, Department of Physics (United States); Bertsche, W. [Swansea University, Department of Physics (United Kingdom); Bowe, P. D. [Aarhus University, Department of Physics and Astronomy (Denmark); Butler, E. [CERN, Physics Department (Switzerland); Cesar, C. L. [Universidade Federal do Rio de Janeiro, Instituto de Fisica (Brazil); Chapman, S. [University of California, Department of Physics (United States); Charlton, M.; Eriksson, S. [Swansea University, Department of Physics (United Kingdom); Fajans, J. [University of California, Department of Physics (United States); Fujiwara, M. C. [University of Calgary, Department of Physics and Astronomy (Canada); Gill, D. R. [TRIUMF (Canada); Gutierrez, A. [University of British Columbia, Department of Physics and Astronomy (Canada); Hangst, J. S. [Aarhus University, Department of Physics and Astronomy (Denmark); Hardy, W. N. [University of British Columbia, Department of Physics and Astronomy (Canada); Hayano, R. S. [University of Tokyo, Department of Physics (Japan); Hayden, M. E. [Simon Fraser University, Department of Physics (Canada); Humphries, A. J. [Swansea University, Department of Physics (United Kingdom); Collaboration: ALPHA Collaboration; and others

    2012-12-15

    The goal of the ALPHA experiment is the production, trapping and spectroscopy of antihydrogen. A direct comparison of the ground state hyperfine spectra in hydrogen and antihydrogen has the potential to be a high-precision test of CPT symmetry. We present a novel method for measuring the strength of a microwave field for hyperfine spectroscopy in a Penning trap. This method incorporates a non-destructive plasma diagnostic system based on electrostatic modes within an electron plasma. We also show how this technique can be used to measure the cyclotron resonance of the electron plasma, which can potentially serve as a non-destructive measurement of plasma temperature.

  14. 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)

  15. 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.

  16. Empirical evidence of design-related bias in studies of diagnostic tests

    NARCIS (Netherlands)

    Lijmer, J. G.; Mol, B. W.; Heisterkamp, S.; Bonsel, G. J.; Prins, M. H.; van der Meulen, J. H.; Bossuyt, P. M.

    1999-01-01

    CONTEXT: The literature contains a large number of potential biases in the evaluation of diagnostic tests. Strict application of appropriate methodological criteria would invalidate the clinical application of most study results. OBJECTIVE: To empirically determine the quantitative effect of study

  17. Attentional scope is reduced by Internet use: A behavior and ERP study.

    Directory of Open Access Journals (Sweden)

    Ming Peng

    Full Text Available As a crucial living environment, the Internet shapes cognition. The Internet provides massive information that can be accessed quickly via hyperlinks, but the information is typically fragmentary and concrete rather than integrative. According to construal level theory, the processing of this concrete and fragmentary information, should reduce attentional scope. Two experiments were conducted to test this hypothesis. In Experiment 1, three groups of participants were asked to shop online, read magazines or have a rest respectively, and a divided attention Navon-letter task was employed to measure the attentional scope before and after the assigned activity. It was found that the difference between reaction times in response to local vs. global targets was decreased only after Internet use, while there was no decrease in either the reading or resting group. In Experiment 2, the same procedure was used, and EEG/ERP methods were used to record both behavioral response and neural activity. Results showed that before the assigned activity, there was no significant difference in N2 amplitude in response to local vs. global targets in any of the three groups; during the activity, the lower-alpha activity induced by Internet use was significantly lower than that induced by reading or resting; after the activity, correspondingly, a more negative N2 wave was induced by the global than local targets only in the Internet group, while there were no significant differences in the other groups. Consistent with construal level theory, the results suggest that when surfing the Internet, attentional scope is reduced, and this effect might continue after Internet activity.

  18. Efficient strategies to find diagnostic test accuracy studies in kidney journals.

    Science.gov (United States)

    Rogerson, Thomas E; Ladhani, Maleeka; Mitchell, Ruth; Craig, Jonathan C; Webster, Angela C

    2015-08-01

    Nephrologists looking for quick answers to diagnostic clinical questions in MEDLINE can use a range of published search strategies or Clinical Query limits to improve the precision of their searches. We aimed to evaluate existing search strategies for finding diagnostic test accuracy studies in nephrology journals. We assessed the accuracy of 14 search strategies for retrieving diagnostic test accuracy studies from three nephrology journals indexed in MEDLINE. Two investigators hand searched the same journals to create a reference set of diagnostic test accuracy studies to compare search strategy results against. We identified 103 diagnostic test accuracy studies, accounting for 2.1% of all studies published. The most specific search strategy was the Narrow Clinical Queries limit (sensitivity: 0.20, 95% CI 0.13-0.29; specificity: 0.99, 95% CI 0.99-0.99). Using the Narrow Clinical Queries limit, a searcher would need to screen three (95% CI 2-6) articles to find one diagnostic study. The most sensitive search strategy was van der Weijden 1999 Extended (sensitivity: 0.95; 95% CI 0.89-0.98; specificity 0.55, 95% CI 0.53-0.56) but required a searcher to screen 24 (95% CI 23-26) articles to find one diagnostic study. Bachmann 2002 was the best balanced search strategy, which was sensitive (0.88, 95% CI 0.81-0.94), but also specific (0.74, 95% CI 0.73-0.75), with a number needed to screen of 15 (95% CI 14-17). Diagnostic studies are infrequently published in nephrology journals. The addition of a strategy for diagnostic studies to a subject search strategy in MEDLINE may reduce the records needed to screen while preserving adequate search sensitivity for routine clinical use. © 2015 Asian Pacific Society of Nephrology.

  19. NIH-ABCC pathology studies in Hiroshima and Nagasaki provisional research plan. 1. Description and scope of program

    Energy Technology Data Exchange (ETDEWEB)

    Zeldis, L J; Matsumoto, Y Scott

    1961-04-18

    A proposed program for the conduct of pathology studies within fixed cohorts of Hiroshima and Nagasaki A-bomb survivors is described. It is intended that the program may with appropriate modifications serve as a basis for collaborative efforts by community medical institutions and organizations together with ABCC-NIH in both cities. The report describes the scope of the program, together with epidemiologic aspects of the population base and methods of case procurement, and outlines proposed studies. 36 references, 4 figures, 8 tables.

  20. Analyzing paired diagnostic studies by estimating the expected benefit

    DEFF Research Database (Denmark)

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

    2015-01-01

    is of an indirect nature as test results do influence downstream clinical decisions, but test performance (as characterized by sensitivity, specificity, and the predictive values of a procedure) is, at best, only a surrogate endpoint for patient outcome and does not necessarily translate into it. Not many...... randomized controlled trials have been conducted so far in diagnostic research, and, hence, we need alternative approaches to close the gap between test characteristics and patient outcomes. Several informal approaches have been suggested in order to close this gap, and decision modeling has been advocated...... as a means of obtaining formal approaches. Recently, the expected benefit has been proposed as a quantity that allows a simple formal approach, and we take up this suggestion in this paper. We regard the expected benefit as an estimation problem and consider two approaches to statistical inference. Moreover...

  1. Working practices and success of infection prevention and control teams: a scoping study.

    Science.gov (United States)

    Hale, R; Powell, T; Drey, N S; Gould, D J

    2015-02-01

    Little research has been undertaken on how infection prevention and control (IPC) teams operate and how their effectiveness is assessed. This review aimed to explore how IPC teams embed IPC throughout hospitals, balance outbreak management with strategic aspects of IPC work (e.g. education), and how IPC team performance is measured. A scoping exercise was performed combining literature searches, evidence synthesis, and intelligence from expert advisers. Eleven publications were identified. One paper quantified how IPC nurses spend their time, two described daily activities of IPC teams, five described initiatives to embed IPC across organizations following legislation since 1999 in the UK or changes in the delivery of healthcare, and three explored the contribution of IPC intermediaries (link nurses and champions). Eight publications reported research findings. The others reported how IPC teams are embedding IPC practice in UK hospitals. In conclusion, there is scope for research to explore different models of IPC team-working and effectiveness, and cost-effectiveness. Other topics that need addressing are the willingness and ability of ward staff to assume increased responsibility for IPC and the effectiveness of intermediaries. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  2. [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.

  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. 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)

  5. [Penicillin allergy as a diagnostic problem. Overview and personal studies].

    Science.gov (United States)

    Walker, T; Jung, E G; Bayerl, C

    2000-11-01

    Penicillin allergy is a common clinical problem. The distinction between penicillin and para-infectious exanthems is difficult. We investigated the reliability of the history, as well as the sensitivity and specificity of skin tests and specific IgE levels. 160 patients with a history of penicillin allergy were retrospectively evaluated in the outpatient department of a dermatological clinic. Nearly 50% were diagnosed as allergic to penicillin by detection of specific IgE or skin test. About 60% of the patients with immediate type reactions, and 72% with maculo-papular erythema showed positive reactions in skin tests. Significantly more patients were diagnosed as allergic to penicillin by intradermal testing than by prick testing (p sensitivity of the specific IgE RAST was 17.9%; the specifity, 89.5%. For the prick test the sensitivity was 8.2%; the specificity 90.8%. For the intradermal test the sensitivity was 26%; the specifity 69.7%. We suggest a step by step procedure to detect penicillin allergy making the diagnostic results as valid as possible.

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

    KAUST Repository

    Behenna, Douglas C.; Mohr, Justin T.; Sherden, Nathaniel H.; Marinescu, Smaranda C.; Harned, Andrew M.; Tani, Kousuke; Seto, Masaki; Ma, Sandy; Nová k, Zoltá n; 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.

    2011-01-01

    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 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.

  7. 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

  8. 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.

  9. [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.

  10. A study of occupational stress, scope of practice, and collaboration in nurse anesthetists practicing in anesthesia care team settings.

    Science.gov (United States)

    Alves, Steve L

    2005-12-01

    This study examined occupational stress in Certified Registered Nurse Anesthetists (CRNAs) practicing with anesthesiologists in anesthesia care team (ACT) settings. The focus was to examine the relationships among CRNA scope of practice (SOP) in ACTs, collaboration, and role-related occupational stress. A survey questionnaire was mailed to CRNAs from the 6 New England states, with a return rate of 30.87% (n = 347). Data analysis included practice characteristics and demographics of the sample, and the research questions were examined applying correlational analysis, t test, and analysis of variance addressing relationships among the study measures. Data analyses revealed that limited, restricted CRNA practice scope was particularly evident in respondents employed by anesthesiology groups, compared with hospital-employed CRNAs. Few CRNA respondents perceived their practice as collaborative, and many used compromise as a conflict-resolution style. Respondents with a broader SOP reported higher collaboration than those with restrictions. Respondents reporting a broader SOP also experienced increased job stress in relation to role overload but used coping resources effectively. Implications for future studies include exploring strategies that achieve consensus between CRNAs and anesthesiologists in ACTs, emphasizing clearly defined roles and optimizing productivity.

  11. 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

    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...

  12. Design studies for ITER x-ray diagnostics

    International Nuclear Information System (INIS)

    Hill, K.W.; Bitter, M.; von Goeler, S.; Hsuan, H.

    1995-01-01

    Concepts for adapting conventional tokamak x-ray diagnostics to the harsh radiation environment of ITER include use of grazing-incidence (GI) x-ray mirrors or man-made Bragg multilayer (ML) elements to remove the x-ray beam from the neutron beam, or use of bundles of glass-capillary x-ray ''light pipes'' embedded in radiation shields to reduce the neutron/gamma-ray fluxes onto the detectors while maintaining usable x-ray throughput. The x-ray optical element with the broadest bandwidth and highest throughput, the GI mirror, can provide adequate lateral deflection (10 cm for a deflected-path length of 8 m) at x-ray energies up to 12, 22, or 30 keV for one, two, or three deflections, respectively. This element can be used with the broad band, high intensity x-ray imaging system (XIS), the pulseheight analysis (PHA) survey spectrometer, or the high resolution Johann x-ray crystal spectrometer (XCS), which is used for ion-temperature measurement. The ML mirrors can isolate the detector from the neutron beam with a single deflection for energies up to 50 keV, but have much narrower bandwidth and lower x-ray power throughput than do the GI mirrors; they are unsuitable for use with the XIS or PHA, but they could be used with the XCS; in particular, these deflectors could be used between ITER and the biological shield to avoid direct plasma neutron streaming through the biological shield. Graded-d ML mirrors have good reflectivity from 20 to 70 keV, but still at grazing angles (<3 mrad). The efficiency at 70 keV for double reflection (10 percent), as required for adequate separation of the x-ray and neutron beams, is high enough for PHA requirements, but not for the XIS. Further optimization may be possible

  13. 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

  14. 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.

  15. 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

  16. 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.

  17. Gender incongruence: a comparative study using ICD-10 and DSM-5 diagnostic criteria.

    Science.gov (United States)

    Soll, Bianca M; Robles-García, Rebeca; Brandelli-Costa, Angelo; Mori, Daniel; Mueller, Andressa; Vaitses-Fontanari, Anna M; Cardoso-da-Silva, Dhiordan; Schwarz, Karine; Abel-Schneider, Maiko; Saadeh, Alexandre; Lobato, Maria-Inês-Rodrigues

    2018-01-01

    To compare the presence of criteria listed in the DSM-5 and ICD-10 diagnostic manuals in a Brazilian sample of transgender persons seeking health services specifically for physical transition. This multicenter cross-sectional study included a sample of 103 subjects who sought services for gender identity disorder in two main reference centers in Brazil. The method involved a structured interview encompassing the diagnostic criteria in the two manuals. The results revealed that despite theoretical disagreement about the criteria, the manuals overlap regarding diagnosis confirmation; the DSM-5 was more inclusive (97.1%) than the ICD-10 (93.2%) in this population. Although there is no consensus on diagnostic criteria on transgenderism in the diversity of social and cultural contexts, more comprehensive diagnostic criteria are evolving due to society's increasing inclusivity.

  18. 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

  19. 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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    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...

  1. 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)

  2. 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.

  3. Radiation: Rational use of diagnostic imaging studies in pediatrics

    International Nuclear Information System (INIS)

    Gentile, Fernando

    2008-01-01

    The objectives of this paper are to recognize the biological effects of radiation; explain the action of ionizing radiation on the cell; list the main sources of ionizing radiation; to indicate imaging studies considering the danger of radiation; select the method of imaging saving radiation; rational use of imaging studies without repeating exams. [es

  4. APEX_SCOPE: A graphical user interface for visualization of multi-modal data in inter-disciplinary studies.

    Science.gov (United States)

    Kanbar, Lara J; Shalish, Wissam; Precup, Doina; Brown, Karen; Sant'Anna, Guilherme M; Kearney, Robert E

    2017-07-01

    In multi-disciplinary studies, different forms of data are often collected for analysis. For example, APEX, a study on the automated prediction of extubation readiness in extremely preterm infants, collects clinical parameters and cardiorespiratory signals. A variety of cardiorespiratory metrics are computed from these signals and used to assign a cardiorespiratory pattern at each time. In such a situation, exploratory analysis requires a visualization tool capable of displaying these different types of acquired and computed signals in an integrated environment. Thus, we developed APEX_SCOPE, a graphical tool for the visualization of multi-modal data comprising cardiorespiratory signals, automated cardiorespiratory metrics, automated respiratory patterns, manually classified respiratory patterns, and manual annotations by clinicians during data acquisition. This MATLAB-based application provides a means for collaborators to view combinations of signals to promote discussion, generate hypotheses and develop features.

  5. 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.

  6. 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 ...

  7. 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

  8. 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

  9. Integration of Diagnostics into Ground Equipment Study. Volume 1

    National Research Council Canada - National Science Library

    Kumara, Soundar; Gautam, N; Hall, Dave; Purao, Sandeep; Garga, Amulya; Grimes, Barney

    2004-01-01

    ...) for Ground Equipment used by the U.S. Marine Corps. The study reviewed the sources of Autonomic Logistics data, the data requirements, the timeliness or required "pull" of such data, its transmission means...

  10. An empirical operationalization study of DSM-IV diagnostic criteria for premature ejaculation

    NARCIS (Netherlands)

    Waldinger, M. D.; Hengeveld, M. W.; Zwinderman, A. H.; Olivier, B.

    1998-01-01

    The DSM-IV diagnostic criteria for premature ejaculation remain to be investigated by a clinical study. A prospective study was therefore conducted to investigate the DSM-IV definition and to provide an empirical operationalization of premature ejaculation. In this study 140 men suffering from

  11. 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

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

    African Journals Online (AJOL)

    1993-05-07

    May 7, 1993 ... Antoinette Swart' and J. Heyns. Department of ... comparative study of different populations of H. bickneriChitwood, 1956. Hierdie laaste ... ments, length and shape of spicules, tail shape, prominence of slIiations on .... A: anterior region of male; B: female tail; C: anterior region of female; 0: male tail with ...

  13. 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…

  14. 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.

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

    International Nuclear Information System (INIS)

    Engelbrecht, J.; Kavouras, I.; Campbell, D.; Campbell, S.; Kohl, S.; Shafer, D.

    2009-01-01

    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

  16. Letter Report Yucca Mountain Environmental Monitoring Systems Initiative - Air Quality Scoping Study for Tonopah Airport, Nye County, Nevada

    International Nuclear Information System (INIS)

    Engelbrecht, J.; Kavouras, I.; Campbell, D.; Campbell, S.; Kohl, S.; Shafer, D.

    2009-01-01

    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), Tonopah Airport, Beatty, Rachel, Caliente, Pahranagat NWR, Crater Flat, and the 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

  17. Letter Report Yucca Mountain Environmental Monitoring Systems Initiative - Air Quality Scoping Study for Caliente, Lincoln County, Nevada

    International Nuclear Information System (INIS)

    Engelbrecht, J.; Kavouras, I.; Campbell, D.; Campbell, S.; Kohl, S.; Shafer, D.

    2009-01-01

    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), Beatty, Sarcobatus Flats, Rachel, Caliente, Pahranagat NWR, 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

  18. 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)

  19. 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)

  20. 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.

  1. Diagnostic labelling influences self-rated health. A prospective cohort study: the HUNT Study, Norway.

    Science.gov (United States)

    Jørgensen, Pål; Langhammer, Arnulf; Krokstad, Steinar; Forsmo, Siri

    2015-10-01

    Studies have shown an independent association between poor self-rated health (SRH) and increased mortality. Few studies, however, have investigated any possible impact on SRH of diagnostic labelling. To test whether SRH differed in persons with known and unknown hypothyroidism, diabetes mellitus (DM) or hypertension, opposed to persons without these conditions, after 11-year follow-up. Prospective population-based cohort study in North-Trøndelag County, Norway, HUNT2 (1995-97) to HUNT3 (2006-08). All inhabitants aged 20 years and older were invited. The response rate was 69.5% in HUNT2 and 54.1% in HUNT3. In total, 34144 persons aged 20-70 years were included in the study population. The outcome was poor SRH. Persons with known disease had an increased odds ratio (OR) to report poor SRH at follow-up; figures ranging from 1.11 (0.68-1.79) to 2.52 (1.46-4.34) (men with hypothyroidism kept out owing to too few numbers). However, in persons not reporting, but having laboratory results indicating these diseases (unknown disease), no corresponding associations with SRH were found. Contrary, the OR for poor SRH in women with unknown hypothyroidism and unknown hypertension was 0.64 (0.38-1.06) and 0.89 (0.79-1.01), respectively. Awareness opposed to ignorance of hypothyroidism, DM and hypertension seemed to be associated with poor perceived health, suggesting that diagnostic labelling could have a negative effect on SRH. This relationship needs to be tested more thoroughly in future research but should be kept in mind regarding the benefits of early diagnosing of diseases. © The Author 2015. Published by Oxford University Press.

  2. 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.

  3. 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

  4. Diagnostic imaging in the study of human hepatobiliary fascioliasis.

    Science.gov (United States)

    Cantisani, V; Cantisani, C; Mortelé, K; Pagliara, E; D'Onofrio, M; Fernandez, M; D'Ambrosio, U; Lombardi, V; Marigliano, C; Ricci, P

    2010-02-01

    Fascioliasis is a rare zoonotic disease caused by the trematode Fasciola hepatica. We present the typical patterns of hepatobiliary fascioliasis observed in ten patients studied with multimodality imaging. Between 2002 and 2005, ten women with fascioliasis were admitted to the Brigham and Women's Hospital, Harvard Medical School (BWH), with abdominal pain and mild fever. All imaging modalities, including ultrasound (US), computed tomography (CT), magnetic resonance (MR) imaging (n = 2) and endoscopic retrograde cholangiopancreatography (ERCP) (n = 1) were reviewed by two expert radiologists working in consensus. In all patients (10/10, 100%), US showed parenchymal heterogeneity characterised by multiple subcapsular and peribiliary hypoechoic nodular lesions that were ill-defined and coalesced into tubular or tortuous structures. In six patients (6/10, 60%), the lesions appeared hypoechoic, whereas in four patients (4/10, 40%), there was an alternation of hyperechoic and hypoechoic nodules. On CT, all patients (10/10, 100%) showed hypodense patchy lesions in subcapsular, peribiliary or periportal locations, which coalesced to form tubular structures and were more evident during the portal phase. Lesion diameter ranged from 2 cm to 7 cm. Capsular enhancement was seen in four cases on CT (4/10, 40%) and in one also at MR imaging. MR imaging, performed in two patients, confirmed the presence of the lesions, which appeared hyperintense on T2-weighted images and were characterised by mild peripheral enhancement after gadolinium administration. Four patients had gallbladder wall thickening (4/10, 40%), with parasites in the gallbladder lumen. Although rare, hepatobiliary fascioliasis should be considered in the differential diagnosis in the appropriate clinical scenario, especially in patients coming from endemic areas. The typical imaging pattern of fascioliasis is the presence of subcapsular, peribiliary or periportal nodules that are usually ill-defined and coalesce

  5. 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

  6. STARD 2015: An Updated List of Essential Items for Reporting Diagnostic Accuracy Studies

    NARCIS (Netherlands)

    Bossuyt, P.M.; Reitsma, J.B.; Bruns, D.E.; Gatsonis, C.A.; Glasziou, P.P.; Irwig, L.; Lijmer, J.G.; Moher, D.; Rennie, D.; de Vet, H.C.W.; Kressel, H.Y.; Rifai, N.; Golub, R.M.; Altman, D.G.; Hooft, L.; Korevaar, D.A.; Cohen, J.F.

    2015-01-01

    Incomplete reporting has been identified as a major source of avoidable waste in biomedical research. Essential information is often not provided in study reports, impeding the identification, critical appraisal, and replication of studies. To improve the quality of reporting of diagnostic accuracy

  7. Assessing the Utility of Diagnostic Criteria: A Multisite Study on Gender Identity Disorder

    NARCIS (Netherlands)

    Paap, M.C.S.; Kreukels, B.P.C.; Cohen-Kettenis, P.T.; Richter-Appelt, H.; De Cuypere, G.; Haraldsen, I.R.

    2011-01-01

    Studies involving patients with gender identity disorder (GID) are inconsistent with regard to outcomes and often difficult to compare because of the vague descriptions of the diagnostic process. A multisite study is needed to scrutinize the utility and generality of different aspects of the

  8. Assessing the utility of diagnostic criteria: a multi-site study on gender identity disorder

    NARCIS (Netherlands)

    Paap, Muirne; Kreukels, Baudewijntje P.C.; Cohen-Kettenis, Peggy; Richter-Appelt, Hertha; De Cuypere, Griet; Haraldsen, Ira R.

    2011-01-01

    Introduction: Studies involving patients with gender identity disorder (GID) are inconsistent with regard to outcomes and often difficult to compare because of the vague descriptions of the diagnostic process. A multisite study is needed to scrutinize the utility and generality of different aspects

  9. 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

  10. Towards 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

    Background: To comprehend the results of diagnostic accuracy studies, readers must understand the design, conduct, analysis, and results of such studies. That goal can be achieved only through complete transparency from authors. Objective: To improve the accuracy and completeness of reporting of

  11. 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

    , and 4 (3%) were treated for depression or referred for another condition. A total of 6 patients were lost to follow-up. In the remaining 102 undiagnosed patients the main reasons for not performing a diagnostic evaluation of dementia were patient/relative hesitation (34%), the GP thought that it would......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 study...... of dementia, laboratory-screening tests prescribed by the GPs and referral status after 6 months, and follow-up questionnaire. RESULTS: Of 793 patients a total of 138 patients were identified with possible dementia. Among the identified patients 26 (20%) were referred for further evaluation within 6 months...

  12. 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

    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......-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....

  13. Overdiagnosis across medical disciplines: a scoping review.

    Science.gov (United States)

    Jenniskens, Kevin; de Groot, Joris A H; Reitsma, Johannes B; Moons, Karel G M; Hooft, Lotty; Naaktgeboren, Christiana A

    2017-12-27

    To provide insight into how and in what clinical fields overdiagnosis is studied and give directions for further applied and methodological research. Scoping review. Medline up to August 2017. All English studies on humans, in which overdiagnosis was discussed as a dominant theme. Studies were assessed on clinical field, study aim (ie, methodological or non-methodological), article type (eg, primary study, review), the type and role of diagnostic test(s) studied and the context in which these studies discussed overdiagnosis. From 4896 studies, 1851 were included for analysis. Half of all studies on overdiagnosis were performed in the field of oncology (50%). Other prevalent clinical fields included mental disorders, infectious diseases and cardiovascular diseases accounting for 9%, 8% and 6% of studies, respectively. Overdiagnosis was addressed from a methodological perspective in 20% of studies. Primary studies were the most common article type (58%). The type of diagnostic tests most commonly studied were imaging tests (32%), although these were predominantly seen in oncology and cardiovascular disease (84%). Diagnostic tests were studied in a screening setting in 43% of all studies, but as high as 75% of all oncological studies. The context in which studies addressed overdiagnosis related most frequently to its estimation, accounting for 53%. Methodology on overdiagnosis estimation and definition provided a source for extensive discussion. Other contexts of discussion included definition of disease, overdiagnosis communication, trends in increasing disease prevalence, drivers and consequences of overdiagnosis, incidental findings and genomics. Overdiagnosis is discussed across virtually all clinical fields and in different contexts. The variability in characteristics between studies and lack of consensus on overdiagnosis definition indicate the need for a uniform typology to improve coherence and comparability of studies on overdiagnosis. © Article author

  14. Feasibility Study on a Neutral Beam Diagnostic Injector for TJ-II

    International Nuclear Information System (INIS)

    McCarthy, K. J.; Balbin, R.; Lopez-Fraguas, A.

    2003-01-01

    A diagnostic neutral beam system is proposed for the TJ-II stellarator. The main goal of installing such a system in TJ-II is to increase the signal to noise ratio and provide spatial resolution in diagnostic systems based on Charge Exchange Recombination Spectroscopy and Neutral Particle Analysis, while also opening up new opportunities for physics studies in this magnetically confined plasma device. After outlining the unique characteristics of the TJ-II and reviewing available diagnostic injector systems, the compact system selected for TJ-II is presented together with estimates of the resulting increased signal levels Finally other important aspects are discussed, in particular its location and orientation, as well as possible solutions to avoid perturbing the TJ-II magnetic configurations in the heliac device. (Author) 31 refs

  15. Feasibility Study on a Neutral Beam Diagnostic Injector for TJ-II

    Energy Technology Data Exchange (ETDEWEB)

    McCarthy, K. J.; Balbin, R.; Lopez-Fraguas, A.

    2003-07-01

    A diagnostic neutral beam system is proposed for the TJ-II stellarator. The main goal of installing such a system in TJ-II is to increase the signal to noise ratio and provide spatial resolution in diagnostic systems based on Charge Exchange Recombination Spectroscopy and Neutral Particle Analysis, while also opening up new opportunities for physics studies in this magnetically confined plasma device. After outlining the unique characteristics of the TJ-II and reviewing available diagnostic injector systems, the compact system selected for TJ-II is presented together with estimates of the resulting increased signal levels Finally other important aspects are discussed, in particular its location and orientation, as well as possible solutions to avoid perturbing the TJ-II magnetic configurations in the heliac device. (Author) 31 refs.

  16. 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.

  17. A study on the Fusion Reactor - Development of charge exchange recombination spectroscopy for tokamak diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Tong Nyong; Kim, Dong Eon; Kim, Dae Sung; Kim, Seong Ho [Pohang University of Science and Technology, Pohang (Korea, Republic of)

    1996-09-01

    This project has been carried to train people and accumulate the knowledge and techniques related to the measurement of the profiles of ion temperature, toroidal rotation velocity, and fully-stripped ion density in a fusion tokamak plasma by the development of plasma diagnostics using charge exchange recombination (CER) spectroscopy. Daring the 1 st year, the basic study and review on the charge exchange process and the conceptual design and review of the diagnostics have been conducted. In addition, the various atomic data centers around the world have been surveyed and atomic data related to CER have been constructed. The results of this project can be used to the construction and tokamak machine installation of a CER plasma diagnostic to a new superconducting supported by National Fusion Program. 42 refs., 3 tabs., 16 figs. (author)

  18. How unemployment and precarious employment affect the health of young people: A scoping study on social determinants.

    Science.gov (United States)

    Vancea, Mihaela; Utzet, Mireia

    2017-02-01

    The impact of unemployment and precarious employment on the health of young people is not well understood. However, according to social causation, higher socio-economic positions and thus better working conditions are beneficial to health in general. We tried to synthesize the results of studies that test this hypothesis in the case of young people. We conducted a scoping study mapping all the academic articles published in the period 2006-2016 in Europe. The literature was searched in PubMed/Medline, Science Direct, Web of Science and Scopus. We identified 1770 studies, of which only 46 met the inclusion criteria. There are more studies that focus on the relationship between unemployment and health than between precarious employment and health (28 and 16, respectively). The vast majority of the studies (44) found support for the social causation hypothesis, the most common health outcomes being mental health disorders, health risk behaviour, poor quality of life and occupational injuries. The causal mechanisms behind this association relied mainly on the life-course perspective, the breadwinner model, and the lack of social and economic benefits provided by standard employment. There is evidence that young people are especially vulnerable to health problems when unemployed or working in precarious conditions. Active labour market and training programmes, inclusive social security measures, improved working conditions and targeted health programmes are important for addressing this vulnerability. Further research should strive to enhance the causal model by including a gender perspective, longitudinal data, more indicators on precariousness and third factor explanations.

  19. 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

  20. Statistical analysis and interpretation of prenatal diagnostic imaging studies, Part 2: descriptive and inferential statistical methods.

    Science.gov (United States)

    Tuuli, Methodius G; Odibo, Anthony O

    2011-08-01

    The objective of this article is to discuss the rationale for common statistical tests used for the analysis and interpretation of prenatal diagnostic imaging studies. Examples from the literature are used to illustrate descriptive and inferential statistics. The uses and limitations of linear and logistic regression analyses are discussed in detail.

  1. 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...

  2. 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.; Bergh-Weerman, M.A. van den; Florquin, S.; Kok, W.E.; Deprez, R.H.L.; 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

  3. Weeds as agricultural constraint in Benin: results of a diagnostic study

    NARCIS (Netherlands)

    Vissoh, P.V.; Gbèhounou, G.; Ahanchedé, A.; Kuyper, T.W.; Röling, N.G.

    2004-01-01

    Weeds are an emerging constraint on crop production, as a result of population pressure and more intensive use of cultivated land. A diagnostic study was carried out from June through August 2002 in the five agro-ecological zones of Benin (1) to identify the relative importance of weeds among major

  4. 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.

  5. Effect Size (Cohen's d of Cognitive Screening Instruments Examined in Pragmatic Diagnostic Accuracy Studies

    Directory of Open Access Journals (Sweden)

    Andrew J. Larner

    2014-07-01

    Full Text Available Background/Aims: Many cognitive screening instruments (CSI are available to clinicians to assess cognitive function. The optimal method comparing the diagnostic utility of such tests is uncertain. The effect size (Cohen's d, calculated as the difference of the means of two groups divided by the weighted pooled standard deviations of these groups, may permit such comparisons. Methods: Datasets from five pragmatic diagnostic accuracy studies, which examined the Mini-Mental State Examination (MMSE, the Mini-Mental Parkinson (MMP, the Six-Item Cognitive Impairment Test (6CIT, the Montreal Cognitive Assessment (MoCA, the Test Your Memory test (TYM, and the Addenbrooke's Cognitive Examination-Revised (ACE-R, were analysed to calculate the effect size (Cohen's d for the diagnosis of dementia versus no dementia and for the diagnosis of mild cognitive impairment versus no dementia (subjective memory impairment. Results: The effect sizes for dementia versus no dementia diagnosis were large for all six CSI examined (range 1.59-1.87. For the diagnosis of mild cognitive impairment versus no dementia, the effect sizes ranged from medium to large (range 0.48-1.45, with MoCA having the largest effect size. Conclusion: The calculation of the effect size (Cohen's d in diagnostic accuracy studies is straightforward. The routine incorporation of effect size calculations into diagnostic accuracy studies merits consideration in order to facilitate the comparison of the relative value of CSI.

  6. 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 ...

  7. 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

  8. The role of general practice in routes to diagnosis of lung cancer in Denmark: a population-based study of general practice involvement, diagnostic activity and diagnostic intervals.

    Science.gov (United States)

    Guldbrandt, Louise Mahncke; Fenger-Grøn, Morten; Rasmussen, Torben Riis; Jensen, Henry; Vedsted, Peter

    2015-01-22

    Lung cancer stage at diagnosis predicts possible curative treatment. In Denmark and the UK, lung cancer patients have lower survival rates than citizens in most other European countries, which may partly be explained by a comparatively longer diagnostic interval in these two countries. In Denmark, a pathway was introduced in 2008 allowing general practitioners (GPs) to refer patients suspected of having lung cancer directly to fast-track diagnostics. However, symptom presentation of lung cancer in general practice is known to be diverse and complex, and systematic knowledge of the routes to diagnosis is needed to enable earlier lung cancer diagnosis in Denmark. This study aims to describe the routes to diagnosis, the diagnostic activity preceding diagnosis and the diagnostic intervals for lung cancer in the Danish setting. We conducted a national registry-based cohort study on 971 consecutive incident lung cancer patients in 2010 using data from national registries and GP questionnaires. GPs were involved in 68.3% of cancer patients' diagnostic pathways, and 27.4% of lung cancer patients were referred from the GP to fast-track diagnostic work-up. A minimum of one X-ray was performed in 85.6% of all cases before diagnosis. Patients referred through a fast-track route more often had diagnostic X-rays (66.0%) than patients who did not go through fast-track (49.4%). Overall, 33.6% of all patients had two or more X-rays performed during the 90 days before diagnosis. Patients whose symptoms were interpreted as non-alarm symptoms or who were not referred to fast-track were more likely to experience a long diagnostic interval than patients whose symptoms were interpreted as alarm symptoms or who were referred to fast-track. Lung cancer patients followed several diagnostic pathways. The existing fast-track pathway must be supplemented to ensure earlier detection of lung cancer. The high incidence of multiple X-rays warrants a continued effort to develop more accurate lung

  9. 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.

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

    Science.gov (United States)

    Topolovec-Vranic, Jane; Natarajan, Karthik

    2016-11-07

    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. 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? 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. 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 media to be the most effective recruitment

  11. 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

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

    International Nuclear Information System (INIS)

    Tan, S.S.; Oppe, M.; Zoet-Nugteren, S.K.; Niezen, R.A.; Kofflard, M.J.M.; Ten Cate, F.J.; Roijen, L. Hakkaart-van

    2009-01-01

    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.

  13. 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.

  14. Veda-scope: More comfortable than the bivalve speculum and cytologically equivalent.

    Science.gov (United States)

    Longmore, Peter G

    2004-04-01

    The aim of the present study was to confirm that the Veda-scope is equivalent to the bivalve speculum in the collection of endocervical cells, as confirmation of adequate cervical sampling for Pap smear testing. The study also aimed to assess the comfort level of the Veda-scope compared to the traditional bivalve speculum and the patient preference of the Veda-scope compared to the bivalve speculum. Multicentre, randomised, controlled crossover, cytologist blinded study. The total number of subjects enrolled in the study were 250. The number of evaluable subjects were 210. In primary efficacy analysis, no significant difference was seen between the presence or absence of endocervical cells in the smears using either the Veda-scope or the bivalve speculum. There was a high concordance level between the diagnosis assigned to each specimen of a paired sample, the diagnosis agreeing in 97.6% cases. The primary reason given by many women for avoidance of regular Pap smear examinations is the discomfort or pain experienced with sample collection with the bivalve speculum. In the present study, 92% of subjects indicated a preference for the Veda-scope for Pap smear collection, while only 8.4% preferred the bivalve speculum. Subject preference was also assessed with respect to how the subject rated the comfort level of her previous Pap smear. In subjects who rated their previous Pap smear as very comfortable or comfortable, 86% expressed a preference for the Veda-scope. This rose to 93% in subjects who rated their previous Pap smear as only tolerable. The results of the present study show that Pap smear collections with the Veda-scope are of equal quality to those collected with the bivalve speculum, with an equivalent diagnostic outcome. A very strong preference for the Veda-scope was shown by the women enrolled in the present study based on the comfort levels experienced with the two devices.

  15. What Makes for Good Collaboration and Communication in Maternity Care? : A Scoping Study

    NARCIS (Netherlands)

    Isabel van Helmond; Irene Korstjens; Jessica Mesman; Marianne Nieuwenhuijze; Klasien Horstman; Hubertina Scheepers; Mark Spaanderman; Judit Keulen; Raymond de Vries

    2015-01-01

    Problems with communication and collaboration among perinatal caregivers threaten the quality and safety of care given to mothers and babies. Good communication and collaboration are critical to safe care for mothers and babies. In this study the researchers focused on studies examining the factors

  16. Pathways for the developing Myanmar’s seed sector: A scoping study

    NARCIS (Netherlands)

    Broek, van den J.A.; Subedi, A.; Jongeleen, F.; Naing Lin Oo,

    2015-01-01

    The study presents an integrated assessment of Myanmar’s seed sector. The study includes information and analyses on regulatory environment for seed production and sales, a characterization of Myanmar’s seed sector with its various seed systems, a landscape of current seed sector interventions; an

  17. Diagnostic and laboratory test ordering in Northern Portuguese Primary Health Care: a cross-sectional study

    Science.gov (United States)

    Sá, Luísa; Teixeira, Andreia Sofia Costa; Tavares, Fernando; Costa-Santos, Cristina; Couto, Luciana; Costa-Pereira, Altamiro; Hespanhol, Alberto Pinto; Santos, Paulo

    2017-01-01

    Objectives To characterise the test ordering pattern in Northern Portugal and to investigate the influence of context-related factors, analysing the test ordered at the level of geographical groups of family physicians and at the level of different healthcare organisations. Design Cross-sectional study. Setting Northern Primary Health Care, Portugal. Participants Records about diagnostic and laboratory tests ordered from 2035 family physicians working at the Northern Regional Health Administration, who served approximately 3.5 million Portuguese patients, in 2014. Outcomes To determine the 20 most ordered diagnostic and laboratory tests in the Northern Regional Health Administration; to identify the presence and extent of variations in the 20 most ordered diagnostic and laboratory tests between the Groups of Primary Care Centres and between health units; and to study factors that may explain these variations. Results The 20 most ordered diagnostic and laboratory tests almost entirely comprise laboratory tests and account for 70.9% of the total tests requested. We can trace a major pattern of test ordering for haemogram, glucose, lipid profile, creatinine and urinalysis. There was a significant difference (P<0.001) in test orders for all tests between Groups of Primary Care Centres and for all tests, except glycated haemoglobin (P=0.06), between health units. Generally, the Personalised Healthcare Units ordered more than Family Health Units. Conclusions The results from this study show that the most commonly ordered tests in Portugal are laboratory tests, that there is a tendency for overtesting and that there is a large variability in diagnostic and laboratory test ordering in different geographical and organisational Portuguese primary care practices, suggesting that there may be considerable potential for the rationalisation of test ordering. The existence of Family Health Units seems to be a strong determinant in decreasing test ordering by Portuguese family

  18. 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

  19. A scoping study for an environmental impact field programme in tidal current energy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    This report summarises the results of a study to identify the environmental impacts of tidal current energy with the aim of prioritising research. The background to the study is traced, and the interaction between tidal current energy technology and the marine environment, the modeling of the consequences of the environmental interactions, the quantification of the environmental impacts of key environmental interactions, and the formulation of a programme of research are discussed. Recommendations are given and research needs are highlighted.

  20. 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...

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

    OpenAIRE

    Topolovec-Vranic, Jane; Natarajan, Karthik

    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 met...

  2. 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...... for Reporting of Animal Diagnostic Accuracy Studies for paratuberculosis), should facilitate improved quality of reporting of the design, conduct and results of paratuberculosis test accuracy studies which were identified as “poor” in a review published in 2008 in Veterinary Microbiology...

  3. Experimental and numerical studies on liquid wicking into filter papers for paper-based diagnostics

    International Nuclear Information System (INIS)

    Liu, Zhi; Hu, Jie; Zhao, Yimeng; Qu, Zhiguo; Xu, Feng

    2015-01-01

    Paper-based diagnostics have shown promising potential applications in human disease surveillance and food safety analysis at the point-of-care (POC). The liquid wicking behavior in diagnostic fibrous paper plays an important role in development of paper-based diagnostics. In the current study, we performed experimental and numerical research on the liquid wicking height and mass with three width strips into filter paper. The effective porosity could be conveniently measured in the light of the linear correlation between wicking height and mass by the experimental system. A modified model with considering evaporation effect was proposed to predict wicking height and mass. The predicted wicking height and mass using the evaporation model was much closer to the experimental data compared with the model without evaporation. The wicking speed initially decreased significantly and then maintained at a constant value at lower level. The evaporation effect tends to reduce the wicking flow speed. More wicking mass could be obtained at larger strip width but the corresponding reagent loss became significant. The proposed model with evaporation paved a way to understanding the fundamental of fluid flow in diagnostic paper and was essential to provide meaningful and useful reference for the research and development of paper-based diagnostics devices. - Highlights: • A model with considering evaporation was proposed to predict wicking height and mass. • Flow characteristics of filter paper were experimentally and theoretically studied. • Effective porosity could be conveniently measured by the experimental platform. • The evaporation effect tended to reduce the wicking flow speed

  4. 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.

  5. Portuguese Family Physicians' Awareness of Diagnostic and Laboratory Test Costs: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Luísa Sá

    Full Text Available Physicians' ability to make cost-effective decisions has been shown to be affected by their knowledge of health care costs. This study assessed whether Portuguese family physicians are aware of the costs of the most frequently prescribed diagnostic and laboratory tests.A cross-sectional study was conducted in a representative sample of Portuguese family physicians, using computer-assisted telephone interviews for data collection. A Likert scale was used to assess physician's level of agreement with four statements about health care costs. Family physicians were also asked to estimate the costs of diagnostic and laboratory tests. Each physician's cost estimate was compared with the true cost and the absolute error was calculated.One-quarter (24%; 95% confidence interval: 23%-25% of all cost estimates were accurate to within 25% of the true cost, with 55% (95% IC: 53-56 overestimating and 21% (95% IC: 20-22 underestimating the true actual cost. The majority (76% of family physicians thought they did not have or were uncertain as to whether they had adequate knowledge of diagnostic and laboratory test costs, and only 7% reported receiving adequate education. The majority of the family physicians (82% said that they had adequate access to information about the diagnostic and laboratory test costs. Thirty-three percent thought that costs did not influence their decision to order tests, while 27% were uncertain.Portuguese family physicians have limited awareness of diagnostic and laboratory test costs, and our results demonstrate a need for improved education in this area. Further research should focus on identifying whether interventions in cost knowledge actually change ordering behavior, in identifying optimal methods to disseminate cost information, and on improving the cost-effectiveness of care.

  6. Portuguese Family Physicians’ Awareness of Diagnostic and Laboratory Test Costs: A Cross-Sectional Study

    Science.gov (United States)

    Sá, Luísa; Costa-Santos, Cristina; Teixeira, Andreia; Couto, Luciana; Costa-Pereira, Altamiro; Hespanhol, Alberto; Santos, Paulo; Martins, Carlos

    2015-01-01

    Background Physicians’ ability to make cost-effective decisions has been shown to be affected by their knowledge of health care costs. This study assessed whether Portuguese family physicians are aware of the costs of the most frequently prescribed diagnostic and laboratory tests. Methods A cross-sectional study was conducted in a representative sample of Portuguese family physicians, using computer-assisted telephone interviews for data collection. A Likert scale was used to assess physician’s level of agreement with four statements about health care costs. Family physicians were also asked to estimate the costs of diagnostic and laboratory tests. Each physician’s cost estimate was compared with the true cost and the absolute error was calculated. Results One-quarter (24%; 95% confidence interval: 23%–25%) of all cost estimates were accurate to within 25% of the true cost, with 55% (95% IC: 53–56) overestimating and 21% (95% IC: 20–22) underestimating the true actual cost. The majority (76%) of family physicians thought they did not have or were uncertain as to whether they had adequate knowledge of diagnostic and laboratory test costs, and only 7% reported receiving adequate education. The majority of the family physicians (82%) said that they had adequate access to information about the diagnostic and laboratory test costs. Thirty-three percent thought that costs did not influence their decision to order tests, while 27% were uncertain. Conclusions Portuguese family physicians have limited awareness of diagnostic and laboratory test costs, and our results demonstrate a need for improved education in this area. Further research should focus on identifying whether interventions in cost knowledge actually change ordering behavior, in identifying optimal methods to disseminate cost information, and on improving the cost-effectiveness of care. PMID:26356625

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. Lyricist’s Lyrical Lyrics: Widening the Scope of Poetry Studies by Claiming the Obvious

    NARCIS (Netherlands)

    Buelens, G.

    2011-01-01

    Poetry is all but absent from Cultural Studies. Most treatments of the genre tend to focus on canonized poets whose work is wilfully difficult and obscure. Alternative histories should be explored, opening up possibilities to view poetry again as a culturally relevant art form. The demotic and

  12. 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

  13. 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 ... The philosophy behind this subject was to make it help solve the numerous problems associated with nation building in Nigeria. Today, there are burning global ...

  14. A Systematic Scoping Study of the Socio-Economic Impact of Rift Valley Fever: Research Gaps and Needs.

    Science.gov (United States)

    Peyre, M; Chevalier, V; Abdo-Salem, S; Velthuis, A; Antoine-Moussiaux, N; Thiry, E; Roger, F

    2015-08-01

    Rift Valley fever (RVF) is a severe mosquito-borne disease affecting humans and domestic ruminants. RVF virus has been reported in most African countries, as well as in the Arabic Peninsula. This paper reviews the different types of socio-economic impact induced by RVF disease and the attempts to evaluate them. Of the 52 papers selected for this review, 13 types of socio-economic impact were identified according to the sector impacted, the level and temporal scale of the impact. RVF has a dramatic impact on producers and livestock industries, affecting public and animal health, food security and the livelihood of the pastoralist communities. RVF also has an impact on international trade and other agro-industries. The risk of introducing RVF into disease-free countries via the importation of an infected animal or mosquito is real, and the consequent restriction of access to export markets may induce dramatic economic consequences for national and local economies. Despite the important threat of RVF, few studies have been conducted to assess the socio-economic impact of the disease. The 17 studies identified for quantitative analysis in this review relied only on partial cost analysis, with limited reference to mid- and long-term impact, public health or risk mitigation measures. However, the estimated impacts were high (ranging from $5 to $470 million USD losses). To reduce the impact of RVF, early detection and rapid response should be implemented. Comprehensive disease impact studies are required to provide decision-makers with science-based information on the best intervention measure to implement ensuring efficient resource allocation. Through the analysis of RVF socio-economic impact, this scoping study proposes insights into the mechanisms underpinning its often-underestimated importance. This study highlights the need for comparative socio-economic studies to help decision-makers with their choices related to RVF disease management. © 2014 The Authors

  15. The organizational culture of emergency departments and the effect on care of older adults: a modified scoping study.

    Science.gov (United States)

    Skar, Pål; Bruce, Anne; Sheets, Debra

    2015-04-01

    How does the organizational micro culture in emergency departments (EDs) impact the care of older adults presenting with a complaint or condition perceived as non-acute? This scoping study reviews the literature and maps three levels of ED culture (artifacts, values and beliefs, and assumptions). Findings on the artifact level indicate that EDs are poorly designed for the needs of older adults. Findings on the ED value and belief level indicate that EDs are for urgent cases (not geriatric care), that older adults do not receive the care and respect they should be given, that older adults require too much time, and that the basic nursing needs of older adults are not a priority for ED nurses. Finally, finding on the assumptions level underpinning ED behaviors suggest that older adults do not belong in the ED, most older adults in the ED are not critically ill and therefore can wait, and staff need to be available for acute cases at all times. A systematic review on the effect of ED micro culture on the quality of geriatric care is warranted. Copyright © 2014. Published by Elsevier Ltd.

  16. 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.

  17. Psychological treatment of depression and anxiety in patients with co-morbid personality disorder: A scoping study of trial evidence.

    Science.gov (United States)

    French, L R M; Turner, K M; Dawson, S; Moran, P

    2017-05-01

    It is unclear what the best psychological treatment is for depression and anxiety in people with co-morbid personality disorder. Trials of different psychological treatment options for this patient group have been conducted, but this evidence has not previously been systematically reviewed or critically appraised. We set out to conduct a scoping review in order to describe which psychological therapies appear most effective in treating depression and/or anxiety in patients with co-morbid personality disorder. PsycINFO, Cochrane library trials, Medline and Embase databases were searched for studies involving randomized, controlled, experimental, parallel-arm comparisons, examining any well-defined, psychotherapeutic intervention for adults, in an outpatient setting, with a clearly defined diagnosis of depression and/or anxiety, and co-morbid personality disorder. A total of 1662 papers were identified. Fifteen met criteria for inclusion and were reviewed. There was weak evidence to support the use of cognitive behavioural therapy as a psychological treatment for depression in patients with co-morbid personality disorder. However, the literature is characterized by considerable methodological heterogeneity, and further research is needed before there is sufficient evidence to indicate which psychological treatment would be most effective in treating anxiety and/or depression in this patient group. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  18. 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.

  19. Pd-Catalyzed N-Arylation of Secondary Acyclic Amides: Catalyst Development, Scope, and Computational Study

    Science.gov (United States)

    Hicks, Jacqueline D.; Hyde, Alan M.; Cuezva, Alberto Martinez; Buchwald, Stephen L.

    2009-01-01

    We report the efficient N-arylation of acyclic secondary amides and related nucleophiles with aryl nonaflates, triflates, and chlorides. This method allows for easy variation of the aromatic component in tertiary aryl amides. A new biaryl phosphine with P-bound 3,5-(bis)trifluoromethylphenyl groups was found to be uniquely effective for this amidation. The critical aspects of the ligand were explored through synthetic, mechanistic, and computational studies. Systematic variation of the ligand revealed the importance of (1) a methoxy group on the aromatic carbon of the “top ring” ortho to the phosphorus and (2) two highly electron-withdrawing P-bound 3,5-(bis)trifluoromethylphenyl groups. Computational studies suggest the electron-deficient nature of the ligand is important in facilitating amide binding to the LPd(II)(Ph)(X) intermediate. PMID:19886610

  20. 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)

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

    OpenAIRE

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

    2016-01-01

    Background 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. Methods Nine periodontal case reports were twice presented to sixteen boar...

  2. 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)

  3. Scope and design of the Following Rehabilitation, Economics and Everyday-Dialysis Outcome Measurements (FREEDOM) Study.

    Science.gov (United States)

    Jaber, Bertrand L; Finkelstein, Fredric O; Glickman, Joel D; Hull, Alan R; Kraus, Michael A; Leypoldt, John K; Liu, Jiannong; Gilbertson, David; McCarthy, James; Miller, Brent W; Moran, John; Collins, Allan J

    2009-02-01

    Conventional thrice-weekly hemodialysis (HD) has limited the ability to generate further improvements in patient quality of life, morbidity, and mortality. Daily HD (DHD) offers the promise of providing clinical and economic benefits. The objectives of the Following Rehabilitation, Economics and Everyday-Dialysis Outcome Measurements Study are to evaluate outcomes of DHD (6 times/wk) with the NxStage System One (NxStage Medical Inc, Lawrence, MA) device. Cohort study with matched control group. The DHD group will include up to 500 participants at 70 clinical sites, enrolling for 3 years with a minimum of 1-year follow-up. Study candidates include adult patients (age >or= 18 years) with end-stage renal disease who are considered suitable candidates for DHD with the NxStage System One device by the treating physician and who have Medicare as their primary insurance payer. The control group will consist of a matched thrice-weekly in-center HD cohort derived from the US Renal Data System database using a 10:1 ratio, totaling 5,000 patients. Treatment with DHD and "standard of care" thrice-weekly HD. The primary intent-to-treat analysis compares hospitalization days/patient-year between the DHD and thrice-weekly HD groups. Other outcomes recorded in both groups include non-treatment-related medical expenditures. In addition, in the DHD cohort, changes in quality-of-life measures (baseline, 4 and 12 months, and every 6 months thereafter); urea kinetics; parameters related to anemia, bone and mineral metabolism, and nutrition; vascular access interventions; and use of medications will be examined. This study has the potential to elucidate the health and economic benefits of DHD and complement results of current clinical trials.

  4. The cost of child health inequalities in Aotearoa New Zealand: a preliminary scoping study

    Directory of Open Access Journals (Sweden)

    Mills Clair

    2012-05-01

    Full Text Available Abstract Background Health inequalities have been extensively documented, internationally and in New Zealand. The cost of reducing health inequities is often perceived as high; however, recent international studies suggest the cost of “doing nothing” is itself significant. This study aimed to develop a preliminary estimate of the economic cost of health inequities between Māori (indigenous and non-Māori children in New Zealand. Methods Standard quantitative epidemiological methods and “cost of illness” methodology were employed, within a Kaupapa Māori theoretical framework. Data were obtained from national data collections held by the New Zealand Health Information Service and other health sector agencies. Results Preliminary estimates suggest child health inequities between Māori and non-Māori in New Zealand are cost-saving to the health sector. However the societal costs are significant. A conservative “base case” scenario estimate is over $NZ62 million per year, while alternative costing methods yield larger costs of nearly $NZ200 million per annum. The total cost estimate is highly sensitive to the costing method used and Value of Statistical Life applied, as the cost of potentially avoidable deaths of Māori children is the major contributor to this estimate. Conclusions This preliminary study suggests that health sector spending is skewed towards non-Māori children despite evidence of greater Māori need. Persistent child health inequities result in significant societal economic costs. Eliminating child health inequities, particularly in primary care access, could result in significant economic benefits for New Zealand. However, there are conceptual, ethical and methodological challenges in estimating the economic cost of child health inequities. Re-thinking of traditional economic frameworks and development of more appropriate methodologies is required.

  5. The cost of child health inequalities in Aotearoa New Zealand: a preliminary scoping study.

    Science.gov (United States)

    Mills, Clair; Reid, Papaarangi; Vaithianathan, Rhema

    2012-05-28

    Health inequalities have been extensively documented, internationally and in New Zealand. The cost of reducing health inequities is often perceived as high; however, recent international studies suggest the cost of "doing nothing" is itself significant. This study aimed to develop a preliminary estimate of the economic cost of health inequities between Māori (indigenous) and non-Māori children in New Zealand. Standard quantitative epidemiological methods and "cost of illness" methodology were employed, within a Kaupapa Māori theoretical framework. Data were obtained from national data collections held by the New Zealand Health Information Service and other health sector agencies. Preliminary estimates suggest child health inequities between Māori and non-Māori in New Zealand are cost-saving to the health sector. However the societal costs are significant. A conservative "base case" scenario estimate is over $NZ62 million per year, while alternative costing methods yield larger costs of nearly $NZ200 million per annum. The total cost estimate is highly sensitive to the costing method used and Value of Statistical Life applied, as the cost of potentially avoidable deaths of Māori children is the major contributor to this estimate. This preliminary study suggests that health sector spending is skewed towards non-Māori children despite evidence of greater Māori need. Persistent child health inequities result in significant societal economic costs. Eliminating child health inequities, particularly in primary care access, could result in significant economic benefits for New Zealand. However, there are conceptual, ethical and methodological challenges in estimating the economic cost of child health inequities. Re-thinking of traditional economic frameworks and development of more appropriate methodologies is required.

  6. 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.

  7. A scoping study of the application of neutral beam heating on the TCV tokamak

    Energy Technology Data Exchange (ETDEWEB)

    Karpushov, Alexander N., E-mail: alexander.karpushov@epfl.ch [Ecole Polytechnique Federale de Lausanne (EPFL), Centre de Recherches en Physique des Plasmas, Association Euratom-Confederation Suisse, CH-1015 Lausanne (Switzerland); Duval, Basil P.; Chavan, Rene [Ecole Polytechnique Federale de Lausanne (EPFL), Centre de Recherches en Physique des Plasmas, Association Euratom-Confederation Suisse, CH-1015 Lausanne (Switzerland); Fable, Emiliano [Max-Planck-Institut fuer Plasmaphysik, Euratom-IPP Association, Boltzmannstrasse 2, D-85748 Garching (Germany); Mayor, Jean-Michel; Sauter, Olivier; Weisen, Henri [Ecole Polytechnique Federale de Lausanne (EPFL), Centre de Recherches en Physique des Plasmas, Association Euratom-Confederation Suisse, CH-1015 Lausanne (Switzerland)

    2011-10-15

    The TCV tokamak contributes to the physics understanding of fusion plasmas, broadening the parameter range of reactor relevant regimes, by investigations based on an extensive use of the existing main experimental tools: flexible shaping and high power real time-controllable electron cyclotron heating (ECH) and current drive (ECCD) systems. A proposed implementation of direct ion heating on the TCV by the installation of a 20-35 keV neutral beam injection (NBI) with a total power of 1-3 MW would permit an extension of the accessible range of ion to electron temperatures (T{sub i}/T{sub e} {approx} 0.1-0.8) to well beyond unity, depending on the NBI/ECH mix and the plasma density. A NBI system would provide TCV with a tool for plasma study at reactor relevant T{sub i}/T{sub e} ratios {approx}1 and in investigating fast ion and MHD physics together with the effects of plasma rotation and high plasma {beta} scenarios. The feasibility studies for a NBI heating on TCV presented in this paper were undertaken to construct a specification for the neutral beam injectors together with an experimental geometry for possible operational scenarios.

  8. 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.

  9. 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.

  10. Scoping Adaptation Needs for Smallholders in the Brazilian Amazon: A Municipal Level Case Study

    Directory of Open Access Journals (Sweden)

    Osuna Vanesa Rodríguez

    2014-05-01

    Full Text Available Over the past decade, several climate extreme events have caused considerable economic damage and hardship in the Brazilian Amazon region, especially for small-scale producers. Based on household surveys and focus group interviews in the Municipality of Alenquer as well as secondary data analyses and a literature review at the regional level, this study seeks to assess rural small-scale producers’ vulnerability to climate and non-climate related shocks and identify entry points for government action to support adaptation at the local level. In our case study area, small-scale producers with similar wealth, self-sufficiency, and resource use specialisation levels exhibited stark variation in levels of sensitivity and adaptive capacity to climate and nonclimate related shocks. Our findings indicate that this variation is partly driven by cultural, historical, and environmental resource use specialisation strategies and partly by differences in local governance capacity and the level of social organisation. Emerging governmentled initiatives to promote climate change adaptation in the region would benefit from taking these factors into account when designing local implementation strategies and priorities.

  11. 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

  12. 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.

  13. 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.

  14. Liquid Scoping Study for Tritium-Lean, Fast Ignition Inertial Fusion Energy Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, R C; Latkowski, J F; Durbin, S G; Meier, W R; Reyes, S

    2001-08-14

    In a thick-liquid protected chamber design, such as HYLIFE-II, a molten-salt is used to attenuate neutrons and protect the chamber structures from radiation damage. The molten-salt absorbs some of the material and energy given off by the target explosion. In the case of a fast ignition inertial fusion system, advanced targets have been proposed that may be Self-sufficient in the tritium breeding (i.e., the amount of tritium bred in target exceeds the amount burned). These ''tritium-lean'' targets contain approximately 0.5% tritium and 99.5% deuterium, but require a large pr of 10-20 g/cm{sup 2}. Although most of the yield is provided by D-T reactions, the majority of fusion reactions are D-D, which produces a net surplus of tritium. This aspect allows for greater freedom when selecting a liquid for the protective blanket (lithium-bearing compounds are not required). This study assesses characteristics of many single, binary, and ternary molten-salts. Using the NIST Properties of Molten Salts Database, approximately 4300 molten-salts were included in the study [1]. As an initial screening, salts were evaluated for their safety and environmental (S&E) characteristics, which included an assessment of waste disposal rating, contact dose, and radioactive afterheat. Salts that passed the S&E criteria were then evaluated for neutron shielding ability and pumping power. The pumping power was calculated using three components: velocity head losses, frictional losses, and lift. This assessment left us with 57 molten-salts to recommend for further analysis. Many of these molten-salts contain elements such as sodium, lithium, beryllium, boron, fluorine, and oxygen. Recommendations for further analysis are also made.

  15. Liquid Scoping Study for Tritium-Lean, Fast Ignition Inertial Fusion Energy Power Plants

    International Nuclear Information System (INIS)

    Schmitt, R C; Latkowski, J F; Durbin, S G; Meier, W R; Reyes, S

    2001-01-01

    In a thick-liquid protected chamber design, such as HYLIFE-II, a molten-salt is used to attenuate neutrons and protect the chamber structures from radiation damage. The molten-salt absorbs some of the material and energy given off by the target explosion. In the case of a fast ignition inertial fusion system, advanced targets have been proposed that may be Self-sufficient in the tritium breeding (i.e., the amount of tritium bred in target exceeds the amount burned). These ''tritium-lean'' targets contain approximately 0.5% tritium and 99.5% deuterium, but require a large pr of 10-20 g/cm 2 . Although most of the yield is provided by D-T reactions, the majority of fusion reactions are D-D, which produces a net surplus of tritium. This aspect allows for greater freedom when selecting a liquid for the protective blanket (lithium-bearing compounds are not required). This study assesses characteristics of many single, binary, and ternary molten-salts. Using the NIST Properties of Molten Salts Database, approximately 4300 molten-salts were included in the study [1]. As an initial screening, salts were evaluated for their safety and environmental (SandE) characteristics, which included an assessment of waste disposal rating, contact dose, and radioactive afterheat. Salts that passed the SandE criteria were then evaluated for neutron shielding ability and pumping power. The pumping power was calculated using three components: velocity head losses, frictional losses, and lift. This assessment left us with 57 molten-salts to recommend for further analysis. Many of these molten-salts contain elements such as sodium, lithium, beryllium, boron, fluorine, and oxygen. Recommendations for further analysis are also made

  16. A mannequin study of intubation with the AP advance and GlideScope Ranger videolaryngoscopes and the Macintosh laryngoscope.

    Science.gov (United States)

    Hodd, Jack A R; Doyle, D John; Gupta, Shipra; Dalton, Jarrod E; Cata, Juan P; Brewer, Edward J; James, Monyulona; Sessler, Daniel I

    2011-10-01

    The AP Advance (APA) is a videolaryngoscope with interchangeable blades: intubators can choose standard Macintosh blades or a difficult-airway blade with increased curvature and a channel to guide the tube to the larynx. The APA may therefore be comparably effective in both normal and difficult airways. We tested the hypotheses that intubation with the APA is no slower than Macintosh laryngoscopy for normal mannequin airways, and that it is no slower than videolaryngoscopy using a GlideScope Ranger in difficult mannequin airways. Medical professionals whose roles potentially include tracheal intubation were trained with each device. Participants intubated simulated (Laerdal SimMan) normal and difficult airways with the APA, GlideScope, and a conventional Macintosh blade. Speed of intubation was compared using Cox proportional hazards regression, with a hazard ratio >0.8 considered noninferior. We also compared laryngeal visualization, failures, and participant preferences. Unadjusted intubation times in the normal airway with the APA and Macintosh were virtually identical (median, 22 vs 23 seconds); after adjustment for effects of experience, order, and period, the hazard ratio (95% confidence interval) comparing APA with Macintosh laryngoscopy was 0.87 (0.65, 1.17), which was not significantly more than our predefined noninferiority boundary of 0.8 (P = 0.26). Intubation with the APA was faster than with the GlideScope in difficult airways (hazard ratio = 7.6 [5.0, 11.3], P APA, whereas 33% and 37% failed with the GlideScope and Macintosh, respectively. In the difficult airway, 99% of participants achieved a Cormack and Lehane grade I to II view with the APA, versus 85% and 33% with the GlideScope and Macintosh, respectively. When asked to choose 1 device overall, 82% chose the APA. Intubation times were similar with the APA and Macintosh laryngoscopes in mannequins with normal airways. However, intubation with the APA was significantly faster than with the GlideScope

  17. Assessing the utility of diagnostic criteria: a multisite study on gender identity disorder.

    Science.gov (United States)

    Paap, Muirne C S; Kreukels, Baudewijntje P C; Cohen-Kettenis, Peggy T; Richter-Appelt, Hertha; de Cuypere, Griet; Haraldsen, Ira R

    2011-01-01

    Studies involving patients with gender identity disorder (GID) are inconsistent with regard to outcomes and often difficult to compare because of the vague descriptions of the diagnostic process. A multisite study is needed to scrutinize the utility and generality of different aspects of the diagnostic criteria for GID. To investigate the way in which the diagnosis-specific Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criteria for GID were used to reach a psychiatric diagnosis in four European countries: the Netherlands (Amsterdam), Norway (Oslo), Germany (Hamburg), and Belgium (Ghent). The main goal was to compare item (symptom) characteristics across countries. The current study included all new applicants to the four GID clinics who were seen between January 2007 and March 2009, were at least 16 years of age at their first visit, and had completed the diagnostic assessment (N = 214, mean age = 32 ± 12.2 years). Mokken scale analysis, a form of Nonparametric Item Response Theory (NIRT) was performed. Operationalization and quantification of the core criteria A and B resulted in a 23-item score sheet that was filled out by the participating clinicians after they had made a diagnosis. We found that, when ordering the 23 items according to their means for each country separately, the rank ordering was similar among the four countries for 21 of the items. Furthermore, only one scale emerged, which combined criteria A and B when all data were analyzed together. Our results indicate that patients' symptoms were interpreted in a similar fashion in all four countries. However, we did not find support for the treatment of A and B as two separate criteria. We recommend the use of NIRT in future studies, especially in studies with small sample sizes and/or with data that show a poor fit to parametric IRT models. © 2010 International Society for Sexual Medicine.

  18. 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.

  19. 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

  20. 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.

  1. Fire Risk Scoping Study: Investigation of nuclear power plant fire risk, including previously unaddressed issues

    International Nuclear Information System (INIS)

    Lambright, J.A.; Nowlen, S.P.; Nicolette, V.F.; Bohn, M.P.

    1989-01-01

    An investigation of nuclear power plant fire risk issues raised as a result of the USNRC sponsored Fire Protection Research Program at Sandia National Laboratories has been performed. The specific objectives of this study were (1) to review and requantify fire risk scenarios from four fire probabilistic risk assessments (PRAs) in light of updated data bases made available as a result of USNRC sponsored Fire Protection Research Program and updated computer fire modeling capabilities, (2) to identify potentially significant fire risk issues that have not been previously addressed in a fire risk context and to quantify the potential impact of those identified fire risk issues where possible, and (3) to review current fire regulations and plant implementation practices for relevance to the identified unaddressed fire risk issues. In performance of the fire risk scenario requantifications several important insights were gained. It was found that utilization of a more extensive operational experience base resulted in both fire occurrence frequencies and fire duration times (i.e., time required for fire suppression) increasing significantly over those assumed in the original works. Additionally, some thermal damage threshold limits assumed in the original works were identified as being nonconservative based on more recent experimental data. Finally, application of the COMPBRN III fire growth model resulted in calculation of considerably longer fire damage times than those calculated in the original works using COMPBRN I. 14 refs., 2 figs., 16 tabs

  2. The study of diagnostic accuracy of chest nodules by using different compression methods

    International Nuclear Information System (INIS)

    Liang Zhigang; Kuncheng, L.I.; Zhang Jinghong; Liu Shuliang

    2005-01-01

    Background: The purpose of this study was to compare the diagnostic accuracy of small nodules in the chest by using different compression methods. Method: Two radiologists with 5 years experience twice interpreted 39 chest images by using lossless and lossy compression methods. The time interval was 3 weeks. Each time the radiologists interpreted one kind of compressed images. The image browser used the Unisight software provided by Atlastiger Company in Shanghai. The interpreting results were analyzed by the ROCKIT software and the ROC curves were painted by Excel 2002. Results: In studies of receiver operating characteristics for scoring the presence or absence of nodules, the images with lossy compression method showed no statistical difference as compared with the images with lossless compression method. Conclusion: The diagnostic accuracy of chest nodules by using the lossless and lossy compression methods had no significant difference, we could use the lossy compression method to transmit and archive the chest images with nodules

  3. Theoretical studies of flash x-ray diagnostics for fuel motion experiments

    International Nuclear Information System (INIS)

    Halbleib, J.A. Sr.; Phillips, A.R.

    1975-09-01

    The results of preliminary theoretical studies concerning the possible employment of short-pulse, high-current field emission diodes as sources for the flash x-ray diagnostics of fuel-pin motion are reported. The predicted thick-target photon environments are obtained from state-of-the-art coupled electron/photon transport models. Through qualitative figures of merit these environments are used to study the importance of source current and voltage. For a selected experimental configuration a comparison is made between the absolute flash x-ray imaging signals predicted for these environments and Monte Carlo/analytic calculations of absolute fission-gamma backgrounds. These preliminary data suggest that field emission sources operating at voltages in the 1-to 5-MeV range and at currents of the order of 100-kA or greater may be adequate diagnostic sources for test-pin configurations as complex as a full LMFBR subassembly

  4. 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

  5. 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.

  6. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young Jun; Chung, Mi Sun; Koo, Hyun Jung; Park, Ji Eun; Yoon, Hee Mang; Park, Seong Ho [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2016-09-15

    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.

  8. How doctors diagnose diseases and prescribe treatments: an fMRI study of diagnostic salience

    OpenAIRE

    Melo, Marcio; Gusso, Gustavo D. F.; Levites, Marcelo; Amaro Jr., Edson; Massad, Eduardo; Lotufo, Paulo A.; Zeidman, Peter; Price, Cathy J.; Friston, Karl J.

    2017-01-01

    Understanding the brain mechanisms involved in diagnostic reasoning may contribute to the development of methods that reduce errors in medical practice. In this study we identified similar brain systems for diagnosing diseases, prescribing treatments, and naming animals and objects using written information as stimuli. Employing time resolved modeling of blood oxygen level dependent (BOLD) responses enabled time resolved (400 milliseconds epochs) analyses. With this approach it was possible t...

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

    OpenAIRE

    Sanchini, Andrea; Donoso-Mantke, Oliver; 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 E...

  10. Palliative care in the home: a scoping review of study quality, primary outcomes, and thematic component analysis.

    Science.gov (United States)

    Hofmeister, Mark; Memedovich, Ally; Dowsett, Laura E; Sevick, Laura; McCarron, Tamara; Spackman, Eldon; Stafinski, Tania; Menon, Devidas; Noseworthy, Tom; Clement, Fiona

    2018-03-07

    The aim of palliative care is to improve the quality of life of patients and families through the prevention and relief of suffering. Frequently, patients may choose to receive palliative care in the home. The objective of this paper is to summarize the quality and primary outcomes measured within the palliative care in the home literature. This will synthesize the current state of the literature and inform future work. A scoping review was completed using PRISMA guidelines. PubMed, Embase, CINAHL, Web of Science, Cochrane Library, EconLit, PsycINFO, Centre for Reviews and Dissemination, Database of Abstracts of Reviews of Effects, and National Health Service Economic Evaluation Database were searched from inception to August 2016. Inclusion criteria included: 1) care was provided in the "home of the patient" as defined by the study, 2) outcomes were reported, and 3) reported original data. Thematic component analysis was completed to categorize interventions. Fifty-three studies formed the final data set. The literature varied extensively. Five themes were identified: accessibility of healthcare, caregiver support, individualized patient centered care, multidisciplinary care provision, and quality improvement. Primary outcomes were resource use, symptom burden, quality of life, satisfaction, caregiver distress, place of death, cost analysis, or described experiences. The majority of studies were of moderate or unclear quality. There is robust literature of varying quality, assessing different components of palliative care in the home interventions, and measuring different outcomes. To be meaningful to patients, these interventions need to be consistently evaluated with outcomes that matter to patients. Future research could focus on reaching a consensus for outcomes to evaluate palliative care in the home interventions.

  11. 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

  12. Serum and urine metabolomics study reveals a distinct diagnostic model for cancer cachexia

    Science.gov (United States)

    Yang, Quan‐Jun; Zhao, Jiang‐Rong; Hao, Juan; Li, Bin; Huo, Yan; Han, Yong‐Long; Wan, Li‐Li; Li, Jie; Huang, Jinlu; Lu, Jin

    2017-01-01

    Abstract Background Cachexia is a multifactorial metabolic syndrome with high morbidity and mortality in patients with advanced cancer. The diagnosis of cancer cachexia depends on objective measures of clinical symptoms and a history of weight loss, which lag behind disease progression and have limited utility for the early diagnosis of cancer cachexia. In this study, we performed a nuclear magnetic resonance‐based metabolomics analysis to reveal the metabolic profile of cancer cachexia and establish a diagnostic model. Methods Eighty‐four cancer cachexia patients, 33 pre‐cachectic patients, 105 weight‐stable cancer patients, and 74 healthy controls were included in the training and validation sets. Comparative analysis was used to elucidate the distinct metabolites of cancer cachexia, while metabolic pathway analysis was employed to elucidate reprogramming pathways. Random forest, logistic regression, and receiver operating characteristic analyses were used to select and validate the biomarker metabolites and establish a diagnostic model. Results Forty‐six cancer cachexia patients, 22 pre‐cachectic patients, 68 weight‐stable cancer patients, and 48 healthy controls were included in the training set, and 38 cancer cachexia patients, 11 pre‐cachectic patients, 37 weight‐stable cancer patients, and 26 healthy controls were included in the validation set. All four groups were age‐matched and sex‐matched in the training set. Metabolomics analysis showed a clear separation of the four groups. Overall, 45 metabolites and 18 metabolic pathways were associated with cancer cachexia. Using random forest analysis, 15 of these metabolites were identified as highly discriminating between disease states. Logistic regression and receiver operating characteristic analyses were used to create a distinct diagnostic model with an area under the curve of 0.991 based on three metabolites. The diagnostic equation was Logit(P) = −400.53 – 481.88

  13. 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

  14. Diagnostic accuracy of the Eurotest for dementia: a naturalistic, multicenter phase II study

    Directory of Open Access Journals (Sweden)

    Frank Ana

    2006-04-01

    Full Text Available Abstract Background Available screening tests for dementia are of limited usefulness because they are influenced by the patient's culture and educational level. The Eurotest, an instrument based on the knowledge and handling of money, was designed to overcome these limitations. The objective of this study was to evaluate the diagnostic accuracy of the Eurotest in identifying dementia in customary clinical practice. Methods A cross-sectional, multi-center, naturalistic phase II study was conducted. The Eurotest was administered to consecutive patients, older than 60 years, in general neurology clinics. The patients' condition was classified as dementia or no dementia according to DSM-IV diagnostic criteria. We calculated sensitivity (Sn, specificity (Sp and area under the ROC curves (aROC with 95% confidence intervals. The influence of social and educational factors on scores was evaluated with multiple linear regression analysis, and the influence of these factors on diagnostic accuracy was evaluated with logistic regression. Results Sixteen neurologists recruited a total of 516 participants: 101 with dementia, 380 without dementia, and 35 who were excluded. Of the 481 participants who took the Eurotest, 38.7% were totally or functionally illiterate and 45.5% had received no formal education. Mean time needed to administer the test was 8.2+/-2.0 minutes. The best cut-off point was 20/21, with Sn = 0.91 (0.84–0.96, Sp = 0.82 (0.77–0.85, and aROC = 0.93 (0.91–0.95. Neither the scores on the Eurotest nor its diagnostic accuracy were influenced by social or educational factors. Conclusion This naturalistic and pragmatic study shows that the Eurotest is a rapid, simple and useful screening instrument, which is free from educational influences, and has appropriate internal and external validity.

  15. 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

  16. Improving the accessibility and re-use of environmental models through provision of model metadata - a scoping study

    Science.gov (United States)

    Riddick, Andrew; Hughes, Andrew; Harpham, Quillon; Royse, Katherine; Singh, Anubha

    2014-05-01

    There has been an increasing interest both from academic and commercial organisations over recent years in developing hydrologic and other environmental models in response to some of the major challenges facing the environment, for example environmental change and its effects and ensuring water resource security. This has resulted in a significant investment in modelling by many organisations both in terms of financial resources and intellectual capital. To capitalise on the effort on producing models, then it is necessary for the models to be both discoverable and appropriately described. If this is not undertaken then the effort in producing the models will be wasted. However, whilst there are some recognised metadata standards relating to datasets these may not completely address the needs of modellers regarding input data for example. Also there appears to be a lack of metadata schemes configured to encourage the discovery and re-use of the models themselves. The lack of an established standard for model metadata is considered to be a factor inhibiting the more widespread use of environmental models particularly the use of linked model compositions which fuse together hydrologic models with models from other environmental disciplines. This poster presents the results of a Natural Environment Research Council (NERC) funded scoping study to understand the requirements of modellers and other end users for metadata about data and models. A user consultation exercise using an on-line questionnaire has been undertaken to capture the views of a wide spectrum of stakeholders on how they are currently managing metadata for modelling. This has provided a strong confirmation of our original supposition that there is a lack of systems and facilities to capture metadata about models. A number of specific gaps in current provision for data and model metadata were also identified, including a need for a standard means to record detailed information about the modelling

  17. 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)

  18. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Jun Su; Seong, Poong Hyun [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

    2005-07-01

    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.

  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.......84) for the tibial measurements and the mean difference for total LLD was 0.01cm (p=0.92) and 0.03cm (p=0.73). All ICC calculations were >.99 indicating excellent inter- and intra-rater reliability. Conclusion. The results strongly imply that LL measurements performed on pre-view images acquired with a new bi...

  1. 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.

  2. 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)

  3. 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

  4. Systematic overview finds variation in approaches to investigating and reporting on sources of heterogeneity in systematic reviews of diagnostic studies

    NARCIS (Netherlands)

    Naaktgeboren, Christiana A.; van Enst, Wynanda A.; Ochodo, Eleanor A.; de Groot, Joris A. H.; Hooft, Lotty; Leeflang, Mariska M.; Bossuyt, Patrick M.; Moons, Karel G. M.; Reitsma, Johannes B.

    2014-01-01

    To examine how authors explore and report on sources of heterogeneity in systematic reviews of diagnostic accuracy studies. A cohort of systematic reviews of diagnostic tests was systematically identified. Data were extracted on whether an exploration of the sources of heterogeneity was undertaken,

  5. Individual patient data meta-analysis of diagnostic and prognostic studies in obstetrics, gynaecology and reproductive medicine

    NARCIS (Netherlands)

    Broeze, Kimiko A.; Opmeer, Brent C.; Bachmann, Lucas M.; Broekmans, Frank J.; Bossuyt, Patrick M. M.; Coppus, Sjors F. P. J.; Johnson, Neil P.; Khan, Khalid S.; ter Riet, Gerben; van der Veen, Fulco; van Wely, Madelon; Mol, Ben W. J.

    2009-01-01

    ABSTRACT: BACKGROUND: In clinical practice a diagnosis is based on a combination of clinical history, physical examination and additional diagnostic tests. At present, studies on diagnostic research often report the accuracy of tests without taking into account the information already known from

  6. Multisite Study of New Autism Diagnostic Interview-Revised (ADI-R) Algorithms for Toddlers and Young Preschoolers

    Science.gov (United States)

    Kim, So Hyun; Thurm, Audrey; Shumway, Stacy; Lord, Catherine

    2013-01-01

    Using two independent datasets provided by National Institute of Health funded consortia, the Collaborative Programs for Excellence in Autism and Studies to Advance Autism Research and Treatment (n = 641) and the National Institute of Mental Health (n = 167), diagnostic validity and factor structure of the new Autism Diagnostic Interview (ADI-R)…

  7. Studying the Impact of Spaceflight Environment on Immune Functions Using New Molecular Diagnostics System

    Science.gov (United States)

    Cohen, Luchino

    Immune functions are altered during space flights. Latent virus reactivation, reduction in the number of immune cells, decreased cell activation and increased sensitivity of astronauts to infections following their return on Earth demonstrate that the immune system is less efficient during space flight. The causes of this immune deficiency are not fully understood and this dysfunction during long-term missions could result in the appearance of opportunistic infections or a decrease in the immuno-surveillance mechanisms that eradicate cancer cells. Therefore, the immune functions of astronauts will have to be monitored continuously during long-term missions in space, using miniature and semi-automated diagnostic systems. The objectives of this project are to study the causes of space-related immunodeficiency, to develop countermeasures to maintain an optimal immune function and to improve our capacity to detect infectious diseases during space missions through the monitoring of astronauts' immune system. In order to achieve these objectives, an Immune Function Diagnostic System (IFDS) will be designed to perform a set of immunological assays on board spacecrafts or on planet-bound bases. Through flow cytometric assays and molecular biology analyses, this diagnostic system could improve medical surveillance of astronauts and could be used to test countermeasures aimed at preventing immune deficiency during space missions. The capacity of the instrument to assess cellular fluorescence and to quantify the presence of soluble molecules in biological samples would support advanced molecular studies in space life sciences. Finally, such diagnostic system could also be used on Earth in remote areas or in mobile hospitals following natural disasters to fight against infectious diseases and other pathologies.

  8. 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

  9. 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.

  10. 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.

  11. 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)

  12. 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

  13. 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.

  14. 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)

  15. 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).

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

    International Nuclear Information System (INIS)

    Docters, E.H.; Smolko, E.E.

    1990-01-01

    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 these grafted polymers were used to study the possibility of a subsequent immobilization of Brucella antigen (BAg) in diagnostic test studies (ELISA). (author)

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

    Energy Technology Data Exchange (ETDEWEB)

    Docters, E H; Smolko, E E [Comision Nacional de Energia Atomica, Buenos Aires (Argentina). Direccion de Radioisotopos y Radiaciones; Suarez, C E [Instituto Nacional de Tecnologia Agropecuaria, Castelar (Argentina)

    1990-01-01

    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 these grafted polymers were used to study the possibility of a subsequent immobilization of Brucella antigen (BAg) in diagnostic test studies (ELISA). (author).

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  19. 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.

  20. 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

  1. 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.

  2. The Substantive Scope of Double Tax Treaties - a Study of Article 2 of the OECD Model Conventions

    OpenAIRE

    Brandstetter, Patricia

    2010-01-01

    Tax treaty protection from international double taxation only goes as far as the treaty's substantive scope. Nations worldwide have adopted the text of Article 2 of the OECD Model Double Taxation Conventions (headed Taxes covered) in concluding bilateral treaties to prevent double taxation in the area of taxes on income and capital and taxes on estates, inheritances, and on gifts. The wording and structure of Article 2 give rise to a host of ambiguities, creating uncertainty for taxpayers reg...

  3. Diagnostic value of eosinophils in pleural effusion: a prospective study of 26 cases.

    Science.gov (United States)

    Matthai, Smita Mary; Kini, Usha

    2003-02-01

    Eosinophilic pleural effusions (EPFs), defined as the presence of 10% or more eosinophils in the pleural fluid, are relatively rare. Their diagnostic and prognostic significance, however, remains controversial, as most of the studies are based almost entirely on retrospective case studies. This prospective study examines 26 eosinophilic pleural effusions from among 444 consecutive pleural effusions investigated at this tertiary health care center from October 1999 to April 2002. This study was attempted to unravel the diagnostic and prognostic significance of these eosinophilic effusions and assess their clinical implications, if any. Koss and Light's criteria were applied in the analysis, which comprised macroscopic, biochemical, cytological, and microbiological examinations. Of the 26 EPFs studied, five were associated with tuberculosis and three with metastatic disease. Nineteen patients had significant associated lymphocytosis. Twenty-four patients have been followed up and are in good health to date and have had no recurrence of effusion. Thus, EPF could be associated with inflammatory, benign, and malignant conditions. Hence, a closer search for a definite etiological agent is warranted in the setting of such an effusion, especially in populations endemic for tuberculosis, as in a developing country like India and in populations with a high prevalence of malignancy. Copyright 2003 Wiley-Liss, Inc.

  4. [Clinical decision making: Fostering critical thinking in the nursing diagnostic process through case studies].

    Science.gov (United States)

    Müller-Staub, Maria; Stuker-Studer, Ursula

    2006-10-01

    Case studies, based on actual patients' situations, provide a method of clinical decision making to foster critical thinking in nurses. This paper describes the method and process of group case studies applied in continuous education settings. This method bases on Balints' case supervision and was further developed and combined with the nursing diagnostic process. A case study contains different phases: Pre-phase, selection phase, case delineation and case work. The case provider narratively tells the situation of a patient. This allows the group to analyze and cluster signs and symptoms, to state nursing diagnoses and to derive nursing interventions. Results of the case study are validated by applying the theoretical background and critical appraisal of the case provider. Learning effects of the case studies were evaluated by means of qualitative questionnaires and analyzed according to Mayring. Findings revealed the following categories: a) Patients' problems are perceived in a patient centred way, accurate nursing diagnoses are stated and effective nursing interventions implemented. b) Professional nursing tasks are more purposefully perceived and named more precise. c) Professional nursing relationship, communication and respectful behaviour with patients were perceived in differentiated ways. The theoretical framework is described in the paper "Clinical decision making and critical thinking in the nursing diagnostic process". (Müller-Staub, 2006).

  5. Study design requirements for RNA sequencing-based breast cancer diagnostics.

    Science.gov (United States)

    Mer, Arvind Singh; Klevebring, Daniel; Grönberg, Henrik; Rantalainen, Mattias

    2016-02-01

    Sequencing-based molecular characterization of tumors provides information required for individualized cancer treatment. There are well-defined molecular subtypes of breast cancer that provide improved prognostication compared to routine biomarkers. However, molecular subtyping is not yet implemented in routine breast cancer care. Clinical translation is dependent on subtype prediction models providing high sensitivity and specificity. In this study we evaluate sample size and RNA-sequencing read requirements for breast cancer subtyping to facilitate rational design of translational studies. We applied subsampling to ascertain the effect of training sample size and the number of RNA sequencing reads on classification accuracy of molecular subtype and routine biomarker prediction models (unsupervised and supervised). Subtype classification accuracy improved with increasing sample size up to N = 750 (accuracy = 0.93), although with a modest improvement beyond N = 350 (accuracy = 0.92). Prediction of routine biomarkers achieved accuracy of 0.94 (ER) and 0.92 (Her2) at N = 200. Subtype classification improved with RNA-sequencing library size up to 5 million reads. Development of molecular subtyping models for cancer diagnostics requires well-designed studies. Sample size and the number of RNA sequencing reads directly influence accuracy of molecular subtyping. Results in this study provide key information for rational design of translational studies aiming to bring sequencing-based diagnostics to the clinic.

  6. Methodological quality of diagnostic accuracy studies on non-invasive coronary CT angiography: influence of QUADAS (Quality Assessment of Diagnostic Accuracy Studies included in systematic reviews) items on sensitivity and specificity

    Energy Technology Data Exchange (ETDEWEB)

    Schueler, Sabine; Walther, Stefan; Schuetz, Georg M. [Humboldt-Universitaet zu Berlin, Freie Universitaet Berlin, Charite Medical School, Department of Radiology, Berlin (Germany); Schlattmann, Peter [University Hospital of Friedrich Schiller University Jena, Department of Medical Statistics, Informatics, and Documentation, Jena (Germany); Dewey, Marc [Humboldt-Universitaet zu Berlin, Freie Universitaet Berlin, Charite Medical School, Department of Radiology, Berlin (Germany); Charite, Institut fuer Radiologie, Berlin (Germany)

    2013-06-15

    To evaluate the methodological quality of diagnostic accuracy studies on coronary computed tomography (CT) angiography using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies included in systematic reviews) tool. Each QUADAS item was individually defined to adapt it to the special requirements of studies on coronary CT angiography. Two independent investigators analysed 118 studies using 12 QUADAS items. Meta-regression and pooled analyses were performed to identify possible effects of methodological quality items on estimates of diagnostic accuracy. The overall methodological quality of coronary CT studies was merely moderate. They fulfilled a median of 7.5 out of 12 items. Only 9 of the 118 studies fulfilled more than 75 % of possible QUADAS items. One QUADAS item (''Uninterpretable Results'') showed a significant influence (P = 0.02) on estimates of diagnostic accuracy with ''no fulfilment'' increasing specificity from 86 to 90 %. Furthermore, pooled analysis revealed that each QUADAS item that is not fulfilled has the potential to change estimates of diagnostic accuracy. The methodological quality of studies investigating the diagnostic accuracy of non-invasive coronary CT is only moderate and was found to affect the sensitivity and specificity. An improvement is highly desirable because good methodology is crucial for adequately assessing imaging technologies. (orig.)

  7. Methodological quality of diagnostic accuracy studies on non-invasive coronary CT angiography: influence of QUADAS (Quality Assessment of Diagnostic Accuracy Studies included in systematic reviews) items on sensitivity and specificity

    International Nuclear Information System (INIS)

    Schueler, Sabine; Walther, Stefan; Schuetz, Georg M.; Schlattmann, Peter; Dewey, Marc

    2013-01-01

    To evaluate the methodological quality of diagnostic accuracy studies on coronary computed tomography (CT) angiography using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies included in systematic reviews) tool. Each QUADAS item was individually defined to adapt it to the special requirements of studies on coronary CT angiography. Two independent investigators analysed 118 studies using 12 QUADAS items. Meta-regression and pooled analyses were performed to identify possible effects of methodological quality items on estimates of diagnostic accuracy. The overall methodological quality of coronary CT studies was merely moderate. They fulfilled a median of 7.5 out of 12 items. Only 9 of the 118 studies fulfilled more than 75 % of possible QUADAS items. One QUADAS item (''Uninterpretable Results'') showed a significant influence (P = 0.02) on estimates of diagnostic accuracy with ''no fulfilment'' increasing specificity from 86 to 90 %. Furthermore, pooled analysis revealed that each QUADAS item that is not fulfilled has the potential to change estimates of diagnostic accuracy. The methodological quality of studies investigating the diagnostic accuracy of non-invasive coronary CT is only moderate and was found to affect the sensitivity and specificity. An improvement is highly desirable because good methodology is crucial for adequately assessing imaging technologies. (orig.)

  8. 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

  9. Diagnostic imaging and interventional radiology of hepatocellular carcinoma: A multicenter study on 290 cases

    International Nuclear Information System (INIS)

    Dalla Palma, Ludovico; Puzzi Mucelli, Roberto; Sponza, Massimo; De Santis, Mario; Gandini, Giovanni; Matricardi, Luigi; Rossi, Cristina

    1997-01-01

    The authors report of a multicenter study on the diagnosis and interventional therapy of hepatocellular carcinoma (HCC).The first aim -diagnostic - was to evaluate the sensitivity of 4 imaging techniques, namely ultrasonography (US), Computed Tomography (CT), digital arteriography (DSA) and Lipiodol CT (LCT), in hepatocellular carcinoma detection. The accuracy of these techniques was also investigated in tumor staging, which is important for treatment planning.The second aim - treatment - consisted in assessing the therapeutic efficacy of intraarterial chemoembolization (CEAT) versus percutaneous ethanol injection (PEI) in non advanced hepatocellular carcinoma and of intraarterial chemoembolization versus no treatment (NT) in advanced hepatocellular carcinoma. Treatment efficacy was evaluated with the following randomized protocols

  10. SPECT Myocardial Blood Flow Quantitation Concludes Equivocal Myocardial Perfusion SPECT Studies to Increase Diagnostic Benefits.

    Science.gov (United States)

    Chen, Lung-Ching; Lin, Chih-Yuan; Chen, Ing-Jou; Ku, Chi-Tai; Chen, Yen-Kung; Hsu, Bailing

    2016-01-01

    Recently, myocardial blood flow quantitation with dynamic SPECT/CT has been reported to enhance the detection of coronary artery disease in human. This advance has created important clinical applications to coronary artery disease diagnosis and management for areas where myocardial perfusion PET tracers are not available. We present 2 clinical cases that undergone a combined test of 1-day rest/dipyridamole-stress dynamic SPECT and ECG-gated myocardial perfusion SPECT scans using an integrated imaging protocol and demonstrate that flow parameters are capable to conclude equivocal myocardial perfusion SPECT studies, therefore increasing diagnostic benefits to add value in making clinical decisions.

  11. 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

  12. Recurrent unexplained palpitations (RUP) study comparison of implantable loop recorder versus conventional diagnostic strategy.

    Science.gov (United States)

    Giada, Franco; Gulizia, Michele; Francese, Maura; Croci, Francesco; Santangelo, Lucio; Santomauro, Maurizio; Occhetta, Eraldo; Menozzi, Carlo; Raviele, Antonio

    2007-05-15

    The aim of the study was to compare the diagnostic yield and the costs of implantable loop recorder (ILR) with those of the conventional strategy in patients with unexplained palpitations. In patients with unexplained palpitations, especially in those with infrequent symptoms, the conventional strategy, including short-term ambulatory electrocardiogram (ECG) monitoring and electrophysiological study, sometimes fails to establish a diagnosis. We studied 50 patients with infrequent (1 min) palpitations. Before enrollment, patients had a negative initial evaluation, including history, physical examination, and ECG. Patients were randomized either to conventional strategy (24-h Holter recording, a 4-week period of ambulatory ECG monitoring with an external recorder, and electrophysiological study) (n = 24) or to ILR implantation with 1-year monitoring (n = 26). Hospital costs of the 2 strategies were calculated. A diagnosis was obtained in 5 patients in the conventional strategy group, and in 19 subjects in the ILR group (21% vs. 73%, p < 0.001). Despite the higher initial cost, the cost per diagnosis in the ILR group was lower than in the conventional strategy group (euro 3,056 +/- euro 363 vs. euro 6,768 +/- euro 6,672, p = 0.012). In subjects without severe heart disease and with infrequent palpitations, ILR is a safe and more cost-effective diagnostic approach than conventional strategy.

  13. 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.)

  14. 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.

  15. A Study on the Diagnostic Significance of Hepatoscintigram with Colloidal Gold in Parenchymal Liver Disease

    International Nuclear Information System (INIS)

    Shin, Dong Ho; Lee, Min Ho; Kim, Mok Hyun

    1982-01-01

    Hapatoscintigram has been a useful diagnostic method for the liver disease since 1953, but reasonable diagnostic criteria for parenchymal liver diseases are not yet accurately established. For the purpose of searching for more advanced diagnostic criteria for various types of live diseases by the liver scan, a retrospective study was made of 272 cases who underwent both hepatoscintigram with 198 Au colloid and liver biopsy in Hanyang University Hospital from Jan, 1978 to Dec, 1981. The results were as follows: 1. Fuzzy margin (irregular indentation of the liver margin) in the hepatoscintigram was noted in 226 cases (97.79%) 2. Of 35 cases with fuzzy margin only, 28 cases (80%)revealed mild parenchymal liver disease, such as acute hepatitis or chronic persistent hepatitis by the liver biopsy. 3. Mottling change (209 cases) was always accomplished by fuzzy margin except only one case, and 31 cases (86.1%) of fuzzy and mottling cases (36 cases) showed mild parenchymal liver disease. 4. Configuration change (193 cases) was usually accompanied with other changes and especially 104 cases had configuration changed with fuzzy and mottling changes. 73 cases (88.445) of 86 cases with severe configuration changed revealed advanced parenchymal liver disease on biopsy. If liver scan showed mild configuration change, we could not decide the type of liver disease only liver scan, and so further studies are needed. 5. Splenic uptake was noted 34 cases (40.48%) of 84 cases with advanced parenchymal liver disease, and the degree of splenic uptake was for the most part moderate or severe; whereas splenic uptake was noted in 18 cases (16.51%) of the mild parenchymal liver disease (109 cases), and the degree of splenic uptake was largely mild.

  16. Enhanced diagnostic of skin conditions by polarized laser speckles: phantom studies and computer modeling

    Science.gov (United States)

    Tchvialeva, Lioudmila; Lee, Tim K.; Markhvida, Igor; Zeng, Haishan; Doronin, Alexander; Meglinski, Igor

    2014-03-01

    The incidence of the skin melanoma, the most commonly fatal form of skin cancer, is increasing faster than any other potentially preventable cancer. Clinical practice is currently hampered by the lack of the ability to rapidly screen the functional and morphological properties of tissues. In our previous study we show that the quantification of scattered laser light polarization provides a useful metrics for diagnostics of the malignant melanoma. In this study we exploit whether the image speckle could improve skin cancer diagnostic in comparison with the previously used free-space speckle. The study includes skin phantom measurements and computer modeling. To characterize the depolarization of light we measure the spatial distribution of speckle patterns and analyse their depolarization ratio taken into account radial symmetry. We examine the dependences of depolarization ratio vs. roughness for phantoms which optical properties are of the order of skin lesions. We demonstrate that the variation in bulk optical properties initiates the assessable changes in the depolarization ratio. We show that image speckle differentiates phantoms significantly better than free-space speckle. The results of experimental measurements are compared with the results of Monte Carlo simulation.

  17. 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

  18. Indications for computed tomography (CT-) diagnostics in proximal humeral fractures: a comparative study of plain radiography and computed tomography

    OpenAIRE

    Weise Kuno; Pereira Philippe L; Dietz Klaus; Eingartner Christoph; Schmal Hagen; Südkamp Norbert P; Rolauffs Bernd; Bahrs Christian; Lingenfelter Erich; Helwig Peter

    2009-01-01

    Abstract Background Precise indications for computed tomography (CT) in proximal humeral fractures are not established. The purpose of this study was a comparison of conventional radiographic views with different CT reconstructions with 2 D and 3 D imaging to establish indications for additional CT diagnostics depending on the fractured parts. Methods In a prospective diagnostic study in two level 1 trauma centers, 44 patients with proximal humeral fractures were diagnosed with conventional X...

  19. A study on the diagnostic accuracy of gastrofiberscopy in the diagnosis of various gastric diseases

    Energy Technology Data Exchange (ETDEWEB)

    Chin, Soo Il; Park, Charn Il; Kim, Young Kun; Oh, In Hyuk [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1971-10-15

    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

  20. 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

  1. 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.

  2. Comparative study of diagnostic efficiency of mammography and ultrasonography for breast cancer

    International Nuclear Information System (INIS)

    Koike, Yasuo; Terai, Naoki; Wakabayashi, Toru; Tsuchiya, Shin-ichi

    1995-01-01

    We performed a study of 448 women with breast cancer who visited the breast clinic of Nagano Cancer Center, and underwent mammography (MMG) and ultrasonography (US) at the last examination, between October 1983 and December 1993. These women subsequently underwent surgery at several hospitals after referral from our center. Definitive diagnoses of breast cancer were made histopathologically. Both MMG and US findings were graded using five-step criteria (indicating the level of malignancy) from I (normal) to V (definite malignancy). The diagnostic efficiencies of the two examinations were then compared clinicopathologically. Furthermore, on the basis of the results obtained, we considered supplemental diagnostic methods that could be introduced for mass screening of breast cancer. There was a significant difference between the incidence of cases diagnosed as V IV III b (malignancy) by US (71.9%) and those diagnosed by MMG (60.9%). Among cases suspected to be breast cancer by palpation, the proportion diagnosed as V IV III b (malignancy) by US (83.3%) was significantly higher than that diagnosed by MMG (73.7%). Among cases suspected to be mastopathy by palpation, the proportion diagnosed as malignant by US was higher than that diagnosed by MMG. The false negativity rate for palpation combined with MMG was higher than that for palpation with US. Among cases without palpable masses, the proportion diagnosed as malignant by MMG was higher than that diagnosed by US. However, for palpable tumors less than 5.0 cm in diameter, the proportion of cases diagnosed as malignant by US was higher than that diagnosed by MMG. In terms of the gross appearance of the cut surface, grade of cancer invasion, histological type and grade of chubbiness, the diagnostic efficiency of US was shown to be slightly better than that of MMG. The above results suggest that US should be considered as a supplemental method for introduction to mass screening of breast cancer. (author)

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. A study on the fault diagnostic techniques for reactor internal structures using neutron noise analysis

    International Nuclear Information System (INIS)

    Kim, Tae Ryong; Jeong, Seong Ho; Park, Jin Ho; Park, Jin Suk

    1994-08-01

    The unfavorable phenomena, such as flow induced vibration and aging process in reactor internals, cause degradation of structural integrity and may result in loosing some mechanical binding components which might impact other equipments and components or cause flow blockage. Since these malfunctions and potential failures change reactor noise signal, it is necessary to analyze reactor noise signal for early fault diagnosis in the point of few of safety and plant economics. The objectives of this study are to establish fault diagnostic and TS(thermal shield), and to develop a data acquisition and signal processing software system. In the first year of this study, an analysis technique for the reactor internal vibration using the reactor noise was proposed. With the technique proposed and the reactor noise signals (ex-core neutron and acceleration), the dynamic characteristics of Ulchin-1 reactor internals were obtained, and compared with those of Tricastin-1 which is the prototype of Ulchin-1. In the second year, a PC-based expert system for reactor internals fault diagnosis is developed, which included data acquisition, signal processing, feature extraction function, and represented diagnostic knowledge by the IF-THEN rule. To know the effect of the faults, the reactor internals of Ulchin-1 is modeled using FEM and simulated with an artificial defect given in the hold-down spring. Trend in the dynamic characteristics of reactor internals is also observed during one fuel cycle to know the effect of boron concentration. 100 figs, 7 tabs, 18 refs. (Author)

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. Changes in the ocular surface: initial observations from a pilot study of diagnostic radiology technicians (radiographers)

    International Nuclear Information System (INIS)

    Guerdal, Canan; Aydin, Sevda; Sengoer, Tomris; Onmus, Hale; Oezarar, Muemtaz

    2002-01-01

    The purpose of this study was to evaluate the clinical and cytological changes in the ocular surface of radiology technicians (radiographers) exposed to diagnostic doses of radiation. The Schirmer, Rose Bengal staining and Tear-Break-Up-Time tear function tests were carried out following routine ophthalmic examination in 15 radiology technicians (group I) and 15 controls (group II). Impression cytology was performed by placing 5-mm-thick half-circular cellulose acetate filter paper in the upper and lower quadrants around the limbus. The cytological evaluation was made using the mapping technique. Significantly increased dry eye was detected in group I. In the impression cytology investigation, squamous metaplasia and intraepithelial lymphocytic infiltration was noted in all the group-I cases. A distinct change was observed between the regions showing squamous metaplasia and neigbouring normal epithelial cell structure. Dry eye and ocular surface cytological changes were observed in diagnostic radiology technicians. Routine ophthalmic evaluation of radiology technicians would be beneficial in detecting early cytological changes and dry eye. (orig.)

  14. 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

  15. Diagnostics upgrade and capability available for physics study on EAST tokamak

    International Nuclear Information System (INIS)

    Hu Liqun

    2013-01-01

    As a consequence of employment of many new techniques and upgrade of EAST superconducting tokamak to enhance divertor plasma performance, significant achievement has been realized in 2012, including 400s long pulse plasma, stationary 35s H-mode and 3.45s H-mode with only ion cyclotron resonant heating (ICRH) etc. To approach steady-state (SS) operation of high-performance plasmas and address key physics on fusion reactor-relevent subjects, recently, capability of the plasma heating and current drive of EAST machine are doubled with total auxiliary injection power over 20 MW, including new methodology of neutral beam injection (NBI) and electron cyclotron resonant heating (ECRH). Most diagnostics have been upgraded to be more compact and integrated due to limited port window and space available, and new advanced neutral-beam related diagnostics have been developed as well, to provide profile of all key parameters for study and understanding critical issues specific to SS high performance plasma. (author)

  16. Foetal Radiation Dose and Risk from Diagnostic Radiology Procedures: A Multinational Study

    International Nuclear Information System (INIS)

    Osei, Ernest K.; Darko, Johnson

    2012-01-01

    In diagnostic radiology examinations there is a benefit that the patient derives from the resulting diagnosis. Given that so many examinations are performed each year, it is inevitable that there will be occasions when an examination(s) may be inadvertently performed on pregnant patients or occasionally it may become clinically necessary to perform an examination(s) on a pregnant patient. In all these circumstances it is necessary to request an estimation of the foetal dose and risk. We initiated a study to investigate fetal doses from different countries. Exposure techniques on 367 foetuses from 414 examinations were collected and investigated. The FetDoseV4 program was used for all dose and risk estimations. The radiation doses received by the 367 foetuses ranges: <0.001–21.9 mGy depending on examination and technique. The associated probability of induced hereditary effect ranges: <1 in 200000000 (5 × 10 −9 ) to 1 in 10000 (1 × 10 −4 ) and the risk of childhood cancer ranges <1 in 12500000 (8 × 10 −8 ) to 1 in 500 (2 × 10 −3 ). The data indicates that foetal doses from properly conducted diagnostic radiology examinations will not result in any deterministic effect and a negligible risk of causing radiation induced hereditary effect in the descendants of the unborn child

  17. The diagnostic value of preoperative inflammatory markers in craniopharyngioma: a multicenter cohort study.

    Science.gov (United States)

    Chen, Ming; Zheng, Shi-Hao; Yang, Min; Chen, Zhi-Hua; Li, Shi-Ting

    2018-05-01

    To compare the different levels of preoperative inflammatory markers in peripheral blood samples between craniopharyngioma (CP) and other sellar region tumors so as to explore their differential diagnostic value. The level of white blood cell (WBC), neutrophil, lymphocyte, monocyte, platelet, albumin, neutrophil lymphocyte ratio (NLR), derived NLR (dNLR), platelet lymphocyte ratio (PLR), monocyte lymphocyte ratio (MLR) and prognostic nutritional index (PNI) were compared between the CP and other sellar region tumors. A receiver operating characteristics (ROC) curve analysis was performed to evaluate the diagnostic significance of the peripheral blood inflammatory markers and their paired combinations for CP including its pathological types. Patients with CP had higher levels of pre-operative WBC, lymphocyte and PNI. The papillary craniopharyngioma (PCP) group had higher neutrophil count and NLR than the adamantinomatous craniopharyngioma (ACP) and healthy control groups whereas the ACP group had higher platelet count and PNI than the PCP and healthy control groups. There were not any significant differences in preoperative inflammatory markers between the primary and recurrent CP groups. The AUC values of WBC, neutrophil, NLR + PLR and dNLR + PLR in PCP were all higher than 0.7. Inflammation seems to be closely correlated with CP's development. The preoperative inflammatory markers including WBC, neutrophil, NLR + PLR and dNLR + PLR may differentially diagnose PCP, pituitary tumor (PT) and Rathke cleft cyst (RCC). In addition, some statistical results in this study indirectly proved previous experimental conclusions and strictly matched CP's biological features.

  18. Diagnostic Value of Tryptase in Food Allergic Reactions: A Prospective Study of 160 Adult Peanut Challenges.

    Science.gov (United States)

    Dua, Shelley; Dowey, James; Foley, Loraine; Islam, Sabita; King, Yvonne; Ewan, Pamela; Clark, Andrew T

    2018-02-27

    Serum tryptase is useful in diagnosing drug and venom anaphylaxis. Its utility in food anaphylaxis is unknown. The objective of this study was to determine whether tryptase rises in food allergic reactions, optimal sampling time points, and a diagnostic cutoff for confirming a clinical reaction. Characterized peanut allergic patients were recruited and underwent up to 4 peanut challenges and 1 placebo challenge each. Tryptase was measured serially on challenge days both before (baseline) and during the challenge. The peak percentage tryptase rise (peak/baseline) was related to reaction severity. Receiver operating characteristic (ROC) curves were generated establishing an optimal diagnostic cutoff. Tryptase was analyzed in 160 reactive (9% anaphylaxis) and 45 nonreactive (placebo) challenges in 50 adults aged 18 to 39 years. Tryptase rose above the normal range (11.4 ng/mL) in 4 of 160 reactions. When compared with baseline levels, a rise was observed in 100 of 160 (62.5%) reactions and 0 of 45 placebo challenges. The median rise (95% confidence interval [CI]) for all reactions was 25% (13.3% to 33.3%) and 70.8% (33.3% to 300%) during anaphylaxis. Peak levels occurred at 2 hours and correlated with severity (P food allergic reactions, and correlates with symptom severity. Comparing peak reaction levels at 2 hours with baseline is essential. A rise in tryptase of 30% is associated with food allergic reactions. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

  19. 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.

  20. Adults with suspected central nervous system infection: A prospective study of diagnostic accuracy.

    Science.gov (United States)

    Khatib, Ula; van de Beek, Diederik; Lees, John A; Brouwer, Matthijs C

    2017-01-01

    To study the diagnostic accuracy of clinical and laboratory features in the diagnosis of central nervous system (CNS) infection and bacterial meningitis. We included consecutive adult episodes with suspected CNS infection who underwent cerebrospinal fluid (CSF) examination. The reference standard was the diagnosis classified into five categories: 1) CNS infection; 2) CNS inflammation without infection; 3) other neurological disorder; 4) non-neurological infection; and 5) other systemic disorder. Between 2012 and 2015, 363 episodes of suspected CNS infection were included. CSF examination showed leucocyte count >5/mm 3 in 47% of episodes. Overall, 89 of 363 episodes were categorized as CNS infection (25%; most commonly viral meningitis [7%], bacterial meningitis [7%], and viral encephalitis [4%]), 36 (10%) episodes as CNS inflammatory disorder, 111 (31%) as systemic infection, in 119 (33%) as other neurological disorder, and 8 (2%) as other systemic disorders. Diagnostic accuracy of individual clinical characteristics and blood tests for the diagnosis of CNS infection or bacterial meningitis was low. CSF leucocytosis differentiated best between bacterial meningitis and other diagnoses (area under the curve [AUC] 0.95) or any neurological infection versus other diagnoses (AUC 0.93). Clinical characteristics fail to differentiate between neurological infections and other diagnoses, and CSF analysis is the main contributor to the final diagnosis. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  1. Diagnostic utility of the cell block method versus the conventional smear study in pleural fluid cytology.

    Science.gov (United States)

    Shivakumarswamy, Udasimath; Arakeri, Surekha U; Karigowdar, Mahesh H; Yelikar, Br

    2012-01-01

    The cytological examinations of serous effusions have been well-accepted, and a positive diagnosis is often considered as a definitive diagnosis. It helps in staging, prognosis and management of the patients in malignancies and also gives information about various inflammatory and non-inflammatory lesions. Diagnostic problems arise in everyday practice to differentiate reactive atypical mesothelial cells and malignant cells by the routine conventional smear (CS) method. To compare the morphological features of the CS method with those of the cell block (CB) method and also to assess the utility and sensitivity of the CB method in the cytodiagnosis of pleural effusions. The study was conducted in the cytology section of the Department of Pathology. Sixty pleural fluid samples were subjected to diagnostic evaluation for over a period of 20 months. Along with the conventional smears, cell blocks were prepared by using 10% alcohol-formalin as a fixative agent. Statistical analysis with the 'z test' was performed to identify the cellularity, using the CS and CB methods. Mc. Naemer's χ(2)test was used to identify the additional yield for malignancy by the CB method. Cellularity and additional yield for malignancy was 15% more by the CB method. The CB method provides high cellularity, better architectural patterns, morphological features and an additional yield of malignant cells, and thereby, increases the sensitivity of the cytodiagnosis when compared with the CS method.

  2. Diagnostic utility of the cell block method versus the conventional smear study in pleural fluid cytology

    Directory of Open Access Journals (Sweden)

    Udasimath Shivakumarswamy

    2012-01-01

    Full Text Available Background: The cytological examinations of serous effusions have been well-accepted, and a positive diagnosis is often considered as a definitive diagnosis. It helps in staging, prognosis and management of the patients in malignancies and also gives information about various inflammatory and non-inflammatory lesions. Diagnostic problems arise in everyday practice to differentiate reactive atypical mesothelial cells and malignant cells by the routine conventional smear (CS method. Aims: To compare the morphological features of the CS method with those of the cell block (CB method and also to assess the utility and sensitivity of the CB method in the cytodiagnosis of pleural effusions. Materials and Methods: The study was conducted in the cytology section of the Department of Pathology. Sixty pleural fluid samples were subjected to diagnostic evaluation for over a period of 20 months. Along with the conventional smears, cell blocks were prepared by using 10% alcohol-formalin as a fixative agent. Statistical analysis with the ′z test′ was performed to identify the cellularity, using the CS and CB methods. Mc. Naemer′s χ2 test was used to identify the additional yield for malignancy by the CB method. Results: Cellularity and additional yield for malignancy was 15% more by the CB method. Conclusions: The CB method provides high cellularity, better architectural patterns, morphological features and an additional yield of malignant cells, and thereby, increases the sensitivity of the cytodiagnosis when compared with the CS method.

  3. Gearbox tooth cut fault diagnostics using acoustic emission and vibration sensors--a comparative study.

    Science.gov (United States)

    Qu, Yongzhi; He, David; Yoon, Jae; Van Hecke, Brandon; Bechhoefer, Eric; Zhu, Junda

    2014-01-14

    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.

  4. 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.

  5. Gearbox Tooth Cut Fault Diagnostics Using Acoustic Emission and Vibration Sensors — A Comparative Study

    Science.gov (United States)

    Qu, Yongzhi; He, David; Yoon, Jae; Van Hecke, Brandon; Bechhoefer, Eric; Zhu, Junda

    2014-01-01

    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. PMID:24424467

  6. Diagnostic accuracy for apical and chronic periodontitis biomarkers in gingival crevicular fluid: an exploratory study.

    Science.gov (United States)

    Baeza, Mauricio; Garrido, Mauricio; Hernández-Ríos, Patricia; Dezerega, Andrea; García-Sesnich, Jocelyn; Strauss, Franz; Aitken, Juan Pablo; Lesaffre, Emmanuel; Vanbelle, Sophie; Gamonal, Jorge; Brignardello-Petersen, Romina; Tervahartiala, Taina; Sorsa, Timo; Hernández, Marcela

    2016-01-01

    The aim of this study was to assess the levels and diagnostic accuracy of a set of potential biomarkers of periodontal tissue metabolism in gingival crevicular fluid (GCF) from patients with chronic periodontitis (CP) and asymptomatic apical periodontitis ( AAP). Thirty one GCF samples from 11 CP patients, 44 GCF samples from 38 AAP patients and 31 GCF samples from 13 healthy volunteers were obtained (N = 106). Matrix metalloproteinases (MMPs) -2 and -9 were determined by zymography; levels of MMP-8 by ELISA and IFMA and MPO by ELISA. IL-1, IL-6, TNFα, DKK-1, Osteonectin, Periostin, TRAP-5 and OPG were determined by a multiplex quantitative panel. Statistical analysis was performed using linear mixed-effects models. The MMP-9 and MMP-8 were higher in CP, followed by AAP, versus healthy individuals (p 0.97) in CP, and for the active form of MMP-9 and MMP-8 (AUC > 0.90) in AAP. Gingival crevicular fluid composition is modified by CP and AAP. MMP-9 and MMP-8 show diagnostic potential for CP and AAP, whereas MMP-2 and TRAP-5 are useful only for CP. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. 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

  8. 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.

  9. Study on the metabolic peculiarities of renal radiotracer 99mTc-PAHIDA and diagnostic use

    International Nuclear Information System (INIS)

    Zhu Shoupeng; Wang Liuyi; Lun Mingyue

    1994-11-01

    The metabolic peculiarities of renal radiotracer 99m Tc-PAHIDA and diagnostic use were studied. The results of the radioactive tracing study showed that 99m Tc-PAHIDA was distributed predominantly in kidney, and then in heart, gastrointestinal tract, liver, spleen, musculus quadriceps femoris, adipose tissue, testes and brain. It should be noted that when smaller dose of this agent was given, more 99m Tc-PAHIDA was concentrated in kidney and, at the same time, the level of its binding to plasma protein was lower. The experimental results indicated that 99m Tc-PAHIDA was rapidly excreted in urine. Autoradiochromatographic examination of the urine showed a single radioactive peak corresponding to the authentic 99m Tc-PAHIDA, indicating that 99m Tc-PAHIDA was excreted in the unchanged form. (3 tabs.)

  10. MTX [Microwave Tokamak Experiment] diagnostic and auxiliary systems for confinement, transport, and plasma physics studies

    International Nuclear Information System (INIS)

    Hooper, E.B.; Allen, S.L.; Casper, T.A.; Thomassen, K.I.

    1989-01-01

    This note describes the diagnostics and auxiliary systems on the Microwave Tokamak Experiment (MTX) for confinement, transport, and other plasma physics studies. It is intended as a reference on the installed and planned hardware on the machine for those who need more familiarity with this equipment. Combined with the tokamak itself, these systems define the opportunities and capabilities for experiments in the MTX facility. We also illustrate how these instruments and equipment are to be used in carrying out the MTX Operations Plan. Near term goals for MTX are focussed on the absorption and heating by the microwave beam from the FEL, but the Plan also includes using the facility to study fundamental phenomena in the plasma, to control MHD activity, and to drive current noninductively

  11. 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.

  12. Development of a positronium atom diagnostic beam to study transport in tokamaks

    International Nuclear Information System (INIS)

    Surko, C.M.

    1992-01-01

    Anomalous transport is probably the key physics issue in magnetic confinement fusion. It severely limits our ability to create and maintain a dense, hot, fusion plasma. There is also good evidence that there is a fundamental lack of understanding in this area, namely the transport of particles and energy induced by waves and fluctuations in magnetically confined plasmas. The positronium atom beam diagnostic, if successful, can provide a qualitatively new and different way of studying transport in tokamak fusion plasmas. The use of the positron as a thermalized, electron-mass test particle will allow important new tests of current theories of plasma transport. In particular, it could provide unique insights into the potential role of magnetic fluctuations in producing anomalous transport. This is particularly significant in that, at present, there is essentially no in situ probe of these fluctuations or the transport which they produce. Some results of this study are summarized

  13. Predictive ability of an early diagnostic guess in patients presenting with chest pain; a longitudinal descriptive study.

    Science.gov (United States)

    Verdon, François; Junod, Michel; Herzig, Lilli; Vaucher, Paul; Burnand, Bernard; Bischoff, Thomas; Pécoud, Alain; Favrat, Bernard

    2010-02-21

    The intuitive early diagnostic guess could play an important role in reaching a final diagnosis. However, no study to date has attempted to quantify the importance of general practitioners' (GPs) ability to correctly appraise the origin of chest pain within the first minutes of an encounter. The validation study was nested in a multicentre cohort study with a one year follow-up and included 626 successive patients who presented with chest pain and were attended by 58 GPs in Western Switzerland. The early diagnostic guess was assessed prior to a patient's history being taken by a GP and was then compared to a diagnosis of chest pain observed over the next year. Using summary measures clustered at the GP's level, the early diagnostic guess was confirmed by further investigation in 51.0% (CI 95%; 49.4% to 52.5%) of patients presenting with chest pain. The early diagnostic guess was more accurate in patients with a life threatening illness (65.4%; CI 95% 64.5% to 66.3%) and in patients who did not feel anxious (62.9%; CI 95% 62.5% to 63.3%). The predictive abilities of an early diagnostic guess were consistent among GPs. The GPs early diagnostic guess was correct in one out of two patients presenting with chest pain. The probability of a correct guess was higher in patients with a life-threatening illness and in patients not feeling anxious about their pain.

  14. The value of diagnostic information to patients with suspected multiple sclerosis. Rochester-Toronto MRI Study Group.

    Science.gov (United States)

    Mushlin, A I; Mooney, C; Grow, V; Phelps, C E

    1994-01-01

    To determine the value of diagnostic information to patients with suspected multiple sclerosis (MS). Because treatment choices would be only minimally affected by earlier diagnosis for most patients with this clinical problem, this study assessed the "nondecisional" value of diagnosis. Prospective survey of patients before and after diagnostic workup, including imaging with magnetic resonance scanning. We assessed the effect of diagnostic information on patients' sense of well-being, as well as direct measures of the utility of information (using time trade-off and willingness-to-pay techniques). Patients referred from primary care practices for diagnostic workup for suspected MS to neurology clinics and practices. Sixty-eight individuals, mean age 37.5 years, 53 female and 15 male. Thirty-one patients were classified as having "probable MS," and 37 were classified as having "possible MS" by the examining neurologist before workup. Present and future health perception, uncertainty about diagnosis-prognosis, and level of anxiety. Willingness to pay for diagnostic information, quality of life as measured by the time trade-off technique, and psychological state of the patient before and after diagnosis. Diagnostic uncertainty fell significantly as a result of the diagnostic workup. Most patients (59/62) said that they were better off having received diagnostic information. Although anxiety seemed to be reduced by testing, overall anxiety levels did not decrease as much as anticipated. Patients also became less optimistic about their future health after testing. On average, patients were willing to forgo 4.5 quality-adjusted life days to receive an earlier diagnosis and their quality of life after diagnosis improved slightly. Subgroups of patients differed in their response to diagnostic information. Those in whom no definitive diagnosis emerged tend to be more anxious rather than being reassured by the "negative" workup. Individuals with "positive" workups became less

  15. 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.

  16. 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.

  17. 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)

  18. 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.

  19. Important considerations for feasibility studies in physical activity research involving persons with multiple sclerosis: a scoping systematic review and case study.

    Science.gov (United States)

    Learmonth, Yvonne C; Motl, Robert W

    2018-01-01

    Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis (MS). There is disagreement regarding the strength of this research, perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing. We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS. A systematic scoping review was conducted based on a literature search of five databases to identify feasibility processes described in preliminary studies of physical activity in MS. We read and extracted methodology from each study based on the following feasibility metrics: process (e.g. recruitment), resource (e.g. monetary costs), management (e.g. personnel time requirements) and scientific outcomes (e.g. clinical/participant reported outcome measures). We illustrate the use of the four feasibility metrics within a randomised controlled trial of a home-based exercise intervention in persons with MS. Twenty-five studies were identified. Resource feasibility (e.g. time and resources) and scientific outcomes feasibility (e.g. clinical outcomes) methodologies were applied and described in many studies; however, these metrics have not been systematically addressed. Metrics related to process feasibility (e.g. recruitment) and management feasibility (e.g. human and data management) are not well described within the literature. Our case study successfully enabled us to address the four feasibility metrics, and we provide new information on management feasibility (i.e. estimate data completeness and estimate data entry) and scientific outcomes feasibility (i.e. determining data collection materials appropriateness). Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility. This review serves as a clarion call for feasibility trials that will

  20. Source localization of rhythmic ictal EEG activity: a study of diagnostic accuracy following STARD criteria.

    Science.gov (United States)

    Beniczky, Sándor; Lantz, Göran; Rosenzweig, Ivana; Åkeson, Per; Pedersen, Birthe; Pinborg, Lars H; Ziebell, Morten; Jespersen, Bo; Fuglsang-Frederiksen, Anders

    2013-10-01

    Although precise identification of the seizure-onset zone is an essential element of presurgical evaluation, source localization of ictal electroencephalography (EEG) signals has received little attention. The aim of our study was to estimate the accuracy of source localization of rhythmic ictal EEG activity using a distributed source model. Source localization of rhythmic ictal scalp EEG activity was performed in 42 consecutive cases fulfilling inclusion criteria. The study was designed according to recommendations for studies on diagnostic accuracy (STARD). The initial ictal EEG signals were selected using a standardized method, based on frequency analysis and voltage distribution of the ictal activity. A distributed source model-local autoregressive average (LAURA)-was used for the source localization. Sensitivity, specificity, and measurement of agreement (kappa) were determined based on the reference standard-the consensus conclusion of the multidisciplinary epilepsy surgery team. Predictive values were calculated from the surgical outcome of the operated patients. To estimate the clinical value of the ictal source analysis, we compared the likelihood ratios of concordant and discordant results. Source localization was performed blinded to the clinical data, and before the surgical decision. Reference standard was available for 33 patients. The ictal source localization had a sensitivity of 70% and a specificity of 76%. The mean measurement of agreement (kappa) was 0.61, corresponding to substantial agreement (95% confidence interval (CI) 0.38-0.84). Twenty patients underwent resective surgery. The positive predictive value (PPV) for seizure freedom was 92% and the negative predictive value (NPV) was 43%. The likelihood ratio was nine times higher for the concordant results, as compared with the discordant ones. Source localization of rhythmic ictal activity using a distributed source model (LAURA) for the ictal EEG signals selected with a standardized method

  1. 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

  2. Diagnostic performance of computed tomography coronary angiography (from the Prospective National Multicenter Multivendor EVASCAN Study).

    Science.gov (United States)

    Gueret, Pascal; Deux, Jean-François; Bonello, Laurent; Sarran, Anthony; Tron, Christophe; Christiaens, Luc; Dacher, Jean-Nicolas; Bertrand, David; Leborgne, Laurent; Renard, Cedric; Caussin, Christophe; Cluzel, Philippe; Helft, Gerard; Crochet, Dominique; Vernhet-Kovacsik, Hélène; Chabbert, Valérie; Ferrari, Emile; Gilard, Martine; Willoteaux, Serge; Furber, Alain; Barone-Rochette, Gilles; Jankowski, Adrien; Douek, Philippe; Mousseaux, Elie; Sirol, Marc; Niarra, Ralph; Chatellier, Gilles; Laissy, Jean-Pierre

    2013-02-15

    Computed tomographic coronary angiography (CTCA) has been proposed as a noninvasive test for significant coronary artery disease (CAD), but only limited data are available from prospective multicenter trials. The goal of this study was to establish the diagnostic accuracy of CTCA compared to coronary angiography (CA) in a large population of symptomatic patients with clinical indications for coronary imaging. This national, multicenter study was designed to prospectively evaluate stable patients able to undergo CTCA followed by conventional CA. Data from CTCA and CA were analyzed in a blinded fashion at central core laboratories. The main outcome was the evaluation of patient-, vessel-, and segment-based diagnostic performance of CTCA to detect or rule out significant CAD (≥50% luminal diameter reduction). Of 757 patients enrolled, 746 (mean age 61 ± 12 years, 71% men) were analyzed. They underwent CTCA followed by CA 1.7 ± 0.8 days later using a 64-detector scanner. The prevalence of significant CAD in native coronary vessels by CA was 54%. The rate of nonassessable segments by CTCA was 6%. In a patient-based analysis, sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of CTCA were 91%, 50%, 68%, 83%, 1.82, and 0.18, respectively. The strongest predictors of false-negative results on CTCA were high estimated pretest probability of CAD (odds ratio [OR] 1.97, p <0.001), male gender (OR 1.5, p <0.002), diabetes (OR 1.5, p <0.0001), and age (OR 1.2, p <0.0001). In conclusion, in this large multicenter study, CTCA identified significant CAD with high sensitivity. However, in routine clinical practice, each patient should be individually evaluated, and the pretest probability of obstructive CAD should be taken into account when deciding which method, CTCA or CA, to use to diagnose its presence and severity. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. 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.

  4. Continuous electroencephalography predicts delayed cerebral ischemia after subarachnoid hemorrhage: A prospective study of diagnostic accuracy.

    Science.gov (United States)

    Rosenthal, Eric S; Biswal, Siddharth; Zafar, Sahar F; O'Connor, Kathryn L; Bechek, Sophia; Shenoy, Apeksha V; Boyle, Emily J; Shafi, Mouhsin M; Gilmore, Emily J; Foreman, Brandon P; Gaspard, Nicolas; Leslie-Mazwi, Thabele M; Rosand, Jonathan; Hoch, Daniel B; Ayata, Cenk; Cash, Sydney S; Cole, Andrew J; Patel, Aman B; Westover, M Brandon

    2018-04-16

    Delayed cerebral ischemia (DCI) is a common, disabling complication of subarachnoid hemorrhage (SAH). Preventing DCI is a key focus of neurocritical care, but interventions carry risk and cannot be applied indiscriminately. Although retrospective studies have identified continuous electroencephalographic (cEEG) measures associated with DCI, no study has characterized the accuracy of cEEG with sufficient rigor to justify using it to triage patients to interventions or clinical trials. We therefore prospectively assessed the accuracy of cEEG for predicting DCI, following the Standards for Reporting Diagnostic Accuracy Studies. We prospectively performed cEEG in nontraumatic, high-grade SAH patients at a single institution. The index test consisted of clinical neurophysiologists prospectively reporting prespecified EEG alarms: (1) decreasing relative alpha variability, (2) decreasing alpha-delta ratio, (3) worsening focal slowing, or (4) late appearing epileptiform abnormalities. The diagnostic reference standard was DCI determined by blinded, adjudicated review. Primary outcome measures were sensitivity and specificity of cEEG for subsequent DCI, determined by multistate survival analysis, adjusted for baseline risk. One hundred three of 227 consecutive patients were eligible and underwent cEEG monitoring (7.7-day mean duration). EEG alarms occurred in 96.2% of patients with and 19.6% without subsequent DCI (1.9-day median latency, interquartile range = 0.9-4.1). Among alarm subtypes, late onset epileptiform abnormalities had the highest predictive value. Prespecified EEG findings predicted DCI among patients with low (91% sensitivity, 83% specificity) and high (95% sensitivity, 77% specificity) baseline risk. cEEG accurately predicts DCI following SAH and may help target therapies to patients at highest risk of secondary brain injury. Ann Neurol 2018. © 2018 American Neurological Association.

  5. 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.

  6. Diagnostic test of predicted height model in Indonesian elderly: a study in an urban area

    Directory of Open Access Journals (Sweden)

    Fatmah Fatmah

    2010-08-01

    Full Text Available Aim In an anthropometric assessment, elderly are frequently unable to measure their height due to mobility and skeletal deformities. An alternative is to use a surrogate value of stature from arm span, knee height, and sitting height. The equations developed for predicting height in Indonesian elderly using these three predictors. The equations put in the nutritional assessment card (NSA of older people. Before the card which is the first new technology in Indonesia will be applied in the community, it should be tested. The study aimed was to conduct diagnostic test of predicted height model in the card compared to actual height.Methods Model validation towards 400 healthy elderly conducted in Jakarta City with cross-sectional design. The study was the second validation test of the model besides Depok City representing semi urban area which was undertaken as the first study.Result Male elderly had higher mean age, height, weight, arm span, knee height, and sitting height as compared to female elderly. The highest correlation between knee height and standing height was similar in women (r = 0.80; P < 0.001 and men (r = 0.78; P < 0.001, and followed by arm span and sitting height. Knee height had the lowest difference with standing height in men (3.13 cm and women (2.79 cm. Knee height had the biggest sensitivity (92.2%, and the highest specificity on sitting height (91.2%.Conclusion Stature prediction equation based on knee-height, arm span, and sitting height are applicable for nutritional status assessment in Indonesian elderly. (Med J Indones 2010;19:199-204Key words: diagnostic test, elderly, predicted height model

  7. 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

  8. Diagnostic imaging procedure volume in the United States

    International Nuclear Information System (INIS)

    Johnson, J.L.; Abernathy, D.L.

    1983-01-01

    Comprehensive data on 1979 and 1980 diagnostic imaging procedure volume were collected from a stratified random sample of U.S. short-term general-care hospitals and private practices of radiologists, cardiologists, obstetricians/gynecologists, orthopedic surgeons, and neurologists/neurosurgeons. Approximately 181 million imaging procedures (within the study scope) were performed in 1980. Despite the rapidly increasing use of newer imaging methods, plain film radiography (140.3 million procedures) and contrast studies (22.9 million procedures) continue to comprise the vast majority of diagnostic imaging volume. Ultrasound, computed tomography, nuclear medicine, and special procedures make up less than 10% of total diagnostic imaging procedures. Comparison of the data from this study with data from an earlier study indicates that imaging procedure volume in hospitals expanded at an annual growth rate of almost 8% from 1973 to 1980

  9. 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

  10. Visualization of the diaphragm muscle with ultrasound improves diagnostic accuracy of phrenic nerve conduction studies.

    Science.gov (United States)

    Johnson, Nicholas E; Utz, Michael; Patrick, Erica; Rheinwald, Nicole; Downs, Marlene; Dilek, Nuran; Dogra, Vikram; Logigian, Eric L

    2014-05-01

    Evaluation of phrenic neuropathy (PN) with phrenic nerve conduction studies (PNCS) is associated with false negatives. Visualization of diaphragmatic muscle twitch with diaphragm ultrasound (DUS) when performing PNCS may help to solve this problem. We performed bilateral, simultaneous DUS-PNCS in 10 healthy adults and 12 patients with PN. The amplitude of the diaphragm compound muscle action potential (CMAP) (on PNCS) and twitch (on DUS) was calculated. Control subjects had phrenic CMAP (on PCNS). In the 12 patients with PN, 12 phrenic neuropathies were detected. Three of these patients had either significant side-to-side asymmetry or absolute reduction in diaphragm movement that was not detected with PNCS. There were no cases in which the PNCS showed an abnormality but the DUS did not. The addition of DUS to PNCS enhances diagnostic accuracy in PN. Copyright © 2013 Wiley Periodicals, Inc.

  11. 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

  12. Confirmatory Tests for the Diagnosis of Primary Aldosteronism: A Prospective Diagnostic Accuracy Study.

    Science.gov (United States)

    Song, Ying; Yang, Shumin; He, Wenwen; Hu, Jinbo; Cheng, Qingfeng; Wang, Yue; Luo, Ting; Ma, Linqiang; Zhen, Qianna; Zhang, Suhua; Mei, Mei; Wang, Zhihong; Qing, Hua; Bruemmer, Dennis; Peng, Bin; Li, Qifu

    2018-01-01

    The diagnosis of primary aldosteronism typically requires at least one confirmatory test. The fludrocortisone suppression test is generally accepted as a reliable confirmatory test, but it is cumbersome. Evidence from accuracy studies of the saline infusion test (SIT) and the captopril challenge test (CCT) has provided conflicting results. This prospective study aimed to evaluate the diagnostic accuracy of the SIT and CCT using fludrocortisone suppression test as the reference standard. One hundred thirty-five patients diagnosed with primary aldosteronism and 101 patients diagnosed with essential hypertension who completed the 3 confirmatory tests were included for the diagnostic accuracy analysis. The areas under the receiver-operator characteristics curves of the CCT and SIT were 0.96 (95% confidence interval [CI], 0.92-0.98) and 0.96 (95% CI, 0.92-0.98), respectively, using post-test plasma aldosterone concentration (PAC) for diagnosis. However, the areas under the receiver-operator characteristics curves of the CCT decreased to 0.71 (95% CI, 0.65-0.77) when the PAC suppression percentage was used to diagnose primary aldosteronism. The optimal cutoff of PAC post-CCT was set at 11 ng/dL, resulting in a sensitivity of 0.90 (95% CI, 0.84-0.95) and a specificity of 0.90 (95% CI, 0.83-0.95), which were not significantly different from those of SIT (with PAC post-SIT set at 8 ng/dL, sensitivity: 0.85 [95% CI, 0.78-0.91], P =0.192; specificity: 0.92 [95% CI, 0.85-0.97], P =0.551). In conclusion, both CCT and SIT are accurate alternatives to the more complex fludrocortisone suppression test. Because CCT is safe and much easier to perform, it may serve as a more feasible alternative. When interpreting the results of CCT, PAC post-CCT is highly recommended. © 2017 American Heart Association, Inc.

  13. [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.

  14. The PROgnostic Value of unrequested Information in Diagnostic Imaging (PROVIDI) Study: rationale and design

    International Nuclear Information System (INIS)

    Gondrie, M. J. A.; Mali, W. P. Th. M.; Buckens, C. F. M.; Jacobs, P. C. A.; Grobbee, D. E.; Graaf, Y van der

    2010-01-01

    We describe the rationale for a new study examining the prognostic value of unrequested findings in diagnostic imaging. The deployment of more advanced imaging modalities in routine care means that such findings are being detected with increasing frequency. However, as the prognostic significance of many types of unrequested findings is unknown, the optimal response to such findings remains uncertain and in many cases an overly defensive approach is adopted, to the detriment of patient-care. Additionally, novel and promising image findings that are newly available on many routine scans cannot be used to improve patient care until their prognostic value is properly determined. The PROVIDI study seeks to address these issues using an innovative multi-center case-cohort study design. PROVIDI is to consist of a series of studies investigating specific, selected disease entities and clusters. Computed Tomography images from the participating hospitals are reviewed for unrequested findings. Subsequently, this data is pooled with outcome data from a central population registry. Study populations consist of patients with endpoints relevant to the (group of) disease(s) under study along with a random control sample from the cohort. This innovative design allows PROVIDI to evaluate selected unrequested image findings for their true prognostic value in a series of manageable studies. By incorporating unrequested image findings and outcomes data relevant to patients, truly meaningful conclusions about the prognostic value of unrequested and emerging image findings can be reached and used to improve patient-care.

  15. Palladium(II)-catalyzed desulfitative synthesis of aryl ketones from sodium arylsulfinates and nitriles: scope, limitations, and mechanistic studies.

    Science.gov (United States)

    Skillinghaug, Bobo; Sköld, Christian; Rydfjord, Jonas; Svensson, Fredrik; Behrends, Malte; Sävmarker, Jonas; Sjöberg, Per J R; Larhed, Mats

    2014-12-19

    A fast and efficient protocol for the palladium(II)-catalyzed production of aryl ketones from sodium arylsulfinates and various organic nitriles under controlled microwave irradiation has been developed. The wide scope of the reaction has been demonstrated by combining 14 sodium arylsulfinates and 21 nitriles to give 55 examples of aryl ketones. One additional example illustrated that, through the choice of the nitrile reactant, benzofurans are also accessible. The reaction mechanism was investigated by electrospray ionization mass spectrometry and DFT calculations. The desulfitative synthesis of aryl ketones from nitriles was also compared to the corresponding transformation starting from benzoic acids. Comparison of the energy profiles indicates that the free energy requirement for decarboxylation of 2,6-dimethoxybenzoic acid and especially benzoic acid is higher than the corresponding desulfitative process for generating the key aryl palladium intermediate. The palladium(II) intermediates detected by ESI-MS and the DFT calculations provide a detailed understanding of the catalytic cycle.

  16. 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

  17. 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.

  18. ScienceScope: Aerospace

    CSIR Research Space (South Africa)

    CSIR

    2006-12-01

    Full Text Available In this edition of ScienceScope, innovations in and around aerodynamics research and development is explored. The publication explores activities in environmentally friendly aerospace technologies to enhance the aviation industry....

  19. 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

  20. RADAR PPI Scope Overlay

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — RADAR PPI Scope Overlays are used to position a RADAR image over a station at the correct resolution. The archive maintains several different RADAR resolution types,...

  1. Diagnostic Algorithm for Glycogenoses and Myoadenylate Deaminase Deficiency Based on Exercise Testing Parameters: A Prospective Study.

    Directory of Open Access Journals (Sweden)

    Fabrice Rannou

    Full Text Available Our aim was to evaluate the accuracy of aerobic exercise testing to diagnose metabolic myopathies.From December 2008 to September 2012, all the consecutive patients that underwent both metabolic exercise testing and a muscle biopsy were prospectively enrolled. Subjects performed an incremental and maximal exercise testing on a cycle ergometer. Lactate, pyruvate, and ammonia concentrations were determined from venous blood samples drawn at rest, during exercise (50% predicted maximal power, peak exercise, and recovery (2, 5, 10, and 15 min. Biopsies from vastus lateralis or deltoid muscles were analysed using standard techniques (reference test. Myoadenylate deaminase (MAD activity was determined using p-nitro blue tetrazolium staining in muscle cryostat sections. Glycogen storage was assessed using periodic acid-Schiff staining. The diagnostic accuracy of plasma metabolite levels to identify absent and decreased MAD activity was assessed using Receiver Operating Characteristic (ROC curve analysis.The study involved 51 patients. Omitting patients with glycogenoses (n = 3, MAD staining was absent in 5, decreased in 6, and normal in 37 subjects. Lactate/pyruvate at the 10th minute of recovery provided the greatest area under the ROC curves (AUC, 0.893 ± 0.067 to differentiate Abnormal from Normal MAD activity. The lactate/rest ratio at the 10th minute of recovery from exercise displayed the best AUC (1.0 for discriminating between Decreased and Absent MAD activities. The resulting decision tree achieved a diagnostic accuracy of 86.3%.The present algorithm provides a non-invasive test to accurately predict absent and decreased MAD activity, facilitating the selection of patients for muscle biopsy and target appropriate histochemical analysis.

  2. A Design Research Study of a Curriculum and Diagnostic Assessment System for a Learning Trajectory on Equipartitioning

    Science.gov (United States)

    Confrey, Jere; Maloney, Alan

    2015-01-01

    Design research studies provide significant opportunities to study new innovations and approaches and how they affect the forms of learning in complex classroom ecologies. This paper reports on a two-week long design research study with twelve 2nd through 4th graders using curricular materials and a tablet-based diagnostic assessment system, both…

  3. A hybrid model for combining case-control and cohort studies in systematic reviews of diagnostic tests

    Science.gov (United States)

    Chen, Yong; Liu, Yulun; Ning, Jing; Cormier, Janice; Chu, Haitao

    2014-01-01

    Systematic reviews of diagnostic tests often involve a mixture of case-control and cohort studies. The standard methods for evaluating diagnostic accuracy only focus on sensitivity and specificity and ignore the information on disease prevalence contained in cohort studies. Consequently, such methods cannot provide estimates of measures related to disease prevalence, such as population averaged or overall positive and negative predictive values, which reflect the clinical utility of a diagnostic test. In this paper, we propose a hybrid approach that jointly models the disease prevalence along with the diagnostic test sensitivity and specificity in cohort studies, and the sensitivity and specificity in case-control studies. In order to overcome the potential computational difficulties in the standard full likelihood inference of the proposed hybrid model, we propose an alternative inference procedure based on the composite likelihood. Such composite likelihood based inference does not suffer computational problems and maintains high relative efficiency. In addition, it is more robust to model mis-specifications compared to the standard full likelihood inference. We apply our approach to a review of the performance of contemporary diagnostic imaging modalities for detecting metastases in patients with melanoma. PMID:25897179

  4. Screening Characteristics of TIMI Score in Predicting Acute Coronary Syndrome Outcome; a Diagnostic Accuracy Study

    Directory of Open Access Journals (Sweden)

    Mostafa Alavi-Moghaddam

    2017-01-01

    Full Text Available Introduction: In cases with potential diagnosis of ischemic chest pain, screening high risk patients for adverse outcomes would be very helpful. The present study was designed aiming to determine the diagnostic accuracy of thrombolysis in myocardial infarction (TIMI score in Patients with potential diagnosis of ischemic chest pain.Method: This diagnostic accuracy study was designed to evaluate the screening performance characteristics of TIMI score in predicting 30-day outcomes of mortality, myocardial infarction (MI, and need for revascularization in patients presenting to ED with complaint of typical chest pain and diagnosis of unstable angina or Non-ST elevation MI.Results: 901 patients with the mean age of 58.17 ± 15.00 years (19-90 were studied (52.9% male. Mean TIMI score of the studied patients was 0.97 ± 0.93 (0-5 and the highest frequency of the score belonged to 0 to 2 with 37.2%, 35.3%, and 21.4%, respectively. In total, 170 (18.8% patients experienced the outcomes evaluated in this study. Total sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratio of TIMI score were 20 (95% CI: 17 – 24, 99 (95% CI: 97 – 100, 98 (95% CI: 93 – 100, 42 (95% CI: 39 – 46, 58 (95% CI: 14 – 229, and 1.3 (95% CI: 1.2 – 1.4, respectively. Area under the ROC curve of this system for prediction of 30-day mortality, MI, and need for revascularization were 0.51 (95% CI: 0.47 – 0.55, 0.58 (95% CI: 0.54 – 0.62 and 0.56 (95% CI: 0.52 – 0.60, respectively.Conclusion: Based on the findings of the present study, it seems that TIMI score has a high specificity in predicting 30-day adverse outcomes of mortality, MI, and need for revascularization following acute coronary syndrome. However, since its sensitivity, negative predictive value, and negative likelihood ratio are low, it cannot be used as a proper screening tool for ruling out low risk patients in ED.

  5. 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...

  6. 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)

  7. A national study of breast and colorectal cancer patients' decision-making for novel personalized medicine genomic diagnostics.

    Science.gov (United States)

    Issa, Amalia M; Tufail, Waqas; Atehortua, Nelson; McKeever, John

    2013-05-01

    Molecular diagnostics are increasingly being used to help guide decision-making for personalized medical treatment of breast and colorectal cancer patients. The main aim of this study was to better understand and determine breast and colorectal cancer patients' decision-making strategies and the trade-offs they make in deciding about characteristics of molecular genomic diagnostics for breast and colorectal cancer. We surveyed a nationally representative sample of 300 breast and colorectal cancer patients using a previously developed web-administered instrument. Eligibility criteria included patients aged 18 years and older with either breast or colorectal cancer. We explored several attributes and attribute levels of molecular genomic diagnostics in 20 scenarios. Our analysis revealed that both breast and colorectal cancer patients weighted the capability of molecular genomic diagnostics to determine the probability of treatment efficacy as being of greater importance than information provided to detect adverse events. The probability of either false-positive or -negative results was ranked highly as a potential barrier by both breast and colorectal patients. However, 78.6% of breast cancer patients ranked the possibility of a 'false-negative test result leading to undertreatment' higher than the 'chance of a false positive, which may lead to overtreatment' (68%). This finding contrasted with the views of colorectal cancer patients who ranked the chance of a false positive as being of greater concern than a false negative (72.8 vs 63%). Overall, cancer patients exhibited a high willingness to accept and pay for genomic diagnostic tests, especially among breast cancer patients. Cancer patients seek a test accuracy rate of 90% or higher. Breast and colorectal cancer patients' decisions about genomic diagnostics are influenced more by the probability of being cured than by avoiding potential severe adverse events. This study provides insights into the relative weight

  8. 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

  9. 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

  10. Diagnostic reasoning strategies and diagnostic success.

    Science.gov (United States)

    Coderre, S; Mandin, H; Harasym, P H; Fick, G H

    2003-08-01

    Cognitive psychology research supports the notion that experts use mental frameworks or "schemes", both to organize knowledge in memory and to solve clinical problems. The central purpose of this study was to determine the relationship between problem-solving strategies and the likelihood of diagnostic success. Think-aloud protocols were collected to determine the diagnostic reasoning used by experts and non-experts when attempting to diagnose clinical presentations in gastroenterology. Using logistic regression analysis, the study found that there is a relationship between diagnostic reasoning strategy and the likelihood of diagnostic success. Compared to hypothetico-deductive reasoning, the odds of diagnostic success were significantly greater when subjects used the diagnostic strategies of pattern recognition and scheme-inductive reasoning. Two other factors emerged as independent determinants of diagnostic success: expertise and clinical presentation. Not surprisingly, experts outperformed novices, while the content area of the clinical cases in each of the four clinical presentations demonstrated varying degrees of difficulty and thus diagnostic success. These findings have significant implications for medical educators. It supports the introduction of "schemes" as a means of enhancing memory organization and improving diagnostic success.

  11. Spectroscopic diagnostics for liquid lithium divertor studies on National Spherical Torus Experiment

    International Nuclear Information System (INIS)

    Soukhanovskii, V. A.; Roquemore, A. L.; Bell, R. E.; Kaita, R.; Kugel, H. W.

    2010-01-01

    The use of lithium-coated plasma facing components for plasma density control is studied in the National Spherical Torus Experiment (NSTX). A recently installed liquid lithium divertor (LLD) module has a porous molybdenum surface, separated by a stainless steel liner from a heated copper substrate. Lithium is deposited on the LLD from two evaporators. Two new spectroscopic diagnostics are installed to study the plasma surface interactions on the LLD: (1) A 20-element absolute extreme ultraviolet (AXUV) diode array with a 6 nm bandpass filter centered at 121.6 nm (the Lyman-α transition) for spatially resolved divertor recycling rate measurements in the highly reflective LLD environment, and (2) an ultraviolet-visible-near infrared R=0.67 m imaging Czerny-Turner spectrometer for spatially resolved divertor D I, Li I-II, C I-IV, Mo I, D 2 , LiD, CD emission and ion temperature on and around the LLD module. The use of photometrically calibrated measurements together with atomic physics factors enables studies of recycling and impurity particle fluxes as functions of LLD temperature, ion flux, and divertor geometry.

  12. Diagnostic electrocardiography in epidemiological studies of Chagas' disease: multicenter evaluation of a standardized method

    Directory of Open Access Journals (Sweden)

    Lázzari Julio O.

    1998-01-01

    Full Text Available An electrocardiographic recording method with an associated reading guide, designed for epidemiological studies on Chagas' disease, was tested to assess its diagnostic reproducibility. Six cardiologists from five countries each read 100 electrocardiographic (ECG tracings, including 30 from chronic chagasic patients, then reread them after an interval of 6 months. The readings were blind, with the tracings numbered randomly for the first reading and renumbered randomly for the second reading. The physicians, all experienced in interpreting ECGs from chagasic patients, followed printed instructions for reading the tracings. Reproducibility of the readings was evaluated using the kappa (k index for concordance. The results showed a high degree of interobserver concordance with respect to the diagnosis of normal vs. abnormal tracings (k = 0.66; SE 0.02. While the interpretations of some categories of ECG abnormalities were highly reproducible, others, especially those having a low prevalence, showed lower levels of concordance. Intraobserver concordance was uniformly higher than interobserver concordance. The findings of this study justify the use by specialists of the recording of readings method proposed for epidemiological studies on Chagas' disease, but warrant caution in the interpretation of some categories of electrocardiographic alterations.

  13. Diagnostic electrocardiography in epidemiological studies of Chagas' disease: multicenter evaluation of a standardized method

    Directory of Open Access Journals (Sweden)

    Julio O. Lázzari

    1998-11-01

    Full Text Available An electrocardiographic recording method with an associated reading guide, designed for epidemiological studies on Chagas' disease, was tested to assess its diagnostic reproducibility. Six cardiologists from five countries each read 100 electrocardiographic (ECG tracings, including 30 from chronic chagasic patients, then reread them after an interval of 6 months. The readings were blind, with the tracings numbered randomly for the first reading and renumbered randomly for the second reading. The physicians, all experienced in interpreting ECGs from chagasic patients, followed printed instructions for reading the tracings. Reproducibility of the readings was evaluated using the kappa (k index for concordance. The results showed a high degree of interobserver concordance with respect to the diagnosis of normal vs. abnormal tracings (k = 0.66; SE 0.02. While the interpretations of some categories of ECG abnormalities were highly reproducible, others, especially those having a low prevalence, showed lower levels of concordance. Intraobserver concordance was uniformly higher than interobserver concordance. The findings of this study justify the use by specialists of the recording of readings method proposed for epidemiological studies on Chagas' disease, but warrant caution in the interpretation of some categories of electrocardiographic alterations.

  14. Diagnostic study of multiple double layer formation in expanding RF plasma

    Science.gov (United States)

    Chakraborty, Shamik; Paul, Manash Kumar; Roy, Jitendra Nath; Nath, Aparna

    2018-03-01

    Intensely luminous double layers develop and then expand in size in a visibly glowing RF discharge produced using a plasma source consisting of a semi-transparent cylindrical mesh with a central electrode, in a linear plasma chamber. Although RF discharge is known to be independent of device geometry in the absence of magnetic field, the initiation of RF discharge using such a plasma source results in electron drift and further expansion of the plasma in the vessel. The dynamics of complex plasma structures are studied through electric probe diagnostics in the expanding RF plasma. The measurements made to study the parametric dependence of evolution of double layer structures are analyzed and presented here. The plasma parameter measurements suggest that the complex potential structures initially form with low potential difference between the layers and then gradually expand producing burst oscillations. The present study provides interesting information about the stability of plasma sheath and charge particle dynamics in it that are important to understand the underlying basic sheath physics along with applications in plasma acceleration and propulsion.

  15. Study of the audiological' profile of individuals attended in a brazilian diagnostic service

    Directory of Open Access Journals (Sweden)

    Jardim, Isabela de Souza

    2010-03-01

    Full Text Available Introduction: Hearing loss can affect the health and quality of life of the individual. The finding of the audio logical profile becomes important epidemiological tool for the explanation of new health policies, effective prevention measures, aid in medical diagnosis and improvement of techniques for the auditory rehabilitation. Objective: To evaluate the audio logical profile of the individuals treated in a service of audio logical diagnosis describing the age, gender, chief complaints and to characterize the audiometric thresholds of individuals second degree, type and configuration. Method: A retrospective study, through analysis of medical records of 217 individuals of both genders in the private sector attended in a Brazilian service of diagnostic audiology between January and June 2009. For the study were analyzed the complaints following the evaluation of tonal audiometry. Results: The main complaints were 110 (50.7% individuals reported tinnitus, 48 (22.1% dizziness, and 116 (53.4% dysacusis. The audio logical profile of the individuals was characterized by 36.4% of individuals with normal hearing, 45.6% with dysacusis bilateral and unilateral 18%. When considering both groups with dysacusis there was predominance of the sensory neuro type and of mild grade. Conclusion: The main complaints founded were tinnitus, dizziness, and dysacusis. The Audiometry showed the predominance of bilateral dysacusis of type sensory neuro and of mild grade for the study constituted by adults and seniors individuals attended in the sector.

  16. 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

  17. Impact of Diagnosticity on the Adequacy of Models for Cognitive Diagnosis under a Linear Attribute Structure: A Simulation Study

    Science.gov (United States)

    de La Torre, Jimmy; Karelitz, Tzur M.

    2009-01-01

    Compared to unidimensional item response models (IRMs), cognitive diagnostic models (CDMs) based on latent classes represent examinees' knowledge and item requirements using discrete structures. This study systematically examines the viability of retrofitting CDMs to IRM-based data with a linear attribute structure. The study utilizes a procedure…

  18. Investigation of publication bias in meta-analyses of diagnostic test accuracy: a meta-epidemiological study

    NARCIS (Netherlands)

    van Enst, W. Annefloor; Ochodo, Eleanor; Scholten, Rob J. P. M.; Hooft, Lotty; Leeflang, Mariska M.

    2014-01-01

    The validity of a meta-analysis can be understood better in light of the possible impact of publication bias. The majority of the methods to investigate publication bias in terms of small study-effects are developed for meta-analyses of intervention studies, leaving authors of diagnostic test

  19. Diagnostic assessment of painless microhematuria: prospective study comparing image quality, assessibility and diagnostic certainty of multidetector-row CT and intravenous pyelography within a single examination

    International Nuclear Information System (INIS)

    Boehm, T.; John, H.; Ruedi, C.; Marincek, B.; Wildermuth, S.; Michael, M.

    2005-01-01

    Purpose: The purpose of this study is to prospectively compare intravenous pyelography (IVP) and combined unenhanced and excretory phase multidetector-row CT (MDCT) with respect to image quality, diagnostic certainty and diagnostic concordance with the final clinical diagnosis in patients with painless microhematuria. Materials and Methods: Unenhanced MDCT, IVP and excretory phase MDCT were performed in 59 consecutive patients (21 women, 38 men, mean age 56±19 years, range 23-83 years) with painless microhematuria of unknown origin during a single examination with a single contrast media application (100 ml, non-ionic iodinate contrast media). Images were assessed by two experienced urogenital radiologists in consensus for image quality, diagnostic certainty of stone detection, obstruction, parenchymal lesions and morphological distinctive features. Imaging diagnoses of MDCT and IVP were compared with the final clinical diagnoses. In case of failure to detect an relevant pathology, the final clinical diagnosis was established after a mean follow-up period of 18±6 months (10 months to 2 years). Costs and radiation exposure of IVP and MDCT were compared. Results: MDCT scan performed better than IVP in terms of image quality for all regarded variables. Image quality of MDCT was rated in all parameters as very good or good; the image quality of IVP differed in a wide range. MDCT and IVP reached a sensitivity of 100% and 50% for stone detection (n=14, p=0.008), respectively. Two bladder stones were not detected by IVU but correctly seen with MDCT. MDCT and IVP were unsatisfactory for detecting transitional cell carcinomas (n=4, 2 of 4 detected with MDCT, 0 of 4 detected with IVU). One false positive transitional cell carcinoma was detected with IVP, none with MDCT. Additional relevant pathological changes (one teratoma, one abdominal aortic aneurysma and one abscess) were detected using MDCT but missed with IVP. In 38 of 59 patients (64%) imaging and clinical follow

  20. 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

  1. Full-scope training simulators

    International Nuclear Information System (INIS)

    Ugedo, E.

    1986-01-01

    The following topics to be covered in this report are: Reasons justifying the use of full-scope simulators for operator qualification. Full-scope simulator description: the control room, the physical models, the computer complex, the instructor's console. Main features of full-scope simulators. Merits of simulator training. The role of full-scope simulators in the training programs. The process of ordering and acquiring a full-scope simulator. Maintaining and updating simulator capabilities. (orig./GL)

  2. Endoscopic Management of Gastrointestinal Leaks and Bleeding with the Over-the-Scope Clip: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Mahesh Kumar Goenka

    2017-01-01

    Full Text Available Background/Aims The over-the-scope clip (OTSC is a device used for endoscopic closure of perforations, leaks and fistulas, and for endoscopic hemostasis. To evaluate the clinical effectiveness and safety of OTSC. Methods Between October 2013 and November 2015, 12 patients underwent OTSC placement by an experienced endoscopist. OTSC was used for the closure of gastrointestinal (GI leaks and fistula in six patients, three of which were iatrogenic (esophageal, gastric, and duodenal and three of which were inflammatory. In six patients, OTSC was used for hemostasis of non-variceal upper GI bleeding. Endoscopic tattooing using India ink was used to assist the accurate placement of the clip. Results All subjects except one with a colonic defect experienced immediate technical success as well as long-term clinical success, during a mean follow-up of 6 weeks. Only one clip was required to close each of the GI defects and to achieve hemostasis in all patients. There were no misfirings or complications of clips. The procedure was well tolerated, and patients were hospitalized for an average of 8 days (range, 3 to 10. Antiplatelet therapy was continued in patients with GI bleeding. Conclusions In our experience, OTSC was safe and effective for the closure of GI defect and to achieve hemostasis of non-variceal GI bleeding.

  3. 76 FR 23825 - Study Methodologies for Diagnostics in the Postmarket Setting; Public Workshop

    Science.gov (United States)

    2011-04-28

    ... understanding of the performance of diagnostics at the postmarket settings. II. Who is the target audience for... interested parties. The target audience is professionals in the scientific community with experience in...

  4. Amplitude Integrated Electroencephalography Compared With Conventional Video EEG for Neonatal Seizure Detection: A Diagnostic Accuracy Study.

    Science.gov (United States)

    Rakshasbhuvankar, Abhijeet; Rao, Shripada; Palumbo, Linda; Ghosh, Soumya; Nagarajan, Lakshmi

    2017-08-01

    This diagnostic accuracy study compared the accuracy of seizure detection by amplitude-integrated electroencephalography with the criterion standard conventional video EEG in term and near-term infants at risk of seizures. Simultaneous recording of amplitude-integrated EEG (2-channel amplitude-integrated EEG with raw trace) and video EEG was done for 24 hours for each infant. Amplitude-integrated EEG was interpreted by a neonatologist; video EEG was interpreted by a neurologist independently. Thirty-five infants were included in the analysis. In the 7 infants with seizures on video EEG, there were 169 seizure episodes on video EEG, of which only 57 were identified by amplitude-integrated EEG. Amplitude-integrated EEG had a sensitivity of 33.7% for individual seizure detection. Amplitude-integrated EEG had an 86% sensitivity for detection of babies with seizures; however, it was nonspecific, in that 50% of infants with seizures detected by amplitude-integrated EEG did not have true seizures by video EEG. In conclusion, our study suggests that amplitude-integrated EEG is a poor screening tool for neonatal seizures.

  5. 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.

  6. Diagnostic budget study of the internal variability in ensemble simulations of the Canadian RCM

    Energy Technology Data Exchange (ETDEWEB)

    Nikiema, Oumarou; Laprise, Rene [UQAM, Canadian Network for Regional Climate Modelling and Diagnostics, Centre ESCER, Departement des Sciences de la Terre et de l' Atmosphere, B.P. 8888, Montreal, QC (Canada)

    2011-06-15

    Due to the chaotic and nonlinear nature of the atmospheric dynamics, it is known that small differences in the initial conditions (IC) of models can grow and affect the simulation evolution. In this study, we perform a quantitative diagnostic budget calculation of the various diabatic and dynamical contributions to the time evolution and spatial distribution of internal variability (IV) in simulations with the nested Canadian Regional Climate Model. We establish prognostic budget equations of the IV for the potential temperature and the relative vorticity fields. For both of these variables, the IV equations present similar terms, notably terms relating to the transport of IV by ensemble-mean flow and to the covariance of fluctuations acting on the gradient of the ensemble-mean state. We show the skill of these equations to diagnose the IV that took place in an ensemble of 20 3-month (summer season) simulations that differed only in their IC. Our study suggests that the dominant terms responsible for the large increase of IV are either the covariance term involving the potential temperature fluctuations and diabatic heating fluctuations, or the covariance of inter-member fluctuations acting upon ensemble-mean gradients. Our results also show that, on average, the third-order terms are negligible, but they can become important when the IV is large. (orig.)

  7. 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.

  8. Comparative Study for the Accuracy of Helicobacter pylori Diagnostic Methods Associated with Some Inflammatory Factors

    Directory of Open Access Journals (Sweden)

    Eman N. Naji

    2018-04-01

    Full Text Available This Study was intended to diagnose H. pyiori the major causative pathogen in gastro duodenal irritation and ulceration. Differert techniques were used invasive tests (histopathological examina-tion, rapid urea CLO test and culture , while noninvasive tests includes (serological tests and stool antigen in addition to determination of some immune response factors (IgM , IgG , IgA as well as (IL – 8 and IFN – y in Ptients Sera. According to the results of invasive diagnostic method 30/113 (26.69% patients were considered to be infected and 83/113(73.31% patients were considered as noninfeted was contrasted with noninvasive diagnostic method 25/113 (22.14% patients were considered to be infected and 88/133(77.83% patients were considered as noninfeted. In order to get the overall percentage of the infected people included in this study, we merge the results of the two methods ,so we found out that the total infected patients with H. pylori diagnosed by invasive and noninvasive methods were 42 /113 (37.2% while the noninfected 71/113 (62.8 disseminated as 27/68(39.71% infect-ed male ,which was privileged than the infected female when it was 15/45(33.33%. The high prevalence of H. pylori infection in the age group ranging between (46-60 in male and female. Histology (invasive teq. and ECO rapid test (noninvasive teq. were considered as the ‘‘best techniques ’’ for H. pylori detection, in the outlook of its high specificity, sensitivity and because it detected the major number of H. pylori-positive patients along with the other techniques used in this work. The sensitivity, specificity, positive predictive values (PPV and negative predictive values (NPV for histology were 100,100,100 and 94.5% , respectively, while for the ECO rapid test they were 96, 93, 91.5, and 97.14%. Culture (invasive teq. and IgG anti H. pylori (noninvasive teq. coming secondly in the diagnosis of H. pylori infection because they detected a little fewer number of

  9. 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

  10. Predictive ability of an early diagnostic guess in patients presenting with chest pain; a longitudinal descriptive study

    Directory of Open Access Journals (Sweden)

    Bischoff Thomas

    2010-02-01

    Full Text Available Abstract Background The intuitive early diagnostic guess could play an important role in reaching a final diagnosis. However, no study to date has attempted to quantify the importance of general practitioners' (GPs ability to correctly appraise the origin of chest pain within the first minutes of an encounter. Methods The validation study was nested in a multicentre cohort study with a one year follow-up and included 626 successive patients who presented with chest pain and were attended by 58 GPs in Western Switzerland. The early diagnostic guess was assessed prior to a patient's history being taken by a GP and was then compared to a diagnosis of chest pain observed over the next year. Results Using summary measures clustered at the GP's level, the early diagnostic guess was confirmed by further investigation in 51.0% (CI 95%; 49.4% to 52.5% of patients presenting with chest pain. The early diagnostic guess was more accurate in patients with a life threatening illness (65.4%; CI 95% 64.5% to 66.3% and in patients who did not feel anxious (62.9%; CI 95% 62.5% to 63.3%. The predictive abilities of an early diagnostic guess were consistent among GPs. Conclusions The GPs early diagnostic guess was correct in one out of two patients presenting with chest pain. The probability of a correct guess was higher in patients with a life-threatening illness and in patients not feeling anxious about their pain.

  11. 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.

  12. 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.

  13. 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.

  14. Results of the study of entrance surface dose from conventional examinations in diagnostic radiology

    International Nuclear Information System (INIS)

    Martinez, A.; Jova, L.; Carrazana, J.; Diaz, E.; Mora, R. de la; Guevara, C.; Fleitas, I.

    2001-01-01

    The wide diffusion of X-ray diagnostic together with the quick development and expansion that has come with experiencing the technology in this practice, has motivated the emission of recommendations in the Basic Safety Standards of the IAEA for the establishment of guidance levels for different radiological examinations in each country that allow the optimization of the medical exposure. Considering the above-mentioned and the existence in Cuba in a great number of conventional X-ray equipment, with an average of over 10 years of use which influences directly on the patient dose, in 1999, an investigation began in the country on the patient exposure in this practice. This work shows the first results of measurements carried out in 9 major hospitals of several provinces of the country. The doses were evaluated in the examinations of lumbar spine AP, lumbar spine LAT, thorax PA, skull AP and skull LAT. The determination of the doses in these examinations was carried out by 'in-vivo' measurements on the patients, placing in the center of the irradiation field TLD of LiF. The distributions obtained in the studies are compared with the guidance levels that is shown in the Basic Safety Standards of the IAEA. (author)

  15. Tolerance and diagnostic accuracy of an abbreviated adenosine infusion for myocardial scintigraphy: a randomized, prospective study.

    Science.gov (United States)

    Treuth, M G; Reyes, G A; He, Z X; Cwajg, E; Mahmarian, J J; Verani, M S

    2001-01-01

    The objectives of this study were 2-fold: (1) to determine the tolerance of adenosine perfusion tomography with the use of an abbreviated (3-minute) infusion in comparison to the standard (6-minute) infusion, and (2) to assess the relative diagnostic accuracy of a 3-minute adenosine infusion in patients referred for arteriography. An abbreviated adenosine infusion may decrease the frequency and duration of side effects and be a more cost-effective alternative. We prospectively randomized 599 patients undergoing adenosine myocardial perfusion tomography to either a 3-minute or 6-minute adenosine infusion at 140 microg/kg per minute. Among the 599 enrolled patients, 142 subsequently underwent coronary angiography. Patients randomized to the 3-minute adenosine infusion tolerated the procedure better than those randomized to the standard infusion (P <.01). Flushing, headache, neck pain, and atrioventricular block were all significantly less frequent (P <.01) with the abbreviated infusion. Moreover, patients receiving the abbreviated infusion had less hypotension and tachycardia (P <.05). The sensitivity of the test for detection of coronary artery disease was 88% for both the 3- and 6-minute infusions. In patients with abnormal scan results, perfusion defect size was slightly larger in those receiving a 6-minute infusion versus those receiving a 3-minute infusion (P =.05). An abbreviated 3-minute adenosine infusion, in combination with perfusion tomography, has similar sensitivity for detection of coronary artery disease and is better tolerated than the standard 6-minute infusion.

  16. A correlation study of diagnostic fine-needle aspiration with histologic diagnosis in cystic neck lesions.

    Science.gov (United States)

    Moatamed, Neda A; Naini, Bita V; Fathizadeh, Payman; Estrella, Julie; Apple, Sophia K

    2009-10-01

    The clinical diagnosis of a mass in the neck region encompasses a wide spectrum of differential diagnosis. Fine-needle aspiration is a quick and safe technique, which can provide useful information for initial assessment and further therapeutic measures. The aim of this retrospective study was to evaluate the performance characteristics of the fine-needle aspiration (FNA) in cystic neck lesions. Of 142 patients with FNA for cystic neck masses during 2002-2007, 92 cases were selected with a follow-up histologic diagnosis, excluding the cystic colloid nodule of the thyroid. The cases were divided into salivary gland cystic neck (37 patients) and non-salivary cystic neck (55 patients) mass groups. False-positive and false-negative diagnoses were applied only to the malignant lesions after confirmation by histopathology. In the first group, nine malignant and 28 benign diagnoses were made by FNA; of which three were false-negative. In the second group, there were nine malignant and 46 benign diagnoses with three false negatives. The overall performance of the FNA showed 76% sensitivity and 100% specificity. In conclusion, FNA of the cystic neck lesions offers an invaluable and highly specific initial diagnostic approach for the management of the patients. (c) 2009 Wiley-Liss, Inc.

  17. Studies of renal parenchymal impairments with extracorporeal shock wave lithotripsy (ESWL) by diagnostic imaging methods

    Energy Technology Data Exchange (ETDEWEB)

    Ohishi, Yukihiko; Machida, Toyohei; Tashiro, Kazuya; Wada, Tetsuro; Mochizuki, Atsushi; Torii, Shinichiro; Yoshigoe, Fukuo; Kawashima, Yoshio; Asano, Koji (Jikei Univ., Tokyo (Japan). School of Medicine)

    1989-05-01

    Renal parenchymal impairments with extracorporeal shock wave lithotripsy (ESWL) were studied by diagnostic imaging methods. The subjects were 25 patients with renal stones, and EDAP LT-01 (piezoelectric system) was used for the equipment of ESWL. The examination by MRI, X-ray CT and /sup 99m/Tc-DMSA scintigraphy using SPECT were performed before and after ESWL. To the 24 kidneys of 12 adult dogs, shock waves were fired in order to examine the experimental renal parenchymal impairments. After the treatment with ESWL, renal abnormal findings were obtained with MRI in 6 patients out of 11 (54.5%), with X-ray CT in 1 patient out of 12 (8.3%), and with the /sup 99m/Tc-DMSA renal scintigraphy in 4 patients out of 6 (66.7%). In the inspections with X-ray CT and renal scintigraphy conducted in 4 weeks, it was noted that the conditions of patients were recovered to the states before ESWL was performed. Using the therapeutic doses of shock wave for humans, the renal parenchymal impairments in the kidney in dogs were normalized in 7 days. Although it has been considered that the degree of renal parenchymal impairments with ESWL treatment may be influenced by the kind of the equipment, frequency of shock waves and their strength, the extent of impairments were rather mild, and it was presumed that the impairments might be recovered on the images in 3 to 4 weeks at the latest. (author).

  18. Studies of renal parenchymal impairments with extracorporeal shock wave lithotripsy (ESWL) by diagnostic imaging methods

    International Nuclear Information System (INIS)

    Ohishi, Yukihiko; Machida, Toyohei; Tashiro, Kazuya; Wada, Tetsuro; Mochizuki, Atsushi; Torii, Shinichiro; Yoshigoe, Fukuo; Kawashima, Yoshio; Asano, Koji

    1989-01-01

    Renal parenchymal impairments with extracorporeal shock wave lithotripsy (ESWL) were studied by diagnostic imaging methods. The subjects were 25 patients with renal stones, and EDAP LT-01 (piezoelectric system) was used for the equipment of ESWL. The examination by MRI, X-ray CT and 99m Tc-DMSA scintigraphy using SPECT were performed before and after ESWL. To the 24 kidneys of 12 adult dogs, shock waves were fired in order to examine the experimental renal parenchymal impairments. After the treatment with ESWL, renal abnormal findings were obtained with MRI in 6 patients out of 11 (54.5%), with X-ray CT in 1 patient out of 12 (8.3%), and with the 99m Tc-DMSA renal scintigraphy in 4 patients out of 6 (66.7%). In the inspections with X-ray CT and renal scintigraphy conducted in 4 weeks, it was noted that the conditions of patients were recovered to the states before ESWL was performed. Using the therapeutic doses of shock wave for humans, the renal parenchymal impairments in the kidney in dogs were normalized in 7 days. Although it has been considered that the degree of renal parenchymal impairments with ESWL treatment may be influenced by the kind of the equipment, frequency of shock waves and their strength, the extent of impairments were rather mild, and it was presumed that the impairments might be recovered on the images in 3 to 4 weeks at the latest. (author)

  19. Growth studies of CVD-MBE by in-situ diagnostics

    Science.gov (United States)

    Maracas, George N.; Steimle, Timothy C.

    1992-10-01

    This is the final technical report for the three year DARPA-URI program 'Growth Studies of CVD-MBE by in-situ Diagnostics'. The goals of the program were to develop non-invasive, real time epitaxial growth monitoring techniques and combine them to gain an understanding of processes that occur during MBE growth from gas sources. We have adapted these techniques to a commercially designed gas source MBE system (Vacuum Generators Inc.) to facilitate technology transfer out of the laboratory into industrial environments. The in-situ measurement techniques of spectroscopic ellipsometry (SE) and laser induced fluorescence (LIF) have been successfully implemented to monitor the optical and chemical properties of the growing epitaxial film and the gas phase reactants. The ellipsometer was jointly developed with the J. Woolam Co. and has become a commercial product. The temperature dependence of group 3 and 5 desorption from GaAs and InP has been measured as well as the incident effusion cell fluxes. The temporal evolution of the growth has also been measured both by SE and LIF to show the smoothing of heterojunction surfaces during growth interruption. Complicated microcavity optical device structures have been monitored by ellipsometry in real time to improve device quality. This data has been coupled with the structural information obtained from reflection high energy electron diffraction (RHEED) to understand the growth processes in binary and ternary bulk 3-5 semiconductors and heterojunctions.

  20. [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.

  1. Salivary cortisol as a tool for physiological studies and diagnostic strategies

    Directory of Open Access Journals (Sweden)

    Castro M.

    2000-01-01

    Full Text Available Salivary cortisol is an index of plasma free cortisol and is obtained by a noninvasive procedure. We have been using salivary cortisol as a tool for physiological and diagnostic studies, among them the emergence of circadian rhythm in preterm and term infants. The salivary cortisol circadian rhythm in term and premature infants was established between 8 and 12 postnatal weeks. In the preterm infants the emergence of circadian rhythm was parallel to the onset of sleep rhythm. We also studied the use of salivary cortisol for screening for Cushing's syndrome (CS in control and obese outpatients based on circadian rhythm and the overnight 1 mg dexamethasone (DEX suppression test. Salivary cortisol was suppressed to less than 100 ng/dl after 1 mg DEX in control and obese patients. A single salivary cortisol measurement at 23:00 h and again after 1 mg DEX above the 90th percentile of the obese group values had sensitivity and specificity of 93 and 93% (23:00 h, and 91 and 94% (after DEX, respectively. The sensitivity improved to 100% when we combined both parameters. We also studied 11 CS children and 21 age-matched primary obese children for whom salivary cortisol sensitivity and specificity were 100/95% (23:00 h, and 100/95% (1 mg DEX, respectively. Similar to adults, sensitivity and specificity of 100% were obtained by combining 23:00 h and 1 mg DEX. The measurement of salivary cortisol is a useful tool for physiological studies and for the diagnosis of CS in children and adults on an outpatient basis.