WorldWideScience

Sample records for levels diagnostic analysis

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

    International Nuclear Information System (INIS)

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

    1988-01-01

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

  2. Diagnostic reference levels in medical imaging

    International Nuclear Information System (INIS)

    Rosenstein, M.

    2001-01-01

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

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

    Science.gov (United States)

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

    2017-02-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  5. Analysis of Vibration Diagnostics Methods for Induction Motors

    Directory of Open Access Journals (Sweden)

    A. P. Kalinov

    2012-01-01

    Full Text Available The paper presents an analysis of existing vibration diagnostics methods. In order to evaluate an efficiency of method application the following criteria have been proposed: volume of input data required for establishing diagnosis, data content, software and hardware level, execution time for vibration diagnostics. According to the mentioned criteria a classification of vibration diagnostics methods for determination of their advantages and disadvantages, search for their development and improvement has been presented in paper. The paper contains a comparative estimation of methods in accordance with the proposed  criteria. According to this estimation the most efficient methods are a spectral analysis and spectral analysis of the vibration signal envelope.

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

    Directory of Open Access Journals (Sweden)

    Zhang Jingjing

    2016-11-01

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

  7. Radiation levels in nuclear diagnostic examinations

    International Nuclear Information System (INIS)

    Vermeulen, A.M.T.I.

    1987-01-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

  9. Establishing diagnostic reference levels in digital radiology

    International Nuclear Information System (INIS)

    Bana, Remy Wilson

    2016-04-01

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

  10. The level of diagnostic assessment in severe asthma

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  11. Statistical evaluation of diagnostic performance topics in ROC analysis

    CERN Document Server

    Zou, Kelly H; Bandos, Andriy I; Ohno-Machado, Lucila; Rockette, Howard E

    2016-01-01

    Statistical evaluation of diagnostic performance in general and Receiver Operating Characteristic (ROC) analysis in particular are important for assessing the performance of medical tests and statistical classifiers, as well as for evaluating predictive models or algorithms. This book presents innovative approaches in ROC analysis, which are relevant to a wide variety of applications, including medical imaging, cancer research, epidemiology, and bioinformatics. Statistical Evaluation of Diagnostic Performance: Topics in ROC Analysis covers areas including monotone-transformation techniques in parametric ROC analysis, ROC methods for combined and pooled biomarkers, Bayesian hierarchical transformation models, sequential designs and inferences in the ROC setting, predictive modeling, multireader ROC analysis, and free-response ROC (FROC) methodology. The book is suitable for graduate-level students and researchers in statistics, biostatistics, epidemiology, public health, biomedical engineering, radiology, medi...

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

    Science.gov (United States)

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

    2018-03-01

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

  13. Application of diagnostic reference levels in medical practice

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-01

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

  14. Application of diagnostic reference levels in medical practice

    International Nuclear Information System (INIS)

    Bourguignon, Michel

    2006-01-01

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

  15. Microbial Diagnostic Array Workstation (MDAW: a web server for diagnostic array data storage, sharing and analysis

    Directory of Open Access Journals (Sweden)

    Chang Yung-Fu

    2008-09-01

    Full Text Available Abstract Background Microarrays are becoming a very popular tool for microbial detection and diagnostics. Although these diagnostic arrays are much simpler when compared to the traditional transcriptome arrays, due to the high throughput nature of the arrays, the data analysis requirements still form a bottle neck for the widespread use of these diagnostic arrays. Hence we developed a new online data sharing and analysis environment customised for diagnostic arrays. Methods Microbial Diagnostic Array Workstation (MDAW is a database driven application designed in MS Access and front end designed in ASP.NET. Conclusion MDAW is a new resource that is customised for the data analysis requirements for microbial diagnostic arrays.

  16. Patient dose with quality image under diagnostic reference levels

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  17. Technical Analysis of the Slosson-Diagnostic Math Screener (S-DMS)

    Science.gov (United States)

    Erford, Bradley T.; Klein, Lauren

    2007-01-01

    The Slosson-Diagnostic Math Screener (S-DMS) was designed to help identify students in Grades 1 to 8 at risk for mathematics failure. Internal consistency, test-retest reliability, item analysis, decision efficiency, convergent validity, and factorial validity of all five levels of the S-DMS were studied using 20 independent samples of students…

  18. Guidance levels for diagnostic radiology in Romania

    International Nuclear Information System (INIS)

    Iacob, O.; Diaconescu, C.

    2002-01-01

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

  19. Analysis of licensed South African diagnostic imaging equipment ...

    African Journals Online (AJOL)

    Analysis of licensed South African diagnostic imaging equipment. ... Pan African Medical Journal ... Introduction: Objective: To conduct an analysis of all registered South Africa (SA) diagnostic radiology equipment, assess the number of equipment units per capita by imaging modality, and compare SA figures with published ...

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  1. Application of noise analysis methods in nuclear reactor diagnostics

    International Nuclear Information System (INIS)

    Dach, K.

    1985-01-01

    By statistical evaluation of the fluctuation component of signals from selected detectors, noise diagnostics detects conditions of equipment which might later result in failure. The objective of early diagnostics is to detect the failed integrity of primary circuit components, failed detectors or anomalies of the thermohydraulic process. The commonest method of experimental data analysis is spectral analysis in the frequency range 0 to 50 Hz. Recently, expert diagnostic systems have been built based on artificial intelligence systems. Czechoslovakia participates in the experimental research of noise diagnostics in the context of the development of diagnostic assemblies for WWER-440 reactors. (M.D.)

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2018-05-01

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

  4. Diagnostic value of adenosine deaminase in ascites for tuberculosis ascites: a meta-analysis.

    Science.gov (United States)

    Tao, Lin; Ning, Hong-Jian; Nie, Hai-Ming; Guo, Xiao-Yun; Qin, Shan-Yu; Jiang, Hai-Xing

    2014-05-01

    The diagnosis of tuberculosis (TB) ascites using standard diagnostic tools is difficult. The aim of the present meta-analysis was to establish the overall diagnostic accuracy of adenosine deaminase (ADA) levels in ascites for diagnosing TB ascites. A systematic review was performed of English language publications prior to April 2013. Sensitivity, specificity, and other measures of the accuracy of ADA for the diagnosis of TB ascites using ascites fluid were summarized using a random-effects model or a fixed-effects model. Receiver operating characteristic curves were used to summarize overall test performance. Seventeen studies involving 1797 subjects were eligible for the analysis. The summary estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and the area under cure of overall analysis were: 0.93, 0.94, 13.55, 0.11, 169.83, and 0.976, respectively; the results of sensitivity analysis of studies that used Giusti method were 0.94, 0.94, 12.99, 0.08, 183.18, and 0.977, respectively. Our results suggest that ADA in the ascites can be a sensitive and specific target and a critical criterion for the diagnosis of TB ascites. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Yang Zhang

    2017-06-01

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

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

    Science.gov (United States)

    Ou-Yang, Li-Xue; Yang, Fan

    2017-07-01

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

  7. Diagnostic markers of urothelial cancer based on DNA methylation analysis

    International Nuclear Information System (INIS)

    Chihara, Yoshitomo; Hirao, Yoshihiko; Kanai, Yae; Fujimoto, Hiroyuki; Sugano, Kokichi; Kawashima, Kiyotaka; Liang, Gangning; Jones, Peter A; Fujimoto, Kiyohide; Kuniyasu, Hiroki

    2013-01-01

    Early detection and risk assessment are crucial for treating urothelial cancer (UC), which is characterized by a high recurrence rate, and necessitates frequent and invasive monitoring. We aimed to establish diagnostic markers for UC based on DNA methylation. In this multi-center study, three independent sample sets were prepared. First, DNA methylation levels at CpG loci were measured in the training sets (tumor samples from 91 UC patients, corresponding normal-appearing tissue from these patients, and 12 normal tissues from age-matched bladder cancer-free patients) using the Illumina Golden Gate methylation assay to identify differentially methylated loci. Next, these methylated loci were validated by quantitative DNA methylation by pyrosequencing, using another cohort of tissue samples (Tissue validation set). Lastly, methylation of these markers was analyzed in the independent urine samples (Urine validation set). ROC analysis was performed to evaluate the diagnostic accuracy of these 12 selected markers. Of the 1303 CpG sites, 158 were hyper ethylated and 356 were hypo ethylated in tumor tissues compared to normal tissues. In the panel analysis, 12 loci showed remarkable alterations between tumor and normal samples, with 94.3% sensitivity and 97.8% specificity. Similarly, corresponding normal tissue could be distinguished from normal tissues with 76.0% sensitivity and 100% specificity. Furthermore, the diagnostic accuracy for UC of these markers determined in urine samples was high, with 100% sensitivity and 100% specificity. Based on these preliminary findings, diagnostic markers based on differential DNA methylation at specific loci can be useful for non-invasive and reliable detection of UC and epigenetic field defect

  8. Applications of ROC analysis in diagnostic image evaluation

    International Nuclear Information System (INIS)

    Metz, C.E.

    1979-01-01

    The need for Receiver Operating Characteristic (ROC) analysis is indicated by a discussion of the limitations of accuracy and of sensitivity and specificity as indices of diagnostic detection or discrmination performance. The concept of a variable decision threshold is shown to lead in a natural way to the ROC curve as a means for specifying diagnostic performance. Practical techniques for measuring ROC curves are described, and directions for possible generalizations of conventional ROC analysis are indicated

  9. Diagnostics for generalized linear hierarchical models in network meta-analysis.

    Science.gov (United States)

    Zhao, Hong; Hodges, James S; Carlin, Bradley P

    2017-09-01

    Network meta-analysis (NMA) combines direct and indirect evidence comparing more than 2 treatments. Inconsistency arises when these 2 information sources differ. Previous work focuses on inconsistency detection, but little has been done on how to proceed after identifying inconsistency. The key issue is whether inconsistency changes an NMA's substantive conclusions. In this paper, we examine such discrepancies from a diagnostic point of view. Our methods seek to detect influential and outlying observations in NMA at a trial-by-arm level. These observations may have a large effect on the parameter estimates in NMA, or they may deviate markedly from other observations. We develop formal diagnostics for a Bayesian hierarchical model to check the effect of deleting any observation. Diagnostics are specified for generalized linear hierarchical NMA models and investigated for both published and simulated datasets. Results from our example dataset using either contrast- or arm-based models and from the simulated datasets indicate that the sources of inconsistency in NMA tend not to be influential, though results from the example dataset suggest that they are likely to be outliers. This mimics a familiar result from linear model theory, in which outliers with low leverage are not influential. Future extensions include incorporating baseline covariates and individual-level patient data. Copyright © 2017 John Wiley & Sons, Ltd.

  10. Development of ITER diagnostics: Neutronic analysis and radiation hardness

    Energy Technology Data Exchange (ETDEWEB)

    Vukolov, Konstantin, E-mail: vukolov_KY@nrcki.ru; Borisov, Andrey; Deryabina, Natalya; Orlovskiy, Ilya

    2015-10-15

    Highlights: • Problems of ITER diagnostics caused by neutron radiation from hot DT plasma considered. • Careful neutronic analysis is necessary for ITER diagnostics development. • Effective nuclear shielding for ITER diagnostics in the 11th equatorial port plug proposed. • Requirements for study of radiation hardness of diagnostic elements defined. • Results of optical glasses irradiation tests in a fission reactor given. - Abstract: The paper is dedicated to the problems of ITER diagnostics caused by effects of radiation from hot DT plasma. An effective nuclear shielding must be arranged in diagnostic port plugs to meet the nuclear safety requirements and to provide reliable operation of the diagnostics. This task can be solved with the help of neutronic analysis of the diagnostics environment within the port plugs at the design stage. Problems of neutronic calculations are demonstrated for the 11th equatorial port plug. The numerical simulation includes the calculations of neutron fluxes in the port-plug and in the interspace. Options for nuclear shielding, such as tungsten collimator, boron carbide and water moderators, stainless steel and lead screens are considered. Data on neutron fluxes along diagnostic labyrinths allow to define radiation hardness requirements for the diagnostic components and to specify their materials. Options for windows and lenses materials for optical diagnostics are described. The results of irradiation of flint and silica glasses in nuclear reactor have shown that silica KU-1 and KS-4V retain transparency in visible range after neutron fluence of 10{sup 17} cm{sup −2}. Flints required for achromatic objectives have much less radiation hardness about 5 × 10{sup 14} n/cm{sup 2}.

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

    Science.gov (United States)

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

    2017-03-01

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

  12. A new perspective into root-cause analysis and diagnostics

    International Nuclear Information System (INIS)

    Kim, Inn Seock; Kim, Tae Kwon; Kim, Min Chull

    1998-01-01

    A critical review of diagnostic and root-cause analysis methods, developed in nuclear, chemical process, aviation industries, was made. Based on this review, the insights into both off-line and on-line diagnostics, and also root-cause analysis are preseted from a new perspective. This perspective may be applied for various purposes, including real-time on-line process diagnosis, root-cause analysis of reactor scrams, diagnosis of severe accidents, or situation identification of an on-going emergency at a nuclear site

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

    Science.gov (United States)

    Sohrabi, Mehdi; Parsi, Masoumeh; Sina, Sedigheh

    2018-05-17

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

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

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

    Science.gov (United States)

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

    2012-03-01

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

  16. Diagnostic Performance of Mammographic Texture Analysis in the Differential Diagnosis of Benign and Malignant Breast Tumors.

    Science.gov (United States)

    Li, Zhiming; Yu, Lan; Wang, Xin; Yu, Haiyang; Gao, Yuanxiang; Ren, Yande; Wang, Gang; Zhou, Xiaoming

    2017-11-09

    The purpose of this study was to investigate the diagnostic performance of mammographic texture analysis in the differential diagnosis of benign and malignant breast tumors. Digital mammography images were obtained from the Picture Archiving and Communication System at our institute. Texture features of mammographic images were calculated. Mann-Whitney U test was used to identify differences between the benign and malignant group. The receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of texture features. Significant differences of texture features of histogram, gray-level co-occurrence matrix (GLCM) and run length matrix (RLM) were found between the benign and malignant breast group (P  .05). The AUROCs of imaging-based diagnosis, texture analysis, and imaging-based diagnosis combined with texture analysis were 0.873, 0.863, and 0.961, respectively. When imaging-based diagnosis was combined with texture analysis, the AUROC was higher than that of imaging-based diagnosis or texture analysis (P benign and malignant breast tumors. Furthermore, the combination of imaging-based diagnosis and texture analysis can significantly improve diagnostic performance. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Analysis of acid-base misconceptions using modified certainty of response index (CRI and diagnostic interview for different student levels cognitive

    Directory of Open Access Journals (Sweden)

    Satya Sadhu

    2017-08-01

    Full Text Available The authors in this paper draw attention to the importance of an instrument that can analyze student’s misconception.This study described the kind of the misconception in acid-base theory, and the percentage students’ misconception occur in every subconcept of acid-base theory. The design of this study is a descriptive method, involved 148 of 11th grade science students from Senior High School, which divided into two classes are high cognitive and low cognitive. Further analysis of using Modified Certainty of Response Index (CRI as a diagnostic instrument is used to explore misconception which in that test included evaluating only content knowledge with considering the reason behind the students' choice of response and their certainty of response in every question. The result of data analysis has shown that misconception occurred in high cognitive class, gained 43,86% and misconception occurred in low cognitive class, gained 24,63%. Based on the diagnostic interview has shown that misconception occurred in students due to students does not understand the concept well and they related the one concept to the other concepts with partial understanding, the result students make the failed conclusions. The type of misconception occurred is a conceptual misunderstanding.  According to the data analysis showed that Modified Certainty of Response Index (CRI is effective used to analyze students’ misconceptions and the diagnostic interview is effective used to know the reasons that caused students which having misconceptions.

  18. Bayesian analysis of ion beam diagnostics

    International Nuclear Information System (INIS)

    Toussaint, U. von; Fischer, R.; Dose, V.

    2001-01-01

    Ion beam diagnostics are routinely used for quantitative analysis of the surface composition of mixture materials up to a depth of a few μm. Unfortunately, advantageous properties of the diagnostics, like high depth resolution in combination with a large penetration depth, no destruction of the surface, high sensitivity for large as well as for small atomic numbers, and high sensitivity are mutually exclusive. Among other things, this is due to the ill-conditioned inverse problem of reconstructing depth distributions of the composition elements. Robust results for depth distributions are obtained with adaptive methods in the framework of Bayesian probability theory. The method of adaptive kernels allows for distributions which contain only the significant information of the data while noise fitting is avoided. This is achieved by adaptively reducing the degrees of freedom supporting the distribution. As applications for ion beam diagnostics Rutherford backscattering spectroscopy and particle induced X-ray emission are shown

  19. Integrated data analysis of fusion diagnostics by means of the Bayesian probability theory

    International Nuclear Information System (INIS)

    Fischer, R.; Dinklage, A.

    2004-01-01

    Integrated data analysis (IDA) of fusion diagnostics is the combination of heterogeneous diagnostics to obtain validated physical results. Benefits from the integrated approach result from a systematic use of interdependencies; in that sense IDA optimizes the extraction of information from sets of different data. For that purpose IDA requires a systematic and formalized error analysis of all (statistical and systematic) uncertainties involved in each diagnostic. Bayesian probability theory allows for a systematic combination of all information entering the diagnostic model by considering all uncertainties of the measured data, the calibration measurements, and the physical model. Prior physics knowledge on model parameters can be included. Handling of systematic errors is provided. A central goal of the integration of redundant or complementary diagnostics is to provide information to resolve inconsistencies by exploiting interdependencies. A comparable analysis of sets of diagnostics (meta-diagnostics) is performed by combining statistical and systematical uncertainties with model parameters and model uncertainties. Diagnostics improvement and experimental optimization and design of meta-diagnostics will be discussed

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

    International Nuclear Information System (INIS)

    Vega, Walter Flores

    1999-04-01

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

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  2. Battery Test Facility- Electrochemical Analysis and Diagnostics Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The Electrochemical Analysis and Diagnostics Laboratory (EADL) provides battery developers with reliable, independent, and unbiased performance evaluations of their...

  3. Diagnostics of the Enterprise Export Potential

    Directory of Open Access Journals (Sweden)

    Skrynkovskyy Ruslan M.

    2016-11-01

    Full Text Available The aim of the article is to form and develop theoretical and methodological foundations for diagnostics of the enterprise export potential, which should be understood as a process of identification, analysis and assessment of the level of potential possibility and readiness of the enterprise to implement export activities taking into account the impact of interrelated internal variables (goals, technology, structure, tasks, educational and professional potential of the staff and factors of the enterprise external environment (customers, competitors, suppliers, intermediaries, contact audience, etc. in order to ensure a qualitatively new level of its development and formation of its prospects. It is determined that the key business indicators of the system for diagnostics of enterprise export potential are: the level of enterprises competitiveness in the international (global market; the level of competitiveness of enterprise products; the level of competitiveness of enterprise export products; the level of enterprise resource opportunities; the level of enterprise export performance. Prospects for further research in this direction are to develop a classification (specifically detailed list of objectives of the enterprise diagnostics by the level of detail (element, partial, complex, taking into account diagnostics of export potential of the enterprise as part of diagnostic objective.

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

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

    International Nuclear Information System (INIS)

    A-Aziz, R.O.

    2007-08-01

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

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

    International Nuclear Information System (INIS)

    2016-11-01

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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  8. Preliminary results of the analysis of the administered activities in diagnostic studies of nuclear medicine

    International Nuclear Information System (INIS)

    Lopez Bejerano, G.; Sed, L.J.

    2001-01-01

    The worldwide use of Nuclear Medicine diagnostic procedures and the tendency to its increment, infers an important exposure of the population to ionising radiation; it has motivated that the IAEA in the International Basic Safety Standards (BSS), emits recommendations for the establishment of guidance levels of activities administered to the patients in diagnostic procedures. Taking into account the above-mentioned and that in Cuba there exist 20 departments of Nuclear Medicine that in the majority possess equipment with more than 20 years of operation, which influences directly the medical exposure. A survey was designed and applied in 10 of these departments. The survey evaluates the compliance with the BSS requirements, and specifically, the activities administered to the patients in Nuclear Medicine diagnostic procedures are analysed. In the present work the obtained preliminary results of the statistical analysis carried out on the activity values used in Nuclear Medicine departments are presented, and comparisons made for a proposal of guidance levels for the national practice, which is compared with those recommended internationally. (author)

  9. Evolution of diagnostic reference levels in Spanish intraoral radiology

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  10. Electromagnetic analysis of ITER diagnostic equatorial port plugs during plasma disruptions

    International Nuclear Information System (INIS)

    Zhai, Y.; Feder, R.; Brooks, A.; Ulrickson, M.; Pitcher, C.S.; Loesser, G.D.

    2013-01-01

    Highlights: ► Disruption loads on ITER diagnostic equatorial port plugs are extracted. ► Upward major disruption produces the largest radial moment and radial force on diagnostic first walls and diagnostic shield modules. ► Large eddy currents on supporting rails, keys and water pipes are observed during disruption. -- Abstract: ITER diagnostic port plugs perform many functions including structural support of diagnostic systems under high electromagnetic loads while allowing for diagnostic access to the plasma. The design of diagnostic equatorial port plugs (EPP) are largely driven by electromagnetic loads and associate responses of EPP structure during plasma disruptions and VDEs. This paper summarizes results of transient electromagnetic analysis using Opera 3d in support of the design activities for ITER diagnostic EPP. A complete distribution of disruption loads on the diagnostic first walls (DFWs), diagnostic shield modules (DSMs) and the EPP structure, as well as impact on the system design integration due to electrical contact among various EPP structural components are discussed

  11. Diagnostic performance of semi-quantitative and quantitative stress CMR perfusion analysis: a meta-analysis.

    Science.gov (United States)

    van Dijk, R; van Assen, M; Vliegenthart, R; de Bock, G H; van der Harst, P; Oudkerk, M

    2017-11-27

    Stress cardiovascular magnetic resonance (CMR) perfusion imaging is a promising modality for the evaluation of coronary artery disease (CAD) due to high spatial resolution and absence of radiation. Semi-quantitative and quantitative analysis of CMR perfusion are based on signal-intensity curves produced during the first-pass of gadolinium contrast. Multiple semi-quantitative and quantitative parameters have been introduced. Diagnostic performance of these parameters varies extensively among studies and standardized protocols are lacking. This study aims to determine the diagnostic accuracy of semi- quantitative and quantitative CMR perfusion parameters, compared to multiple reference standards. Pubmed, WebOfScience, and Embase were systematically searched using predefined criteria (3272 articles). A check for duplicates was performed (1967 articles). Eligibility and relevance of the articles was determined by two reviewers using pre-defined criteria. The primary data extraction was performed independently by two researchers with the use of a predefined template. Differences in extracted data were resolved by discussion between the two researchers. The quality of the included studies was assessed using the 'Quality Assessment of Diagnostic Accuracy Studies Tool' (QUADAS-2). True positives, false positives, true negatives, and false negatives were subtracted/calculated from the articles. The principal summary measures used to assess diagnostic accuracy were sensitivity, specificity, andarea under the receiver operating curve (AUC). Data was pooled according to analysis territory, reference standard and perfusion parameter. Twenty-two articles were eligible based on the predefined study eligibility criteria. The pooled diagnostic accuracy for segment-, territory- and patient-based analyses showed good diagnostic performance with sensitivity of 0.88, 0.82, and 0.83, specificity of 0.72, 0.83, and 0.76 and AUC of 0.90, 0.84, and 0.87, respectively. In per territory

  12. On-line diagnostic techniques for air-operated control valves based on time series analysis

    International Nuclear Information System (INIS)

    Ito, Kenji; Matsuoka, Yoshinori; Minamikawa, Shigeru; Komatsu, Yasuki; Satoh, Takeshi.

    1996-01-01

    The objective of this research is to study the feasibility of applying on-line diagnostic techniques based on time series analysis to air-operated control valves - numerous valves of the type which are used in PWR plants. Generally the techniques can detect anomalies by failures in the initial stages for which detection is difficult by conventional surveillance of process parameters measured directly. However, the effectiveness of these techniques depends on the system being diagnosed. The difficulties in applying diagnostic techniques to air-operated control valves seem to come from the reduced sensitivity of their response as compared with hydraulic control systems, as well as the need to identify anomalies in low level signals that fluctuate only slightly but continuously. In this research, simulation tests were performed by setting various kinds of failure modes for a test valve with the same specifications as of a valve actually used in the plants. Actual control signals recorded from an operating plant were then used as input signals for simulation. The results of the tests confirmed the feasibility of applying on-line diagnostic techniques based on time series analysis to air-operated control valves. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-12-15

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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  15. Common faults in turbines and applying neural networks in order to fault diagnostic by vibration analysis

    International Nuclear Information System (INIS)

    Masoudifar, M.; AghaAmini, M.

    2001-01-01

    Today the fault diagnostic of the rotating machinery based on the vibration analysis is an effective method in designing predictive maintenance programs. In this method, vibration level of the turbines is monitored and if it is higher than the allowable limit, vibrational data will be analyzed and the growing faults will be detected. But because of the high complexity of the system monitoring, the interpretation of the measured data is more difficult. Therefore, design of the fault diagnostic expert systems by using the expert's technical experiences and knowledge; seem to be the best solution. In this paper,at first several common faults in turbines are studied and the how applying the neural networks to interpret the vibrational data for fault diagnostic is explained

  16. FISH analysis for diagnostic evaluation of challenging melanocytic lesions.

    Science.gov (United States)

    Zimmermann, A K; Hirschmann, A; Pfeiffer, D; Paredes, B E; Diebold, J

    2010-09-01

    The differential diagnosis of malignant melanomas and atypical melanocytic nevi is still a diagnostic challenge. The currently accepted morphologic criteria show substantial interobserver variability, likewise immunohistochemical studies are often not able to discriminate these lesions reliably. Techniques that support diagnostic accuracy are of the greatest importance considering the growing incidence of malignant melanomas and their increase in younger patients. In this study we analyzed the feasibility of fluorescence in situ hybridization (FISH) analysis for the discrimination of malignant and benign melanocytic tumors. A panel of DNA probes was used to detect chromosomal aberrations of chromosomes 6 and 11. On a series of 5 clearly malignant and benign melanocytic tumors we confirmed the applicability of the test. Then we focused on examination of ambiguous melanocytic lesions, where atypical cells are often difficult to relocalize in the 4',6-Diamidino-2-phenylindol (DAPI)-fluorescence stain. FISH analyses were conducted on destained H&E-stained slides. By comparison of the DAPI-image with photos taken from the H&E stain, unambiguous assignment of the FISH results to the conspicuous groups of cells was possible. The results of FISH analysis were consistent with the conventional diagnosis in 11 of 14 small ambiguous lesions. Of the remaining 3 cases, 2 showed FISH-results close to the cut-off level. Comparison of FISH results on thin and thick sections revealed that the cut-off values have to be adapted for 2 microm destained sections. In conclusion, FISH analysis is a useful and applicable tool for assessment of even smallest melanocytic neoplasms, although there will remain unclear cases that cannot be solved even after additional FISH evaluation.

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

    International Nuclear Information System (INIS)

    Drexler, G.

    1998-01-01

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

  18. The Diagnostic Efficacy of Cone-beam Computed Tomography in Endodontics: A Systematic Review and Analysis by a Hierarchical Model of Efficacy.

    Science.gov (United States)

    Rosen, Eyal; Taschieri, Silvio; Del Fabbro, Massimo; Beitlitum, Ilan; Tsesis, Igor

    2015-07-01

    The aim of this study was to evaluate the diagnostic efficacy of cone-beam computed tomographic (CBCT) imaging in endodontics based on a systematic search and analysis of the literature using an efficacy model. A systematic search of the literature was performed to identify studies evaluating the use of CBCT imaging in endodontics. The identified studies were subjected to strict inclusion criteria followed by an analysis using a hierarchical model of efficacy (model) designed for appraisal of the literature on the levels of efficacy of a diagnostic imaging modality. Initially, 485 possible relevant articles were identified. After title and abstract screening and a full-text evaluation, 58 articles (12%) that met the inclusion criteria were analyzed and allocated to levels of efficacy. Most eligible articles (n = 52, 90%) evaluated technical characteristics or the accuracy of CBCT imaging, which was defined in this model as low levels of efficacy. Only 6 articles (10%) proclaimed to evaluate the efficacy of CBCT imaging to support the practitioner's decision making; treatment planning; and, ultimately, the treatment outcome, which was defined as higher levels of efficacy. The expected ultimate benefit of CBCT imaging to the endodontic patient as evaluated by its level of diagnostic efficacy is unclear and is mainly limited to its technical and diagnostic accuracy efficacies. Even for these low levels of efficacy, current knowledge is limited. Therefore, a cautious and rational approach is advised when considering CBCT imaging for endodontic purposes. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  19. Analysis of Steel Wire Rope Diagnostic Data Applying Multi-Criteria Methods

    Directory of Open Access Journals (Sweden)

    Audrius Čereška

    2018-02-01

    Full Text Available Steel ropes are complex flexible structures used in many technical applications, such as elevators, cable cars, and funicular cabs. Due to the specific design and critical safety requirements, diagnostics of ropes remains an important issue. Broken wire number in the steel ropes is limited by safety standards when they are used in the human lifting and carrying installations. There are some practical issues on loose wires—firstly, it shows end of lifetime of the entire rope, independently of wear, lubrication or wrong winding on the drums or through pulleys; and, secondly, it can stick in the tight pulley—support gaps and cause deterioration of rope structure up to birdcage formations. Normal rope operation should not generate broken wires, so increasing of their number shows a need for rope installation maintenance. This paper presents a methodology of steel rope diagnostics and the results of analysis using multi-criteria analysis methods. The experimental part of the research was performed using an original test bench to detect broken wires on the rope surface by its vibrations. Diagnostics was performed in the range of frequencies from 60 to 560 Hz with a pitch of 50 Hz. The obtained amplitudes of the broken rope wire vibrations, different from the entire rope surface vibration parameters, was the significant outcome. Later analysis of the obtained experimental results revealed the most significant values of the diagnostic parameters. The evaluation of the power of the diagnostics was implemented by using multi-criteria decision-making (MCDM methods. Various decision-making methods are necessary due to unknown efficiencies with respect to the physical phenomena of the evaluated processes. The significance of the methods was evaluated using objective methods from the structure of the presented data. Some of these methods were proposed by authors of this paper. Implementation of MCDM in diagnostic data analysis and definition of the

  20. DIII-D Thomson Scattering Diagnostic Data Acquisition, Processing and Analysis Software

    International Nuclear Information System (INIS)

    Middaugh, K.R.; Bray, B.D.; Hsieh, C.L.; McHarg, B.B.Jr.; Penaflor, B.G.

    1999-01-01

    One of the diagnostic systems critical to the success of the DIII-D tokamak experiment is the Thomson scattering diagnostic. This diagnostic is unique in that it measures local electron temperature and density: (1) at multiple locations within the tokamak plasma; and (2) at different times throughout the plasma duration. Thomson ''raw'' data are digitized signals of scattered light, measured at different times and locations, from the laser beam paths fired into the plasma. Real-time acquisition of this data is performed by specialized hardware. Once obtained, the raw data are processed into meaningful temperature and density values which can be analyzed for measurement quality. This paper will provide an overview of the entire Thomson scattering diagnostic software and will focus on the data acquisition, processing, and analysis software implementation. The software falls into three general categories: (1) Set-up and Control: Initializes and controls all Thomson hardware and software, synchronizes with other DIII-D computers, and invokes other Thomson software as appropriate. (2) Data Acquisition and Processing: Obtains raw measured data from memory and processes it into temperature and density values. (3) Analysis: Provides a graphical user interface in which to perform analysis and sophisticated plotting of analysis parameters

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

    Directory of Open Access Journals (Sweden)

    A. V. Vodovatov

    2013-01-01

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

  2. Free insulin-like growth factor I serum levels in 1430 healthy children and adults, and its diagnostic value in patients suspected of growth hormone deficiency

    DEFF Research Database (Denmark)

    Juul, A; Holm, K; Kastrup, K W

    1997-01-01

    fraction of the total IGF-I circulates in its free form, which is believed to be the biologically active form. However, our knowledge of the clinical or physiological value of determination of free IGF-I in serum is limited at present. In adults, the diagnostic value of total IGF-I and IGFBP-3......, commercially available immunoradiometric assay (Diagnostic Systems Laboratories) to establish valid normative data for this analysis. We studied the diagnostic value of free IGF-I in relation to total IGF-I and IGFBP-3 determinations in adults who were suspected of GHD. A GH provocative test, using oral...... determinations in patients suspected of GHD has only been reported in a few studies, whereas no previous reports on the diagnostic value of free IGF-I levels in adults suspected of GHD exist. Serum levels of free IGF-I were determined in 1430 healthy children, adolescents, and adults by a newly developed...

  3. Free insulin-like growth factor I serum levels in 1430 healthy children and adults, and its diagnostic value in patients suspected of growth hormone deficiency

    DEFF Research Database (Denmark)

    Juul, A; Holm, K; Kastrup, K W

    1997-01-01

    fraction of the total IGF-I circulates in its free form, which is believed to be the biologically active form. However, our knowledge of the clinical or physiological value of determination of free IGF-I in serum is limited at present. In adults, the diagnostic value of total IGF-I and IGFBP-3...... determinations in patients suspected of GHD has only been reported in a few studies, whereas no previous reports on the diagnostic value of free IGF-I levels in adults suspected of GHD exist. Serum levels of free IGF-I were determined in 1430 healthy children, adolescents, and adults by a newly developed......, commercially available immunoradiometric assay (Diagnostic Systems Laboratories) to establish valid normative data for this analysis. We studied the diagnostic value of free IGF-I in relation to total IGF-I and IGFBP-3 determinations in adults who were suspected of GHD. A GH provocative test, using oral...

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

    International Nuclear Information System (INIS)

    2014-01-01

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

  5. Instrumentation for localized superconducting cavity diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Conway, Z. A. [Argonne National Lab. (ANL), Argonne, IL (United States). Physics Division; Ge, M. [Cornell Lab. for Accelerator-Based Sciences and Education, Ithaca, NY (United States); Iwashita, Y. [Kyoto Univ. (Japan)

    2017-01-12

    Superconducting accelerator cavities are now routinely operated at levels approaching the theoretical limit of niobium. To achieve these operating levels more information than is available from the RF excitation signal is required to characterize and determine fixes for the sources of performance limitations. This information is obtained using diagnostic techniques which complement the analysis of the RF signal. In this paper we describe the operation and select results from three of these diagnostic techniques: the use of large scale thermometer arrays, second sound wave defect location and high precision cavity imaging with the Kyoto camera.

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

    Science.gov (United States)

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

    2017-12-31

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

  7. Full Life Cycle of Data Analysis with Climate Model Diagnostic Analyzer (CMDA)

    Science.gov (United States)

    Lee, S.; Zhai, C.; Pan, L.; Tang, B.; Zhang, J.; Bao, Q.; Malarout, N.

    2017-12-01

    We have developed a system that supports the full life cycle of a data analysis process, from data discovery, to data customization, to analysis, to reanalysis, to publication, and to reproduction. The system called Climate Model Diagnostic Analyzer (CMDA) is designed to demonstrate that the full life cycle of data analysis can be supported within one integrated system for climate model diagnostic evaluation with global observational and reanalysis datasets. CMDA has four subsystems that are highly integrated to support the analysis life cycle. Data System manages datasets used by CMDA analysis tools, Analysis System manages CMDA analysis tools which are all web services, Provenance System manages the meta data of CMDA datasets and the provenance of CMDA analysis history, and Recommendation System extracts knowledge from CMDA usage history and recommends datasets/analysis tools to users. These four subsystems are not only highly integrated but also easily expandable. New datasets can be easily added to Data System and scanned to be visible to the other subsystems. New analysis tools can be easily registered to be available in the Analysis System and Provenance System. With CMDA, a user can start a data analysis process by discovering datasets of relevance to their research topic using the Recommendation System. Next, the user can customize the discovered datasets for their scientific use (e.g. anomaly calculation, regridding, etc) with tools in the Analysis System. Next, the user can do their analysis with the tools (e.g. conditional sampling, time averaging, spatial averaging) in the Analysis System. Next, the user can reanalyze the datasets based on the previously stored analysis provenance in the Provenance System. Further, they can publish their analysis process and result to the Provenance System to share with other users. Finally, any user can reproduce the published analysis process and results. By supporting the full life cycle of climate data analysis

  8. Diagnostic value of tumor markers for lung adenocarcinoma-associated malignant pleural effusion: a validation study and meta-analysis.

    Science.gov (United States)

    Feng, Mei; Zhu, Jing; Liang, Liqun; Zeng, Ni; Wu, Yanqiu; Wan, Chun; Shen, Yongchun; Wen, Fuqiang

    2017-04-01

    Pleural effusion is one of the most common complications of lung adenocarcinoma and is diagnostically challenging. This study aimed to investigate the diagnostic performance of carcinoembryonic antigen (CEA), cytokeratin fragment (CYFRA) 21-1, and cancer antigen (CA) 19-9 for lung adenocarcinoma-associated malignant pleural effusion (MPE) through a validation study and meta-analysis. Pleural effusion samples were collected from 81 lung adenocarcinoma-associated MPEs and 96 benign pleural effusions. CEA, CYFRA 21-1, and CA19-9 were measured by electrochemiluminescence immunoassay. The capacity of tumor markers was assessed with receiver operating characteristic curve analyses and the area under the curve (AUC) was calculated. Standard methods for meta-analysis of diagnostic studies were used to summarize the diagnostic performance of CEA, CYFRA 21-1, and CA19-9 for lung adenocarcinoma-associated MPE. The pleural levels of CEA, CYFRA 21-1, and CA19-9 were significantly increased in lung adenocarcinoma-associated MPE compared to benign pleural effusion. The cut-off points for CEA, CYFRA 21-1, and CA19-9 were optimally set at 4.55 ng/ml, 43.10 μg/ml, and 12.89 U/ml, and corresponding AUCs were 0.93, 0.85, and 0.81, respectively. The combination of CEA, CYFRA 21-1, and CA19-9 increased the sensitivity to 95.06%, with an AUC of 0.95. Eight studies were included in this meta-analysis. CEA showed the best diagnostic performance with pooled sensitivity, specificity, positive/negative likelihood ratio, and diagnostic odds ratio of 0.75, 0.96, 16.01, 0.23, and 81.49, respectively. The AUC was 0.93. CEA, CYFRA 21-1, and CA19-9 play a role in the diagnosis of lung adenocarcinoma-associated MPE. The combination of these tumor markers increases the diagnostic accuracy.

  9. Network meta-analysis of diagnostic test accuracy studies identifies and ranks the optimal diagnostic tests and thresholds for health care policy and decision-making.

    Science.gov (United States)

    Owen, Rhiannon K; Cooper, Nicola J; Quinn, Terence J; Lees, Rosalind; Sutton, Alex J

    2018-07-01

    Network meta-analyses (NMA) have extensively been used to compare the effectiveness of multiple interventions for health care policy and decision-making. However, methods for evaluating the performance of multiple diagnostic tests are less established. In a decision-making context, we are often interested in comparing and ranking the performance of multiple diagnostic tests, at varying levels of test thresholds, in one simultaneous analysis. Motivated by an example of cognitive impairment diagnosis following stroke, we synthesized data from 13 studies assessing the efficiency of two diagnostic tests: Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), at two test thresholds: MMSE accounting for the correlations between multiple test accuracy measures from the same study. We developed and successfully fitted a model comparing multiple tests/threshold combinations while imposing threshold constraints. Using this model, we found that MoCA at threshold decision making. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

    Yeh, M; Wang, Y; Weng, H

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

  12. Diagnostics of subtropical plants functional state by cluster analysis

    Directory of Open Access Journals (Sweden)

    Oksana Belous

    2016-05-01

    Full Text Available The article presents an application example of statistical methods for data analysis on diagnosis of the adaptive capacity of subtropical plants varieties. We depicted selection indicators and basic physiological parameters that were defined as diagnostic. We used evaluation on a set of parameters of water regime, there are: determination of water deficit of the leaves, determining the fractional composition of water and detection parameters of the concentration of cell sap (CCS (for tea culture flushes. These settings are characterized by high liability and high responsiveness to the effects of many abiotic factors that determined the particular care in the selection of plant material for analysis and consideration of the impact on sustainability. On the basis of the experimental data calculated the coefficients of pair correlation between climatic factors and used physiological indicators. The result was a selection of physiological and biochemical indicators proposed to assess the adaptability and included in the basis of methodical recommendations on diagnostics of the functional state of the studied cultures. Analysis of complex studies involving a large number of indicators is quite difficult, especially does not allow to quickly identify the similarity of new varieties for their adaptive responses to adverse factors, and, therefore, to set general requirements to conditions of cultivation. Use of cluster analysis suggests that in the analysis of only quantitative data; define a set of variables used to assess varieties (and the more sampling, the more accurate the clustering will happen, be sure to ascertain the measure of similarity (or difference between objects. It is shown that the identification of diagnostic features, which are subjected to statistical processing, impact the accuracy of the varieties classification. Selection in result of the mono-clusters analysis (variety tea Kolhida; hazelnut Lombardsky red; variety kiwi Monty

  13. Density-dependent lines of one- and two-electron ions in diagnostics of laboratory plasma. I. The rates of collision relaxation of excited levels

    Energy Technology Data Exchange (ETDEWEB)

    Shevelko, V P; Skobelev, I Yu; Vinogradov, A V [Lebedev Physical Institute, Academy of Sciences of the USSR, Moscow, USSR

    1977-01-01

    Plasma devices with inertial plasma confinement such as laser produced plasmas, exploding wires, plasma focus, etc., which have been rapidly developed during recent years., appear to be very intensive sources of spectral line radiation in far UV and X-ray regions. Analysis of this radiation provides a good tool for plasma diagnostics with very high electron densities up to 10/sup 22/cm/sup -3/. In this work, consisting of two parts, the authors consider the mechanism of the formation of spectral lines in hot and dense plasma. The key point for density diagnostics is the fact that for some ion levels the rate of collisional relaxation has the same order of magnitude as the radiative decay. Thus the intensities of spectral lines arising from these levels show a strong dependence on electron density which makes diagnostics possible. In this paper, emphasis is laid on the calculation of rates of transition between close ion levels induced by electron or ion impact, which usually gives the main contribution to the collisional relaxation constants. The influence of plasma polarization effects on the collision frequency in a dense plasma is also considered.

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

    Science.gov (United States)

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

    2009-08-01

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

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

    International Nuclear Information System (INIS)

    Roch, P.; Aubert, B.

    2013-01-01

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

  16. Cost-benefit analysis in decision making for diagnostic radiology

    International Nuclear Information System (INIS)

    Fabrikant, J.I.; Hilberg, A.W.

    1982-02-01

    This paper reviews certain current concepts and methods relating to benefit-risk analysis, in terms of economic costs and raidation risks to health, in relation to the benefits from diagnostic radiology in clinical medicine

  17. Diagnostic value of multislice computed tomography angiography in coronary artery disease: A meta-analysis

    International Nuclear Information System (INIS)

    Sun Zhonghua; Jiang Wen

    2006-01-01

    Purpose: To perform a meta-analysis of the diagnostic value of multislice CT (MSCT) angiography in the detection of coronary artery disease (CAD) when compared to conventional coronary angiography. Materials and methods: A search of PubMed and MEDLINE databases for English literature was performed. Only studies with at least 10 patients comparing MSCT angiography with conventional coronary angiography in the detection of CAD were included. Diagnostic value of MSCT angiography compared to coronary angiography was compared and analyzed at segment-, vessel- and patient-based assessment. Results: 47 studies (67 comparisons) met the criteria and were included in our study. Pooled overall sensitivity, specificity and 95% confidence interval for MSCT angiography in the detection of CAD were 83% (79%, 89%), 93% (91%, 96%) at segment-based analysis; 90% (87%, 94%), 87% (80%, 93%) at vessel-based analysis; and 91% (88%, 95%), 86% (81%, 92%) at patient-based analysis, respectively. Diagnostic accuracy of MSCT angiography in evaluating assessable segments was significantly improved with 64-slice scanners when compared to that with 4- and 16-slice scanners (p < 0.05). Conclusion: Our meta-analysis showed that MSCT angiography has potential diagnostic accuracy in the detection of CAD. Diagnostic performance of MSCT angiography has been significantly improved with the latest 64-slice CT, with resultant high qualitative and quantitative diagnostic accuracy. 16-slice CT was limited in spatial resolution which makes it difficult to perform quantitative assessment of coronary artery stenoses

  18. Cost-effectiveness analysis of malaria rapid diagnostic tests for appropriate treatment of malaria at the community level in Uganda

    DEFF Research Database (Denmark)

    Hansen, Kristian S; Ndyomugyenyi, Richard; Magnussen, Pascal

    2017-01-01

    was a cost-effectiveness analysis of the introduction of malaria rapid diagnostic tests (mRDTs) performed by CHWs in two areas of moderate-to-high and low malaria transmission in rural Uganda. CHWs were trained to perform mRDTs and treat children with artemisinin-based combination therapy (ACT......) in the intervention arm while CHWs offered treatment based on presumptive diagnosis in the control arm. Data on the proportion of children with fever 'appropriately treated for malaria with ACT' were captured from a randomised trial. Health sector costs included: training of CHWs, community sensitisation, supervision...

  19. Cost-risk-benefit analysis in diagnostic radiology: a theoretical and economic basis for radiation protection of the patient

    International Nuclear Information System (INIS)

    Moores, B. Michael

    2016-01-01

    In 1973, International Commission on Radiological Protection Publication 22 recommended that the acceptability of radiation exposure levels for a given activity should be determined by a process of cost-benefit analysis. It was felt that this approach could be used to underpin both the principle of ALARA as well for justification purposes. The net benefit, B, of an operation involving irradiation was regarded as equal to the difference between its gross benefit, V, and the sum of three components; the basic production cost associated with the operation, P; the cost of achieving the selected level of protection, X; and the cost Y of the detriment involved in the operation: B=V-(P+X+Y). This article presents a theoretical cost-risk-benefit analysis that is applicable to the diagnostic accuracy (Levels 1 and 2) of the hierarchical efficacy model presented by National Council on Radiation Protection and Measurements in 1992. This enables the costs of an examination to be related to the sensitivity and specificity of an X-ray examination within a defined clinical problem setting and introduces both false-positive/false-negative diagnostic outcomes into the patient radiation protection framework. (author)

  20. COST-RISK-BENEFIT ANALYSIS IN DIAGNOSTIC RADIOLOGY: A THEORETICAL AND ECONOMIC BASIS FOR RADIATION PROTECTION OF THE PATIENT.

    Science.gov (United States)

    Moores, B Michael

    2016-06-01

    In 1973, International Commission on Radiological Protection Publication 22 recommended that the acceptability of radiation exposure levels for a given activity should be determined by a process of cost-benefit analysis. It was felt that this approach could be used to underpin both the principle of ALARA as well for justification purposes. The net benefit, B, of an operation involving irradiation was regarded as equal to the difference between its gross benefit, V, and the sum of three components; the basic production cost associated with the operation, P; the cost of achieving the selected level of protection, X; and the cost Y of the detriment involved in the operation: [Formula: see text] This article presents a theoretical cost-risk-benefit analysis that is applicable to the diagnostic accuracy (Levels 1 and 2) of the hierarchical efficacy model presented by National Council on Radiation Protection and Measurements in 1992. This enables the costs of an examination to be related to the sensitivity and specificity of an X-ray examination within a defined clinical problem setting and introduces both false-positive/false-negative diagnostic outcomes into the patient radiation protection framework. © The Author 2015. Published by Oxford University Press.

  1. The diagnostic performance of CT-derived fractional flow reserve for evaluation of myocardial ischaemia confirmed by invasive fractional flow reserve: a meta-analysis.

    Science.gov (United States)

    Li, S; Tang, X; Peng, L; Luo, Y; Dong, R; Liu, J

    2015-05-01

    To review the literature on the diagnostic accuracy of CT-derived fractional flow reserve (FFRCT) for the evaluation of myocardial ischaemia in patients with suspected or known coronary artery disease, with invasive fractional flow reserve (FFR) as the reference standard. A PubMed, EMBASE, and Cochrane cross-search was performed. The pooled diagnostic accuracy of FFRCT, with FFR as the reference standard, was primarily analysed, and then compared with that of CT angiography (CTA). The thresholds to diagnose ischaemia were FFR ≤0.80 or CTA ≥50% stenosis. Data extraction, synthesis, and statistical analysis were performed by standard meta-analysis methods. Three multicentre studies (NXT Trial, DISCOVER-FLOW study and DeFACTO study) were included, examining 609 patients and 1050 vessels. The pooled sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR-), and diagnostic odds ratio (DOR) for FFRCT were 89% (85-93%), 71% (65-75%), 70% (65-75%), 90% (85-93%), 3.31 (1.79-6.14), 0.16 (0.11-0.23), and 21.21 (9.15-49.15) at the patient-level, and 83% (78-63%), 78% (75-81%), 61% (56-65%), 92% (89-90%), 4.02 (1.84-8.80), 0.22 (0.13-0.35), and 19.15 (5.73-63.93) at the vessel-level. At per-patient analysis, FFRCT has similar sensitivity but improved specificity, PPV, NPV, LR+, LR-, and DOR versus those of CTA. At per-vessel analysis, FFRCT had a slightly lower sensitivity, similar NPV, but improved specificity, PPV, LR+, LR-, and DOR compared with those of CTA. The area under the summary receiver operating characteristic curves for FFRCT was 0.8909 at patient-level and 0.8865 at vessel-level, versus 0.7402 for CTA at patient-level. FFRCT, which was associated with improved diagnostic accuracy versus CTA, is a viable alternative to FFR for detecting coronary ischaemic lesions. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2017-01-01

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

  3. Optical spectra analysis for breast cancer diagnostics

    Science.gov (United States)

    Belkov, S. A.; Kochemasov, G. G.; Lyubynskaya, T. E.; Maslov, N. V.; Nuzhny, A. S.; da Silva, L. B.; Rubenchik, A.

    2011-11-01

    Minimally invasive probe and optical biopsy system based on optical spectra recording and analysis seem to be a promising tool for early diagnostics of breast cancer. Light scattering and absorption spectra are generated continuously as far as the needle-like probe with one emitting and several collecting optical fibers penetrates through the tissues toward to the suspicious area. That allows analyzing not only the state of local site, but also the structure of tissues along the needle trace. The suggested method has the advantages of automated on-line diagnosing and minimal tissue destruction and in parallel with the conventional diagnostic procedures provides the ground for decision-making. 165 medical trials were completed in Nizhny Novgorod Regional Oncology Centre, Russia. Independent diagnoses were the results of fine biopsy and histology. Application of wavelet expansion and clasterization techniques for spectra analysis revealed several main spectral types for malignant and benign tumors. Automatic classification algorithm demonstrated specificity ˜90% and sensitivity ˜91%. Large amount of information, fuzziness in criteria and data noisiness make neural networks to be an attractive analytic tool. The model based on three-layer perceptron was tested over the sample of 29 `cancer' and 29 `non-cancer' cases and demonstrated total separation.

  4. Urine microRNAs as biomarkers for bladder cancer: a diagnostic meta-analysis

    Directory of Open Access Journals (Sweden)

    Cheng Y

    2015-08-01

    Full Text Available Yidong Cheng,* Xiaheng Deng,* Xiao Yang,* Pengchao Li, Xiaolei Zhang, Peng Li, Jun Tao, Qiang Lu, Zengjun Wang Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China *These authors contributed equally to this work Background: The diagnostic value of microRNA (miRNA detection in patients with bladder cancer (BCa is controversial. We performed a diagnostic meta-analysis to evaluate current evidence on the use of miRNA assays to diagnose BCa. Methods: We systematically searched PubMed, Embase, and Web of Science for studies published before March 31, 2015. The pooled sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, and area under the curve (AUC were calculated to evaluate the overall test performance. Subgroup analyses were used to explore the between-study heterogeneity. Deeks’ funnel plot asymmetry test was used to test publication bias. We applied the software of RevMan 5.2 and Stata 11.0 to the meta-analysis. Results: A total of 23 studies from nine articles were included in the meta-analysis, with a total of 719 patients and 494 controls. The pooled sensitivity and specificity were 0.75 (95% confidence interval [CI], 0.68–0.80 and 0.75 (95% CI, 0.70–0.80, respectively. The pooled positive likelihood ratio was 3.03 (95% CI, 2.50–3.67; negative likelihood ratio was 0.33 (95% CI, 0.27–0.42; and diagnostic odds ratio was 9.07 (95% CI, 6.35–12.95. The pooled AUC was 0.81 (95% CI, 0.78–0.85. Subgroup analyses indicated that the multiple miRNAs assays and urine supernatant assays showed high accuracies in diagnosing BCa. Conclusion: The miRNA assays may serve as potential noninvasive diagnostic tool for the detection of BCa. However, the clinical application of miRNA assays for BCa diagnosis still needs further validation by large prospective studies. Keywords: microRNAs, bladder cancer, diagnostic accuracy, meta-analysis

  5. [Analysis of characteristics and influence factors of diagnostic delay of endometriosis].

    Science.gov (United States)

    Han, X T; Guo, H Y; Kong, D L; Han, J S; Zhang, L F

    2018-02-25

    Objective: To access the influence factors of diagnostic delay of endometriosis. Methods: We designed a questionnaire of diagnostic delay of endometriosis. From February 2014 to February 2016, 400 patients who had dysmenorrhea and diagnosed with endometriosis by surgery in Peking University Third Hospital were surveyed retrospectively. Time and risk factors of diagnostic delay were analyzed. Results: The diagnostic delay of 400 patients was 13.0 years (0.2-43.0 years), 78.5%(314/400) patients thought pain was a normal phenomenon and didn't see the doctor. Patients who suffered dysmenorrhea at menarche experienced longer diagnostic delay than those who had dysmenorrhea after menarche (18.0 vs 4.5 years; Z= 191.800, Pendometriosis (DIE) , family history of dysmenorrhea or endometriosis, previous surgical history of endometriosis, high stage, with infertility, adenomyoma or other symptoms, could help to shorten diagnostic delay with no significant difference ( P> 0.05) . By multiple logistic regression analysis, the results shown that whether have dysmenorrhea at menarche and clinical diagnosis time were the independent factors affecting delayed diagnosis ( Pendometriosis is common and the mean delay time is 13.0 years mainly due to the unawareness of dysmenorrhea. Dysmenorrhea at menarche, clinical diagnosis time and dysmenorrhea intensity are the factors affecting time of diagnostic delay.

  6. Diagnostic accuracy of dual-energy computed tomography in patients with gout: A meta-analysis.

    Science.gov (United States)

    Lee, Young Ho; Song, Gwan Gyu

    2017-08-01

    This study aimed to evaluate the diagnostic performance of dual-energy computed tomography (DECT) for patients with gout. We searched the Medline, Embase, and Cochrane Library databases, and performed a meta-analysis on the diagnostic accuracy of DECT in patients with gout. A total of eight studies including 510 patients with gout and 268 controls (patients with non-gout inflammatory arthritis) were available for the meta-analysis. The pooled sensitivity and specificity of DECT were 84.7% (95% confidence interval [CI]: 81.3-87.7) and 93.7% (93.0-96.3), respectively. The positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 9.882 (6.122-15.95), 0.163 (0.097-0.272), and 78.10 (31.14-195.84), respectively. The area under the curve of DECT was 0.956 and the Q * index was 0.889, indicating a high diagnostic accuracy. Some between-study heterogeneity was found in the meta-analyses. However, there was no evidence of a threshold effect (Spearman correlation coefficient = 0.419; p = 0.035). In addition, meta-regression showed that the sample size, study design, and diagnostic criteria were not sources of heterogeneity, and subgroup meta-analyses did not change the overall diagnostic accuracy. Our meta-analysis of published studies demonstrates that DECT has a high diagnostic accuracy and plays an important role in the diagnosis of gout. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Magnetic resonance colonography versus colonoscopy as a diagnostic investigation for colorectal cancer: a meta-analysis

    International Nuclear Information System (INIS)

    Purkayastha, S.; Tekkis, P.P.; Athanasiou, T.; Aziz, O.; Negus, R.; Gedroyc, W.; Darzi, A.W.

    2005-01-01

    AIMS: Magnetic resonance colonography (MRC) is emerging as a potential complementary investigation for the diagnosis of colorectal cancer (CRC) and also for benign pathology such as diverticular disease. A meta-analysis reporting the use of MRC is yet to be performed. The aim of this study was to evaluate the diagnostic accuracy of MRC compared with the gold-standard investigation, conventional colonoscopy (CC). METHODS: A literature search was carried out to identify studies containing comparative data between MRC findings and CC findings. Quantitative meta-analysis for diagnostic tests was performed, which included the calculation of independent sensitivities, specificities, diagnostic odds ratios, the construction of summary receiver operating characteristic (SROC) curves, pooled analysis and sensitivity analysis. The study heterogeneity was evaluated by the Q-test using a random-effect model to accommodate the cluster of outcomes between individual studies. RESULTS: In all, 8 comparative studies were identified, involving 563 patients. The calculated pooled sensitivity for all lesions was 75% (95% CI: 47% to 91%), the specificity was 96% (95% CI: 86% to 98%) and the area under the ROC curve was 90% (weighted). On sensitivity analysis, MRC had a better diagnostic accuracy for CRC than for polyps, with a sensitivity of 91% (95% CI: 97% to 91%), a specificity of 98% (95% CI: 66% to 99%) and an area under the ROC curve of 92%. There was no significant heterogeneity between the studies with regard to the diagnostic accuracy of MRC for CRC. CONCLUSION: This meta-analysis suggests that MRC is an imaging technique with high discrimination for cases presenting with colorectal cancer. The exact diagnostic role of MRC needs to be clarified (e.g. suitable for an elderly person with suspected CRC). Further evaluation is necessary to refine its applicability and diagnostic accuracy in comparison with other imaging methods such as computed tomography colonography

  8. Nordic Guidance Levels for Patient Doses in Diagnostic Radiology

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  9. CLASSIFICATION AND DIAGNOSTICS OF ANEMIA IN CHILDREN

    OpenAIRE

    A. G. Rumyantsev

    2011-01-01

    Anemia in children is one of the most frequent somatic diseases. Criteria of anemia diagnosis are strictly regulated as decrease of hemoglobin/erythrocytes level accompanies majority of infectious, inflammatory, autoimmune, hereditary diseases and, in several cases, it is estimated as transitory disease in some periods of children’s growth and development. The article presents main classification and differential diagnostic schemes of anemia. Diagnostics makes accent on laboratory analysis; t...

  10. Using the method of judgement analysis to address variations in diagnostic decision making

    OpenAIRE

    Hancock, Helen C; Mason, James M; Murphy, Jerry J

    2012-01-01

    Abstract Background Heart failure is not a clear-cut diagnosis but a complex clinical syndrome with consequent diagnostic uncertainty. Judgment analysis is a method to help clinical teams to understand how they make complex decisions. The method of judgment analysis was used to determine the factors that influence clinicians' diagnostic decisions about heart failure. Methods Three consultants, three middle grade doctors, and two junior doctors each evaluated 45 patient scenarios. The main out...

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

    Science.gov (United States)

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

    2015-03-01

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

  12. The diagnostic performance of CT-derived fractional flow reserve for evaluation of myocardial ischaemia confirmed by invasive fractional flow reserve: a meta-analysis

    International Nuclear Information System (INIS)

    Li, S.; Tang, X.; Peng, L.; Luo, Y.; Dong, R.; Liu, J.

    2015-01-01

    Aim: To review the literature on the diagnostic accuracy of CT-derived fractional flow reserve (FFR CT ) for the evaluation of myocardial ischaemia in patients with suspected or known coronary artery disease, with invasive fractional flow reserve (FFR) as the reference standard. Materials and methods: A PubMed, EMBASE, and Cochrane cross-search was performed. The pooled diagnostic accuracy of FFR CT , with FFR as the reference standard, was primarily analysed, and then compared with that of CT angiography (CTA). The thresholds to diagnose ischaemia were FFR ≤0.80 or CTA ≥50% stenosis. Data extraction, synthesis, and statistical analysis were performed by standard meta-analysis methods. Results: Three multicentre studies (NXT Trial, DISCOVER-FLOW study and DeFACTO study) were included, examining 609 patients and 1050 vessels. The pooled sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR−), and diagnostic odds ratio (DOR) for FFR CT were 89% (85–93%), 71% (65–75%), 70% (65–75%), 90% (85–93%), 3.31 (1.79–6.14), 0.16 (0.11–0.23), and 21.21 (9.15–49.15) at the patient-level, and 83% (78–63%), 78% (75–81%), 61% (56–65%), 92% (89–90%), 4.02 (1.84–8.80), 0.22 (0.13–0.35), and 19.15 (5.73–63.93) at the vessel-level. At per-patient analysis, FFR CT has similar sensitivity but improved specificity, PPV, NPV, LR+, LR−, and DOR versus those of CTA. At per-vessel analysis, FFR CT had a slightly lower sensitivity, similar NPV, but improved specificity, PPV, LR+, LR−, and DOR compared with those of CTA. The area under the summary receiver operating characteristic curves for FFR CT was 0.8909 at patient-level and 0.8865 at vessel-level, versus 0.7402 for CTA at patient-level. Conclusions: FFR CT , which was associated with improved diagnostic accuracy versus CTA, is a viable alternative to FFR for detecting coronary ischaemic lesions

  13. Latent class analysis of diagnostic science assessment data using Bayesian networks

    Science.gov (United States)

    Steedle, Jeffrey Thomas

    2008-10-01

    longitudinal model in order to provide educators and curriculum developers with a sense of how students advance in understanding over the course of instruction. Results indicated that expected student response patterns rarely reflected the assumptions of the learning progression approach. That is, students tended not to systematically apply a coherent set of ideas across different problem contexts. Even those students expected to express scientifically-accurate understanding had substantial probabilities of reporting certain problematic ideas. The learning progression models failed to make as many substantively-meaningful distinctions among students as the facet models. In statistical comparisons, model-data fit was better for the facet model, but the models were quite comparable on all other statistical criteria. Studying the effects of test length revealed that approximately 8 items are needed to obtain adequate diagnostic certainty, but more items are needed to obtain adequate diagnostic reliability. The longitudinal analysis demonstrated that students either advance in their understanding (i.e., switch to the more advanced latent class) over a short period of instruction or stay at the same level. There was no significant relationship between the probability of changing latent classes and time between testing occasions. In all, this study is valuable because it provides evidence informing decisions about modeling and reporting on student understanding, it assesses the quality of measurement available from short clusters of diagnostic multiple-choice items, and it provides educators with knowledge of the paths that student may take as they advance from novice to expert understanding over the course of instruction.

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

    International Nuclear Information System (INIS)

    Awad, Ezdehar Mohammed Satti.

    2016-03-01

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

  15. Identification of candidate diagnostic serum biomarkers for Kawasaki disease using proteomic analysis

    Science.gov (United States)

    Kimura, Yayoi; Yanagimachi, Masakatsu; Ino, Yoko; Aketagawa, Mao; Matsuo, Michie; Okayama, Akiko; Shimizu, Hiroyuki; Oba, Kunihiro; Morioka, Ichiro; Imagawa, Tomoyuki; Kaneko, Tetsuji; Yokota, Shumpei; Hirano, Hisashi; Mori, Masaaki

    2017-01-01

    Kawasaki disease (KD) is a systemic vasculitis and childhood febrile disease that can lead to cardiovascular complications. The diagnosis of KD depends on its clinical features, and thus it is sometimes difficult to make a definitive diagnosis. In order to identify diagnostic serum biomarkers for KD, we explored serum KD-related proteins, which differentially expressed during the acute and recovery phases of two patients by mass spectrometry (MS). We identified a total of 1,879 proteins by MS-based proteomic analysis. The levels of three of these proteins, namely lipopolysaccharide-binding protein (LBP), leucine-rich alpha-2-glycoprotein (LRG1), and angiotensinogen (AGT), were higher in acute phase patients. In contrast, the level of retinol-binding protein 4 (RBP4) was decreased. To confirm the usefulness of these proteins as biomarkers, we analyzed a total of 270 samples, including those collected from 55 patients with acute phase KD, by using western blot analysis and microarray enzyme-linked immunosorbent assays (ELISAs). Over the course of this experiment, we determined that the expression level of these proteins changes specifically in the acute phase of KD, rather than the recovery phase of KD or other febrile illness. Thus, LRG1 could be used as biomarkers to facilitate KD diagnosis based on clinical features. PMID:28262744

  16. [Methods of statistical analysis in differential diagnostics of the degree of brain glioma anaplasia during preoperative stage].

    Science.gov (United States)

    Glavatskiĭ, A Ia; Guzhovskaia, N V; Lysenko, S N; Kulik, A V

    2005-12-01

    The authors proposed a possible preoperative diagnostics of the degree of supratentorial brain gliom anaplasia using statistical analysis methods. It relies on a complex examination of 934 patients with I-IV degree anaplasias, which had been treated in the Institute of Neurosurgery from 1990 to 2004. The use of statistical analysis methods for differential diagnostics of the degree of brain gliom anaplasia may optimize a diagnostic algorithm, increase reliability of obtained data and in some cases avoid carrying out irrational operative intrusions. Clinically important signs for the use of statistical analysis methods directed to preoperative diagnostics of brain gliom anaplasia have been defined

  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. 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.

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  20. Diagnostic Value of Procalcitonin Levels in Acute Mesenteric Ischemia

    Directory of Open Access Journals (Sweden)

    Yunus Karaca

    2015-09-01

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

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  2. Diagnostic accuracy of dual-source CT coronary angiography in patients with atrial fibrillation: Meta analysis

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Gang, E-mail: cjr.sungang@vip.163.com [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Li, Min [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Jiang, Zhi-wei [Department of Health Statistics, School of Public Health, Fourth Military Medical University, No. 169, Changle West Road, Xi’an, Shaanxi 710032 (China); Xu, Lin [Department of Medical Cardiology, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Peng, Zhao-hui; Ding, Juan; Li, Li [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Jin, Zhi-tao [Department of Cardiology, General Hospital of the Second Artillery, Beijing 100088 (China)

    2013-10-01

    Rationale and objective: To synthesize the available data to underscore the diagnostic accuracy of dual-source CT (DSCT) coronary angiography in patients with atrial fibrillation (AF). Materials and methods: We searched in the electronic databases of PubMed for all published studies that examined patients with AF using DSCT. We used an exact binomial rendition of the bivariate mixed-effects regression model to synthesize the diagnostic data. Results: The positive and negative likelihood ratios (LRs) at the patient level were 6.0 (CI, 3.6–10.1) and 0.03(CI, 0.004–0.2), respectively. The negative predictive values higher than 90% were available for a CAD prevalence <78%. The pooled vessel- and segment-level estimates showed higher positive and negative LRs than the patient-level estimates (15.3 [CI, 9.8–23.9] and 0.1 [CI, 0.07–0.3]; 25.1 [CI, 10.8–58.5] and 0.2 [CI, 0.2–0.3], respectively). No statistically significant heterogeneity between studies and publication bias were found at the patient level estimate. A sensitivity analysis showed that no study influenced the pooled results larger than 0.02. Conclusions: Cardiac angiography with DSCT can be applied as an imaging test for ruling out CAD in patient with AF. However, DSCT angiography may be not an effective tool for risk stratification for the high negative LR at the artery and segment levels.

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  4. Diagnostic value of WIF1 methylation for colorectal cancer: a meta-analysis

    Science.gov (United States)

    Chen, Min; Huang, Tianyi; Chen, Yuehong; Ji, Huihui; Pan, Ranran; Wang, Tiangong; Jiang, Danjie; Chen, Yanfei; Yang, Yong; Duan, Shiwei

    2018-01-01

    As a common antagonist of Wnt/β-catenin signaling, Wnt inhibitory factor 1 (WIF1) plays an important role in the tumor progression. The aim of our meta-analysis was to summarize the diagnostic value of WIF1 methylation in colorectal cancer (CRC). Eligible studies were retrieved by a systemic search among PubMed, Embase, CNKI, and Wanfang literature databases. The diagnostic value of WIF1 methylation for CRC was assessed by the summary receiver operating characteristics (SROC) test. Our meta-analysis of 12 studies between 1420 CRC samples and 946 control samples showed that WIF1 hypermethylation was significantly associated with CRC (P < 0.001, OR = 30.10, 95% CI = 19.48-46.50). WIF1 hypermethylation, as a diagnostic biomarker for CRC, has a pooled sensitivity of 0.40 (95% CI: 0.37-0.42), a pooled specificity of 0.95 (95% CI: 0.93-0.96), a pooled positive-likelihood ratio (PLR) of 8.65 (95% CI, 4.47-16.73), and a pooled negative-likelihood ratio (NLR) of 0.41 (95% CI, 0.30-0.55), a diagnostic odds ratio (DOR) of 26.86 (95% CI: 15.73-45.89), and an area under the curve (AUC) of 0.9115. In conclusion, our study established that WIF1 hypermethylation might be a promising diagnostic biomarker for CRC. PMID:29435185

  5. Systematic internal transcribed spacer sequence analysis for identification of clinical mold isolates in diagnostic mycology: a 5-year study.

    Science.gov (United States)

    Ciardo, Diana E; Lucke, Katja; Imhof, Alex; Bloemberg, Guido V; Böttger, Erik C

    2010-08-01

    The implementation of internal transcribed spacer (ITS) sequencing for routine identification of molds in the diagnostic mycology laboratory was analyzed in a 5-year study. All mold isolates (n = 6,900) recovered in our laboratory from 2005 to 2009 were included in this study. According to a defined work flow, which in addition to troublesome phenotypic identification takes clinical relevance into account, 233 isolates were subjected to ITS sequence analysis. Sequencing resulted in successful identification for 78.6% of the analyzed isolates (57.1% at species level, 21.5% at genus level). In comparison, extended in-depth phenotypic characterization of the isolates subjected to sequencing achieved taxonomic assignment for 47.6% of these, with a mere 13.3% at species level. Optimization of DNA extraction further improved the efficacy of molecular identification. This study is the first of its kind to testify to the systematic implementation of sequence-based identification procedures in the routine workup of mold isolates in the diagnostic mycology laboratory.

  6. The proposed Diagnostic Instrumentation and Analysis Laboratory, Mississippi State University

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-11-01

    The Department of Energy (DOE) proposes to authorize Mississippi State University (MSU) to proceed with the detailed design, construction and equipping of the proposed Diagnostic Instrumentation and Analysis Laboratory (DIAL). DOE grant funds are available to the University for the limited purpose of performing preliminary studies, including analysis necessary to conduct this environmental assessment. The proposed facility would be located in the Mississippi Research and Technology Park, adjacent to the Mississippi Agriculture and Forestry Experiment Station campus in Starkville, Mississippi. Total project cost is estimated at $7,953,600. This proposed laboratory would be designed to conduct research into combustion devices related to waste management and environmental restoration that is of importance to industry and government. The proposed facility`s role would be to develop diagnostic instrumentation capabilities in the area of combustion and related processes.

  7. Cognitive diagnostic assessment via Bayesian evaluation of informative diagnostic hypotheses.

    NARCIS (Netherlands)

    Hoijtink, Herbert; Béland, Sébastien; Vermeulen, Jorine A.

    2014-01-01

    There exist diverse approaches that can be used for cognitive diagnostic assessment, such as mastery testing, constrained latent class analysis, rule space methodology, diagnostic cognitive modeling, and person-fit analysis. Each of these approaches can be used within 1 of the 4 psychometric

  8. Cognitive Diagnostic Assessment via Bayesian Evaluation of Informative Diagnostic Hypotheses

    NARCIS (Netherlands)

    Hoitink, Herbert; Beland, Sebastien; Vermeulen, Jorine

    2014-01-01

    There exist diverse approaches that can be used for cognitive diagnostic assessment, such as mastery testing, constrained latent class analysis, rule space methodology, diagnostic cognitive modeling, and person-fit analysis. Each of these approaches can be used within 1 of the 4 psychometric

  9. Time-dependent analysis of visible helium line-ratios for electron temperature and density diagnostic using synthetic simulations on NSTX-U

    Energy Technology Data Exchange (ETDEWEB)

    Muñoz Burgos, J. M., E-mail: jmunozbu@pppl.gov; Stutman, D.; Tritz, K. [Department of Physics and Astronomy, Johns Hopkins University, Baltimore, Maryland 21218 (United States); Barbui, T.; Schmitz, O. [Department of Engineering Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706 (United States)

    2016-11-15

    Helium line-ratios for electron temperature (T{sub e}) and density (n{sub e}) plasma diagnostic in the Scrape-Off-Layer (SOL) and edge regions of tokamaks are widely used. Due to their intensities and proximity of wavelengths, the singlet, 667.8 and 728.1 nm, and triplet, 706.5 nm, visible lines have been typically preferred. Time-dependency of the triplet line (706.5 nm) has been previously analyzed in detail by including transient effects on line-ratios during gas-puff diagnostic applications. In this work, several line-ratio combinations within each of the two spin systems are analyzed with the purpose of eliminating transient effects to extend the application of this powerful diagnostic to high temporal resolution characterization of plasmas. The analysis is done using synthetic emission modeling and diagnostic for low electron density NSTX SOL plasma conditions by several visible lines. Quasi-static equilibrium and time-dependent models are employed to evaluate transient effects of the atomic population levels that may affect the derived electron temperatures and densities as the helium gas-puff penetrates the plasma. The analysis of a wider range of spectral lines will help to extend this powerful diagnostic to experiments where the wavelength range of the measured spectra may be constrained either by limitations of the spectrometer or by other conflicting lines from different ions.

  10. Decision analysis to complete diagnostic research by closing the gap between test characteristics and cost-effectiveness

    NARCIS (Netherlands)

    Schaafsma, Joanna D.; van der Graaf, Yolanda; Rinkel, Gabriel J. E.; Buskens, Erik

    2009-01-01

    Objective: The lack of a standard methodology in diagnostic research impedes adequate evaluation before implementation of constantly developing diagnostic techniques. We discuss the methodology of diagnostic research and underscore the relevance of decision analysis in the process of evaluation of

  11. CAD-Based Shielding Analysis for ITER Port Diagnostics

    Directory of Open Access Journals (Sweden)

    Serikov Arkady

    2017-01-01

    Full Text Available Radiation shielding analysis conducted in support of design development of the contemporary diagnostic systems integrated inside the ITER ports is relied on the use of CAD models. This paper presents the CAD-based MCNP Monte Carlo radiation transport and activation analyses for the Diagnostic Upper and Equatorial Port Plugs (UPP #3 and EPP #8, #17. The creation process of the complicated 3D MCNP models of the diagnostics systems was substantially accelerated by application of the CAD-to-MCNP converter programs MCAM and McCad. High performance computing resources of the Helios supercomputer allowed to speed-up the MCNP parallel transport calculations with the MPI/OpenMP interface. The found shielding solutions could be universal, reducing ports R&D costs. The shield block behind the Tritium and Deposit Monitor (TDM optical box was added to study its influence on Shut-Down Dose Rate (SDDR in Port Interspace (PI of EPP#17. Influence of neutron streaming along the Lost Alpha Monitor (LAM on the neutron energy spectra calculated in the Tangential Neutron Spectrometer (TNS of EPP#8. For the UPP#3 with Charge eXchange Recombination Spectroscopy (CXRS-core, an excessive neutron streaming along the CXRS shutter, which should be prevented in further design iteration.

  12. CAD-Based Shielding Analysis for ITER Port Diagnostics

    Science.gov (United States)

    Serikov, Arkady; Fischer, Ulrich; Anthoine, David; Bertalot, Luciano; De Bock, Maartin; O'Connor, Richard; Juarez, Rafael; Krasilnikov, Vitaly

    2017-09-01

    Radiation shielding analysis conducted in support of design development of the contemporary diagnostic systems integrated inside the ITER ports is relied on the use of CAD models. This paper presents the CAD-based MCNP Monte Carlo radiation transport and activation analyses for the Diagnostic Upper and Equatorial Port Plugs (UPP #3 and EPP #8, #17). The creation process of the complicated 3D MCNP models of the diagnostics systems was substantially accelerated by application of the CAD-to-MCNP converter programs MCAM and McCad. High performance computing resources of the Helios supercomputer allowed to speed-up the MCNP parallel transport calculations with the MPI/OpenMP interface. The found shielding solutions could be universal, reducing ports R&D costs. The shield block behind the Tritium and Deposit Monitor (TDM) optical box was added to study its influence on Shut-Down Dose Rate (SDDR) in Port Interspace (PI) of EPP#17. Influence of neutron streaming along the Lost Alpha Monitor (LAM) on the neutron energy spectra calculated in the Tangential Neutron Spectrometer (TNS) of EPP#8. For the UPP#3 with Charge eXchange Recombination Spectroscopy (CXRS-core), an excessive neutron streaming along the CXRS shutter, which should be prevented in further design iteration.

  13. Whole Genome Sequencing Increases Molecular Diagnostic Yield Compared with Current Diagnostic Testing for Inherited Retinal Disease.

    Science.gov (United States)

    Ellingford, Jamie M; Barton, Stephanie; Bhaskar, Sanjeev; Williams, Simon G; Sergouniotis, Panagiotis I; O'Sullivan, James; Lamb, Janine A; Perveen, Rahat; Hall, Georgina; Newman, William G; Bishop, Paul N; Roberts, Stephen A; Leach, Rick; Tearle, Rick; Bayliss, Stuart; Ramsden, Simon C; Nemeth, Andrea H; Black, Graeme C M

    2016-05-01

    To compare the efficacy of whole genome sequencing (WGS) with targeted next-generation sequencing (NGS) in the diagnosis of inherited retinal disease (IRD). Case series. A total of 562 patients diagnosed with IRD. We performed a direct comparative analysis of current molecular diagnostics with WGS. We retrospectively reviewed the findings from a diagnostic NGS DNA test for 562 patients with IRD. A subset of 46 of 562 patients (encompassing potential clinical outcomes of diagnostic analysis) also underwent WGS, and we compared mutation detection rates and molecular diagnostic yields. In addition, we compared the sensitivity and specificity of the 2 techniques to identify known single nucleotide variants (SNVs) using 6 control samples with publically available genotype data. Diagnostic yield of genomic testing. Across known disease-causing genes, targeted NGS and WGS achieved similar levels of sensitivity and specificity for SNV detection. However, WGS also identified 14 clinically relevant genetic variants through WGS that had not been identified by NGS diagnostic testing for the 46 individuals with IRD. These variants included large deletions and variants in noncoding regions of the genome. Identification of these variants confirmed a molecular diagnosis of IRD for 11 of the 33 individuals referred for WGS who had not obtained a molecular diagnosis through targeted NGS testing. Weighted estimates, accounting for population structure, suggest that WGS methods could result in an overall 29% (95% confidence interval, 15-45) uplift in diagnostic yield. We show that WGS methods can detect disease-causing genetic variants missed by current NGS diagnostic methodologies for IRD and thereby demonstrate the clinical utility and additional value of WGS. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  14. Diagnostic accuracy of pleural fluid tumor necrosis factor-α in tuberculous pleurisy: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Zhenzhen Li

    2015-01-01

    Full Text Available Background: Pleurisy is a common extra pulmonary complication of tuberculosis, but current methods for diagnosing it are fairly crude. Here we product a meta-analysis for the available evidence on the ability of tumor necrosis factor-α (TNF-α in pleural fluid to serve as a diagnostic marker of tuberculous pleurisy (TP. Materials and Methods: We searched the PubMed, EMBASE, and Google Scholar databases systematically for studies measuring sensitivity, specificity and other measures of diagnostic accuracy of pleural fluid TNF-α in the diagnosis of TP were meta-analyzed by Stata, version 12 and meta-disc. Results: A total of six publications reporting seven case-control studies were identified. Pooled results indicated that pleural fluid TNF-α showed a diagnostic sensitivity of 0.89 (95% confidence interval [95% CI] 0.83-0.93; range, 0.42-1.0 and a diagnostic specificity of 0.82 (95% CI: 0.78-0.86; range, 0.58-0.98. The pooled positive likelihood ratio was 4.78 (95% CI: 3.32-6.89; the negative likelihood ratio, 0.16 (95% CI: 0.1-0.27; the diagnostic odds ratio, 32.43 (95% CI: 14.48-72.6; and the area under the curve was 0.8556 (standard error of mean 0.0559. Conclusion: Pleural fluid TNF-α levels shows relatively high sensitivity but insufficient specificity for diagnosing TP. Pleural fluid TNF-α measurement may be useful in combination with clinical manifestations and conventional tests such as microbiological examination or pleural biopsy.

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  16. Variance in total levels of phospholipase C zeta (PLC-ζ) in human sperm may limit the applicability of quantitative immunofluorescent analysis as a diagnostic indicator of oocyte activation capability.

    Science.gov (United States)

    Kashir, Junaid; Jones, Celine; Mounce, Ginny; Ramadan, Walaa M; Lemmon, Bernadette; Heindryckx, Bjorn; de Sutter, Petra; Parrington, John; Turner, Karen; Child, Tim; McVeigh, Enda; Coward, Kevin

    2013-01-01

    To examine whether similar levels of phospholipase C zeta (PLC-ζ) protein are present in sperm from men whose ejaculates resulted in normal oocyte activation, and to examine whether a predominant pattern of PLC-ζ localization is linked to normal oocyte activation ability. Laboratory study. University laboratory. Control subjects (men with proven oocyte activation capacity; n = 16) and men whose sperm resulted in recurrent intracytoplasmic sperm injection failure (oocyte activation deficient [OAD]; n = 5). Quantitative immunofluorescent analysis of PLC-ζ protein in human sperm. Total levels of PLC-ζ fluorescence, proportions of sperm exhibiting PLC-ζ immunoreactivity, and proportions of PLC-ζ localization patterns in sperm from control and OAD men. Sperm from control subjects presented a significantly higher proportion of sperm exhibiting PLC-ζ immunofluorescence compared with infertile men diagnosed with OAD (82.6% and 27.4%, respectively). Total levels of PLC-ζ in sperm from individual control and OAD patients exhibited significant variance, with sperm from 10 out of 16 (62.5%) exhibiting levels similar to OAD samples. Predominant PLC-ζ localization patterns varied between control and OAD samples with no predictable or consistent pattern. The results indicate that sperm from control men exhibited significant variance in total levels of PLC-ζ protein, as well as significant variance in the predominant localization pattern. Such variance may hinder the diagnostic application of quantitative PLC-ζ immunofluorescent analysis. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  18. Aquifer test interpretation using derivative analysis and diagnostic plots

    Science.gov (United States)

    Hernández-Espriú, Antonio; Real-Rangel, Roberto; Cortés-Salazar, Iván; Castro-Herrera, Israel; Luna-Izazaga, Gabriela; Sánchez-León, Emilio

    2017-04-01

    Pumping tests remain a method of choice to deduce fundamental aquifer properties and to assess well condition. In the oil and gas (O&G) industry, well testing has been the core technique in examining reservoir behavior over the last 50 years. The pressure derivative by Bourdet, it is perhaps, the most significant single development in the history of well test analysis. Recently, the so-called diagnostics plots (e.g. drawdown and drawdown derivative in a log-log plot) have been successfully tested in aquifers. However, this procedure is still underutilized by groundwater professionals. This research illustrates the applicability range, advantages and drawbacks (e.g. smoothing procedures) of diagnostic plots using field examples from a wide spectrum of tests (short/long tests, constant/variable flow rates, drawdown/buildup stages, pumping well/observation well) in dissimilar geological conditions. We analyze new and pre-existent aquifer tests in Mexico, USA, Canada, Germany, France and Saudi Arabia. In constant flow rate tests, our results show that derivative analysis is an easy, robust and powerful tool to assess near-borehole damage effects, formation heterogeneity, boundaries, flow regimes, infinite-acting radial stages, i.e., valid Theisian framework, and fracture-driven flow. In step tests, the effectiveness relies on high-frequency drawdown measurements. Moreover, we adapt O&G analytical solutions to cater for the conditions in groundwater systems. In this context, further parameters can be computed analytically from the plots, such as skin factor, head losses, wellbore storage, distance to the boundary, channel-aquifer and/or fracture zone width, among others. Therefore, diagnostic plots should be considered a mandatory tool for pumping tests analysis among hydrogeologists. This project has been supported by DGAPA (UNAM) under the research project PAPIIT IN-112815.

  19. Common pitfalls in statistical analysis: Understanding the properties of diagnostic tests - Part 1.

    Science.gov (United States)

    Ranganathan, Priya; Aggarwal, Rakesh

    2018-01-01

    In this article in our series on common pitfalls in statistical analysis, we look at some of the attributes of diagnostic tests (i.e., tests which are used to determine whether an individual does or does not have disease). The next article in this series will focus on further issues related to diagnostic tests.

  20. Magnetic resonance imaging and magnetic resonance arthrography of the shoulder: dependence on the level of training of the performing radiologist for diagnostic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Theodoropoulos, John S. [University of Toronto, Division of Orthopaedics, Mount Sinai Hospital and the University Health Network, Toronto, ON (Canada); Andreisek, Gustav [University of Toronto, Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, Toronto, ON (Canada); University Hospital Zuerich, Institute for Diagnostic Radiology, Zuerich (Switzerland); Harvey, Edward J. [McGill University, Division of Orthopaedics, MUHC - Montreal General Hospital, Montreal, Quebec (Canada); Wolin, Preston [Center for Athletic Medicine, Chicago, IL (United States)

    2010-07-15

    Discrepancies were identified between magnetic resonance (MR) imaging and clinical findings in patients who had MR imaging examinations evaluated by community-based general radiologists. The purpose of this study was to evaluate the diagnostic performance of MR imaging examinations of the shoulder with regard to the training level of the performing radiologist. A review of patient charts identified 238 patients (male/female, 175/63; mean age, 40.4 years) in whom 250 arthroscopies were performed and who underwent MR imaging or direct MR arthrography in either a community-based or hospital-based institution prior to surgery. All MR imaging and surgical reports were reviewed and the diagnostic performance for the detection of labral, rotator cuff, biceps, and Hill-Sachs lesions was determined. Kappa and Student's t test analyses were performed in a subset of cases in which initial community-based MR images were re-evaluated by hospital-based musculoskeletal radiologists, to determine the interobserver agreement and any differences in image interpretation. The diagnostic performance of community-based general radiologists was lower than that of hospital-based sub-specialized musculoskeletal radiologists. A sub-analysis of re-evaluated cases showed that musculoskeletal radiologists performed better. {kappa} values were 0.208, 0.396, 0.376, and 0.788 for labral, rotator cuff, biceps, and Hill-Sachs lesions (t test statistics: p =<0.001, 0.004, 0.019, and 0.235). Our results indicate that the diagnostic performance of MR imaging and MR arthrography of the shoulder depends on the training level of the performing radiologist, with sub-specialized musculoskeletal radiologists having a better diagnostic performance than general radiologists. (orig.)

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  2. The market trend analysis and prospects of cancer molecular diagnostics kits.

    Science.gov (United States)

    Seo, Ju Hwan; Lee, Joon Woo; Cho, Daemyeong

    2018-01-01

    The molecular diagnostics market can be broadly divided into PCR (rt-PCR, d-PCR), NGS(Next Generation Sequencing), Microarray, FISH(Fluorescent in situ-hybridization) and other categories, based on the diagnostic technique. Also, depending on the disease being diagnosed, the market can also be divided into cancer, infectious diseases, HIV/STDs (herpes, syphilis), and women's health issues such as breast cancer, cervical cancer, ovarian cancer, HPV(human papillomavirus), and vaginitis.Chromosome analysis (including Fluorescent In-situ Hybridization) is one type of blood cancer diagnostic method, which involves the direct detection of individual cells with chromosomal translocation, but there have been problems of sensitivity when using this method. PCR targeting individual genes or the RT (reverse transcription)-PCR method offers outstanding sensitivity, but one drawback is the risk of false-positive reaction caused by contamination of samples, etc. Blood cancer molecular diagnostics kits allow us to overcome these shortcomings, and related products have been under development, with a focus on improving detection sensitivity, enabling multiple tests, and reducing the cost and diagnostic time. Blood cancer molecular diagnostics is usually performed based on platforms such as PCR. The global market for blood cancer molecular diagnostics kits is $ 335.9 million as of 2016 and is expected to reach $ 6980 million in 2026 with an average annual growth rate of 32.9%. The market in South Korea is anticipated to grow at an average annual rate of 28.9%, from $ 3.75 million as of 2016 to $ 60.89 million in 2026. The Market for blood cancer molecular diagnostics kits is judged to be higher in growth possibility due to the increase in the number of cancer patients.

  3. Comparative analysis of diagnostic significance of biomarkers’ panels in cardiac recipients in the long term period after transplantation

    Directory of Open Access Journals (Sweden)

    O. P. Shevchenko

    2017-01-01

    Full Text Available Aim. To perform comparative analysis of the diagnostic efficacy of sCD40L, PDGF-BB, VEGF-A and ST2 in recipients with cardiac rejection in different periods after transplantation. Materials and methods. The study included 144 cardiac recipients aged from 12 to 71 (mean age 44 ± 14 years old, among those 112 were men. Venous blood plasma taken on the same day with endomyocardial biopsy was used for the study. The concentrations of soluble CD40 ligand (sCD40L, vascular endothelial growth factor (VEGF-A, platelet-derived growth factor (PDGF-BB were measured using xMAP technology. The concentrations of ST2 were measured by ELISA. Results. Men had significantly higher levels of ST2 and VEGF-A compared to women (p = 0.03. No correlation was found between the levels of biomarkers (sCD40L, PDGF-BB, VEGF-A, ST2 and age, diagnosis before transplantation, presence of arterial hypertension and diabetes mellitus. Comparative analysis of the biomarkers’ levels didn’t show significant difference between patients with heart transplant rejection and without it in the first month and in the first year after transplantation. The ST2 level was significantly higher in patients with heart rejection (p = 0.01 in the long term period (1–5 years after transplantation compared to patients without rejection. Relative risk of cardiac transplant rejection was significantly higher in patients with high (>22.8 ng/ml ST2 level (RR = 2.59 ± 0.33; Se – 35%, Sp – 93%. However, its combination with other biomarkers improved their diagnostic value. Relative risk for panel including ST2, VEGF-A and PDGF-BB 3.47 ± 0.55, Se – 57%, Sp – 91%; relative risk for panel including ST2, sCD40L and PDGF-BB was 3.75 ± 0.59, Se – 50%, Sp – 92%. The highest diagnostic efficacy for the heart transplant rejection was reached by a panel of biomarkers that included ST2 and PDGF-BB (RR = 5.0 ± 0.56 [95% CI 1.68–14.92], Se – 63%, Sp – 94%. Conclusion. ST2 had the biggest

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

    Science.gov (United States)

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

    2015-01-01

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

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    Serkan Kahyaoğlu

    2012-03-01

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

  7. Neutronics analysis for integration of ITER diagnostics port EP10

    Energy Technology Data Exchange (ETDEWEB)

    Colling, Bethany, E-mail: bethany.colling@ccfe.ac.uk [Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Department of Engineering, Lancaster University, Lancashire LA1 4YR (United Kingdom); Eade, Tim [Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Joyce, Malcolm J. [Department of Engineering, Lancaster University, Lancashire LA1 4YR (United Kingdom); Pampin, Raul; Seyvet, Fabien [Fusion for Energy, Josep Pla 2, Torres Diagonal Litoral B3, 08019 Barcelona (Spain); Turner, Andrew [Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Udintsev, Victor [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St. Paul Lez Durance Cedex (France)

    2016-11-01

    Shutdown dose rate calculations have been performed on an integrated ITER C-lite neutronics model with equatorial port 10. A ‘fully shielded’ configuration, optimised for a given set of diagnostic designs (i.e. shielding in all available space within the port plug drawers), results in a shutdown dose rate in the port interspace, from the activation of materials comprising equatorial port 10, in excess of 2000 μSv/h. Achieving dose rates of 100 μSv/h or less, as required in areas where hands-on maintenance can be performed, in the port interspace region will be challenging. A combination of methods will need to be implemented, such as reducing mass and/or the use of reduced activation steel in the port interspace, optimisation of the diagnostic designs and shielding of the port interspace floor. Further analysis is required to test these options and the ongoing design optimisation of the EP10 diagnostic systems.

  8. 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…

  9. Systematic Internal Transcribed Spacer Sequence Analysis for Identification of Clinical Mold Isolates in Diagnostic Mycology: a 5-Year Study▿ †

    Science.gov (United States)

    Ciardo, Diana E.; Lucke, Katja; Imhof, Alex; Bloemberg, Guido V.; Böttger, Erik C.

    2010-01-01

    The implementation of internal transcribed spacer (ITS) sequencing for routine identification of molds in the diagnostic mycology laboratory was analyzed in a 5-year study. All mold isolates (n = 6,900) recovered in our laboratory from 2005 to 2009 were included in this study. According to a defined work flow, which in addition to troublesome phenotypic identification takes clinical relevance into account, 233 isolates were subjected to ITS sequence analysis. Sequencing resulted in successful identification for 78.6% of the analyzed isolates (57.1% at species level, 21.5% at genus level). In comparison, extended in-depth phenotypic characterization of the isolates subjected to sequencing achieved taxonomic assignment for 47.6% of these, with a mere 13.3% at species level. Optimization of DNA extraction further improved the efficacy of molecular identification. This study is the first of its kind to testify to the systematic implementation of sequence-based identification procedures in the routine workup of mold isolates in the diagnostic mycology laboratory. PMID:20573873

  10. Open Rotor - Analysis of Diagnostic Data

    Science.gov (United States)

    Envia, Edmane

    2011-01-01

    NASA is researching open rotor propulsion as part of its technology research and development plan for addressing the subsonic transport aircraft noise, emission and fuel burn goals. The low-speed wind tunnel test for investigating the aerodynamic and acoustic performance of a benchmark blade set at the approach and takeoff conditions has recently concluded. A high-speed wind tunnel diagnostic test campaign has begun to investigate the performance of this benchmark open rotor blade set at the cruise condition. Databases from both speed regimes will comprise a comprehensive collection of benchmark open rotor data for use in assessing/validating aerodynamic and noise prediction tools (component & system level) as well as providing insights into the physics of open rotors to help guide the development of quieter open rotors.

  11. 42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

    Science.gov (United States)

    2010-10-01

    ... Procedural Terminology published by the American Medical Association. (3) Levels of supervision. Except where... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.32 Diagnostic x-ray tests, diagnostic laboratory...

  12. Simplified diagnostic coding sheet for computerized data storage and analysis in ophthalmology.

    Science.gov (United States)

    Tauber, J; Lahav, M

    1987-11-01

    A review of currently-available diagnostic coding systems revealed that most are either too abbreviated or too detailed. We have compiled a simplified diagnostic coding sheet based on the International Coding and Diagnosis (ICD-9), which is both complete and easy to use in a general practice. The information is transferred to a computer, which uses the relevant (ICD-9) diagnoses as database and can be retrieved later for display of patients' problems or analysis of clinical data.

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

    Science.gov (United States)

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

    2016-07-01

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

  14. MEDICAL DIAGNOSTICS BY MICROSTRUCTURAL ANALYSIS OF BIOLOGICAL LIQUID DRIED PATTERNS AS A PROBLEM OF BIOINFORMATICS

    Directory of Open Access Journals (Sweden)

    Petr Vladimirovich Lebedev-Stepanov, Dr.

    2018-02-01

    Full Text Available Motivation: It is important to develop the high-precision computerized methods for medical rapid diagnostic which is generalizing the unique clinical experience obtained in the past decade as specialized solutions for diagnostic problems of control of specific diseases and, potentially, for a wide health monitoring of virtually healthy population, identify the reserves of human health and take the actions to prevent of these reserves depletion. In this work we present one of the new directions in bioinformatics, i.e. medical diagnostics by automated expert system on basis of morphology analysis of digital image of biological liquid dried pattern. Results: Proposed method is combination of bioinformatics and biochemistry approaches for obtaining diagnostic information from a morphological analysis of standardized dried patterns of biological liquid sessile drop. We have carried out own research in collaboration with medical diagnostic centers and formed the electronic database for recognition the following types of diseases: candidiasis; neoplasms; diabetes mellitus; diseases of the circulatory system; cerebrovascular disease; diseases of the digestive system; diseases of the genitourinary system; infectious diseases; factors relevant to the work; factors associated with environmental pollution; factors related to lifestyle. The laboratory setup for diagnostics of the human body in pathology states is developed. The diagnostic results are considered. Availability: Access to testing the software can be obtained on request to the contact email below.

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

    Science.gov (United States)

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

    2018-05-09

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

  16. Diagnostic value of WIF1 methylation for colorectal cancer: a meta-analysis

    OpenAIRE

    Hu, Haochang; Li, Bin; Zhou, Cong; Ying, Xiuru; Chen, Min; Huang, Tianyi; Chen, Yuehong; Ji, Huihui; Pan, Ranran; Wang, Tiangong; Jiang, Danjie; Chen, Yanfei; Yang, Yong; Duan, Shiwei

    2018-01-01

    As a common antagonist of Wnt/β-catenin signaling, Wnt inhibitory factor 1 (WIF1) plays an important role in the tumor progression. The aim of our meta-analysis was to summarize the diagnostic value of WIF1 methylation in colorectal cancer (CRC). Eligible studies were retrieved by a systemic search among PubMed, Embase, CNKI, and Wanfang literature databases. The diagnostic value of WIF1 methylation for CRC was assessed by the summary receiver operating characteristics (SROC) test. Our meta-a...

  17. Diagnostics of the Factors Influencing the Export Activity of an Enterprise

    Directory of Open Access Journals (Sweden)

    Skrynkovskyy Ruslan M.

    2017-09-01

    Full Text Available The modern practice of doing business proves that a successful entrance of any enterprise to external (international markets depends on the level of its readiness for carrying out foreign economic activity. Under such circumstances, the process of targeted analysis and assessment of factors influencing the export activity of the enterprise is relevant, expedient and important. The aim of the article is the formation and development of theoretical and methodological bases for diagnosing factors influencing the export activity of an enterprise on the basis of theory and practice in the field of management and administration. It is found that the diagnostics should be understood as the process of identification, analysis and evaluation of influence (functional, dysfunctional of the factors (circumstances, conditions, etc. on the export activity of an enterprise in order to identify and solve problems (current, possible ones in the sphere of supply and implementation of specific actions (steps related to its entrance to external (international markets. It is determined that the key business indicators of the system for diagnosing the factors influencing the export activity of an enterprise are indicators reflecting the influence of the main factors on its export activity: level of fulfillment of obligations in terms of cost; level of conclusion of “expensive contracts”; share of renewed business contracts in the total number of contracts; level of satisfaction of claims; level of delivery variability. The prospect for further research in this scientific direction is developing a system of partial diagnostic goals of the integrated system of goals for conducting economic diagnostics of enterprises taking into account the diagnostics of factors influencing the export activity of an enterprise as a partial diagnostic goal.

  18. Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis

    International Nuclear Information System (INIS)

    Goodacre, Steve; Sampson, Fiona; Thomas, Steve; Beek, Edwin van; Sutton, Alex

    2005-01-01

    Ultrasound (US) has largely replaced contrast venography as the definitive diagnostic test for deep vein thrombosis (DVT). We aimed to derive a definitive estimate of the diagnostic accuracy of US for clinically suspected DVT and identify study-level factors that might predict accuracy. We undertook a systematic review, meta-analysis and meta-regression of diagnostic cohort studies that compared US to contrast venography in patients with suspected DVT. We searched Medline, EMBASE, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, Database of Reviews of Effectiveness, the ACP Journal Club, and citation lists (1966 to April 2004). Random effects meta-analysis was used to derive pooled estimates of sensitivity and specificity. Random effects meta-regression was used to identify study-level covariates that predicted diagnostic performance. We identified 100 cohorts comparing US to venography in patients with suspected DVT. Overall sensitivity for proximal DVT (95% confidence interval) was 94.2% (93.2 to 95.0), for distal DVT was 63.5% (59.8 to 67.0), and specificity was 93.8% (93.1 to 94.4). Duplex US had pooled sensitivity of 96.5% (95.1 to 97.6) for proximal DVT, 71.2% (64.6 to 77.2) for distal DVT and specificity of 94.0% (92.8 to 95.1). Triplex US had pooled sensitivity of 96.4% (94.4 to 97.1%) for proximal DVT, 75.2% (67.7 to 81.6) for distal DVT and specificity of 94.3% (92.5 to 95.8). Compression US alone had pooled sensitivity of 93.8 % (92.0 to 95.3%) for proximal DVT, 56.8% (49.0 to 66.4) for distal DVT and specificity of 97.8% (97.0 to 98.4). Sensitivity was higher in more recently published studies and in cohorts with higher prevalence of DVT and more proximal DVT, and was lower in cohorts that reported interpretation by a radiologist. Specificity was higher in cohorts that excluded patients with previous DVT. No studies were identified that compared repeat US to venography in all patients. Repeat US

  19. Golgi protein 73 as a biomarker for hepatocellular carcinoma: A diagnostic meta-analysis.

    Science.gov (United States)

    Yang, Jing; Li, Jingjing; Dai, Weiqi; Wang, Fan; Shen, Miao; Chen, Kan; Cheng, Ping; Zhang, Yan; Wang, Chengfen; Zhu, Rong; Zhang, Huawei; Zheng, Yuanyuan; Wang, Junshan; Xia, Yujing; Lu, Jie; Zhou, Yingqun; Guo, Chuanyong

    2015-04-01

    Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and the third leading cause of cancer-related mortality worldwide. Conflicting results have been reported regarding the use of serum Golgi protein 73 (GP73) as a promising serum marker for the diagnosis of HCC; therefore, the aim of the present study was to provide a systematic review of the diagnostic performance of GP73 for HCC. Following a systematic review of the relevant studies, a number of indices associated with the accuracy of the diagnostic performance of GP73, including the sensitivity and specificity, were pooled using Meta Disc 1.4 software. Data were presented as forest plots, and summary receiver operating characteristic (SROC) curve analysis was used to summarize the overall test performance. Eleven studies were included in this meta-analysis. The summary estimates for serum GP73 in diagnosing HCC were as follows: Sensitivity, 77% [95% confidence interval (CI), 75-79%]; specificity, 91% (95% CI, 90-92%); positive likelihood ratio, 4.34 (95% CI, 2.19-8.59); negative likelihood ratio, 0.30 (95% CI, 0.26-0.36) and diagnostic odds ratio, 15.78 (95% CI, 6.95-35.83). The area under the SROC curve was 0.8638, and the Q index was 0.7944. Significant heterogeneity was found. This meta-analysis indicates a moderate diagnostic value of GP73 in HCC; however, further studies with rigorous design, large sample size and multiregional cooperation are required.

  20. Analysis Tools for the Ion Cyclotron Emission Diagnostic on DIII-D

    Science.gov (United States)

    Del Castillo, C. A.; Thome, K. E.; Pinsker, R. I.; Meneghini, O.; Pace, D. C.

    2017-10-01

    Ion cyclotron emission (ICE) waves are excited by suprathermal particles such as neutral beam particles and fusion products. An ICE diagnostic is in consideration for use at ITER, where it could provide important passive measurement of fast ions location and losses, which are otherwise difficult to determine. Simple ICE data analysis codes had previously been developed, but more sophisticated codes are required to facilitate data analysis. Several terabytes of ICE data were collected on DIII-D during the 2015-2017 campaign. The ICE diagnostic consists of antenna straps and dedicated magnetic probes that are both digitized at 200 MHz. A suite of Python spectral analysis tools within the OMFIT framework is under development to perform the memory-intensive analysis of this data. A fast and optimized analysis allows ready access to data visualizations as spectrograms and as plots of both frequency and time cuts of the data. A database of processed ICE data is being constructed to understand the relationship between the frequency and intensity of ICE and a variety of experimental parameters including neutral beam power and geometry, local and global plasma parameters, magnetic fields, and many others. Work supported in part by US DoE under the Science Undergraduate Laboratory Internship (SULI) program and under DE-FC02-04ER54698.

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

    Science.gov (United States)

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

    2009-07-01

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

  2. 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.)

  3. Advances in medical diagnostic technology

    CERN Document Server

    Lai, Khin Wee; Mohamad Salim, Maheza Irna; Ong, Sang-Bing; Utama, Nugraha Priya; Myint, Yin Mon; Mohd Noor, Norliza; Supriyanto, Eko

    2014-01-01

    This book provides the most recent findings and knowledge in advanced diagnostics technology, covering a wide spectrum including brain activity analysis, breast and lung cancer detection, echocardiography, computer aided skeletal assessment to mitochondrial biology imaging at the cellular level. The authors explored magneto acoustic approaches and tissue elasticity imaging for the purpose of breast cancer detection. Perspectives in fetal echocardiography from an image processing angle are included. Diagnostic imaging in the field of mitochondrial diseases as well as the use of Computer-Aided System (CAD) are also discussed in the book. This book will be useful for students, lecturers or professional researchers in the field of biomedical sciences and image processing.

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

    International Nuclear Information System (INIS)

    Yang Jingxiu; Shi Shaohong; Wang Yuping

    2005-01-01

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

  5. Enhanced vibration diagnostics using vibration signature analysis

    International Nuclear Information System (INIS)

    Ahmed, S.; Shehzad, K.; Zahoor, Y.; Mahmood, A.; Bibi, A.

    2001-01-01

    Symptoms will appear in equipment, as well as in human beings. when 'suffering from sickness. Symptoms of abnormality in equipment are vibration, noise, deformation, temperature, pressure, electric current, crack, wearing, leakage etc. these are called modes of failure. If the mode of failure is vibration then the vibration signature analysis can be effectively used in order to diagnose the machinery problems. Much valuable information is contained within these vibration 'Spectra' or 'Signatures' but is only of use if the analyst can unlock its 'Secrets'. This paper documents a vibration problem in the motor of a centrifugal pump (Type ETA). It focuses mainly on the roll of modern vibration monitoring system in problem analysis. The problem experienced was the motor unstability and noise due to high vibration. Using enhanced vibration signature data, the problem was analyzed. which suggested that the rotor eccentricity was the cause of excessive noise and vibration in the motor. In conclusion, advanced electronic monitoring and diagnostic systems provide powerful information for machine's condition assessment and problem analysis. Appropriate interpretation and use of this information is important for accurate and effective vibration analysis. (author)

  6. Evaluating the diagnostic device DETEC-PC for the thyroid uptakes

    International Nuclear Information System (INIS)

    Alonso Abad, Dolores; Arista Romeu, Eduardo; Alonso Abad, Ariel

    2008-01-01

    A study is presented for evaluating the diagnostic capacity of the DETEC-PC, detection measurement system for the Thyroid Uptakes. A clinical trial was designed for that effect and all the patients included were evaluated using the DETEC-PC and the well-known radioimmunoassay (RIA) standard diagnostic procedure known by acronym RIA. For the Thyroid Uptakes using the DETEC-PC patients received an oral administration of a solution of radioactive iodine. The radioactive substance is attracted chemically to the gland and ionising radiation detector captures their emissions. The iodine concentration in the Thyroid, as well as the variation of this concentration over time reflects the function of the gland. The RIA is based on the analysis of the values associated with the t3, t4 and tsh hormones, and when these three parameters are in a certain range the patients can be classified. The sample size was calculated in order to estimate the gross coincidence percent between both methods with a precision of 1 % at a confidence level of 95%. In total 110 patients were included in the trial. Mainly two types of statistical analysis were carried out, in the first analysis all the patients included in the study were considered whereas in the second analysis the patients with doubtful RIA results were not included. Ideally the performance of a diagnostic tool is evaluated through the estimation of its sensitivity and specificity. Nevertheless, in the present study the reference procedure (RIA) can not be considered a gold standard diagnostic device. In such a setting the international regulations advise to use measurements of agreement to evaluate the diagnostic capacity of the new method. In the present study we evaluated the level of diagnostic agreement between the DETEC-PC and the RIA using the Kappa statistics. Additionally, the confidence interval for the Kappa statistics and the corresponding significant test for the present of agreement were also computes. The obtained

  7. Decision analysis to complete diagnostic research by closing the gap between test characteristics and cost-effectiveness.

    Science.gov (United States)

    Schaafsma, Joanna D; van der Graaf, Yolanda; Rinkel, Gabriel J E; Buskens, Erik

    2009-12-01

    The lack of a standard methodology in diagnostic research impedes adequate evaluation before implementation of constantly developing diagnostic techniques. We discuss the methodology of diagnostic research and underscore the relevance of decision analysis in the process of evaluation of diagnostic tests. Overview and conceptual discussion. Diagnostic research requires a stepwise approach comprising assessment of test characteristics followed by evaluation of added value, clinical outcome, and cost-effectiveness. These multiple goals are generally incompatible with a randomized design. Decision-analytic models provide an important alternative through integration of the best available evidence. Thus, critical assessment of clinical value and efficient use of resources can be achieved. Decision-analytic models should be considered part of the standard methodology in diagnostic research. They can serve as a valid alternative to diagnostic randomized clinical trials (RCTs).

  8. Electric probe data analysis for glow discharge diagnostics

    International Nuclear Information System (INIS)

    Cain, B.L.

    1987-01-01

    This report summarizes the development and application of digital computations for the analysis of data from an electric probe used for glow discharge diagnostics. The essential physics of the probe/discharge interaction is presented, along with formulations from modern electric probe theory. These results are then digitally implemented by a set of computer programs which both calculate discharge properties of electron temperature and density, and aid in the interpretation of these property estimates. The method of analysis, and the theories selected for implementation, are valid only for low pressure, collisionless sheath, and quiescent discharges where the single electric probe has a much smaller area than the discharge reference electrode. However, certain algorithms are included which, in some cases, can extend the analysis into intermediate pressure regimes. The digital programs' functional capabilities are demonstrated by the analysis of experimental probe data, collected using a laboratory glow discharge. Typical sources of error inherent in the electric probe method are discussed, along with an analysis of error induced by the computational methods of the programs. 27 refs., 49 figs., 20 tabs

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

    Science.gov (United States)

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

    2010-01-01

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

  10. Usage of Latent Class Analysis in Diagnostic Microbiology in the Absence of Gold Standard Test

    Directory of Open Access Journals (Sweden)

    Gul Bayram Abiha

    2016-12-01

    Full Text Available The evaluation of performance of various tests diagnostic tests in the absence of gold standard is an important problem. Latent class analysis (LCA is a statistical analysis method known for many years, especially in the absence of a gold standard for evaluation of diagnostic tests so that LCA has found its wide application area. During the last decade, LCA method has widely used in for determining sensivity and specifity of different microbiological tests. It has investigated in the diagnosis of mycobacterium tuberculosis, mycobacterium bovis, human papilloma virus, bordetella pertussis, influenza viruses, hepatitis E virus (HEV, hepatitis C virus (HCV and other various viral infections. Researchers have compared several diagnostic tests for the diagnosis of different pathogens with LCA. We aimed to evaluate performance of latent class analysis method used microbiological diagnosis in various diseases in several researches. When we took into account all of these tests' results, we suppose that LCA is a good statistical analysis method to assess different test performances in the absence of gold standard. [Archives Medical Review Journal 2016; 25(4.000: 467-488

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  12. Analysis of Chronic Temporomandibular Disorders Based on the Latest Diagnostic Criteria

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    Svechtarov V.

    2015-05-01

    Full Text Available The objective of this study is to analyze the distribution of the most common diagnoses observed in patients with chronic temporomandibular disorders, based on the new diagnostic criteria (DC/TMD adopted in 2014. The previous Research Diagnostic Criteria (RDC/TMD adopted in 1992, consisted of three main groups of eight diagnostic subgroups and is currently transformed into two main groups and twelve subgroups, respectively. All subgroups correspond to the nomenclature of the ICD-10. The new clinical diagnostic indices are also modified. The analysis showed a prevalence of Pain-Related TMD compared with that of intra-articular disorders in ratio 57.89% to 42.10%. In Pain-Related TMD arthralgia was represented in 55% of cases; local myalgia - in 12%, myofascial pain - in 18%, myofascial pain with referral - in 14%, headache attributed to TMD - in 1%. In Intra-articular TMD disc displacement with reduction was found in 23% of the cases, disc displacement with reduction with intermittent locking - in 3%, disc displacement without reduction with limited opening - in 25%, disc displacement without reduction and without limited opening - in 8%. Degenerative diseases were found in 14.28%, and hypermobility and subluxations - in 26.98%. These analyzes differ and can only partly be compared with previous analyzes based on RDC system. The changes in the diagnostic criteria require new clinical studies in order to refine the picture of temporomandibular pathology in accordance with the modern views on the matter.

  13. Systematic review of reliability and diagnostic validity of joint vibration analysis for diagnosis of temporomandibular disorders.

    Science.gov (United States)

    Sharma, Sonia; Crow, Heidi C; McCall, W D; Gonzalez, Yoly M

    2013-01-01

    To conduct a systematic review of papers reporting the reliability and diagnostic validity of the joint vibration analysis (JVA) for diagnosis of temporomandibular disorders (TMD). A search of Pubmed identified English-language publications of the reliability and diagnostic validity of the JVA. Guidelines were adapted from applied STAndards for the Reporting of Diagnostic accuracy studies (STARD) to evaluate the publications. Fifteen publications were included in this review, each of which presented methodological limitations. This literature is unable to provide evidence to support the reliability and diagnostic validity of the JVA for diagnosis of TMD.

  14. Bayesian tomography and integrated data analysis in fusion diagnostics

    Science.gov (United States)

    Li, Dong; Dong, Y. B.; Deng, Wei; Shi, Z. B.; Fu, B. Z.; Gao, J. M.; Wang, T. B.; Zhou, Yan; Liu, Yi; Yang, Q. W.; Duan, X. R.

    2016-11-01

    In this article, a Bayesian tomography method using non-stationary Gaussian process for a prior has been introduced. The Bayesian formalism allows quantities which bear uncertainty to be expressed in the probabilistic form so that the uncertainty of a final solution can be fully resolved from the confidence interval of a posterior probability. Moreover, a consistency check of that solution can be performed by checking whether the misfits between predicted and measured data are reasonably within an assumed data error. In particular, the accuracy of reconstructions is significantly improved by using the non-stationary Gaussian process that can adapt to the varying smoothness of emission distribution. The implementation of this method to a soft X-ray diagnostics on HL-2A has been used to explore relevant physics in equilibrium and MHD instability modes. This project is carried out within a large size inference framework, aiming at an integrated analysis of heterogeneous diagnostics.

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

    International Nuclear Information System (INIS)

    Wang Yuyi; Gu Yan

    2007-01-01

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

  16. Diagnostics of oral lichen planus based on analysis of volatile organic compounds in saliva

    Science.gov (United States)

    Kistenev, Yury; Borisov, Alexey; Shapovalov, Alexander; Baydik, Olga; Titarenko, Maria

    2017-03-01

    The ability of diagnostics of oral lichen planus (OLP) based on spectral analysis of saliva using the THz spectroscopy is presented. The study included 8 patients with clinically proven OLP. The comparison group consisted of 8 healthy volunteers. Absorption spectra of the saliva was measured using time-domain spectrometer T-spec (EXPLA) in the range 0.2-3THz and have been considered as the feature vectors of the state. The spatial distribution of the objects under study in the feature space was analyzed using principle component analysis. The groups under study were shown to separate in full. Thus, the saliva analysis by the THz spectroscopy technique can be potentially used as a method of noninvasive diagnostics of the OLP.

  17. Cost-Effectiveness Analysis of Helicobacter pylori Diagnostic Methods in Patients with Atrophic Gastritis

    Directory of Open Access Journals (Sweden)

    Fumio Omata

    2017-01-01

    Full Text Available Background. There are several diagnostic methods for Helicobacter pylori (H. pylori infection. A cost-effective analysis is needed to decide on the optimal diagnostic method. The aim of this study was to determine a cost-effective diagnostic method in patients with atrophic gastritis (AG. Methods. A decision-analysis model including seven diagnostic methods was constructed for patients with AG diagnosed by esophagogastroduodenoscopy. Expected values of cost and effectiveness were calculated for each test. Results. If the prevalence of H. pylori in the patients with AG is 85% and CAM-resistant H. pylori is 30%, histology, stool H. pylori antigen (SHPAg, bacterial culture (BC, and urine H. pylori antibody (UHPAb were dominated by serum H. pylori IgG antibody (SHPAb, rapid urease test (RUT, and urea breath test (UBT. Among three undominated methods, the incremental cost-effective ratios (ICER of RUT versus SHPAb and UBT versus RUT were $214 and $1914, respectively. If the prevalence of CAM-sensitive H. pylori was less than 55%, BC was not dominated, but its H. pylori eradication success rate was 0.86. Conclusions. RUT was the most cost-effective at the current prevalence of CAM-resistant H. pylori. BC could not be selected due to its poor effectiveness even if CAM-resistant H. pylori was more than 45%.

  18. Prediction of miscarriage in women with viable intrauterine pregnancy-A systematic review and diagnostic accuracy meta-analysis.

    Science.gov (United States)

    Pillai, Rekha N; Konje, Justin C; Richardson, Matthew; Tincello, Douglas G; Potdar, Neelam

    2018-01-01

    Both ultrasound and biochemical markers either alone or in combination have been described in the literature for the prediction of miscarriage. We performed this systematic review and meta-analysis to determine the best combination of biochemical, ultrasound and demographic markers to predict miscarriage in women with viable intrauterine pregnancy. The electronic database search included Medline (1946-June 2017), Embase (1980-June 2017), CINAHL (1981-June 2017) and Cochrane library. Key MESH and Boolean terms were used for the search. Data extraction and collection was performed based on the eligibility criteria by two authors independently. Quality assessment of the individual studies was done using QUADAS 2 (Quality Assessment for Diagnostic Accuracy Studies-2: A Revised Tool) and statistical analysis performed using the Cochrane systematic review manager 5.3 and STATA vs.13.0. Due to the diversity of the combinations used for prediction in the included papers it was not possible to perform a meta-analysis on combination markers. Therefore, we proceeded to perform a meta-analysis on ultrasound markers alone to determine the best marker that can help to improve the diagnostic accuracy of predicting miscarriage in women with viable intrauterine pregnancy. The systematic review identified 18 eligible studies for the quantitative meta-analysis with a total of 5584 women. Among the ultrasound scan markers, fetal bradycardia (n=10 studies, n=1762 women) on hierarchical summary receiver operating characteristic showed sensitivity of 68.41%, specificity of 97.84%, positive likelihood ratio of 31.73 (indicating a large effect on increasing the probability of predicting miscarriage) and negative likelihood ratio of 0.32. In studies for women with threatened miscarriage (n=5 studies, n=771 women) fetal bradycardia showed further increase in sensitivity (84.18%) for miscarriage prediction. Although there is gestational age dependent variation in the fetal heart rate, a plot

  19. Mobile diagnostics: next-generation technologies for in vitro diagnostics.

    Science.gov (United States)

    Shin, Joonchul; Chakravarty, Sudesna; Choi, Wooseok; Lee, Kyungyeon; Han, Dongsik; Hwang, Hyundoo; Choi, Jaekyu; Jung, Hyo-Il

    2018-03-26

    The emergence of a wide range of applications of smartphones along with advances in 'liquid biopsy' has significantly propelled medical research particularly in the field of in vitro diagnostics (IVD). Herein, we have presented a detailed analysis of IVD, its associated critical concerns and probable solutions. It also demonstrates the transition in terms of analytes from minimally invasive (blood) to non-invasive (urine, saliva and sweat) and depicts how the different features of a smartphone can be integrated for specific diagnostic purposes. This review basically highlights recent advances in the applications of smartphone-based biosensors in IVD taking into account the following factors: accuracy and portability; quantitative and qualitative analysis; and centralization and decentralization tests. Furthermore, the critical concerns and future direction of diagnostics based on smartphones are also discussed.

  20. Potential diagnostic value of serum p53 antibody for detecting colorectal cancer: A meta-analysis.

    Science.gov (United States)

    Meng, Rongqin; Wang, Yang; He, Liang; He, Yuanqing; Du, Zedong

    2018-04-01

    Numerous studies have assessed the diagnostic value of serum p53 (s-p53) antibody in patients with colorectal cancer (CRC); however, results remain controversial. The present study aimed to comprehensively and quantitatively summarize the potential diagnostic value of s-p53 antibody in CRC. The present study utilized databases, including PubMed and EmBase, systematically regarding s-p53 antibody diagnosis in CRC, accessed on and prior to 31 July 2016. The quality of all the included studies was assessed using quality assessment of studies of diagnostic accuracy (QUADAS). The result of pooled sensitivity, pooled specificity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were analyzed and compared with overall accuracy measures using diagnostic odds ratios (DORs) and area under the curve (AUC) analysis. Publication bias and heterogeneity were also assessed. A total of 11 trials that enrolled a combined 3,392 participants were included in the meta-analysis. Approximately 72.73% (8/11) of the included studies were of high quality (QUADAS score >7), and all were retrospective case-control studies. The pooled sensitivity was 0.19 [95% confidence interval (CI), 0.18-0.21] and pooled specificity was 0.93 (95% CI, 0.92-0.94). Results also demonstrated a PLR of 4.56 (95% CI, 3.27-6.34), NLR of 0.78 (95% CI, 0.71-0.85) and DOR of 6.70 (95% CI, 4.59-9.76). The symmetrical summary receiver operating characteristic curve was 0.73. Furthermore, no evidence of publication bias or heterogeneity was observed in the meta-analysis. Meta-analysis data indicated that s-p53 antibody possesses potential diagnostic value for CRC. However, discrimination power was somewhat limited due to the low sensitivity.

  1. DIAGNOSTIC IMAGING IN A DIRECT-ACCESS SPORTS PHYSICAL THERAPY CLINIC: A 2-YEAR RETROSPECTIVE PRACTICE ANALYSIS.

    Science.gov (United States)

    Crowell, Michael S; Dedekam, Erik A; Johnson, Michael R; Dembowski, Scott C; Westrick, Richard B; Goss, Donald L

    2016-10-01

    While advanced diagnostic imaging is a large contributor to the growth in health care costs, direct-access to physical therapy is associated with decreased rates of diagnostic imaging. No study has systematically evaluated with evidence-based criteria the appropriateness of advanced diagnostic imaging, including magnetic resonance imaging (MRI), when ordered by physical therapists. The primary purpose of this study was to describe the appropriateness of magnetic resonance imaging (MRI) or magnetic resonance arthrogram (MRA) exams ordered by physical therapists in a direct-access sports physical therapy clinic. Retrospective observational study of practice. Greater than 80% of advanced diagnostic imaging orders would have an American College of Radiology (ACR) Appropriateness Criteria rating of greater than 6, indicating an imaging order that is usually appropriate. A 2-year retrospective analysis identified 108 MRI/MRA examination orders from four physical therapists. A board-certified radiologist determined the appropriateness of each order based on ACR appropriateness criteria. The principal investigator and co-investigator radiologist assessed agreement between the clinical diagnosis and MRI/surgical findings. Knee (31%) and shoulder (25%) injuries were the most common. Overall, 55% of injuries were acute. The mean ACR rating was 7.7; scores from six to nine have been considered appropriate orders and higher ratings are better. The percentage of orders complying with ACR appropriateness criteria was 83.2%. Physical therapist's clinical diagnosis was confirmed by MRI/MRA findings in 64.8% of cases and was confirmed by surgical findings in 90% of cases. Physical therapists providing musculoskeletal primary care in a direct-access sports physical therapy clinic appropriately ordered advanced diagnostic imaging in over 80% of cases. Future research should prospectively compare physical therapist appropriateness and utilization to other groups of providers and

  2. Qualitative Analysis of Diagnostic Value of 24-h Proteinuria for Preeclampsia

    Directory of Open Access Journals (Sweden)

    Xu Zhuang

    2015-01-01

    Full Text Available Background: Preeclampsia (PE is a serious idiopathic disease posing a threat to both mothers and fetuses′ lives during pregnancy, whose main diagnostic criteria include hypertension with proteinuria. However, American College of Obstetricians and Gynecologists (ACOG updated the diagnostic criteria for PE and reduced the diagnostic value of proteinuria for patients with PE. Qualitative analysis of the diagnostic value of 24-h proteinuria for patients with PE in China was conducted to evaluate the diagnostic criteria value in the latest ACOG guideline. Methods: Complete clinical data of 65 patients with hypertensive disorder in pregnancy (HDP were collected. All patients were delivered to and hospitalized in Renji Hospital. Adverse outcome was defined in case of the emergence of any serious complication for a mother or the fetus. A retrospective study was conducted according to ACOG guideline, to analyze the relationship between each diagnostic criteria of ACOG guideline and maternal and perinatal outcomes. Spearman correlation test was used to detect the association between each diagnostic criterion, its corresponding value, and the adverse pregnancy outcome. Logistic regression was performed to verify the result of Spearman correlation test. Results: Of 65 HDP patients, the percentage of adverse pregnancy outcome was 63.1%. Adverse pregnancy outcomes constitute diversification. There were 55 cases with 24-h proteinuria value ≥0.3 g, of which the adverse outcome rate was 74.5%. While adverse pregnancy outcomes did not appear in the rest 10 HDP patients with proteinuria <0.3 g/24 h. The statistic difference was significant (P = 0.000. However, no significant difference was found in other criteria groups (impaired liver function: P = 0.417; renal insufficiency: P = 0.194; thrombocytopenia: P = 0.079; and cerebral or visual symptoms: P = 0.296. The correlation coefficient between 24-h proteinuria ≥0.3 g and adverse pregnancy outcomes was 0

  3. Diagnostic value of N-terminal pro-brain natriuretic peptide for pleural effusion due to heart failure: a meta-analysis.

    Science.gov (United States)

    Zhou, Q; Ye, Z J; Su, Y; Zhang, J C; Shi, H Z

    2010-08-01

    N-terminal pro-brain natriuretic peptide (NT-proBNP) is a biomarker useful in diagnosis of pleural effusion due to heart failure. Thus far, its overall diagnostic accuracy has not been systematically reviewed. The aim of the present meta-analysis was to establish the overall diagnostic accuracy of the measurement of pleural NT-proBNP for identifying pleural effusion due to heart failure. After a systematic review of English-language studies, sensitivity, specificity, and other measures of accuracy of NT-proBNP concentrations in pleural fluid in the diagnosis of pleural effusion resulting from heart failure were pooled using fixed-effects models. Summary receiver operating characteristic curves were used to summarise overall test performance. Eight publications met the inclusion criteria. The summary estimates for pleural NT-proBNP in the diagnosis of pleural effusion attributable to heart failure were: sensitivity 0.95 (95% CI 0.92 to 0.97), specificity 0.94 (0.92 to 0.96), positive likelihood ratio 14.12 (10.23 to 19.51), negative likelihood ratio 0.06 (0.04 to 0.09) and diagnostic OR 213.87 (122.50 to 373.40). NT-proBNP levels in pleural fluid showed a high diagnostic accuracy and may help accurately differentiate cardiac from non-cardiac conditions in patients presenting with pleural effusion.

  4. [Laboratory diagnostics in transient loss of consciousness : Serum lactate compared to serum creatine kinase as diagnostic indicator for generalized tonic-clonic seizures].

    Science.gov (United States)

    Dafotakis, M; Heckelmann, J; Zechbauer, S; Litmathe, J; Brokmann, J; Willmes, K; Surges, R; Matz, O

    2018-03-21

    Laboratory parameters can help in the differential diagnostics of acute episodes of transient loss of consciousness. Especially serum lactate and serum creatine kinase (CK) levels may provide valuable hints to distinguish generalized tonic-clonic seizures (GTCS) from syncope. Serum lactate levels at admission and CK levels 10-48 h after the episodes that led to admission were compared between patients with GTCS (n = 30) and those with syncope (n = 15). In addition, sensitivity and specificity of lactate and CK as diagnostic markers for syncope and GTCS were determined. The serum lactate and serum CK levels were significantly increased in patients with GTCS as compared to syncope patients (serum lactate: p lactate as an indicator for GTCS was 0.94 (95% confidence interval [CI] 0.88-1.0). For CK the receiver operating characteristics (ROC) analysis produced an AUC of only 0.77 (95% CI: 0.63-0.9). The determination of the lactate value as point-of-care diagnostics appears to be highly relevant in the rapid clarification of unclear episodes with transient loss of consciousness. The CK level at follow-up is also suitable for distinguishing GTCS from syncope but is inferior to the serum lactate value.

  5. Evaluation of Analysis by Cross-Validation, Part II: Diagnostic and Optimization of Analysis Error Covariance

    Directory of Open Access Journals (Sweden)

    Richard Ménard

    2018-02-01

    Full Text Available We present a general theory of estimation of analysis error covariances based on cross-validation as well as a geometric interpretation of the method. In particular, we use the variance of passive observation-minus-analysis residuals and show that the true analysis error variance can be estimated, without relying on the optimality assumption. This approach is used to obtain near optimal analyses that are then used to evaluate the air quality analysis error using several different methods at active and passive observation sites. We compare the estimates according to the method of Hollingsworth-Lönnberg, Desroziers et al., a new diagnostic we developed, and the perceived analysis error computed from the analysis scheme, to conclude that, as long as the analysis is near optimal, all estimates agree within a certain error margin.

  6. Do blood tests cause anemia in hospitalized patients? The effect of diagnostic phlebotomy on hemoglobin and hematocrit levels.

    Science.gov (United States)

    Thavendiranathan, Paaladinesh; Bagai, Akshay; Ebidia, Albert; Detsky, Allan S; Choudhry, Niteesh K

    2005-06-01

    To determine whether phlebotomy contributes to changes in hemoglobin and hematocrit levels in hospitalized general internal medicine patients. Retrospective cohort study. General internal medicine inpatient service at a tertiary care hospital. All adult patients discharged from the Toronto General Hospital's internal medicine service between January 1 and June 30, 2001. A total of 989 hospitalizations were reviewed and 404 hospitalizations were included in our analysis. Mean (SD) hemoglobin and hematocrit changes during hospitalization were 7.9 (12.6) g/L (Phemoglobin and hematocrit were predicted by the volume of phlebotomy, length of hospital stay, admission hemoglobin/hematocrit value, age, Charlson comorbidity index, and admission intravascular volume status. The volume of phlebotomy remained a strong predictor of drop in hemoglobin and hematocrit after adjusting for other predictors using multivariate analysis (Phemoglobin and hematocrit of 7.0 g/L and 1.9%, respectively. Phlebotomy is highly associated with changes in hemoglobin and hematocrit levels for patients admitted to an internal medicine service and can contribute to anemia. This anemia, in turn, may have significant consequences, especially for patients with cardiorespiratory diseases. Knowing the expected changes in hemoglobin and hematocrit due to diagnostic phlebotomy will help guide when to investigate anemia in hospitalized patients.

  7. Towards diagnostic metagenomics of Campylobacter in fecal samples

    DEFF Research Database (Denmark)

    Andersen, Sandra Christine; Kiil, Kristoffer; Harder, Christoffer Bugge

    2017-01-01

    The development of diagnostic metagenomics is driven by the need for universal, culture-independent methods for detection and characterization of pathogens to substitute the time-consuming, organism-specific, and often culture-based laboratory procedures for epidemiological source-tracing. Some...... of the challenges in diagnostic metagenomics are, that it requires a great next-generation sequencing depth and unautomated data analysis. DNA from human fecal samples spiked with 7.75 × 101-7.75 × 107 colony forming unit (CFU)/ml Campylobacter jejuni and chicken fecal samples spiked with 1 × 102-1 × 106 CFU...... Campylobacter in all the clinical samples. Sensitivity in diagnostic metagenomics is improving and has reached a clinically relevant level. There are still challenges to overcome before real-time diagnostic metagenomics can replace quantitative polymerase chain reaction (qPCR) or culture-based surveillance...

  8. Revisited diagnostics of hereditary epidermolysis bullosa

    Directory of Open Access Journals (Sweden)

    V. I. Albanova

    2014-01-01

    Full Text Available Hereditary epidermolysis bullosa is a big group of hereditary diseases with the main manifestations in the form of blisters on the skin and mucous coat after slight mechanical injuries. It is not always possible to diagnose this disease based on the clinical picture. The article discusses current laboratory diagnostics methods for hereditary epidermolysis bullosa including immunofluorescence antigen mapping (IFM, transmission electron microscopy (TEM and genetic analysis (molecular or DNA diagnostics as well as their advantages and disadvantages. TEM determines the micro splitting level and nature of ultrafine changes in the area of the dermoepidermal junction; at the same time, such tests need special expensive equipment. Substantial experience is also needed to analyze the resulting submicroscopic images. IFM determines whether expression of the affected protein related to the disease development is reduced or absent; however, invalid (false positive or false negative results can be obtained in patients with the reduced expression of the affected protein. Genetic analysis plays a key role for prenatal diagnostics. Therefore, to make an exact diagnosis of hereditary epidermolysis bullosa, it is expedient to apply IFM, TEM and genetic analysis. The need to set an exact diagnosis of the disease is related to the fact that the promising treatment methods being currently developed are aimed at treating patients with certain forms of the disease.

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

    Directory of Open Access Journals (Sweden)

    Michaela Dušková

    2016-01-01

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

  10. System for simulating fluctuation diagnostics for application to turbulence computations

    International Nuclear Information System (INIS)

    Bravenec, R.V.; Nevins, W.M.

    2006-01-01

    Present-day nonlinear microstability codes are able to compute the saturated fluctuations of a turbulent fluid versus space and time, whether the fluid be liquid, gas, or plasma. They are therefore able to determine turbulence-induced fluid (or particle) and energy fluxes. These codes, however, must be tested against experimental data not only with respect to transport but also characteristics of the fluctuations. The latter is challenging because of limitations in the diagnostics (e.g., finite spatial resolution) and the fact that the diagnostics typically do not measure exactly the quantities that the codes compute. In this work, we present a system based on IDL registered analysis and visualization software in which user-supplied 'diagnostic filters' are applied to the code outputs to generate simulated diagnostic signals. The same analysis techniques as applied to the measurements, e.g., digital time-series analysis, may then be applied to the synthesized signals. Their statistical properties, such as rms fluctuation level, mean wave numbers, phase and group velocities, correlation lengths and times, and in some cases full S(k,ω) spectra, can then be compared directly to those of the measurements

  11. The JET diagnostic fast central acquisition and trigger system (abstract)

    Science.gov (United States)

    Edwards, A. W.; Blackler, K.

    1995-01-01

    Most plasma physics diagnostics sample at a fixed frequency that is normally matched to available memory limits. This technique is not appropriate for long pulse machines such as JET where sampling frequencies of hundreds of kHz are required to diagnose very fast events. As a result of work using real-time event selection within the previous JET soft x-ray diagnostic, a single data acquisition and event triggering system for all suitable fast diagnostics, the fast central acquisition and trigger system (Fast CATS), has been developed for JET. The front-end analog-to-digital conversion (ADC) part samples all channels at 250 kHz, with a 100 kHz pass band and a stop band of 125 kHz. The back-end data collection system is based around Texas Instruments TMS320C40 microprocessors. Within this system, two levels of trigger algorithms are able to evaluate data. The first level typically analyzes data on a per diagnostic and individual channel basis. The second level looks at the data from one or more diagnostics in a window around the time of interest flagged by the first level system. Selection criteria defined by the diagnosticians are then imposed on the results from the second level to decide whether that data should be kept. The use of such a system involving intelligent real time trigger algorithms and fast data analysis will improve both the quantity and quality of JET diagnostic data, while providing valuable input to the design of data acquisition systems for very long pulse machines such as ITER. This paper will give an overview of the various elements of this new system. In addition, first results from this system following the restart of JET operation will be presented.

  12. Outcomes of non-invasive diagnostic modalities for the detection of coronary artery disease: network meta-analysis of diagnostic randomised controlled trials

    Science.gov (United States)

    Siontis, George CM; Mavridis, Dimitris; Greenwood, John P; Coles, Bernadette; Nikolakopoulou, Adriani; Jüni, Peter; Salanti, Georgia

    2018-01-01

    Abstract Objective To evaluate differences in downstream testing, coronary revascularisation, and clinical outcomes following non-invasive diagnostic modalities used to detect coronary artery disease. Design Systematic review and network meta-analysis. Data sources Medline, Medline in process, Embase, Cochrane Library for clinical trials, PubMed, Web of Science, SCOPUS, WHO International Clinical Trials Registry Platform, and Clinicaltrials.gov. Eligibility criteria for selecting studies Diagnostic randomised controlled trials comparing non-invasive diagnostic modalities in patients presenting with symptoms suggestive of low risk acute coronary syndrome or stable coronary artery disease. Data synthesis A random effects network meta-analysis synthesised available evidence from trials evaluating the effect of non-invasive diagnostic modalities on downstream testing and patient oriented outcomes in patients with suspected coronary artery disease. Modalities included exercise electrocardiograms, stress echocardiography, single photon emission computed tomography-myocardial perfusion imaging, real time myocardial contrast echocardiography, coronary computed tomographic angiography, and cardiovascular magnetic resonance. Unpublished outcome data were obtained from 11 trials. Results 18 trials of patients with low risk acute coronary syndrome (n=11 329) and 12 trials of those with suspected stable coronary artery disease (n=22 062) were included. Among patients with low risk acute coronary syndrome, stress echocardiography, cardiovascular magnetic resonance, and exercise electrocardiograms resulted in fewer invasive referrals for coronary angiography than coronary computed tomographic angiography (odds ratio 0.28 (95% confidence interval 0.14 to 0.57), 0.32 (0.15 to 0.71), and 0.53 (0.28 to 1.00), respectively). There was no effect on the subsequent risk of myocardial infarction, but estimates were imprecise. Heterogeneity and inconsistency were low. In patients with

  13. Diagnostic imaging for chronic plantar heel pain: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Barrett Joanna T

    2009-11-01

    Full Text Available Abstract Background Chronic plantar heel pain (CPHP is a generalised term used to describe a range of undifferentiated conditions affecting the plantar heel. Plantar fasciitis is reported as the most common cause and the terms are frequently used interchangeably in the literature. Diagnostic imaging has been used by many researchers and practitioners to investigate the involvement of specific anatomical structures in CPHP. These observations help to explain the underlying pathology of the disorder, and are of benefit in forming an accurate diagnosis and targeted treatment plan. The purpose of this systematic review was to investigate the diagnostic imaging features associated with CPHP, and evaluate study findings by meta-analysis where appropriate. Methods Bibliographic databases including Medline, Embase, CINAHL, SportDiscus and The Cochrane Library were searched electronically on March 25, 2009. Eligible articles were required to report imaging findings in participants with CPHP unrelated to inflammatory arthritis, and to compare these findings with a control group. Methodological quality was evaluated by use of the Quality Index as described by Downs and Black. Meta-analysis of study data was conducted where appropriate. Results Plantar fascia thickness as measured by ultrasonography was the most widely reported imaging feature. Meta-analysis revealed that the plantar fascia of CPHP participants was 2.16 mm thicker than control participants (95% CI = 1.60 to 2.71 mm, P P = 0.01. CPHP participants were also more likely to show radiographic evidence of subcalcaneal spur than control participants (OR = 8.52, 95% CI = 4.08 to 17.77, P Conclusion This systematic review has identified 23 studies investigating the diagnostic imaging appearance of the plantar fascia and inferior calcaneum in people with CPHP. Analysis of these studies found that people with CPHP are likely to have a thickened plantar fascia with associated fluid collection, and that

  14. Continuous data acquisition with online analysis for the Wendelstein 7-X magnetic diagnostics

    International Nuclear Information System (INIS)

    Hennig, Ch.; Werner, A.; Marquardt, M.; Bluhm, T.; Kroiss, H.; Kuehner, G.; Heimann, P.; Maier, J.; Riemann, H.; Zilker, M.

    2008-01-01

    The coupling of continuous data acquisition and continuous online analysis keeping up with the acquisition is one of the features the W7-X data acquisition system is designed for. As proof of principle of this concept the magnetic diagnostics have been implemented. The magnetic diagnostics measure time derivatives of the magnetic fluxes and the signals have to be time integrated accordingly. Both measurement and analysis tasks are executed on a single PC based system. The configuration of both hard- and software of the system is presented. Special focuses are the task of software integration of a user supplied online analysis function into the data acquisition system and the incorporation of the complete system into the W7-X segment concept in use by the control system. The complete installation has been tested at the WEGA Stellarator experiment. Because WEGA is capable of continuous steady state plasma operation the practical suitability of the installation for W7-X could be demonstrated successfully

  15. Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: A practical review for clinical researchers-Part II. general guidance and tips

    International Nuclear Information System (INIS)

    Kim, Kyung Won; Choi, Sang Hyun; Huh, Jimi; Park, Seong Ho; Lee, June Young

    2015-01-01

    Meta-analysis of diagnostic test accuracy studies differs from the usual meta-analysis of therapeutic/interventional studies in that, it is required to simultaneously analyze a pair of two outcome measures such as sensitivity and specificity, instead of a single outcome. Since sensitivity and specificity are generally inversely correlated and could be affected by a threshold effect, more sophisticated statistical methods are required for the meta-analysis of diagnostic test accuracy. Hierarchical models including the bivariate model and the hierarchical summary receiver operating characteristic model are increasingly being accepted as standard methods for meta-analysis of diagnostic test accuracy studies. We provide a conceptual review of statistical methods currently used and recommended for meta-analysis of diagnostic test accuracy studies. This article could serve as a methodological reference for those who perform systematic review and meta-analysis of diagnostic test accuracy studies

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  18. Diagnostic accuracy of atypical p-ANCA in autoimmune hepatitis using ROC- and multivariate regression analysis.

    Science.gov (United States)

    Terjung, B; Bogsch, F; Klein, R; Söhne, J; Reichel, C; Wasmuth, J-C; Beuers, U; Sauerbruch, T; Spengler, U

    2004-09-29

    Antineutrophil cytoplasmic antibodies (atypical p-ANCA) are detected at high prevalence in sera from patients with autoimmune hepatitis (AIH), but their diagnostic relevance for AIH has not been systematically evaluated so far. Here, we studied sera from 357 patients with autoimmune (autoimmune hepatitis n=175, primary sclerosing cholangitis (PSC) n=35, primary biliary cirrhosis n=45), non-autoimmune chronic liver disease (alcoholic liver cirrhosis n=62; chronic hepatitis C virus infection (HCV) n=21) or healthy controls (n=19) for the presence of various non-organ specific autoantibodies. Atypical p-ANCA, antinuclear antibodies (ANA), antibodies against smooth muscles (SMA), antibodies against liver/kidney microsomes (anti-Lkm1) and antimitochondrial antibodies (AMA) were detected by indirect immunofluorescence microscopy, antibodies against the M2 antigen (anti-M2), antibodies against soluble liver antigen (anti-SLA/LP) and anti-Lkm1 by using enzyme linked immunosorbent assays. To define the diagnostic precision of the autoantibodies, results of autoantibody testing were analyzed by receiver operating characteristics (ROC) and forward conditional logistic regression analysis. Atypical p-ANCA were detected at high prevalence in sera from patients with AIH (81%) and PSC (94%). ROC- and logistic regression analysis revealed atypical p-ANCA and SMA, but not ANA as significant diagnostic seromarkers for AIH (atypical p-ANCA: AUC 0.754+/-0.026, odds ratio [OR] 3.4; SMA: 0.652+/-0.028, OR 4.1). Atypical p-ANCA also emerged as the only diagnostically relevant seromarker for PSC (AUC 0.690+/-0.04, OR 3.4). None of the tested antibodies yielded a significant diagnostic accuracy for patients with alcoholic liver cirrhosis, HCV or healthy controls. Atypical p-ANCA along with SMA represent a seromarker with high diagnostic accuracy for AIH and should be explicitly considered in a revised version of the diagnostic score for AIH.

  19. Real-time measurement and control at JET signal processing and physics analysis for diagnostics

    International Nuclear Information System (INIS)

    Felton, R.; Joffrin, E.; Murari, A.

    2005-01-01

    To meet the requirements of the scientific programme, the EFDA JET real-time measurement and control project has developed an integrated set of real-time plasma measurements, experiment control and communication facilities. Traditional experiments collected instrument data during the plasma pulse and calculated physics data after the pulse. The challenge for continuous tokamak operation is to calculate the physics data in real-time, keeping up with the evolution of the plasma. In JET, many plasma diagnostics have been augmented with extra data acquisition and signal-processing systems so that they can both capture instrument data for conventional post-pulse analysis and calculate calibrated, validated physics results in real-time. During the pulse, the systems send sampled data sets into a network, which distributes the data to several destinations. The receiving systems may do further analysis, integrating data from several measurements, or may control the plasma scenario by heating or fuelling. The simplest real-time diagnostic systems apply scale factors to the signals, as with the electron cyclotron emission (ECE) diagnostic's 96 tuned radiometer channels, giving the electron temperature profile. In various spectroscopy diagnostics, spectral features are least-squares-fitted to measure spectra from several lines of sight, within 50 ms. Ion temperatures and rotation speed can be calculated from the line widths and shifts. For diagnostics using modulation techniques, the systems implement digital-signal processing phase trackers, lock-in amplifiers and filters, e.g., the far infrared (FIR) interferometer samples 15 channels at 400 kHz for 30 s, i.e., six million samples per second. Diagnostics have specific lines of sight, spatial channels, and various sampling rates. The heating/fuelling systems have relatively coarse spatial localisation. Analysis systems have been developed to integrate the basic physics data into smaller sets of controllable parameters on a

  20. An update on the use of cerebrospinal fluid analysis as a diagnostic tool in multiple sclerosis.

    Science.gov (United States)

    Gastaldi, Matteo; Zardini, Elisabetta; Franciotta, Diego

    2017-01-01

    Intrathecal B-lymphocyte activation is a hallmark of multiple sclerosis (MS), a multi-factorial inflammatory-demyelinating disease of the central nervous system. Such activation has a counterpart in the cerebrospinal fluid (CSF) oligoclonal IgG bands (OCB), whose diagnostic role in MS has been downgraded within the current McDonald's criteria. With a theoretico-practical approach, the authors review the physiopathological basis of the CSF dynamics, and the state-of-the-art of routine CSF analysis and CSF biomarkers in MS. Areas covered: The authors discuss pros and cons of CSF analysis, including critical evaluations of both well-established, and promising diagnostic and prognostic laboratory tools. New acquisitions on the CSF and cerebral interstitial fluid dynamics are also presented. The authors searched the PubMed database for English-language articles reported between January 2010 and June 2016, using the key words 'multiple sclerosis', 'cerebrospinal fluid', 'oligoclonal bands'. Reference lists of relevant articles were scanned for additional studies. Expert commentary: The availability of performing high-quality, routine CSF tests in specialized laboratories, the emerging potential of novel CSF biomarkers, and the trend for early treatments should induce a reappraisal of CSF analysis for diagnostic and prognostic purposes in MS. Further procedural and methodological improvements seem to be necessary in both research and translational diagnostic CSF settings.

  1. Diagnostic value of BRAFV600E-mutation analysis in fine-needle aspiration of thyroid nodules: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Su X

    2016-04-01

    Full Text Available Xingyun Su,1 Xiaoxia Jiang,1 Xin Xu,1 Weibin Wang,1 Xiaodong Teng,2 Anwen Shao,3 Lisong Teng1 1Department of Surgical Oncology, 2Department of Pathology, First Affiliated Hospital, 3Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China Abstract: Fine-needle aspiration (FNA is a reliable method for preoperative diagnosis of thyroid nodules; however, about 10%–40% nodules are classified as indeterminate. The BRAFV600E mutation is the most promising marker for thyroid FNA. This meta-analysis was conducted to investigate the diagnostic value of BRAFV600E analysis in thyroid FNA, especially the indeterminate cases. Systematic searches were performed in PubMed, Web of Science, Scopus, Ovid, Elsevier, and the Cochrane Library databases for relevant studies prior to June 2015, and a total of 88 studies were ultimately included in this meta-analysis. Compared with FNA cytology, the synergism of BRAFV600E testing increased the diagnostic sensitivity from 81.4% to 87.4% and decreased the false-negative rate from 8% to 5.2%. In the indeterminate group, the mutation rate of BRAFV600E was 23% and varied in different subcategories (43.2% in suspicious for malignant cells [SMC], 13.77% in atypia of undetermined significance/follicular lesion of undetermined significance [AUS/FLUS], and 4.43% in follicular neoplasm/suspicious for follicular neoplasm [FN/SFN]. The sensitivity of BRAFV600E analysis was higher in SMC than that in AUS/FLUS and FN/SFN cases (59.4% vs 40.1% vs 19.5% respectively, while specificity was opposite (86.1% vs 99.5% vs 99.7% respectively. The areas under the summary receiver-operating characteristic curve also confirmed the diagnostic value of BRAFV600E testing in SMC and AUS/FLUS rather than FN/SFN cases. Therefore, BRAFV600E analysis can improve the diagnostic accuracy of thyroid FNA, especially indeterminate cases classified as SMC, and select malignancy

  2. Regression models of reactor diagnostic signals

    International Nuclear Information System (INIS)

    Vavrin, J.

    1989-01-01

    The application is described of an autoregression model as the simplest regression model of diagnostic signals in experimental analysis of diagnostic systems, in in-service monitoring of normal and anomalous conditions and their diagnostics. The method of diagnostics is described using a regression type diagnostic data base and regression spectral diagnostics. The diagnostics is described of neutron noise signals from anomalous modes in the experimental fuel assembly of a reactor. (author)

  3. LOGICAL CONDITIONS ANALYSIS METHOD FOR DIAGNOSTIC TEST RESULTS DECODING APPLIED TO COMPETENCE ELEMENTS PROFICIENCY

    Directory of Open Access Journals (Sweden)

    V. I. Freyman

    2015-11-01

    Full Text Available Subject of Research.Representation features of education results for competence-based educational programs are analyzed. Solution importance of decoding and proficiency estimation for elements and components of discipline parts of competences is shown. The purpose and objectives of research are formulated. Methods. The paper deals with methods of mathematical logic, Boolean algebra, and parametrical analysis of complex diagnostic test results, that controls proficiency of some discipline competence elements. Results. The method of logical conditions analysis is created. It will give the possibility to formulate logical conditions for proficiency determination of each discipline competence element, controlled by complex diagnostic test. Normalized test result is divided into noncrossing zones; a logical condition about controlled elements proficiency is formulated for each of them. Summarized characteristics for test result zones are imposed. An example of logical conditions forming for diagnostic test with preset features is provided. Practical Relevance. The proposed method of logical conditions analysis is applied in the decoding algorithm of proficiency test diagnosis for discipline competence elements. It will give the possibility to automate the search procedure for elements with insufficient proficiency, and is also usable for estimation of education results of a discipline or a component of competence-based educational program.

  4. Sensitive KIT D816V mutation analysis of blood as a diagnostic test in mastocytosis

    DEFF Research Database (Denmark)

    Kielsgaard Kristensen, Thomas; Vestergaard, Hanne; Bindslev-Jensen, Carsten

    2014-01-01

    The recent progress in sensitive KIT D816V mutation analysis suggests that mutation analysis of peripheral blood (PB) represents a promising diagnostic test in mastocytosis. However, there is a need for systematic assessment of the analytical sensitivity and specificity of the approach in order...... to establish its value in clinical use. We therefore evaluated sensitive KIT D816V mutation analysis of PB as a diagnostic test in an entire case-series of adults with mastocytosis. We demonstrate for the first time that by using a sufficiently sensitive KIT D816V mutation analysis, it is possible to detect...... the mutation in PB in nearly all adult mastocytosis patients. The mutation was detected in PB in 78 of 83 systemic mastocytosis (94%) and 3 of 4 cutaneous mastocytosis patients (75%). The test was 100% specific as determined by analysis of clinically relevant control patients who all tested negative. Mutation...

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  6. Diagnostic and prognostic value of carcinoembryonic antigen in pancreatic cancer: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Meng Q

    2017-09-01

    Full Text Available Qingcai Meng,1–3,* Si Shi,1–3,* Chen Liang,1–3,* Dingkong Liang,1–3 Wenyan Xu,1–3 Shunrong Ji,1–3 Bo Zhang,1–3 Quanxing Ni,1–3 Jin Xu,1–3 Xianjun Yu1–3 1Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, 2Department of Oncology, Shanghai Medical College, 3Pancreatic Cancer Institute, Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: Carcinoembryonic antigen (CEA is one of the most widely used tumor markers and is increased in 30%–60% of patients with pancreatic cancer. Although carbohydrate antigen 19-9 (CA19-9 is the most important serum biomarker in pancreatic cancer, the diagnostic and prognostic value of CEA is gradually being recognized.Materials and methods: The MEDLINE, EMBASE, and Web of Science databases were searched for related literature published until January 2017. Diagnostic accuracy variables were pooled using the Meta-Disc software. The pooled hazard ratios (HRs for prognostic data were calculated and analyzed using Stata software.Results: A total of 3,650 participants enrolled in 19 studies met our inclusion criteria. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of a CEA-based panel were 0.45 (95% confidence interval [CI], 0.41–0.50, 0.89 (95% CI, 0.86–0.91, 5.39 (95% CI, 3.16–9.18, and 0.55 (95% CI, 0.41–0.72, respectively. The area under the curve (AUC, 0.90 and Q-value (0.84 of the CEA-based panel indicated a significantly higher diagnostic accuracy compared with CEA or CA19-9 alone. Moreover, there was also a significant association between high levels of CEA and worse overall survival (HR, 1.43; 95% CI, 1.31–1.56.Conclusion: Our meta-analysis indicated that elevated serum CEA level, as a vital supplementary to CA19-9, can play an important role in the clinical diagnosis of pancreatic cancer patients and predict poor prognosis. Keywords: carcinoembryonic

  7. Bayesian analysis of longitudinal Johne's disease diagnostic data without a gold standard test

    DEFF Research Database (Denmark)

    Wang, C.; Turnbull, B.W.; Nielsen, Søren Saxmose

    2011-01-01

    the posterior estimates of the model parameters that provide the basis for inference concerning the accuracy of the diagnostic procedure. Based on the Bayesian approach, the posterior probability distribution of the change-point onset time can be obtained and used as a criterion for infection diagnosis......-point process with a Weibull survival hazard function was used to model the progression of the hidden disease status. The model adjusted for the fixed effects of covariate variables and random effects of subject on the diagnostic testing procedure. Markov chain Monte Carlo methods were used to compute....... An application is presented to an analysis of ELISA and fecal culture test outcomes in the diagnostic testing of paratuberculosis (Johne's disease) for a Danish longitudinal study from January 2000 to March 2003. The posterior probability criterion based on the Bayesian model with 4 repeated observations has...

  8. Topical Conference on High Temperature Plasma Diagnostics, 7th, Napa, CA, Mar. 13-17, 1988, Proceedings

    International Nuclear Information System (INIS)

    Luhmann, N.C. Jr.; Peebles, W.A.

    1988-01-01

    Various papers concerning scientific instruments are presented. The general topics addressed include: laser scattering and optical diagnostics, collective scattering and interferometry, millimeter wave and current profile measurements, particle-based diagnostics, data acquisition and analysis, X-ray diagnostics, and particle- and photon-based diagnostics. Individual subjects discussed include: atomic hydrogen density measurements in an ion source plasma using VUV absorption spectrometer, resonant diagnostics of laser-produced Ba plasmas, radiative and diffusional effects to the population densities of the excited-state atoms in hydrogen plasma, and Watt-level millimeter-wave monolithic diode-grid frequency multipliers

  9. Diagnostic system and diagnostic experiences at the Paks Nuclear Power Plant

    International Nuclear Information System (INIS)

    Katona, Tamas

    1986-01-01

    The major functions of the diagnostic system of the first two units of the Paks Nuclear Power Plant are as follows: monitoring the mechanical integrity of the reactor and the primary coolant circuit by means of vibration diagnostics; leakage detection of the primary coolant circuit by means of high frequency sonic analysis; loose parts monitoring based on the analysis of high frequency signals of acceleration detectors; and monitoring the vibration state of the turbines and rotary machines by the latter method or by a procedure based on the detection of mechanical vibrations. Up-to-date vibration diagnostics is based on the information supplied by either acceleration detectors or pressure fluctuation detectors, or in-core and ex-core neutron detectors. (V.N.)

  10. A Review of Frequency Response Analysis Methods for Power Transformer Diagnostics

    Directory of Open Access Journals (Sweden)

    Saleh Alsuhaibani

    2016-10-01

    Full Text Available Power transformers play a critical role in electric power networks. Such transformers can suffer failures due to multiple stresses and aging. Thus, assessment of condition and diagnostic techniques are of great importance for improving power network reliability and service continuity. Several techniques are available to diagnose the faults within the power transformer. Frequency response analysis (FRA method is a powerful technique for diagnosing transformer winding deformation and several other types of problems that are caused during manufacture, transportation, installation and/or service life. This paper provides a comprehensive review on FRA methods and their applications in diagnostics and fault identification for power transformers. The paper discusses theory and applications of FRA methods as well as various issues and challenges faced in the application of this method.

  11. Investigation into diagnostic agreement using automated computer-assisted histopathology pattern recognition image analysis

    Directory of Open Access Journals (Sweden)

    Joshua D Webster

    2012-01-01

    Full Text Available The extent to which histopathology pattern recognition image analysis (PRIA agrees with microscopic assessment has not been established. Thus, a commercial PRIA platform was evaluated in two applications using whole-slide images. Substantial agreement, lacking significant constant or proportional errors, between PRIA and manual morphometric image segmentation was obtained for pulmonary metastatic cancer areas (Passing/Bablok regression. Bland-Altman analysis indicated heteroscedastic measurements and tendency toward increasing variance with increasing tumor burden, but no significant trend in mean bias. The average between-methods percent tumor content difference was -0.64. Analysis of between-methods measurement differences relative to the percent tumor magnitude revealed that method disagreement had an impact primarily in the smallest measurements (tumor burden 0.988, indicating high reproducibility for both methods, yet PRIA reproducibility was superior (C.V.: PRIA = 7.4, manual = 17.1. Evaluation of PRIA on morphologically complex teratomas led to diagnostic agreement with pathologist assessments of pluripotency on subsets of teratomas. Accommodation of the diversity of teratoma histologic features frequently resulted in detrimental trade-offs, increasing PRIA error elsewhere in images. PRIA error was nonrandom and influenced by variations in histomorphology. File-size limitations encountered while training algorithms and consequences of spectral image processing dominance contributed to diagnostic inaccuracies experienced for some teratomas. PRIA appeared better suited for tissues with limited phenotypic diversity. Technical improvements may enhance diagnostic agreement, and consistent pathologist input will benefit further development and application of PRIA.

  12. Investigation into diagnostic agreement using automated computer-assisted histopathology pattern recognition image analysis.

    Science.gov (United States)

    Webster, Joshua D; Michalowski, Aleksandra M; Dwyer, Jennifer E; Corps, Kara N; Wei, Bih-Rong; Juopperi, Tarja; Hoover, Shelley B; Simpson, R Mark

    2012-01-01

    The extent to which histopathology pattern recognition image analysis (PRIA) agrees with microscopic assessment has not been established. Thus, a commercial PRIA platform was evaluated in two applications using whole-slide images. Substantial agreement, lacking significant constant or proportional errors, between PRIA and manual morphometric image segmentation was obtained for pulmonary metastatic cancer areas (Passing/Bablok regression). Bland-Altman analysis indicated heteroscedastic measurements and tendency toward increasing variance with increasing tumor burden, but no significant trend in mean bias. The average between-methods percent tumor content difference was -0.64. Analysis of between-methods measurement differences relative to the percent tumor magnitude revealed that method disagreement had an impact primarily in the smallest measurements (tumor burden 0.988, indicating high reproducibility for both methods, yet PRIA reproducibility was superior (C.V.: PRIA = 7.4, manual = 17.1). Evaluation of PRIA on morphologically complex teratomas led to diagnostic agreement with pathologist assessments of pluripotency on subsets of teratomas. Accommodation of the diversity of teratoma histologic features frequently resulted in detrimental trade-offs, increasing PRIA error elsewhere in images. PRIA error was nonrandom and influenced by variations in histomorphology. File-size limitations encountered while training algorithms and consequences of spectral image processing dominance contributed to diagnostic inaccuracies experienced for some teratomas. PRIA appeared better suited for tissues with limited phenotypic diversity. Technical improvements may enhance diagnostic agreement, and consistent pathologist input will benefit further development and application of PRIA.

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

    Directory of Open Access Journals (Sweden)

    Helen L Storey

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

  14. Diagnostic tests’ decision-making rules based upon analysis of ROC-curves

    Directory of Open Access Journals (Sweden)

    Л. В. Батюк

    2015-10-01

    Full Text Available In this paper we propose the model which substantiates diagnostics decision making based on the analysis of Receiver Operating Characteristic curves (ROC-curves and predicts optimal values of diagnostic indicators of biomedical information. To assess the quality of the test result prediction the standard criteria of the sensitivity and specificity of the model were used. Values of these criteria were calculated for the cases when the sensitivity of the test was greater than specificity by several times, when the number of correct diagnoses was maximal, when the sensitivity of the test was equal to its specificity and the sensitivity of the test was several times greater than the specificity of the test. To assess the significance of the factor characteristics and to compare the prognostic characteristics of models we used mathematical modeling and plotting the ROC-curves. The optimal value of the diagnostic indicator was found to be achieved when the sensitivity of the test is equal to its specificity. The model was adapted to solve the case when the sensitivity of the test is greater than specificity of the test.

  15. Diagnostic Performance of Narrow Band Imaging for Laryngeal Cancer: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Sun, Changling; Han, Xue; Li, Xiaoying; Zhang, Yayun; Du, Xiaodong

    2017-04-01

    Objective To evaluate the performance of narrow band imaging (NBI) for the diagnosis of laryngeal cancer and to compare the diagnostic value of NBI with that of white light endoscopy. Data Sources PubMed, Embase, Cochrane Library, and CNKI databases. Review Methods Data analyses were performed with Meta-DiSc. The updated Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess study quality and potential bias. Publication bias was assessed with the Deeks's asymmetry test. The protocol used in this article has been published on PROSPERO and is in accordance with the PRISMA checklist. The registry number for this study is CRD42015025866. Results Six studies including 716 lesions were included in this meta-analysis. The pooled sensitivity, specificity, and diagnostic odds ratio for the NBI diagnosis of laryngeal cancer were 0.94 (95% confidence interval [95% CI]: 0.91-0.96), 0.89 (95% CI: 0.85-0.92), and 142.12 (95% CI: 46.42-435.15), respectively, and the area under receiver operating characteristics curve was 0.97. Among the 6 studies, 3 evaluated the diagnostic value of white light endoscopy, with a sensitivity of 0.81 (95% CI: 0.76-0.86), a specificity of 0.92 (95% CI: 0.88-0.95), and a diagnostic odds ratio of 33.82 (95% CI: 14.76-77.49). The evaluation of heterogeneity, calculated per the diagnostic odds ratio, gave an I 2 of 66%. No marked publication bias ( P = .84) was detected in this meta-analysis. Conclusion The sensitivity of NBI is superior to white light endoscopy, and the potential value of NBI needs to be validated in future studies.

  16. Oil analysis in machine diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Vaehaeoja, P.

    2006-07-01

    This study concentrates on developing and tuning various oil analysis methods to meet the requirements of modern industry and environmental analytics. Oil analysis methods form a vital part of techniques used to monitor the condition of machines and may help to improve the overall equipment effectiveness value of a factory in a significant manner. Worm gears are used in various production machines, and their breakdowns may cause significant production losses. Wearing of these gears is relatively difficult to monitor with vibration analysis. Analysis of two indicator metals, copper and iron, may reveal wearing phenomena of worm gears effectively, and savings can be significant. Effective wear metal analysis requires good tools. ICP-OES with kerosene dilution is widely used in wear metal analysis, but purchasing and using of ICP-OES is expensive. A cheaper FAAS technique with similar pre-treatment of oil samples was tested and it proved to be useful especially in analyzing small amounts of samples. The accuracy of FAAS was sufficient for quantitative work in machine diagnostics and waste oil characterization. Solid debris analyses are useful in oil contamination control as well as in detection of wearing mechanisms. Membrane filtration, optical microscopy, SEM and automatic particle counting were applied in analysis of rolling and gear oils. Particle counting is an effective way to detect oil contamination, but in the studied cases even larger particles than those detected in normal ISO classes would be informative. However, membrane filtration and optical microscopy may reveal the wearing machine element exactly. Additives provide oils with desired properties thus they should be monitored intensively. A FTIR method for quantitative analysis of fatty alcohols and fatty acid esters in machinery oils was developed during this work. It has already been used successfully in quantitative and qualitative analysis of machinery oil samples. Various kinds of oils may be

  17. Study on the diagnostic value of determination of changes of serum CA125 and CA19-9 levels in patients with endometriosis

    International Nuclear Information System (INIS)

    Liu Aimin

    2008-01-01

    Objective: To explore the diagnostic value of determination of changes of serum CA125 and CA19-9 levels in patients with endometriosis. Methods: Serum CA125 and CA19-9 levels were determined with RIA in 45 patients with endometriosis and 40 controls. Results: Serum levels of CA125 and CA19-9 in patients with endometriosis (89.63 ± 30.16u/ml and 95.62±43.67u/ml respectively) were significantly higher than those (16.26±6.37u/ml and 20.26±8.25u/ml respectively) in controls (P<0. 001). Sensitivity of CA125 for diagnosis of endometriosis was 77.78% and that of CA19-9 was 62.22%, while the specificity was 92.50% and 90.00% respectively. If we only took the patients with both markers elevated as being diagnostically positive, the sensitivity would naturally be lower (57.78%) but the specificity would be 100%. Levels of the markers were significantly higher in stage III, IV patients than those in patients with stage I, II disease (P<0.01). Conclusion: Combined determination of serum CA125 and CA19-9 levels were of highly specific diagnostic value in patients with endometriosis. (authors)

  18. Outcomes of non-invasive diagnostic modalities for the detection of coronary artery disease: network meta-analysis of diagnostic randomised controlled trials.

    Science.gov (United States)

    Siontis, George Cm; Mavridis, Dimitris; Greenwood, John P; Coles, Bernadette; Nikolakopoulou, Adriani; Jüni, Peter; Salanti, Georgia; Windecker, Stephan

    2018-02-21

    To evaluate differences in downstream testing, coronary revascularisation, and clinical outcomes following non-invasive diagnostic modalities used to detect coronary artery disease. Systematic review and network meta-analysis. Medline, Medline in process, Embase, Cochrane Library for clinical trials, PubMed, Web of Science, SCOPUS, WHO International Clinical Trials Registry Platform, and Clinicaltrials.gov. Diagnostic randomised controlled trials comparing non-invasive diagnostic modalities in patients presenting with symptoms suggestive of low risk acute coronary syndrome or stable coronary artery disease. A random effects network meta-analysis synthesised available evidence from trials evaluating the effect of non-invasive diagnostic modalities on downstream testing and patient oriented outcomes in patients with suspected coronary artery disease. Modalities included exercise electrocardiograms, stress echocardiography, single photon emission computed tomography-myocardial perfusion imaging, real time myocardial contrast echocardiography, coronary computed tomographic angiography, and cardiovascular magnetic resonance. Unpublished outcome data were obtained from 11 trials. 18 trials of patients with low risk acute coronary syndrome (n=11 329) and 12 trials of those with suspected stable coronary artery disease (n=22 062) were included. Among patients with low risk acute coronary syndrome, stress echocardiography, cardiovascular magnetic resonance, and exercise electrocardiograms resulted in fewer invasive referrals for coronary angiography than coronary computed tomographic angiography (odds ratio 0.28 (95% confidence interval 0.14 to 0.57), 0.32 (0.15 to 0.71), and 0.53 (0.28 to 1.00), respectively). There was no effect on the subsequent risk of myocardial infarction, but estimates were imprecise. Heterogeneity and inconsistency were low. In patients with suspected stable coronary artery disease, an initial diagnostic strategy of stress echocardiography or

  19. Cell Analysis and Early Diagnostics

    NARCIS (Netherlands)

    Subramaniam, Vinod; Jones, Val

    2006-01-01

    In an era of aging populations and rising health-care costs, the shift of medical paradigms towards rapid, accurate, early diagnoses of diseases is inevitable. In addition to further development of ultrasensitive in vitro tests, the focus of attention in both diagnostics and the early drug discovery

  20. Quantitative evaluation of visual detection performance in medicine: ROC analysis and determination of diagnostic benefit

    International Nuclear Information System (INIS)

    Metz, C.E.; Starr, S.J.; Lusted, L.B.

    1976-01-01

    An ROC curve provides an empirical description of the trade-offs which are possible among the various types of correct and incorrect decisions as the human decision-maker varies one or more confidence thresholds. Conventional ROC curves measured in simple decision-making situations can, in some cases, be used to predict human decision performance in more complex situations. By considering both the consequences of the various types of diagnostic decisions and the overhead cost of a diagnostic study, one can use the ROC curve to evaluate the diagnostic usefulness of a study in any particular clinical context. Since the ROC curve describes the possible relationships among the probabilities of the various types of correct and incorrect decisions, it plays a central role in optimizing diagnostic strategies using the general techniques of decision analysis. Applications in radiographic image evaluation are described

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

    International Nuclear Information System (INIS)

    Almen, Anja; Baath, Magnus

    2016-01-01

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

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

    Science.gov (United States)

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

    2010-10-01

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

  3. Comparative analysis of diagnostic accuracy of different brain biopsy procedures.

    Science.gov (United States)

    Jain, Deepali; Sharma, Mehar Chand; Sarkar, Chitra; Gupta, Deepak; Singh, Manmohan; Mahapatra, A K

    2006-12-01

    Image-guided procedures such as computed tomography (CT) guided, neuronavigator-guided and ultrasound-guided methods can assist neurosurgeons in localizing the intraparenchymal lesion of the brain. However, despite improvements in the imaging techniques, an accurate diagnosis of intrinsic lesion requires tissue sampling and histological verification. The present study was carried out to examine the reliability of the diagnoses made on tumor sample obtained via different stereotactic and ultrasound-guided brain biopsy procedures. A retrospective analysis was conducted of all brain biopsies (frame-based and frameless stereotactic and ultrasound-guided) performed in a single tertiary care neurosciences center between 1995 and 2005. The overall diagnostic accuracy achieved on histopathology and correlation with type of biopsy technique was evaluated. A total of 130 cases were included, which consisted of 82 males and 48 females. Age ranged from 4 to 75 years (mean age 39.5 years). Twenty per cent (27 patients) were in the pediatric age group, while 12% (16 patients) were >or= 60-years of age. A definitive histological diagnosis was established in 109 cases (diagnostic yield 80.2%), which encompassed 101 neoplastic and eight nonneoplastic lesions. Frame-based, frameless stereotactic and ultrasound-guided biopsies were done in 95, 15 and 20 patients respectively. Although the numbers of cases were small there was trend for better yield with frameless image-guided stereotactic biopsy and maximum diagnostic yield was obtained i.e, 87% (13/15) in comparison to conventional frame-based CT-guided stereotactic biopsy and ultrasound-guided biopsy. Overall, a trend of higher diagnostic yield was seen in cases with frameless image-guided stereotactic biopsy. Thus, this small series confirms that frameless neuronavigator-guided stereotactic procedures represent the lesion sufficiently in order to make histopathologic diagnosis.

  4. Chest X-ray : a cost-diagnostic benefit analysis

    International Nuclear Information System (INIS)

    Winter, L.H.L.

    1991-01-01

    Although plain chest radiography is one of the most useful diagnostic tools available to the physician, this procedure has not evolved into a consistent method. Two Large Field of View Image Intensifiers (LFOV-II) became available; the large imaging area makes them suitable for chest imaging. Both modalities supply 100 mm images to the radiologist. In this thesis the 'diagnostic benefits and 'costs' of these modalities are evaluated and related to the 'gold' standard (conventional full-size). The emphasis is on diagnostic image quality using phantoms for observer performance qualities. (author). 170 refs.; 21 figs.; 47 tabs

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

    Directory of Open Access Journals (Sweden)

    A. A. Snetkova

    2015-09-01

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

  6. Receiver operating characteristic analysis of eyewitness memory: comparing the diagnostic accuracy of simultaneous versus sequential lineups.

    Science.gov (United States)

    Mickes, Laura; Flowe, Heather D; Wixted, John T

    2012-12-01

    A police lineup presents a real-world signal-detection problem because there are two possible states of the world (the suspect is either innocent or guilty), some degree of information about the true state of the world is available (the eyewitness has some degree of memory for the perpetrator), and a decision is made (identifying the suspect or not). A similar state of affairs applies to diagnostic tests in medicine because, in a patient, the disease is either present or absent, a diagnostic test yields some degree of information about the true state of affairs, and a decision is made about the presence or absence of the disease. In medicine, receiver operating characteristic (ROC) analysis is the standard method for assessing diagnostic accuracy. By contrast, in the eyewitness memory literature, this powerful technique has never been used. Instead, researchers have attempted to assess the diagnostic performance of different lineup procedures using methods that cannot identify the better procedure (e.g., by computing a diagnosticity ratio). Here, we describe the basics of ROC analysis, explaining why it is needed and showing how to use it to measure the performance of different lineup procedures. To illustrate the unique advantages of this technique, we also report 3 ROC experiments that were designed to investigate the diagnostic accuracy of simultaneous versus sequential lineups. According to our findings, the sequential procedure appears to be inferior to the simultaneous procedure in discriminating between the presence versus absence of a guilty suspect in a lineup.

  7. Serum tumor-associated autoantibodies as diagnostic biomarkers for lung cancer: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Zhen-Ming Tang

    Full Text Available We performed a comprehensive review and meta-analysis to evaluate the diagnostic values of serum single and multiplex tumor-associated autoantibodies (TAAbs in patients with lung cancer (LC.We searched the MEDLINE and EMBASE databases for relevant studies investigating serum TAAbs for the diagnosis of LC. The primary outcomes included sensitivity, specificity and accuracy of the test.The systematic review and meta-analysis included 31 articles with single autoantibody and 39 with multiplex autoantibodies. Enzyme-linked immunosorbent assay (ELISA was the most common detection method. For the diagnosis of patients with all stages and early-stage LC, different single or combinations of TAAbs demonstrated different diagnostic values. Although individual TAAbs showed low diagnostic sensitivity, the combination of multiplex autoantibodies offered relatively high sensitivity. For the meta-analysis of a same panel of autoantibodies in patients at all stages of LC, the pooled results of the panel of 6 TAAbs (p53, NY-ESO-1, CAGE, GBU4-5, Annexin 1 and SOX2 were: sensitivity 38% (95% CI 0.35-0.40, specificity 89% (95% CI 0.86-0.91, diagnostic accuracy 65.9% (range 62.5-81.8%, AUC 0.52 (0.48-0.57, while the summary estimates of 7 TAAbs (p53, CAGE, NY-ESO-1, GBU4-5, SOX2, MAGE A4 and Hu-D were: sensitivity 47% (95% CI 0.34-0.60, specificity 90% (95% CI 0.89-0.92, diagnostic accuracy 78.4% (range 67.5-88.8%, AUC 0.90 (0.87-0.93. For the meta-analysis of the same panel of autoantibodies in patients at early-stage of LC, the sensitivities of both panels of 7 TAAbs and 6 TAAbs were 40% and 29.7%, while their specificities were 91% and 87%, respectively.Serum single or combinations of multiplex autoantibodies can be used as a tool for the diagnosis of LC patients at all stages or early-stage, but the combination of multiplex autoantibodies shows a higher detection capacity; the diagnostic value of the panel of 7 TAAbs is higher than the panel of 6 TAAbs, which

  8. Diagnostic Stability of ICD/DSM First Episode Psychosis Diagnoses: Meta-analysis

    Science.gov (United States)

    Fusar-Poli, Paolo; Cappucciati, Marco; Rutigliano, Grazia; Heslin, Margaret; Stahl, Daniel; Brittenden, Zera; Caverzasi, Edgardo; McGuire, Philip; Carpenter, William T.

    2016-01-01

    Background: Validity of current International Classification of Disease/Diagnostic and Statistical Manual of Mental Disorders (ICD/DSM) first episode psychosis diagnoses is essential in clinical practice, research, training and public health. Method: We provide a meta-analytical estimate of prospective diagnostic stability and instability in ICD-10 or DSM-IV first episode diagnoses of functional psychoses. Independent extraction by multiple observers. Random effect meta-analysis conducted with the “metaprop,” “metaninf,” “metafunnel,” “metabias,” and “metareg” packages of STATA13.1. Moderators were tested with meta-regression analyses. Heterogeneity was assessed with the I 2 index. Sensitivity analyses tested robustness of results. Publication biases were assessed with funnel plots and Egger’s test. Findings: 42 studies and 45 samples were included, for a total of 14 484 first episode patients and an average follow-up of 4.5 years. Prospective diagnostic stability ranked: schizophrenia 0.90 (95% CI 0.85–0.95), affective spectrum psychoses 0.84 (95% CI 0.79–0.89), schizoaffective disorder 0.72 (95% CI 0.61–0.73), substance-induced psychotic disorder 0.66 (95% CI 0.51–0.81), delusional disorder 0.59 (95% CI 0.47–0.71), acute and transient psychotic disorder/brief psychotic disorder 0.56 (95% CI 0.62–0.60), psychosis not otherwise specified 0.36 (95% CI 0.27–0.45, schizophreniform disorder 0.29 (95% CI 0.22–0.38). Diagnostic stability within schizophrenia spectrum psychoses was 0.93 (95% CI 0.89–0.97); changes to affective spectrum psychoses were 0.05 (95% CI 0.01–0.08). About 0.10 (95% CI 0.05–0.15) of affective spectrum psychoses changed to schizophrenia spectrum psychosis. Across the other psychotic diagnoses there was high diagnostic instability, mostly to schizophrenia. Interpretation: There is meta-analytical evidence for high prospective diagnostic stability in schizophrenia spectrum and affective spectrum psychoses

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

    Science.gov (United States)

    Higgins, Robert; Hogg, Peter; Robinson, Leslie

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-08-15

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

  11. Applying Diagnostics to Enhance Cable System Reliability (Cable Diagnostic Focused Initiative, Phase II)

    Energy Technology Data Exchange (ETDEWEB)

    Hartlein, Rick [Georgia Tech Research Corporation (GTRC), Atlanta, GA (United States). National Electric Energy Testing, Research and Applications Center (NEETRAC); Hampton, Nigel [Georgia Tech Research Corporation (GTRC), Atlanta, GA (United States). National Electric Energy Testing, Research and Applications Center (NEETRAC); Perkel, Josh [Georgia Tech Research Corporation (GTRC), Atlanta, GA (United States). National Electric Energy Testing, Research and Applications Center (NEETRAC); Hernandez, JC [Univ. de Los Andes, Merida (Venezuela); Elledge, Stacy [Georgia Tech Research Corporation (GTRC), Atlanta, GA (United States). National Electric Energy Testing, Research and Applications Center (NEETRAC); del Valle, Yamille [Georgia Tech Research Corporation (GTRC), Atlanta, GA (United States). National Electric Energy Testing, Research and Applications Center (NEETRAC); Grimaldo, Jose [Georgia Inst. of Technology, Atlanta, GA (United States). School of Electrical and Computer Engineering; Deku, Kodzo [Georgia Inst. of Technology, Atlanta, GA (United States). George W. Woodruff School of Mechanical Engineering

    2016-02-01

    The Cable Diagnostic Focused Initiative (CDFI) played a significant and powerful role in clarifying the concerns and understanding the benefits of performing diagnostic tests on underground power cable systems. This project focused on the medium and high voltage cable systems used in utility transmission and distribution (T&D) systems. While many of the analysis techniques and interpretations are applicable to diagnostics and cable systems outside of T&D, areas such as generating stations (nuclear, coal, wind, etc.) and other industrial environments were not the focus. Many large utilities in North America now deploy diagnostics or have changed their diagnostic testing approach as a result of this project. Previous to the CDFI, different diagnostic technology providers individually promoted their approach as the “the best” or “the only” means of detecting cable system defects.

  12. Meta-Analyst: software for meta-analysis of binary, continuous and diagnostic data

    Directory of Open Access Journals (Sweden)

    Schmid Christopher H

    2009-12-01

    Full Text Available Abstract Background Meta-analysis is increasingly used as a key source of evidence synthesis to inform clinical practice. The theory and statistical foundations of meta-analysis continually evolve, providing solutions to many new and challenging problems. In practice, most meta-analyses are performed in general statistical packages or dedicated meta-analysis programs. Results Herein, we introduce Meta-Analyst, a novel, powerful, intuitive, and free meta-analysis program for the meta-analysis of a variety of problems. Meta-Analyst is implemented in C# atop of the Microsoft .NET framework, and features a graphical user interface. The software performs several meta-analysis and meta-regression models for binary and continuous outcomes, as well as analyses for diagnostic and prognostic test studies in the frequentist and Bayesian frameworks. Moreover, Meta-Analyst includes a flexible tool to edit and customize generated meta-analysis graphs (e.g., forest plots and provides output in many formats (images, Adobe PDF, Microsoft Word-ready RTF. The software architecture employed allows for rapid changes to be made to either the Graphical User Interface (GUI or to the analytic modules. We verified the numerical precision of Meta-Analyst by comparing its output with that from standard meta-analysis routines in Stata over a large database of 11,803 meta-analyses of binary outcome data, and 6,881 meta-analyses of continuous outcome data from the Cochrane Library of Systematic Reviews. Results from analyses of diagnostic and prognostic test studies have been verified in a limited number of meta-analyses versus MetaDisc and MetaTest. Bayesian statistical analyses use the OpenBUGS calculation engine (and are thus as accurate as the standalone OpenBUGS software. Conclusion We have developed and validated a new program for conducting meta-analyses that combines the advantages of existing software for this task.

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

    Data.gov (United States)

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

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  15. Personalized estimates of radiation dose from dedicated breast CT in a diagnostic population and comparison with diagnostic mammography

    International Nuclear Information System (INIS)

    Vedantham, Srinivasan; Shi, Linxi; Karellas, Andrew; O'Connell, Avice M; Conover, David L

    2013-01-01

    This study retrospectively analyzed the mean glandular dose (MGD) to 133 breasts from 132 subjects, all women, who participated in a clinical trial evaluating dedicated breast CT in a diagnostic population. The clinical trial was conducted in adherence to a protocol approved by institutional review boards and the study participants provided written informed consent. Individual estimates of MGD to each breast from dedicated breast CT was obtained by combining x-ray beam characteristics with estimates of breast dimensions and fibroglandular fraction from volumetric breast CT images, and using normalized glandular dose coefficients. For each study participant and for the breast corresponding to that imaged with breast CT, an estimate of the MGD from diagnostic mammography (including supplemental views) was obtained from the DICOM image headers for comparison. This estimate uses normalized glandular dose coefficients corresponding to a breast with 50% fibroglandular weight fraction. The median fibroglandular weight fraction for the study cohort determined from volumetric breast CT images was 15%. Hence, the MGD from diagnostic mammography was corrected to be representative of the study cohort. Individualized estimates of MGD from breast CT ranged from 5.7 to 27.8 mGy. Corresponding to the breasts imaged with breast CT, the MGD from diagnostic mammography ranged from 2.6 to 31.6 mGy. The mean (± inter-breast SD) and the median MGD (mGy) from dedicated breast CT exam were 13.9 ± 4.6 and 12.6, respectively. For the corresponding breasts, the mean (± inter-breast SD) and the median MGD (mGy) from diagnostic mammography were 12.4 ± 6.3 and 11.1, respectively. Statistical analysis indicated that at the 0.05 level, the distributions of MGD from dedicated breast CT and diagnostic mammography were significantly different (Wilcoxon signed ranks test, p = 0.007). While the interquartile range and the range (maximum–minimum) of MGD from dedicated breast CT was lower than

  16. Cost analysis of breast cancer diagnostic assessment programs.

    Science.gov (United States)

    Honein-AbouHaidar, G N; Hoch, J S; Dobrow, M J; Stuart-McEwan, T; McCready, D R; Gagliardi, A R

    2017-10-01

    Diagnostic assessment programs (daps) appear to improve the diagnosis of cancer, but evidence of their cost-effectiveness is lacking. Given that no earlier study used secondary financial data to estimate the cost of diagnostic tests in the province of Ontario, we explored how to use secondary financial data to retrieve the cost of key diagnostic test services in daps, and we tested the reliability of that cost-retrieving method with hospital-reported costs in preparation for future cost-effectiveness studies. We powered our sample at an alpha of 0.05, a power of 80%, and a margin of error of ±5%, and randomly selected a sample of eligible patients referred to a dap for suspected breast cancer during 1 January-31 December 2012. Confirmatory diagnostic tests received by each patient were identified in medical records. Canadian Classification of Health Intervention procedure codes were used to search the secondary financial data Web portal at the Ontario Case Costing Initiative for an estimate of the direct, indirect, and total costs of each test. The hospital-reported cost of each test received was obtained from the host-hospital's finance department. Descriptive statistics were used to calculate the cost of individual or group confirmatory diagnostic tests, and the Wilcoxon signed-rank test or the paired t-test was used to compare the Ontario Case Costing Initiative and hospital-reported costs. For the 191 identified patients with suspected breast cancer, the estimated total cost of $72,195.50 was not significantly different from the hospital-reported total cost of $72,035.52 ( p = 0.24). Costs differed significantly when multiple tests to confirm the diagnosis were completed during one patient visit and when confirmatory tests reported in hospital data and in medical records were discrepant. The additional estimated cost for non-salaried physicians delivering diagnostic services was $28,387.50. It was feasible to use secondary financial data to retrieve the cost

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

    Science.gov (United States)

    Almén, Anja; Båth, Magnus

    2016-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Anil Chander

    2013-02-01

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

  19. Pain in diagnostic hysteroscopy: a multivariate analysis after a randomized, controlled trial.

    Science.gov (United States)

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

    2014-11-01

    To study which variables are able to influence women's experience of pain during diagnostic hysteroscopy. Multivariate analysis (phase II) after a randomized, controlled trial (phase I). Endoscopic gynecologic center. In phase I, 392 patients were analyzed. Group A: 197 women with carbon dioxide (CO2); group B: 195 women with normal saline. In phase II, 392 patients were assigned to two different groups according to their pain experience as measured by a visual analogue scale (VAS): group VAS>3 (170 patients); group VAS≤3 (222 patients). Free-anesthesia diagnostic hysteroscopy performed using CO2 or normal saline as distension media. Procedure time, VAS score, image quality, and side effects during and after diagnostic hysteroscopy. In phase I the median pain score in group A was 2, whereas in group B it was 3. In phase II the duration of the procedure, nulliparity, and the use of normal saline were significantly correlated with VAS>3. A higher presence of cervical synechiae was observed in the group VAS>3. The multivariate analysis revealed an inverse correlation between parity and a VAS>3, whereas the use of normal saline, the presence of synechiae in the cervical canal, and the duration of the hysteroscopy were all directly correlated to a VAS score>3. Pain in hysteroscopy is significantly related to the presence of cervical synechiae, to the duration of the procedure, and to the use of normal saline; conversely, parity seems to have a protective role. NCT01873391. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  20. Diagnostic efficacy of magnifying endoscopy with narrow-band imaging for gastric neoplasms: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Xiuhe Lv

    Full Text Available Magnifying endoscopy with narrow-band imaging (ME-NBI is a novel, image-enhanced endoscopic technique for differentiating gastrointestinal neoplasms and potentially enabling pathological diagnosis.The aim of this analysis was to assess the diagnostic performance of ME-NBI for gastric neoplasms.We performed a systematic search of the PubMed, EMbase, Web of Science, and Cochrane Library databases for relevant studies. Meta-DiSc (version 1.4 and STATA (version 11.0 software were used for the data analysis. Random effects models were used to assess diagnostic efficacy. Heterogeneity was tested by the Q statistic and I2 statistic. Meta-regression was used to analyze the sources of heterogeneity.A total of 10 studies, with 2151 lesions, were included. The pooled characteristics of these studies were as follows: sensitivity 0.85 (95% confidence interval [CI]: 0.81-0.89, specificity 0.96 (95% confidence interval [CI]: 0.95-0.97, and area under the curve (AUC 0.9647. In the subgroup analysis, which compared the diagnostic efficacy of ME-NBI and white light imaging (WLI, the pooled sensitivity and specificity of ME-NBI were 0.87 (95% CI: 0.80-0.92 and 0.93 (95% CI: 0.90-0.95, respectively, and the area under the curve (AUC was 0.9556. In contrast, the pooled sensitivity and specificity of WLI were 0.61 (95% CI: 0.53-0.69 and 0.65 (95% CI: 0.60-0.69, respectively, and the area under the curve (AUC was 0.6772.ME-NBI presents a high diagnostic value for gastric neoplasms and has a high specificity.

  1. Nuclear reactor pump diagnostics via noise analysis/artificial neural networks

    International Nuclear Information System (INIS)

    Keyvan, S.; Rabelo, L.C.

    1991-01-01

    A feasibility study is performed on the utilization of artificial neural networks as a tool for reactor diagnostics. Reactor pump signals utilized in a wear-out monitoring system developed for early detection of degradation of pump shaft are analyzed as a semi-benchmark test to study the feasibility of neural networks for pattern recognition. The Adaptive Resonance Theory (ART 2) paradigm of artificial neural networks is applied in this study. The signals are collected signals as well as generated signals simulating the wear progress. The wear-out monitoring system applies noise analysis techniques, and is capable of distinguishing between these signals and providing a measure of the progress of the degradation. This paper presents the results of the analysis of these data via the ART 2 paradigm

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

    Data.gov (United States)

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

  3. Immunochromatographic diagnostic test analysis using Google Glass.

    Science.gov (United States)

    Feng, Steve; Caire, Romain; Cortazar, Bingen; Turan, Mehmet; Wong, Andrew; Ozcan, Aydogan

    2014-03-25

    We demonstrate a Google Glass-based rapid diagnostic test (RDT) reader platform capable of qualitative and quantitative measurements of various lateral flow immunochromatographic assays and similar biomedical diagnostics tests. Using a custom-written Glass application and without any external hardware attachments, one or more RDTs labeled with Quick Response (QR) code identifiers are simultaneously imaged using the built-in camera of the Google Glass that is based on a hands-free and voice-controlled interface and digitally transmitted to a server for digital processing. The acquired JPEG images are automatically processed to locate all the RDTs and, for each RDT, to produce a quantitative diagnostic result, which is returned to the Google Glass (i.e., the user) and also stored on a central server along with the RDT image, QR code, and other related information (e.g., demographic data). The same server also provides a dynamic spatiotemporal map and real-time statistics for uploaded RDT results accessible through Internet browsers. We tested this Google Glass-based diagnostic platform using qualitative (i.e., yes/no) human immunodeficiency virus (HIV) and quantitative prostate-specific antigen (PSA) tests. For the quantitative RDTs, we measured activated tests at various concentrations ranging from 0 to 200 ng/mL for free and total PSA. This wearable RDT reader platform running on Google Glass combines a hands-free sensing and image capture interface with powerful servers running our custom image processing codes, and it can be quite useful for real-time spatiotemporal tracking of various diseases and personal medical conditions, providing a valuable tool for epidemiology and mobile health.

  4. Serum Immunoglobulin G4 in Discriminating Autoimmune Pancreatitis From Pancreatic Cancer: A Diagnostic Meta-analysis.

    Science.gov (United States)

    Dai, Cong; Cao, Qin; Jiang, Min; Sun, Ming-Jun

    2018-03-01

    Differentiation between autoimmune pancreatitis (AIP) and pancreatic cancer (PC) is a clinical challenge. Emerging published data on the accuracy of serum immunoglobulin G4 (IgG4) for the differential diagnosis between AIP and PC are inconsistent. The objective of our study was to perform a meta-analysis evaluating the clinical utility of serum IgG4 in the differential diagnosis between AIP and PC. We performed a systematic literature search of multiple electronic databases. The methodological quality of each study was assessed according to the Quality Assessment of Diagnostic Accuracy Studies checklist. Random-effects model was used to summarize the diagnostic odds ratio and other measures of accuracy. Eleven studies comprising 523 AIP patients and 771 PC patients were included in the meta-analysis. The summary estimates for serum IgG4 in distinguishing AIP from PC were as follows: diagnostic odds ratio, 57.30 (95% confidence interval [CI], 23.17-141.67); sensitivity, 0.72 (95% CI, 0.68-0.76); specificity, 0.93 (95% CI, 0.91-0.94). The area under the curve of serum IgG4 in distinguishing AIP from PC was 0.9200. Our meta-analysis found that serum IgG4 has high specificity and relatively low sensitivity in the differential diagnosis between AIP and PC. Therefore, serum IgG4 is useful in distinguishing AIP from PC.

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

    Science.gov (United States)

    Mehdizadeh, Mahsa; Rezaei, Omid

    2016-01-01

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

  6. Feature diagnosticity and task context shape activity in human scene-selective cortex.

    Science.gov (United States)

    Lowe, Matthew X; Gallivan, Jason P; Ferber, Susanne; Cant, Jonathan S

    2016-01-15

    Scenes are constructed from multiple visual features, yet previous research investigating scene processing has often focused on the contributions of single features in isolation. In the real world, features rarely exist independently of one another and likely converge to inform scene identity in unique ways. Here, we utilize fMRI and pattern classification techniques to examine the interactions between task context (i.e., attend to diagnostic global scene features; texture or layout) and high-level scene attributes (content and spatial boundary) to test the novel hypothesis that scene-selective cortex represents multiple visual features, the importance of which varies according to their diagnostic relevance across scene categories and task demands. Our results show for the first time that scene representations are driven by interactions between multiple visual features and high-level scene attributes. Specifically, univariate analysis of scene-selective cortex revealed that task context and feature diagnosticity shape activity differentially across scene categories. Examination using multivariate decoding methods revealed results consistent with univariate findings, but also evidence for an interaction between high-level scene attributes and diagnostic visual features within scene categories. Critically, these findings suggest visual feature representations are not distributed uniformly across scene categories but are shaped by task context and feature diagnosticity. Thus, we propose that scene-selective cortex constructs a flexible representation of the environment by integrating multiple diagnostically relevant visual features, the nature of which varies according to the particular scene being perceived and the goals of the observer. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Diagnostic method for photovoltaic systems based on light I-V measurements

    DEFF Research Database (Denmark)

    Spataru, Sergiu; Sera, Dezso; Kerekes, Tamas

    2015-01-01

    , be it external, such as shading or soiling, or degradation or failure of the PV modules and balance-of-system components. This allows for performing preventive and/or reparative maintenance, thus minimizing further losses and costs. This article proposes a complete diagnostic method for detecting shading...... and analysis of the diagnostic parameters and logic was performed based on module level tests on standard crystalline silicon PV modules, and were optimized to detect even small partial shading and increase series-resistance losses. To demonstrate the practical application and operation of this method...

  8. A systematic analysis of commonly used antibodies in cancer diagnostics.

    Science.gov (United States)

    Gremel, Gabriela; Bergman, Julia; Djureinovic, Dijana; Edqvist, Per-Henrik; Maindad, Vikas; Bharambe, Bhavana M; Khan, Wasif Ali Z A; Navani, Sanjay; Elebro, Jacob; Jirström, Karin; Hellberg, Dan; Uhlén, Mathias; Micke, Patrick; Pontén, Fredrik

    2014-01-01

    Immunohistochemistry plays a pivotal role in cancer differential diagnostics. To identify the primary tumour from a metastasis specimen remains a significant challenge, despite the availability of an increasing number of antibodies. The aim of the present study was to provide evidence-based data on the diagnostic power of antibodies used frequently for clinical differential diagnostics. A tissue microarray cohort comprising 940 tumour samples, of which 502 were metastatic lesions, representing tumours from 18 different organs and four non-localized cancer types, was analysed using immunohistochemistry with 27 well-established antibodies used in clinical differential diagnostics. Few antibodies, e.g. prostate-specific antigen and thyroglobulin, showed a cancer type-related sensitivity and specificity of more than 95%. A majority of the antibodies showed a low degree of sensitivity and specificity for defined cancer types. Combinations of antibodies provided limited added value for differential diagnostics of cancer types. The results from analysing 27 diagnostic antibodies on consecutive sections of 940 defined tumours provide a unique repository of data that can empower a more optimal use of clinical immunohistochemistry. Our results highlight the benefit of immunohistochemistry and the unmet need for novel markers to improve differential diagnostics of cancer. © 2013 John Wiley & Sons Ltd.

  9. Molecular malaria diagnostics: A systematic review and meta-analysis.

    Science.gov (United States)

    Roth, Johanna M; Korevaar, Daniël A; Leeflang, Mariska M G; Mens, Pètra F

    2016-01-01

    Accurate diagnosis of malaria is essential for identification and subsequent treatment of the disease. Currently, microscopy and rapid diagnostic tests are the most commonly used diagnostics, next to treatment based on clinical signs only. These tests are easy to deploy, but have a relatively high detection limit. With declining prevalence in many areas, there is an increasing need for more sensitive diagnostics. Molecular tools may be a suitable alternative, although costs and technical requirements currently hamper their implementation in resource limited settings. A range of (near) point-of-care diagnostics is therefore under development, including simplifications in sample preparation, amplification and/or read-out of the test. Accuracy data, in combination with technical characteristics, are essential in determining which molecular test, if any, would be the most promising to be deployed. This review presents a comprehensive overview of the currently available molecular malaria diagnostics, ranging from well-known tests to platforms in early stages of evaluation, and systematically evaluates their published accuracy. No important difference in accuracy was found between the most commonly used PCR-based assays (conventional, nested and real-time PCR), with most of them having high sensitivity and specificity, implying that there are no reasons other than practical ones to choose one technique over the other. Loop-mediated isothermal amplification and other (novel) diagnostics appear to be highly accurate as well, with some offering potential to be used in resource-limited settings.

  10. [Cognitive errors in diagnostic decision making].

    Science.gov (United States)

    Gäbler, Martin

    2017-10-01

    Approximately 10-15% of our diagnostic decisions are faulty and may lead to unfavorable and dangerous outcomes, which could be avoided. These diagnostic errors are mainly caused by cognitive biases in the diagnostic reasoning process.Our medical diagnostic decision-making is based on intuitive "System 1" and analytical "System 2" diagnostic decision-making and can be deviated by unconscious cognitive biases.These deviations can be positively influenced on a systemic and an individual level. For the individual, metacognition (internal withdrawal from the decision-making process) and debiasing strategies, such as verification, falsification and rule out worst-case scenarios, can lead to improved diagnostic decisions making.

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  12. Training for thorax diagnostics. Systematic cardiopulmonary image analysis; Trainer Thoraxdiagnostik. Systematische kardiopulmonale Bildanalyse

    Energy Technology Data Exchange (ETDEWEB)

    Kirchner, Johannes [Allgemeines Krankenhaus Hagen gem.GmbH (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie

    2010-07-01

    The training book on thorax diagnostics using image analysis is supposed to be a supplement to the usual textbooks based on comprehensive experiences of radiologists. The covered issues are the following: heart insufficiency, acute/ chronic bronchitis and pulmonary emphysema; pneumonia and tuberculosis; bronchial carcinoma; lung fibrosis, sarcoidosis and pneumoconiosis, pleural effusion and pneumothorax.

  13. Synthetic Microwave Imaging Reflectometry diagnostic using 3D FDTD Simulations

    Science.gov (United States)

    Kruger, Scott; Jenkins, Thomas; Smithe, David; King, Jacob; Nimrod Team Team

    2017-10-01

    Microwave Imaging Reflectometry (MIR) has become a standard diagnostic for understanding tokamak edge perturbations, including the edge harmonic oscillations in QH mode operation. These long-wavelength perturbations are larger than the normal turbulent fluctuation levels and thus normal analysis of synthetic signals become more difficult. To investigate, we construct a synthetic MIR diagnostic for exploring density fluctuation amplitudes in the tokamak plasma edge by using the three-dimensional, full-wave FDTD code Vorpal. The source microwave beam for the diagnostic is generated and refelected at the cutoff surface that is distorted by 2D density fluctuations in the edge plasma. Synthetic imaging optics at the detector can be used to understand the fluctuation and background density profiles. We apply the diagnostic to understand the fluctuations in edge plasma density during QH-mode activity in the DIII-D tokamak, as modeled by the NIMROD code. This work was funded under DOE Grant Number DE-FC02-08ER54972.

  14. Effectiveness of urine fibronectin as a non-invasive diagnostic biomarker in bladder cancer patients: a systematic review and meta-analysis.

    Science.gov (United States)

    Dong, Fan; Shen, Yifan; Xu, Tianyuan; Wang, Xianjin; Gao, Fengbin; Zhong, Shan; Chen, Shanwen; Shen, Zhoujun

    2018-03-21

    Previous researches pointed out that the measurement of urine fibronectin (Fn) could be a potential diagnostic test for bladder cancer (BCa). We conducted this meta-analysis to fully assess the diagnostic value of urine Fn for BCa detection. A systematic literature search in PubMed, ISI Web of Science, EMBASE, Cochrane library, and CBM was carried out to identify eligible studies evaluating the urine Fn in diagnosing BCa. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) with their 95% confidence intervals (CIs) were calculated, and summary receiver operating characteristic (SROC) curves were established. We applied the STATA 13.0, Meta-Disc 1.4, and RevMan 5.3 software to the meta-analysis. Eight separate studies with 744 bladder cancer patients were enrolled in this meta-analysis. The pooled sensitivity, specificity, and DOR were 0.80 (95%CI = 0.77-0.83), 0.79 (95%CI = 0.73-0.84), and 15.18 (95%CI = 10.07-22.87), respectively, and the area under the curve (AUC) of SROC was 0.83 (95%CI = 0.79-0.86). The diagnostic power of a combined method (urine Fn combined with urine cytology) was also evaluated, and its sensitivity and AUC were significantly higher (0.86 (95%CI = 0.82-0.90) and 0.89 (95%CI = 0.86-0.92), respectively). Meta-regression along with subgroup analysis based on various covariates revealed the potential sources of the heterogeneity and the detailed diagnostic value of each subgroup. Sensitivity analysis supported that the result was robust. No threshold effect and publication bias were found in this meta-analysis. Urine Fn may become a promising non-invasive biomarker for bladder cancer with a relatively satisfactory diagnostic power. And the combination of urine Fn with cytology could be an alternative option for detecting BCa in clinical practice. The potential value of urine Fn still needs to be validated in large, multi-center, and prospective studies.

  15. Comparison with myocardial perfusion MRI and myocardial perfusion SPECT in the diagnostic performance of coronary artery disease. A meta-analysis

    International Nuclear Information System (INIS)

    Iwata, Kunihiro; Kubota, Makoto; Ogasawara, Katsuhiko

    2008-01-01

    We compared the diagnostic abilities of stress myocardial perfusion MRI (myocardial perfusion MRI) and myocardial perfusion single photon emission computed tomography (SPECT), using a meta-analysis method. We investigated the diagnostic abilities of MRI and SPECT in similar subject groups in reports written in English or Japanese. The reports to be used for analysis were selected according to a ''screening standard,'' which was established in advance. After consolidating the data from the selected reports, we compared the integrated odds ratio, the point estimation values of sensibility/specificity, and the summary receiver operating characteristic (ROC) curve. For the analysis, six reports were selected (subjects: 153, coronary-artery target sites: 447). Meta-analysis revealed that the diagnostic ability of myocardial perfusion MRI was superior to that of myocardial perfusion SPECT regarding each of the parameters. This is considered to be supportive evidence of the usefulness of myocardial perfusion MRI. (author)

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

    Science.gov (United States)

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

    2018-03-01

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

  17. Plant diagnostics in power stations

    International Nuclear Information System (INIS)

    Sturm, A.; Doering, D.

    1985-01-01

    The method of noise diagnostics is dealt with as a part of plant diagnostics in nuclear power stations. The following special applications are presented: (1) The modular noise diagnostics system is used for monitoring primary coolant circuits and detecting abnormal processes due to mechanical vibrations, loose parts or leaks. (2) The diagnostics of machines and plants with antifriction bearings is based on bearing vibration measurements. (3) The measurement of the friction moment by means of acoustic emission analysis is used for evaluating the operational state of slide bearings

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  19. Modeling Complex Workflow in Molecular Diagnostics

    Science.gov (United States)

    Gomah, Mohamed E.; Turley, James P.; Lu, Huimin; Jones, Dan

    2010-01-01

    One of the hurdles to achieving personalized medicine has been implementing the laboratory processes for performing and reporting complex molecular tests. The rapidly changing test rosters and complex analysis platforms in molecular diagnostics have meant that many clinical laboratories still use labor-intensive manual processing and testing without the level of automation seen in high-volume chemistry and hematology testing. We provide here a discussion of design requirements and the results of implementation of a suite of lab management tools that incorporate the many elements required for use of molecular diagnostics in personalized medicine, particularly in cancer. These applications provide the functionality required for sample accessioning and tracking, material generation, and testing that are particular to the evolving needs of individualized molecular diagnostics. On implementation, the applications described here resulted in improvements in the turn-around time for reporting of more complex molecular test sets, and significant changes in the workflow. Therefore, careful mapping of workflow can permit design of software applications that simplify even the complex demands of specialized molecular testing. By incorporating design features for order review, software tools can permit a more personalized approach to sample handling and test selection without compromising efficiency. PMID:20007844

  20. Three-layer poly(methyl methacrylate) microsystem for analysis of lysosomal enzymes for diagnostic purposes

    DEFF Research Database (Denmark)

    Kwapiszewski, Radoslaw; Kwapiszewska, Karina; Kutter, Jörg P

    2015-01-01

    by statistical analysis including construction of a Bland-Altman plot. The approach presented can be an alternative for the currently used diagnostic procedures. The method developed has a potential for the implementation into complex microfluidic devices thus becoming a powerful tool for a high...

  1. Diagnostic imaging for chronic plantar heel pain: a systematic review and meta-analysis

    Science.gov (United States)

    2009-01-01

    Background Chronic plantar heel pain (CPHP) is a generalised term used to describe a range of undifferentiated conditions affecting the plantar heel. Plantar fasciitis is reported as the most common cause and the terms are frequently used interchangeably in the literature. Diagnostic imaging has been used by many researchers and practitioners to investigate the involvement of specific anatomical structures in CPHP. These observations help to explain the underlying pathology of the disorder, and are of benefit in forming an accurate diagnosis and targeted treatment plan. The purpose of this systematic review was to investigate the diagnostic imaging features associated with CPHP, and evaluate study findings by meta-analysis where appropriate. Methods Bibliographic databases including Medline, Embase, CINAHL, SportDiscus and The Cochrane Library were searched electronically on March 25, 2009. Eligible articles were required to report imaging findings in participants with CPHP unrelated to inflammatory arthritis, and to compare these findings with a control group. Methodological quality was evaluated by use of the Quality Index as described by Downs and Black. Meta-analysis of study data was conducted where appropriate. Results Plantar fascia thickness as measured by ultrasonography was the most widely reported imaging feature. Meta-analysis revealed that the plantar fascia of CPHP participants was 2.16 mm thicker than control participants (95% CI = 1.60 to 2.71 mm, P plantar fascia thickness values greater than 4.0 mm (OR = 105.11, 95% CI = 3.09 to 3577.28, P = 0.01). CPHP participants were also more likely to show radiographic evidence of subcalcaneal spur than control participants (OR = 8.52, 95% CI = 4.08 to 17.77, P plantar fascia and inferior calcaneum in people with CPHP. Analysis of these studies found that people with CPHP are likely to have a thickened plantar fascia with associated fluid collection, and that thickness values >4.0 mm are diagnostic of

  2. Assessment of the potential diagnostic value of serum p53 antibody for cancer: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jun Zhang

    Full Text Available BACKGROUND: Mutant p53 protein over-expression has been reported to induce serum antibodies against p53. We assessed the diagnostic precision of serum p53 (s-p53 antibodies for diagnosis of cancer patients and compared the positive rates of the s-p53 antibody in different types of cancers. METHODS: We systematically searched PubMed and Embase, through May 31, 2012. Studies were assessed for quality using QUADAS (quality assessment of studies of diagnostic accuracy. The positive likelihood ratio (PLR and negative likelihood ratio (NLR were pooled separately and compared with overall accuracy measures using diagnostic odds ratios (DORs and Area under the curve(AUC. Meta regression and subgroup analyses were done, and heterogeneity and publication bias were assessed. RESULTS: Of 1089 studies initially identified, 100 eligible studies with 23 different types of tumor met the inclusion criteria for the meta-analysis (cases = 15953, controls = 8694. However, we could conduct independent meta analysis on only 13 of 36 types of tumors. Approximately 56% (56/100 of the included studies were of high quality (QUADAS score≥8. The summary estimates for quantitative analysis of serum p53 antibody in the diagnosis of cancers were: PLR 5.75 (95% CI: 4.60-7.19, NLR 0.81 (95%CI: 0.79-0.83 and DOR 7.56 (95% CI: 6.02-9.50. However, for the 13 types of cancers on which meta-analysis was conducted, the ranges for PLR (2.33-11.05, NLR (0.74-0.97, DOR (2.86-13.80, AUC(0.29-0.81, and positive rate (4.47%-28.36% indicated significant heterogeneity. We found that breast, colorectal, esophageal, gastric, hepatic, lymphoma, lung and ovarian cancer had relatively reasonable diagnostic accuracy. The remaining results of the five types of cancers suggested that s-p53 antibody had limited value. CONCLUSIONS: The current evidence suggests that s-p53 antibody has potential diagnostic value for cancer, especially for breast, colorectal, esophageal, gastric, hepatic

  3. Diagnostic value underlies asymmetric updating of impressions in the morality and ability domains.

    Science.gov (United States)

    Mende-Siedlecki, Peter; Baron, Sean G; Todorov, Alexander

    2013-12-11

    While positive behavioral information is diagnostic when evaluating a person's abilities, negative information is diagnostic when evaluating morality. Although social psychology has considered these two domains as orthogonal and distinct from one another, we demonstrate that this asymmetry in diagnosticity can be explained by a single parsimonious principle--the perceived frequency of behaviors in these domains. Less frequent behaviors (e.g., high ability and low morality) are weighed more heavily in evaluations. We show that this statistical principle of frequency-derived diagnosticity is evident in human participants at both behavioral and neural levels of analysis. Specifically, activity in right ventrolateral prefrontal cortex increased preferentially when participants updated impressions based on diagnostic behaviors, and further, activity in this region covaried parametrically with the perceived frequency of behaviors. Activity in left ventrolateral PFC, left inferior frontal gyrus, and left superior temporal sulcus showed similar patterns of diagnosticity and sensitivity, though additional analyses confirmed that these regions responded primarily to updates based on immoral behaviors.

  4. Molecular malaria diagnostics: A systematic review and meta-analysis

    NARCIS (Netherlands)

    Roth, Johanna M.; Korevaar, Daniël A.; Leeflang, Mariska M. G.; Mens, Pètra F.

    2016-01-01

    Accurate diagnosis of malaria is essential for identification and subsequent treatment of the disease. Currently, microscopy and rapid diagnostic tests are the most commonly used diagnostics, next to treatment based on clinical signs only. These tests are easy to deploy, but have a relatively high

  5. Diagnostic value of stool DNA testing for multiple markers of colorectal cancer and advanced adenoma: a meta-analysis.

    Science.gov (United States)

    Yang, Hua; Xia, Bing-Qing; Jiang, Bo; Wang, Guozhen; Yang, Yi-Peng; Chen, Hao; Li, Bing-Sheng; Xu, An-Gao; Huang, Yun-Bo; Wang, Xin-Ying

    2013-08-01

    The diagnostic value of stool DNA (sDNA) testing for colorectal neoplasms remains controversial. To compensate for the lack of large-scale unbiased population studies, a meta-analysis was performed to evaluate the diagnostic value of sDNA testing for multiple markers of colorectal cancer (CRC) and advanced adenoma. The PubMed, Science Direct, Biosis Review, Cochrane Library and Embase databases were systematically searched in January 2012 without time restriction. Meta-analysis was performed using a random-effects model using sensitivity, specificity, diagnostic OR (DOR), summary ROC curves, area under the curve (AUC), and 95% CIs as effect measures. Heterogeneity was measured using the χ(2) test and Q statistic; subgroup analysis was also conducted. A total of 20 studies comprising 5876 individuals were eligible. There was no heterogeneity for CRC, but adenoma and advanced adenoma harboured considerable heterogeneity influenced by risk classification and various detection markers. Stratification analysis according to risk classification showed that multiple markers had a high DOR for the high-risk subgroups of both CRC (sensitivity 0.759 [95% CI 0.711 to 0.804]; specificity 0.883 [95% CI 0.846 to 0.913]; AUC 0.906) and advanced adenoma (sensitivity 0.683 [95% CI 0.584 to 0.771]; specificity 0.918 [95% CI 0.866 to 0.954]; AUC 0.946) but not for the average-risk subgroups of either. In the methylation subgroup, sDNA testing had significantly higher DOR for CRC (sensitivity 0.753 [95% CI 0.685 to 0.812]; specificity 0.913 [95% CI 0.860 to 0.950]; AUC 0.918) and advanced adenoma (sensitivity 0.623 [95% CI 0.527 to 0.712]; specificity 0.926 [95% CI 0.882 to 0.958]; AUC 0.910) compared with the mutation subgroup. There was no significant heterogeneity among studies for subgroup analysis. sDNA testing for multiple markers had strong diagnostic significance for CRC and advanced adenoma in high-risk subjects. Methylation makers had more diagnostic value than mutation

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

    Data.gov (United States)

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

  7. Diagnostic development

    International Nuclear Information System (INIS)

    Barnett, C.F.; Brisson, D.A.; Greco, S.E.

    1978-01-01

    During the past year the far-infrared or submillimeter diagnostic research program resulted in three major developments: (1) an optically pumped 0.385-μm D 2 O-laser oscillator-amplifier system was operated at a power level of 1 MW with a line width of less than 50 MHz; (2) a conical Pyrex submillimeter laser beam dump with a retention efficiency greater than 10 4 was developed for the ion temperature Thompson scattering experiment; and (3) a new diagnostic technique was developed that makes use of the Faraday rotation of a modulated submillimeter laser beam to determine plasma current profile. Measurements of the asymmetric distortion of the H/sub α/ (6563 A) spectral line profile show that the effective toroidal drift velocity, dv/sub two vertical bars i/dT/sub i/, may be used as an indicator of plasma quality and as a complement to other ion temperature diagnostics

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  9. Diagnostic indicators of non-cardiovascular chest pain: a systematic review and meta-analysis

    Science.gov (United States)

    2013-01-01

    Background Non-cardiovascular chest pain (NCCP) has a high healthcare cost, but insufficient guidelines exist for its diagnostic investigation. The objective of the present work was to identify important diagnostic indicators and their accuracy for specific and non-specific conditions underlying NCCP. Methods A systematic review and meta-analysis were performed. In May 2012, six databases were searched. Hand and bibliography searches were also conducted. Studies evaluating a diagnostic test against a reference test in patients with NCCP were included. Exclusion criteria were having diagnostic tests for acute cardiovascular disease. Diagnostic accuracy is given in likelihood ratios (LR): very good (LR+ >10, LR- diagnostic test sensitivity and specificity was performed by applying a hierarchical Bayesian model. Results Out of 6,316 records, 260 were reviewed in full text, and 28 were included: 20 investigating gastroesophageal reflux disorders (GERD), 3 musculoskeletal chest pain, and 5 psychiatric conditions. Study quality was good in 15 studies and moderate in 13. GERD diagnosis was more likely with typical GERD symptoms (LR + 2.70 and 2.75, LR- 0.42 and 0.78) than atypical GERD symptoms (LR + 0.49, LR- 2.71). GERD was also more likely with a positive response to a proton pump inhibitor (PPI) test (LR + 5.48, 7.13, and 8.56; LR- 0.24, 0.25, and 0.28); the posterior mean sensitivity and specificity of six studies were 0.89 (95% credible interval, 0.28 to 1) and 0.88 (95% credible interval, 0.26 to 1), respectively. Panic and anxiety screening scores can identify individuals requiring further testing for anxiety or panic disorders. Clinical findings in musculoskeletal pain either had a fair to moderate LR + and a poor LR- or vice versa. Conclusions In patients with NCCP, thorough clinical evaluation of the patient’s history, symptoms, and clinical findings can indicate the most appropriate diagnostic tests. Treatment response to high-dose PPI

  10. Delirium diagnosis defined by cluster analysis of symptoms versus diagnosis by DSM and ICD criteria: diagnostic accuracy study.

    Science.gov (United States)

    Sepulveda, Esteban; Franco, José G; Trzepacz, Paula T; Gaviria, Ana M; Meagher, David J; Palma, José; Viñuelas, Eva; Grau, Imma; Vilella, Elisabet; de Pablo, Joan

    2016-05-26

    Information on validity and reliability of delirium criteria is necessary for clinicians, researchers, and further developments of DSM or ICD. We compare four DSM and ICD delirium diagnostic criteria versions, which were developed by consensus of experts, with a phenomenology-based natural diagnosis delineated using cluster analysis of delirium features in a sample with a high prevalence of dementia. We also measured inter-rater reliability of each system when applied by two evaluators from distinct disciplines. Cross-sectional analysis of 200 consecutive patients admitted to a skilled nursing facility, independently assessed within 24-48 h after admission with the Delirium Rating Scale-Revised-98 (DRS-R98) and for DSM-III-R, DSM-IV, DSM-5, and ICD-10 criteria for delirium. Cluster analysis (CA) delineated natural delirium and nondelirium reference groups using DRS-R98 items and then diagnostic systems' performance were evaluated against the CA-defined groups using logistic regression and crosstabs for discriminant analysis (sensitivity, specificity, percentage of subjects correctly classified by each diagnostic system and their individual criteria, and performance for each system when excluding each individual criterion are reported). Kappa Index (K) was used to report inter-rater reliability for delirium diagnostic systems and their individual criteria. 117 (58.5 %) patients had preexisting dementia according to the Informant Questionnaire on Cognitive Decline in the Elderly. CA delineated 49 delirium subjects and 151 nondelirium. Against these CA groups, delirium diagnosis accuracy was highest using DSM-III-R (87.5 %) followed closely by DSM-IV (86.0 %), ICD-10 (85.5 %) and DSM-5 (84.5 %). ICD-10 had the highest specificity (96.0 %) but lowest sensitivity (53.1 %). DSM-III-R had the best sensitivity (81.6 %) and the best sensitivity-specificity balance. DSM-5 had the highest inter-rater reliability (K =0.73) while DSM-III-R criteria were the least

  11. Limited diagnostic value of enzyme analysis in patients with mitochondrial tRNA mutations

    DEFF Research Database (Denmark)

    Wibrand, Flemming; Jeppesen, Tina Dysgaard; Frederiksen, Anja L

    2010-01-01

    We evaluated the diagnostic value of respiratory chain (RC) enzyme analysis of muscle in adult patients with mitochondrial myopathy (MM). RC enzyme activity was measured in muscle biopsies from 39 patients who carry either the 3243A>G mutation, other tRNA point mutations, or single, large......, respectively, in these three groups. The results indicate that RC enzyme analysis in muscle is not a sensitive test for MM in adults. In these patients, abnormal muscle histochemistry appears to be a better predictor ofMM....

  12. [Biochemical diagnostics of fatal opium intoxication].

    Science.gov (United States)

    Papyshev, I P; Astashkina, O G; Tuchik, E S; Nikolaev, B S; Cherniaev, A L

    2013-01-01

    Biochemical diagnostics of fatal opium intoxication remains a topical problem in forensic medical science and practice. We investigated materials obtained in the course of forensic medical expertise of the cases of fatal opium intoxication. The study revealed significant differences between myoglobin levels in blood, urine, myocardium, and skeletal muscles. The proposed approach to biochemical diagnostics of fatal opium intoxication enhances the accuracy and the level of evidence of expert conclusions.

  13. Computerized diagnostic data analysis and 3-D visualization

    International Nuclear Information System (INIS)

    Schuhmann, D.; Haubner, M.; Krapichler, C.; Englmeier, K.H.; Seemann, M.; Schoepf, U.J.; Gebicke, K.; Reiser, M.

    1998-01-01

    Purpose: To survey methods for 3D data visualization and image analysis which can be used for computer based diagnostics. Material and methods: The methods available are explained in short terms and links to the literature are presented. Methods which allow basic manipulation of 3D data are windowing, rotation and clipping. More complex methods for visualization of 3D data are multiplanar reformation, volume projections (MIP, semi-transparent projections) and surface projections. Methods for image analysis comprise local data transformation (e.g. filtering) and definition and application of complex models (e.g. deformable models). Results: Volume projections produce an impression of the 3D data set without reducing the data amount. This supports the interpretation of the 3D data set and saves time in comparison to any investigation which requires examination of all slice images. More advanced techniques for visualization, e.g. surface projections and hybrid rendering visualize anatomical information to a very detailed extent, but both techniques require the segmentation of the structures of interest. Image analysis methods can be used to extract these structures (e.g. an organ) from the image data. Discussion: At the present time volume projections are robust and fast enough to be used routinely. Surface projections can be used to visualize complex and presegmented anatomical features. (orig.) [de

  14. An assessment of diagnostic efficiency by Taguchi/DEA methods.

    Science.gov (United States)

    Taner, Mehmet Tolga; Sezen, Bulent

    2009-01-01

    The aim of this paper is to propose a new, objective and consistent method for the calculation of the diagnostic efficiency in medical applications. In this study, a hybrid method of Taguchi and DEA is proposed. This method reflects the diversity of inputs and outputs by incorporating the stepwise application of sensitivity, specificity, leveling threshold, and efficiency score. A hypothetical case study is given which involves eight readers of X-ray films in clinical radiology. The selected pairs of sensitivity and specificity yielded two efficient readers. After super efficiency analysis, Reader 6 is found to be the most efficient reader. The paper presents a new, objective and consistent method for the calculation of the diagnostic efficiency in medical applications.

  15. Analysis of the Astronomy Diagnostic Test

    Science.gov (United States)

    Brogt, Erik; Sabers, Darrell; Prather, Edward E.; Deming, Grace L.; Hufnagel, Beth; Slater, Timothy F.

    2007-01-01

    Seventy undergraduate class sections were examined from the database of Astronomy Diagnostic Test (ADT) results of Deming and Hufnagel to determine if course format correlated with ADT normalized gain scores. Normalized gains were calculated for four different classroom scenarios: lecture, lecture with discussion, lecture with lab, and lecture…

  16. Application of diagnostics to determine motor operated valve operational readiness

    International Nuclear Information System (INIS)

    Eissenberg, D.M.

    1987-01-01

    ORNL has been carrying out an aging assessment of motor-operated valves (MOVs) with the primary objective of recommending diagnostic methods for detecting and trending aging. As a result of experimental investigations at ORNL, it was discovered that the motor current during a valve stroke was a very useful diagnostic parameter for detecting and trending many MOV drive train load variations. The motor current signatures were analyzed at four levels: mean value for a stroke, gross trends during a stroke, transients, and noise frequency spectra. Examples illustrating the use of this technique are presented. The use of motor current signature analysis was also shown to apply to other electric motor driven equipment. Future work includes developing a data base of MOV diagnostics, including criteria for determining the extent of degradation and application of the technique to other LWR motor driven safety equipment

  17. Application of diagnostics to determine motor-operated valve operational readiness

    International Nuclear Information System (INIS)

    Eissenberg, D.M.

    1986-01-01

    ORNL has been carrying out an aging assessment of motor-operated valves (MOVs) with the primary objective of recommending diagnostic methods for detecting and trending aging. As a result of experimental investigations at ORNL, it was discovered that the motor current during a valve stroke was a very useful diagnostic parameter for detecting and trending many MOV drive train load variations. The motor curent signatures were analyzed at four levels: mean value for a stroke, gross trends during a stroke, transients, and noise frequency spectra. Examples illustrating the use of this technique are presented. The use of motor current signature analysis was also shown to apply to other electric motor driven equipment. Future work includes developing a data base of MOV diagnostics, including criteria for determining the extent of degradation and application of the technique to other LWR motor driven safety equipment

  18. 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.

  19. 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

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  1. Development of a Diagnostic Complexity Questionnaire

    International Nuclear Information System (INIS)

    Collier, Steve

    1998-02-01

    The HRP human error analysis project has for some time been investigating what makes certain fault scenarios difficult for operators. One line of research has been to develop a questionnaire to measure diagnostic complexity. This report concerns some theoretical and experimental work underpinning the development of the questionnaire. A study of the literature reviewed the factors or components thought to contribute to difficulty in diagnosing and problem-solving. Two experimental studies of complexity were carried out using two versions of a questionnaire based on the review. The studies were simulator based, using scenarios designed to be diagnostically challenging. A factor-analytic approach to the analysis of the study data was suggested in the literature review. This is reported here (together with other analyses) though the factor analysis did not produce so clear results as was hoped. The present analysis found no clear factor structure with the first version of the complexity questionnaire used in experiment I. Partly because of this result, a factor-analytic approach to a second version of the questionnaire used in experiment II was not considered appropriate. A descriptive and qualitative analysis of the two questionnaire studies and a synthesis of the results from them both was promising. There were indications of components of complexity and some indications of what contributes to a personal perception of high or low diagnostic difficulty in fault scenarios. Components adding to diagnostic difficulty were tentatively named 'severity', 'need for co-operation', 'stress' and 'spread of changes'. Components not adding to difficulty were 'directness of indications', 'familiarity' and 'lack of stress'. There was some evidence of different responses to these components in a comparison of rule-based vs. knowledge-based diagnostic scenarios. These findings and experience with analysis techniques will feed into the design of further work on the human error

  2. Diagnostic performance of dual-source CT coronary angiography with and without heart rate control: Systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Li, M.; Zhang, G.-M.; Zhao, J.-S.; Jiang, Z.-W.; Peng, Z.-H.; Jin, Z.-T.; Sun, G.

    2014-01-01

    Aim: To investigate the diagnostic accuracy of dual-source computed tomography (DSCT) coronary angiography with and without the application of a β-blocker. Materials and methods: An exact binomial rendition of the bivariate mixed-effects regression model was used to synthesize diagnostic test data. Results: The pooled sensitivity at the patient level was 0.98 [95% confidence intervals (CI): 0.97–0.99], and specificity 0.88 (95% CI: 0.84–0.91). The results showed that without heart rate control, the sensitivity and specificity at the patient level did not decrease (p = 0.27 and 0.56, respectively). At the artery level, no significant differences in sensitivity and specificity for studies with and without heart rate control were detected (p = 0.04 and 0.05, respectively). At the segment level, the specificity decreased without heart rate control (p = 0.03), whereas the sensitivity was not influenced (p = 0.63). The median radiation exposure was 2.6 mSv, with 1.6 mSv and 8 mSv for heart rate-controlled studies and uncontrolled studies, respectively. Conclusions: DSCT coronary angiography without heart rate control has a similar excellent diagnostic performance at the patient level as that of heart rate control groups. However, controlling for heart rate to decrease radiation and to provide effective information for selecting the therapeutic strategy and risk stratification is recommended

  3. Diagnostic reference levels in intraoral dental radiography in Korea

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  4. Diagnostic value of 3D time-of-flight magnetic resonance angiography for detecting intracranial aneurysm: a meta-analysis.

    Science.gov (United States)

    HaiFeng, Liu; YongSheng, Xu; YangQin, Xun; Yu, Dou; ShuaiWen, Wang; XingRu, Lu; JunQiang, Lei

    2017-11-01

    This meta-analysis is to comprehensively evaluate the diagnostic performance of three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) for detecting intracranial aneurysm (IA). PubMed, Embase, Web of Science, and the Cochrane library were systematically searched for retrieving eligible studies. Study inclusion, data extraction, and risk of bias assessment were performed by two researchers independently. Pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated to assess the diagnostic value. In addition, heterogeneity and subgroup analysis were carried out. In total, 18 studies comprising 3463 patients were selected. The results of 3D-TOF-MRA for diagnosing IA were SEN 0.89 (95% CI 0.82-0.94), SPE 0.94 (0.86-0.97), PLR 13.79 (5.92-32.12), NLR 0.11 (0.07-0.19), DOR 121.90 (38.81-382.94), and AUC 0.96 (0.94-0.98), respectively. In the subgroup analysis, studies without subarachnoid hemorrhage (SAH) tend to perform statistical significantly better (P 3D-TOF-MRA had better SEN in aneurysms > 3 mm than the aneurysms ≤ 3 mm in diameter: 0.89 (0.87-0.92) vs. 0.78 (0.71-0.84) with P 3D-TOF-MRA has an excellent diagnostic performance for the overall assessment of IA and may serve as an alternative for further patient management with IA.

  5. Feature-tracking myocardial strain analysis in acute myocarditis. Diagnostic value and association with myocardial oedema

    Energy Technology Data Exchange (ETDEWEB)

    Luetkens, Julian A.; Schlesinger-Irsch, Ulrike; Kuetting, Daniel L.; Dabir, Darius; Homsi, Rami; Schmeel, Frederic C.; Sprinkart, Alois M.; Naehle, Claas P.; Schild, Hans H.; Thomas, Daniel [University of Bonn, Department of Radiology, Bonn (Germany); Doerner, Jonas [University Hospital Cologne, Department of Radiology, Cologne (Germany); Fimmers, Rolf [University of Bonn, Department of Medical Biometry, Informatics, and Epidemiology, Bonn (Germany)

    2017-11-15

    To investigate the diagnostic value of cardiac magnetic resonance (CMR) feature-tracking (FT) myocardial strain analysis in patients with suspected acute myocarditis and its association with myocardial oedema. Forty-eight patients with suspected acute myocarditis and 35 control subjects underwent CMR. FT CMR analysis of systolic longitudinal (LS), circumferential (CS) and radial strain (RS) was performed. Additionally, the protocol allowed for the assessment of T1 and T2 relaxation times. When compared with healthy controls, myocarditis patients demonstrated reduced LS, CS and RS values (LS: -19.5 ± 4.4% vs. -23.6 ± 3.1%, CS: -23.0 ± 5.8% vs. -27.4 ± 3.4%, RS: 28.9 ± 8.5% vs. 32.4 ± 7.4%; P < 0.05, respectively). LS (T1: r = 0.462, P < 0.001; T2: r = 0.436, P < 0.001) and CS (T1: r = 0.429, P < 0.001; T2: r = 0.467, P < 0.001) showed the strongest correlations with T1 and T2 relaxations times. Area under the curve of LS (0.79) was higher compared with those of CS (0.75; P = 0.478) and RS (0.62; P = 0.008). FT CMR myocardial strain analysis might serve as a new tool for assessment of myocardial dysfunction in the diagnostic work-up of patients suspected of having acute myocarditis. Especially, LS and CS show a sufficient diagnostic performance and were most closely correlated with CMR parameters of myocardial oedema. (orig.)

  6. Feature-tracking myocardial strain analysis in acute myocarditis. Diagnostic value and association with myocardial oedema

    International Nuclear Information System (INIS)

    Luetkens, Julian A.; Schlesinger-Irsch, Ulrike; Kuetting, Daniel L.; Dabir, Darius; Homsi, Rami; Schmeel, Frederic C.; Sprinkart, Alois M.; Naehle, Claas P.; Schild, Hans H.; Thomas, Daniel; Doerner, Jonas; Fimmers, Rolf

    2017-01-01

    To investigate the diagnostic value of cardiac magnetic resonance (CMR) feature-tracking (FT) myocardial strain analysis in patients with suspected acute myocarditis and its association with myocardial oedema. Forty-eight patients with suspected acute myocarditis and 35 control subjects underwent CMR. FT CMR analysis of systolic longitudinal (LS), circumferential (CS) and radial strain (RS) was performed. Additionally, the protocol allowed for the assessment of T1 and T2 relaxation times. When compared with healthy controls, myocarditis patients demonstrated reduced LS, CS and RS values (LS: -19.5 ± 4.4% vs. -23.6 ± 3.1%, CS: -23.0 ± 5.8% vs. -27.4 ± 3.4%, RS: 28.9 ± 8.5% vs. 32.4 ± 7.4%; P < 0.05, respectively). LS (T1: r = 0.462, P < 0.001; T2: r = 0.436, P < 0.001) and CS (T1: r = 0.429, P < 0.001; T2: r = 0.467, P < 0.001) showed the strongest correlations with T1 and T2 relaxations times. Area under the curve of LS (0.79) was higher compared with those of CS (0.75; P = 0.478) and RS (0.62; P = 0.008). FT CMR myocardial strain analysis might serve as a new tool for assessment of myocardial dysfunction in the diagnostic work-up of patients suspected of having acute myocarditis. Especially, LS and CS show a sufficient diagnostic performance and were most closely correlated with CMR parameters of myocardial oedema. (orig.)

  7. Medical expert system for assessment of coronary heart disease destabilization based on the analysis of the level of soluble vascular adhesion molecules

    Science.gov (United States)

    Serkova, Valentina K.; Pavlov, Sergey V.; Romanava, Valentina A.; Monastyrskiy, Yuriy I.; Ziepko, Sergey M.; Kuzminova, Nanaliya V.; Wójcik, Waldemar; DzierŻak, RóŻa; Kalizhanova, Aliya; Kashaganova, Gulzhan

    2017-08-01

    Theoretical and practical substantiation of the possibility of the using the level of soluble vascular adhesion molecules (sVCAM) is performed. Expert system for the assessment of coronary heart disease (CHD) destabilization on the base of the analysis of soluble vascular adhesion molecules level is developed. Correlation between the increase of VCAM level and C-reactive protein (CRP) in patients with different variants of CHD progression is established. Association of chronic nonspecific vascular inflammation activation and CHD destabilization is shown. The expedience of parallel determination of sVCAM and CRP levels for diagnostics of CHD destabilization and forecast elaboration is noted.

  8. Current Status on Stress Diagnostic Kit and Detection Technology

    International Nuclear Information System (INIS)

    Park, Sang Hyun; Choi, Mi Hee; Ko, Kyong Cheol

    2008-06-01

    The accurate measurement of a stress level is one of the most important issues in a stress diagnosis and its measurement could be of great value in clinical medicine. Stress has a potent effect on the spirit and physical condition of an individual. There are various methods available for its measurement. Some of the commonly used techniques for the diagnosis of a stress level include analysis of the body fluids, questionnaire assessments, psychophysiological evaluations and by determining heart rate variability (HRV) of subjects. However, the existing diagnostic methods have several defects like, a low sensitivity, inaccuracy and long of operation time. In this report, we present a diagnostic technology to detect a stress level which is the origin of various diseases. This method can be of great help in providing an early diagnosis through a biosensor and might play a vital role in preventing diseases like hypochondria and hypertension. Majority of the human population is exposed to stress in one way or another and hence developing a convenient stress diagnosis kit will be of great use to all. This stress diagnostic kit and detection technology dose not involve simple a mechanical measurement or questionnaires, but is based on developing a detection kit with a high sensitivity, which will mean an easy use for common man. Individuals can undergo regular check ups and can personally diagnose their present situation of health by determining their stress levels, thus enabling them to diagnose the early onset of several stress disorders. This might help them take precautionary measures and thereby lead to a healthy life

  9. Current Status on Stress Diagnostic Kit and Detection Technology

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sang Hyun; Choi, Mi Hee; Ko, Kyong Cheol

    2008-06-15

    The accurate measurement of a stress level is one of the most important issues in a stress diagnosis and its measurement could be of great value in clinical medicine. Stress has a potent effect on the spirit and physical condition of an individual. There are various methods available for its measurement. Some of the commonly used techniques for the diagnosis of a stress level include analysis of the body fluids, questionnaire assessments, psychophysiological evaluations and by determining heart rate variability (HRV) of subjects. However, the existing diagnostic methods have several defects like, a low sensitivity, inaccuracy and long of operation time. In this report, we present a diagnostic technology to detect a stress level which is the origin of various diseases. This method can be of great help in providing an early diagnosis through a biosensor and might play a vital role in preventing diseases like hypochondria and hypertension. Majority of the human population is exposed to stress in one way or another and hence developing a convenient stress diagnosis kit will be of great use to all. This stress diagnostic kit and detection technology dose not involve simple a mechanical measurement or questionnaires, but is based on developing a detection kit with a high sensitivity, which will mean an easy use for common man. Individuals can undergo regular check ups and can personally diagnose their present situation of health by determining their stress levels, thus enabling them to diagnose the early onset of several stress disorders. This might help them take precautionary measures and thereby lead to a healthy life.

  10. Feminist identity as a predictor of eating disorder diagnostic status.

    Science.gov (United States)

    Green, Melinda A; Scott, Norman A; Riopel, Cori M; Skaggs, Anna K

    2008-06-01

    Passive Acceptance (PA) and Active Commitment (AC) subscales of the Feminist Identity Development Scale (FIDS) were examined as predictors of eating disorder diagnostic status as assessed by the Questionnaire for Eating Disorder Diagnoses (Q-EDD). Results of a hierarchical regression analysis revealed PA and AC scores were not statistically significant predictors of ED diagnostic status after controlling for diagnostic subtype. Results of a multiple regression analysis revealed FIDS as a statistically significant predictor of ED diagnostic status when failing to control for ED diagnostic subtype. Discrepancies suggest ED diagnostic subtype may serve as a moderator variable in the relationship between ED diagnostic status and FIDS. (c) 2008 Wiley Periodicals, Inc.

  11. Space elevator systems level analysis

    Energy Technology Data Exchange (ETDEWEB)

    Laubscher, B. E. (Bryan E.)

    2004-01-01

    The Space Elevator (SE) represents a major paradigm shift in space access. It involves new, untried technologies in most of its subsystems. Thus the successful construction of the SE requires a significant amount of development, This in turn implies a high level of risk for the SE. This paper will present a systems level analysis of the SE by subdividing its components into their subsystems to determine their level of technological maturity. such a high-risk endeavor is to follow a disciplined approach to the challenges. A systems level analysis informs this process and is the guide to where resources should be applied in the development processes. It is an efficient path that, if followed, minimizes the overall risk of the system's development. systems level analysis is that the overall system is divided naturally into its subsystems, and those subsystems are further subdivided as appropriate for the analysis. By dealing with the complex system in layers, the parameter space of decisions is kept manageable. Moreover, A rational way to manage One key aspect of a resources are not expended capriciously; rather, resources are put toward the biggest challenges and most promising solutions. This overall graded approach is a proven road to success. The analysis includes topics such as nanotube technology, deployment scenario, power beaming technology, ground-based hardware and operations, ribbon maintenance and repair and climber technology.

  12. Cosmological reconstruction and Om diagnostic analysis of Einstein-Aether theory

    Energy Technology Data Exchange (ETDEWEB)

    Pasqua, Antonio [Department of Physics, University of Trieste, Via Valerio 2, 34127 Trieste (Italy); Chattopadhyay, Surajit [Pailan College of Management and Technology, Bengal Pailan Park, Kolkata-700 104 (India); Momeni, Davood; Myrzakulov, Ratbay [Eurasian International Center for Theoretical Physics and Department of General and Theoretical Physics, Eurasian National University, Astana 010008 (Kazakhstan); Raza, Muhammad [Department of Mathematics, COMSATS Institute of Information Technology, Sahiwal 57000 (Pakistan); Faizal, Mir, E-mail: toto.pasqua@gmail.com, E-mail: surajcha@iucaa.ernet.in, E-mail: d.momeni@yahoo.com, E-mail: mraza@zju.edu.cn, E-mail: rmyrzakulov@gmail.com, E-mail: mirfaizalmir@gmail.com [Irving K. Barber School of Arts and Sciences, University of British Columbia—Okanagan, Kelowna, British Columbia V1V 1V7 (Canada)

    2017-04-01

    In this paper, we analyze the cosmological models in Einstein-Aether gravity, which is a modified theory of gravity in which a time-like vector field breaks the Lorentz symmetry. We use this formalism to analyse different cosmological models with different behavior of the scale factor. In this analysis, we use a certain functional dependence of the Dark Energy (DE) on the Hubble parameter H . It will be demonstrated that the Aether vector field has a non-trivial effect on these cosmological models. We also perform the Om diagnostic in Einstein-Aether gravity and we fit the parameters of the cosmological models using recent observational data.

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

    Data.gov (United States)

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

  16. An analysis of cancer death risk among medical diagnostic X-ray workers in China, 1950-1995

    International Nuclear Information System (INIS)

    Zhao Yongcheng; Wang Jixian; Zhang Wei; Li Benxiao; Fan Tiqiang; Zhang Jingyuan

    2002-01-01

    Objective: To investigate effects of occupational radiation exposure on cancer death among medical diagnostic X-ray workers. Methods: A cohort study on medical diagnostic X-ray workers and non-X-ray medical workers was carried out and a risk analysis of cancer death between 1950 and 1995 was conducted with the O/E system. Results: A significant enhancement in cancer death risk for X-ray workers was found, especially those engaged in X-ray work in early calendar years. The overall cancer RR was 1.26, (95 % CI: 1.14 - 1.38), for leukemia it was 2.48, (95% CI: 1.68-3.51 ); for esophagus cancer, 3.18, (95% CI: 2.02 -4.77); for liver cancer, 1.54, (95 % CI: 1.27 - 1.86); and for bone cancer, 2.48, (95 % CI: 1.00 - 5.40). In the late calendar year cohort a significant enhancement of cancer death was seen only in esophagus cancer (RR = 4.19, 95 % CI: 1.80 - 8.25) and lung cancer (RR = 1.60, 95% CI:1.10-2.25). Conclusion: Long-term occupational X-ray irradiation can enhance the risk of cancer death when the cumulative dose reached a certain level. The significant enhancement of cancer death for leukemia and some solid cancers may be related to the occupational exposure to X-rays

  17. Cancer risk analysis among medical diagnostic X-ray workers in China

    International Nuclear Information System (INIS)

    Wang Jixian; Li Benxiao; Gao Zhiwei; Xu Jun; Zhang Jingyuan; Aoyama, Takashi; Sugahara, Tsutomu

    1997-01-01

    To provide the evidence and related rules of human malignant tumors produced by prolonged exposure to low level ionizing radiation. The cancer incidence (1950-1990) among 27011 medical diagnostic X-ray workers was compared with that among 25782 other medical specialists employed between 1950 and 1980 in China by means of O/E system. A significantly elevated risk of cancer was seen among diagnostic x-ray workers (RR = 1.1,95%Cl:1.0-1.2,P <0.05). Significantly elevated risks were seen for leukemia and cancers of skin, female breast, liver and esophagus, the RR being 2.3, 5.0, 1.6, 1.3 and 4.4 respectively. The RR for leukemia was higher for X-ray workers who began employment before 1970 and also for those who were young when employment began. The patterns of risk associated with length of service and with age and calendar year of initial employment suggest that the excesses of leukemia, skin cancer and female breast cancer were due to occupational exposure to X-rays. The ERR and EAR for leukemia and solid cancer were calculated roughly. (author)

  18. Diagnostic accuracy of 64 multislice CT angiography in the assessment of coronary in-stent restenosis: A meta-analysis

    International Nuclear Information System (INIS)

    Sun Zhonghua; Almutairi, Abdulrahman Marzouq D.

    2010-01-01

    Purpose: The aim of this study was to perform a meta-analysis of the diagnostic accuracy of 64-slice CT angiography for the detection of coronary in-stent restenosis in patients treated with coronary stents when compared to conventional coronary angiography. Materials and methods: A search of PUBMED/MEDLINE, ProQuest and Cochrane library databases for English literature was performed. Only studies comparing 64-slice CT angiography with conventional coronary angiography for the detection of coronary in-stent restenosis (more than 50% stenosis) were included for analysis. Sensitivity and specificity estimates pooled across studies were tested using a fixed effects model. Results: Fourteen studies met selection criteria for inclusion in the analysis. The mean value of assessable stents was 89%. Prevalence of in-stent restenosis following coronary stenting was 20% among these studies. Pooled estimates of the sensitivity and specificity of overall 64-slice CT angiography for the detection of coronary in-stent restenosis was 90% (95% CI: 86%, 94%) and 91% (95% CI: 90%, 93%), respectively, based on the evaluation of assessable stents. Diagnostic value of 64-slice CT angiography was found to decrease significantly when the analysis was performed with inclusion of nonassessable segments in five studies, with pooled sensitivity and specificity being 79% (95% CI: 68%, 88%) and 81% (95% CI: 77%, 84%). Stent diameter is the main factor affecting the diagnostic value of 64-slice CT angiography. Conclusion: Our results showed that 64-slice CT angiography has high diagnostic value (both sensitivity and specificity) for detection of coronary in-stent restenosis based on assessable segments when compared to conventional coronary angiography.

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

    International Nuclear Information System (INIS)

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

    1980-07-01

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

  20. Challenges of ITER diagnostic electrical services

    Energy Technology Data Exchange (ETDEWEB)

    Encheva, A., E-mail: anna.encheva@iter.org [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-Lez-Durance (France); Omran, H. [Oxford Technologies Ltd, 7 Nuffield Way, Abingdon OX14 1RL (United Kingdom); Pérez-Lasala, M. [The European Joint Undertaking for ITER and the Development of Fusion Energy, c/Josep Pla, n° 2, Torres Diagonal Litoral, Edificio B3, 08019 Barcelona (Spain); Alekseev, A. [Efremov Institute, Metallostroy, Doroga na Metallostroy, 3 bld., Saint-Petersburg 196641 (Russian Federation); Arshad, S. [The European Joint Undertaking for ITER and the Development of Fusion Energy, c/Josep Pla, n° 2, Torres Diagonal Litoral, Edificio B3, 08019 Barcelona (Spain); Bede, O. [Oxford Technologies Ltd, 7 Nuffield Way, Abingdon OX14 1RL (United Kingdom); Bender, S. [Efremov Institute, Metallostroy, Doroga na Metallostroy, 3 bld., Saint-Petersburg 196641 (Russian Federation); Bertalot, L.; Direz, M.-F.; Drevon, J.-M.; Jakhar, S.; Kaschuk, Y.; Komarov, V.; Lebarbier, R. [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-Lez-Durance (France); Lucca, F. [L.T. Calcoli SaS, Piazza Prinetti 26/B, 23807 Merate (Italy); Macklin, B.; Maquet, P. [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-Lez-Durance (France); Marin, A. [L.T. Calcoli SaS, Piazza Prinetti 26/B, 23807 Merate (Italy); Martin, A. [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-Lez-Durance (France); Mills, S. [Oxford Technologies Ltd, 7 Nuffield Way, Abingdon OX14 1RL (United Kingdom); and others

    2013-10-15

    Highlights: • A brief description of all major components part of diagnostic electrical services has been given. • The integration challenges have been presented. • Design assumptions and requirements for the components have been described. • The design of the conduit/loom and the relevant analysis has been highlighted. -- Abstract: Diagnostic electrical services provide the electrical infrastructure to serve diagnostic components installed on the ITER tokamak. This infrastructure is composed of cables, connectors, cable tails, looms, conduits and feedthroughs. The diagnostic services offer as well a shelter for various instrumentations – vacuum vessel (VV), blanket and divertor. The diagnostic sensors are located on the inner and outer VV wall, on blanket shield modules, divertor cassettes and in port plugs. They require electrical cabling to extract the measurement and, in some cases, to supply electrical power to the sensors. These cables run from the sensors to feedthroughs on the VV and the port interspace or cryostat. The design and integration of all components that are part of diagnostic electrical services is an important engineering activity that is being challenged by the multiple requirements and constraints which have to be satisfied while at the same time delivering the required diagnostic performance. The positioning of the components must correlate not only with their functional specifications but also with the design of the major ITER components. This is a particular challenge because not all systems have reached the same level of design maturity. This paper outlines the engineering challenges of ITER diagnostics electrical services. The environmental conditions inside the VV will have an important impact. Leading risks to these components include poor electrical contact at connectors, the effects of exposure to nuclear irradiation, such as material transmutation, heating, and generation of spurious electrical signals etc., failure due to

  1. Diagnostic value of 3D time-of-flight magnetic resonance angiography for detecting intracranial aneurysm: a meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Liu, HaiFeng; Xu, YongSheng [First Hospital of LanZhou University, Department of Radiology, Lanzhou, Gansu (China); First Clinical Medical College of LanZhou University, Lanzhou, Gansu (China); Xun, YangQin [Lanzhou University, Evidence-based Medicine Center, Lanzhou (China); Dou, Yu; Wang, ShuaiWen; Lu, XingRu; Lei, JunQiang [First Hospital of LanZhou University, Department of Radiology, Lanzhou, Gansu (China)

    2017-11-15

    This meta-analysis is to comprehensively evaluate the diagnostic performance of three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) for detecting intracranial aneurysm (IA). PubMed, Embase, Web of Science, and the Cochrane library were systematically searched for retrieving eligible studies. Study inclusion, data extraction, and risk of bias assessment were performed by two researchers independently. Pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated to assess the diagnostic value. In addition, heterogeneity and subgroup analysis were carried out. In total, 18 studies comprising 3463 patients were selected. The results of 3D-TOF-MRA for diagnosing IA were SEN 0.89 (95% CI 0.82-0.94), SPE 0.94 (0.86-0.97), PLR 13.79 (5.92-32.12), NLR 0.11 (0.07-0.19), DOR 121.90 (38.81-382.94), and AUC 0.96 (0.94-0.98), respectively. In the subgroup analysis, studies without subarachnoid hemorrhage (SAH) tend to perform statistical significantly better (P < 0.05) in detecting IAs than studies with SAH 0.99 (0.98-1.00) vs. 0.89 (0.86-0.91). The diagnostic value of studies with a two-image reconstruction method was higher than studies with only one image reconstruction method: 0.99 (0.98-1.00) vs. 0.91 (0.89-0.94) with P < 0.05. The 3D-TOF-MRA had better SEN in aneurysms > 3 mm than the aneurysms ≤ 3 mm in diameter: 0.89 (0.87-0.92) vs. 0.78 (0.71-0.84) with P < 0.05. This study demonstrated that 3D-TOF-MRA has an excellent diagnostic performance for the overall assessment of IA and may serve as an alternative for further patient management with IA. (orig.)

  2. The Prospective External Validation of International Ovarian Tumor Analysis (IOTA) Simple Rules in the Hands of Level I and II Examiners.

    Science.gov (United States)

    Knafel, A; Banas, T; Nocun, A; Wiechec, M; Jach, R; Ludwin, A; Kabzinska-Turek, M; Pietrus, M; Pitynski, K

    2016-10-01

    Objective: To externally validate the International Ovarian Tumor Analysis (IOTA) Simple Rules (SR) by examiners with different levels of sonographic experience defined by the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) and to assess the morphological ultrasound features of the adnexal tumors classified as inconclusive based on IOTA SR. Materials and Methods: In the two-year prospective study adnexal tumors were assessed preoperatively with transvaginal ultrasound by examiners with different levels of experience (level 1- IOTA SR1, level 2-IOTA SR2). Additionally, an expert (level 3) evaluated all tumors by subjective assessment (SA). If the rules could not be applied, the tumors were considered inconclusive. The final diagnosis was based on the histopathological result of the removed mass. The diagnostic performance measures for the assessed model were sensitivity, specificity, negative (LR-) and positive(LR+) likelihood ratios, accuracy (ACC) and diagnostic odds ratio (DOR). Results: 226 women with adnexal tumors scheduled for surgery were included in the stutdy. The prevalence of malignancy was 36.3 % in the group of all studied tumors and was 52.5 % in the inconclusive group (n = 40) (p = 0.215). Fewer tumors were classified as inconclusive by level 2 examiners compared to level 1 examiners [20 (8.8 %) vs. 40 (17.7 %); p = 0.008], resulting from the discrepancy in the evaluation of acoustic shadows and the vascularization within the tumor. For level 1 examiners a diagnostic strategy using IOTA SR1 +MA (assuming malignancy when SR inconclusive) achieved a sensitivity, specificity and DOR of 96.3 %, 81.9 %, 13.624 respectively. For level 2 examiners the diagnostic strategy for IOTA SR2 +MA achieved a sensitivity, specificity and DOR of 95.1 %, 89.6 %, 137,143, respectively. Adding SA by an expert (or level 3 examiner) when IOTA SR were not applicable improved the specificity of the test and

  3. Microfluidic-integrated biosensors: prospects for point-of-care diagnostics.

    Science.gov (United States)

    Kumar, Suveen; Kumar, Saurabh; Ali, Md Azahar; Anand, Pinki; Agrawal, Ved Varun; John, Renu; Maji, Sagar; Malhotra, Bansi D

    2013-11-01

    There is a growing demand to integrate biosensors with microfluidics to provide miniaturized platforms with many favorable properties, such as reduced sample volume, decreased processing time, low cost analysis and low reagent consumption. These microfluidics-integrated biosensors would also have numerous advantages such as laminar flow, minimal handling of hazardous materials, multiple sample detection in parallel, portability and versatility in design. Microfluidics involves the science and technology of manipulation of fluids at the micro- to nano-liter level. It is predicted that combining biosensors with microfluidic chips will yield enhanced analytical capability, and widen the possibilities for applications in clinical diagnostics. The recent developments in microfluidics have helped researchers working in industries and educational institutes to adopt some of these platforms for point-of-care (POC) diagnostics. This review focuses on the latest advancements in the fields of microfluidic biosensing technologies, and on the challenges and possible solutions for translation of this technology for POC diagnostic applications. We also discuss the fabrication techniques required for developing microfluidic-integrated biosensors, recently reported biomarkers, and the prospects of POC diagnostics in the medical industry. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. The Methodological Aspect of the Diagnostics of Objects in Economics

    Directory of Open Access Journals (Sweden)

    Grynko Pavlo О.

    2017-12-01

    Full Text Available The article on the basis of morphological analysis defines the concept of «diagnostics in economics». The differences of diagnostics in economics, economic diagnostics, and analysis in economics were analyzed. The types, functions, principles of diagnostics in economics in modern conditions have been substantiated. The interrelationship of diagnostics with other functions of management in economics has been concretized. The logic and contents of stages of the diagnostic technology in economics have been clarified. The reliability of diagnostics in economics is determined by analytical tools, which are applicable in its implementation. Recommendations of analytical tools for realization of diagnostics in economics have been substantiated. A structural-logical scheme of diagnostics in economics, firming its scientific base and providing objectivity in practical implementation has been proposed.

  5. Plasma impact on diagnostic mirrors in JET

    Directory of Open Access Journals (Sweden)

    A. Garcia-Carrasco

    2017-08-01

    Full Text Available Metallic mirrors will be essential components of all optical systems for plasma diagnosis in ITER. This contribution provides a comprehensive account on plasma impact on diagnostic mirrors in JET with the ITER-Like Wall. Specimens from the First Mirror Test and the lithium-beam diagnostic have been studied by spectrophotometry, ion beam analysis and electron microscopy. Test mirrors made of molybdenum were retrieved from the main chamber and the divertor after exposure to the 2013–2014 experimental campaign. In the main chamber, only mirrors located at the entrance of the carrier lost reflectivity (Be deposition, while those located deeper in the carrier were only slightly affected. The performance of mirrors in the JET divertor was strongly degraded by deposition of beryllium, tungsten and other species. Mirrors from the lithium-beam diagnostic have been studied for the first time. Gold coatings were severely damaged by intense arcing. As a consequence, material mixing of the gold layer with the stainless steel substrate occurred. Total reflectivity dropped from over 90% to less than 60%, i.e. to the level typical for stainless steel.

  6. Diagnostic accuracy of quantitative 99mTc-MIBI scintimammography according to ROC curve analysis

    International Nuclear Information System (INIS)

    Kim, J. H.; Lee, H. K.; Seo, J. W.; Cho, N. S.; Cha, K. H.; Lee, T. H.

    1998-01-01

    99mTc-sestamibi scintimammography (SMM) has been shown to be a useful diagnostic test in the detection of breast cancer and the receiver operating characteristic (ROC) curve analysis provides detailed information of a diagnostic test. The purpose of this study was to evaluate the feasibility and efficacy of quantitative indices of SMM in the detection of malignant breast lesions according to ROC analysis. Prone anterior, lateral planar and supine SPECT imagings were performed on 75 female patients (mean age=43.4 yr) with breast mass (size≥0.8cm) after intravenous injection of 20-30 mCi 99mTc-sestamibi. 45 Malignant (Invasive ductal ca(36), Inv lobular ca(5), Inv duc + lob (1), Inv tubular ca (3)) and 30 benign (fibroadenoma (13), fib cyst(12), Fat necrosis(3), papilloma(1), paraffinoma (1)) lesions were histologically proven. Data were analyzed by creating three regions of interest (ROIs) over designated areas: lesion, normal breast and right chest wall. Lesion to normal (L/NL) and lesion to chest wall (L/CW) ratios were calculated for each patient both on the planar and SPECT. The area under the ROC curve (AUC) was calculated and compared among four semiquantitative indices and an average scintimammographic index (SMM(mean)) from arithmatic mean. ROC curve analysis revealed planar L/N, SPECT L/N and L/CW ratios provide comparable better diagnostic accuracies for detection of breast cancer than planar L/CW ratio (p<0.05), respectively. For quantitative SMM of 75 lesions, malignancy rate was 60%, and Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value and Accuracy were 0.78, 0.77, 0.84, 0.72 and 0.77, respectively. Quantitative SMM is an useful objective method for differentiating malignant from benign breast lesions

  7. Diagnostic accuracy of quantitative 99mTc-MIBI scintimammography according to ROC curve analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J. H.; Lee, H. K.; Seo, J. W.; Cho, N. S.; Cha, K. H.; Lee, T. H. [Gachon Medical College, Gil Medical Center, Inchon (Korea, Republic of)

    1998-07-01

    99mTc-sestamibi scintimammography (SMM) has been shown to be a useful diagnostic test in the detection of breast cancer and the receiver operating characteristic (ROC) curve analysis provides detailed information of a diagnostic test. The purpose of this study was to evaluate the feasibility and efficacy of quantitative indices of SMM in the detection of malignant breast lesions according to ROC analysis. Prone anterior, lateral planar and supine SPECT imagings were performed on 75 female patients (mean age=43.4 yr) with breast mass (size{>=}0.8cm) after intravenous injection of 20-30 mCi 99mTc-sestamibi. 45 Malignant (Invasive ductal ca(36), Inv lobular ca(5), Inv duc + lob (1), Inv tubular ca (3)) and 30 benign (fibroadenoma (13), fib cyst(12), Fat necrosis(3), papilloma(1), paraffinoma (1)) lesions were histologically proven. Data were analyzed by creating three regions of interest (ROIs) over designated areas: lesion, normal breast and right chest wall. Lesion to normal (L/NL) and lesion to chest wall (L/CW) ratios were calculated for each patient both on the planar and SPECT. The area under the ROC curve (AUC) was calculated and compared among four semiquantitative indices and an average scintimammographic index (SMM(mean)) from arithmatic mean. ROC curve analysis revealed planar L/N, SPECT L/N and L/CW ratios provide comparable better diagnostic accuracies for detection of breast cancer than planar L/CW ratio (p<0.05), respectively. For quantitative SMM of 75 lesions, malignancy rate was 60%, and Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value and Accuracy were 0.78, 0.77, 0.84, 0.72 and 0.77, respectively. Quantitative SMM is an useful objective method for differentiating malignant from benign breast lesions.

  8. 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...

  9. Levels of narrative analysis in health psychology.

    Science.gov (United States)

    Murray, M

    2000-05-01

    The past 10-15 years have seen a rapid increase in the study of narrative across all the social sciences. It is sometimes assumed that narrative has the same meaning irrespective of the context in which it is expressed. This article considers different levels of narrative analysis within health psychology. Specifically, it considers the character of health and illness narratives as a function of the personal, interpersonal, positional and societal levels of analysis. At the personal level of analysis narratives are portrayed as expressions of the lived experience of the narrator. At the interpersonal level of analysis the narrative is one that is co-created in dialogue. At the positional level of analysis the analysis considers the differences in social position between the narrator and the listener. The societal level of analysis is concerned with the socially shared stories that are characteristic of certain communities or societies. The challenge is to articulate the connections between these different levels of narrative analysis and to develop strategies to promote emancipatory narratives.

  10. Molecular diagnostics of periodontitis

    OpenAIRE

    Izabela Korona-Głowniak; Radosław Siwiec; Marcin Berger; Anna Malm; Jolanta Szymańska

    2017-01-01

    The microorganisms that form dental plaque are the main cause of periodontitis. Their identification and the understanding of the complex relationships and interactions that involve these microorganisms, environmental factors and the host’s health status enable improvement in diagnostics and targeted therapy in patients with periodontitis. To this end, molecular diagnostics techniques (both techniques based on the polymerase chain reaction and those involving nucleic acid analysis via hybridi...

  11. Admixture analysis of the diagnostic subtypes of social anxiety disorder: implications for the DSM-V.

    Science.gov (United States)

    Aderka, Idan M; Nickerson, Angela; Hofmann, Stefan G

    2012-06-01

    Much controversy exists regarding diagnostic subtypes of social anxiety disorder (SAD). The present study used admixture analysis to examine whether individuals with generalized and nongeneralized SAD belong to the same or different populations of origin. This can inform diagnostic subtyping of SAD in the forthcoming DSM-V. Treatment-seeking individuals with generalized SAD (n = 154) and nongeneralized SAD (n = 48) completed a battery of questionnaires. Based on participants' responses to the Liebowitz Social Anxiety Scale (LSAS), we estimated log likelihood and chi-square goodness-of-fit for models with 1, 2, 3, or 4 populations of origin, and compared models using forward stepwise estimation and maximum likelihood ratio tests. Admixture analyses suggested that the two diagnostic subtypes of SAD belong to the same underlying population of origin. In addition, observable differences in depression, general anxiety, and comorbidity were no longer significant when controlling for social anxiety severity. Our sample was recruited in the U.S. and was a treatment-seeking sample. Future studies should examine whether our results generalize to different cultures, and community samples. Support for qualitative differences between SAD subtypes was not found. Rather, our findings support the notion that the diagnostic subtypes of SAD differ quantitatively, and that SAD exists on a continuum of severity. This finding informs diagnostic subtyping of SAD in the forthcoming DSM-V. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Image acquisition and analysis for beam diagnostics, applications of the Taiwan photon source

    International Nuclear Information System (INIS)

    Liao, C.Y.; Chen, J.; Cheng, Y.S.; Hsu, K.T.; Hu, K.H.; Kuo, C.H.; Wu, C.Y.

    2012-01-01

    Design and implementation of image acquisition and analysis is in proceeding for the Taiwan Photon Source (TPS) diagnostic applications. The optical system contains screen, lens, and lighting system. A CCD camera with Gigabit Ethernet interface (GigE Vision) will be a standard image acquisition device. Image acquisition will be done on EPICS IOC via PV channel and analysis the properties by using Matlab tool to evaluate the beam profile (sigma), beam size position and tilt angle et al. The EPICS IOC integrated with Matlab as a data processing system is not only could be used in image analysis but also in many types of equipment data processing applications. Progress of the project will be summarized in this report. (authors)

  13. Corpuscular plasma diagnostics

    International Nuclear Information System (INIS)

    Afrosimov, V.; Petrov, M.

    1984-01-01

    An elementary explanation is presented of the physical principles and important methods of corpuscular plasma diagnostics. The invaluable role of corpuscular methods for measuring the hot plasma ion component in thermonuclear facilities, especially hydrogen ions in tokamaks, is emphasized. All corpuscular methods employ analysis of fast neutral atoms and therefore the mechanism of their creation inside a hot plasma is explained first. The ammount of information obtainable from spectra of fast neutrals is discussed. Multichannel analyzers developed at the FTI A.F. Ioffe in Leningrad are described in detail. Classical passive corpuscular diagnostics are examined as are active methods using artifitial beams of hydrogen atoms. The method used for obtaining local values of ion temperature and density is explained. Corpuscular spectroscopic diagnostics and its application for measuring impurities is mentioned. (J.U.)

  14. Cancer imaging phenomics toolkit: quantitative imaging analytics for precision diagnostics and predictive modeling of clinical outcome.

    Science.gov (United States)

    Davatzikos, Christos; Rathore, Saima; Bakas, Spyridon; Pati, Sarthak; Bergman, Mark; Kalarot, Ratheesh; Sridharan, Patmaa; Gastounioti, Aimilia; Jahani, Nariman; Cohen, Eric; Akbari, Hamed; Tunc, Birkan; Doshi, Jimit; Parker, Drew; Hsieh, Michael; Sotiras, Aristeidis; Li, Hongming; Ou, Yangming; Doot, Robert K; Bilello, Michel; Fan, Yong; Shinohara, Russell T; Yushkevich, Paul; Verma, Ragini; Kontos, Despina

    2018-01-01

    The growth of multiparametric imaging protocols has paved the way for quantitative imaging phenotypes that predict treatment response and clinical outcome, reflect underlying cancer molecular characteristics and spatiotemporal heterogeneity, and can guide personalized treatment planning. This growth has underlined the need for efficient quantitative analytics to derive high-dimensional imaging signatures of diagnostic and predictive value in this emerging era of integrated precision diagnostics. This paper presents cancer imaging phenomics toolkit (CaPTk), a new and dynamically growing software platform for analysis of radiographic images of cancer, currently focusing on brain, breast, and lung cancer. CaPTk leverages the value of quantitative imaging analytics along with machine learning to derive phenotypic imaging signatures, based on two-level functionality. First, image analysis algorithms are used to extract comprehensive panels of diverse and complementary features, such as multiparametric intensity histogram distributions, texture, shape, kinetics, connectomics, and spatial patterns. At the second level, these quantitative imaging signatures are fed into multivariate machine learning models to produce diagnostic, prognostic, and predictive biomarkers. Results from clinical studies in three areas are shown: (i) computational neuro-oncology of brain gliomas for precision diagnostics, prediction of outcome, and treatment planning; (ii) prediction of treatment response for breast and lung cancer, and (iii) risk assessment for breast cancer.

  15. Cost-effectiveness analysis of rapid diagnostic test, microscopy and syndromic approach in the diagnosis of malaria in Nigeria: implications for scaling-up deployment of ACT

    Directory of Open Access Journals (Sweden)

    Onwujekwe Obinna E

    2009-11-01

    Full Text Available Abstract Background The diagnosis and treatment of malaria is often based on syndromic presentation (presumptive treatment and microscopic examination of blood films. Treatment based on syndromic approach has been found to be costly, and contributes to the development of drug resistance, while microscopic diagnosis of malaria is time-consuming and labour-intensive. Also, there is lack of trained microscopists and reliable equipment especially in rural areas of Nigeria. However, although rapid diagnostic tests (RDTs have improved the ease of appropriate diagnosis of malaria diagnosis, the cost-effectiveness of RDTs in case management of malaria has not been evaluated in Nigeria. The study hence compares the cost-effectiveness of RDT versus syndromic diagnosis and microscopy. Methods A total of 638 patients with fever, clinically diagnosed as malaria (presumptive malaria by health workers, were selected for examination with both RDT and microscopy. Patients positive on RDT received artemisinin-based combination therapy (ACT and febrile patients negative on RDT received an antibiotic treatment. Using a decision tree model for a hypothetical cohort of 100,000 patients, the diagnostic alternatives considered were presumptive treatment (base strategy, RDT and microscopy. Costs were based on a consumer and provider perspective while the outcome measure was deaths averted. Information on costs and malaria epidemiology were locally generated, and along with available data on effectiveness of diagnostic tests, adherence level to drugs for treatment, and drug efficacy levels, cost-effectiveness estimates were computed using TreeAge programme. Results were reported based on costs and effects per strategy, and incremental cost-effectiveness ratios. Results The cost-effectiveness analysis at 43.1% prevalence level showed an incremental cost effectiveness ratio (ICER of 221 per deaths averted between RDT and presumptive treatment, while microscopy is dominated

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

    International Nuclear Information System (INIS)

    Bessa, Ana Carolina Moreira de

    2007-01-01

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

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

    International Nuclear Information System (INIS)

    Bessa, Ana Carolina Moreira de

    2006-01-01

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

  18. Diagnostic Performance of Bronchoalveolar Lavage Fluid CD4/CD8 Ratio for Sarcoidosis: A Meta-analysis.

    Science.gov (United States)

    Shen, Yongchun; Pang, Caishuang; Wu, Yanqiu; Li, Diandian; Wan, Chun; Liao, Zenglin; Yang, Ting; Chen, Lei; Wen, Fuqiang

    2016-06-01

    The usefulness of bronchoalveolar lavage fluid (BALF) CD4/CD8 ratio for diagnosing sarcoidosis has been reported in many studies with variable results. Therefore, we performed a meta-analysis to estimate the overall diagnostic accuracy of BALF CD4/CD8 ratio based on the bulk of published evidence. Studies published prior to June 2015 and indexed in PubMed, OVID, Web of Science, Scopus and other databases were evaluated for inclusion. Data on sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were pooled from included studies. Summary receiver operating characteristic (SROC) curves were used to summarize overall test performance. Deeks's funnel plot was used to detect publication bias. Sixteen publications with 1885 subjects met our inclusion criteria and were included in this meta-analysis. Summary estimates of the diagnostic performance of the BALF CD4/CD8 ratio were as follows: sensitivity, 0.70 (95%CI 0.64-0.75); specificity, 0.83 (95%CI 0.78-0.86); PLR, 4.04 (95%CI 3.13-5.20); NLR, 0.36 (95%CI 0.30-0.44); and DOR, 11.17 (95%CI 7.31-17.07). The area under the SROC curve was 0.84 (95%CI 0.81-0.87). There was no evidence of publication bias. Measuring the BALF CD4/CD8 ratio may assist in the diagnosis of sarcoidosis when interpreted in parallel with other diagnostic factors. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-01

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

  1. Parent-Child Diagnostic Agreement on Anxiety Symptoms with a Structured Diagnostic Interview for Mental Disorders in Children.

    Science.gov (United States)

    Popp, Lukka; Neuschwander, Murielle; Mannstadt, Sandra; In-Albon, Tina; Schneider, Silvia

    2017-01-01

    Objective: In clinical structured diagnostic interviews, diagnoses based on parent and child reports have low to moderate agreement. The aims of the present study are (1) to examine diagnostic agreement on anxiety disorders between parents and children on the levels of current and lifetime diagnostic category and diagnoses focusing in particular on diagnostic criteria and (2) to identify parent- and child-related predictors for diagnostic agreement. Method: The sample consisted of 166 parent-child dyads interviewed with the Structured Diagnostic Interview for Mental Disorders in Children (Kinder-DIPS, Schneider et al., 2009). The children (51.8% girls) were between the ages of 7 and 18 years ( M = 10.94; SD = 2.22). Results: Overall, parent-child agreement on the diagnostic category of anxiety disorder ( k = 0.21; k = 0.22) and the specific anxiety diagnoses (base rate > 10%) of social phobia, specific phobia and separation anxiety disorder ( k = 0.24-0.52; k = 0.19-0.43) and corresponding diagnostic criteria ( k = 0.22-0.67; k = 0.24-0.41) were low to moderate with the highest agreement on separation anxiety disorder ( k > 0.43). Lower maternal depression, and higher social support reported by mother and father were associated with higher parent-child agreement. Maternal depression was indicated as the strongest predictor. Parental sense of competence, parental anxiety, the amount of parent-child interaction and the child's age and gender had no predictive value. Conclusions: Parent-child agreement can be expected to be higher on the level of anxiety criteria compared to specific anxiety diagnoses and diagnostic anxiety category. Psychological strains in the family-especially maternal depression and low social support-lower the parent-child agreement on anxiety symptoms. Child- and relation-related variables (age, gender, amount of time parent(s) and children interact) play no role in the prediction of low parent-child agreement.

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

    Science.gov (United States)

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

    2017-12-12

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

  3. Diagnostic Performance of Narrow Band Imaging for Nasopharyngeal Cancer: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Sun, Changling; Zhang, Yayun; Han, Xue; Du, Xiaodong

    2018-03-01

    Objective The purposes of this study were to verify the effectiveness of the narrow band imaging (NBI) system in diagnosing nasopharyngeal cancer (NPC) as compared with white light endoscopy. Data Sources PubMed, Cochrane Library, EMBASE, CNKI, and Wan Fang databases. Review Methods Data analyses were performed with Meta-Disc. The updated Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess study quality and potential bias. Publication bias was assessed with a Deeks asymmetry test. The registry number of the protocol published on PROSPERO is CRD42015026244. Results This meta-analysis included 10 studies of 1337 lesions. For NBI diagnosis of NPC, the pooled values were as follows: sensitivity, 0.83 (95% CI, 0.80-0.86); specificity, 0.91 (95% CI, 0.89-0.93); positive likelihood ratio, 8.82 (95% CI, 5.12-15.21); negative likelihood ratio, 0.18 (95% CI, 0.12-0.27); and diagnostic odds ratio, 65.73 (95% CI, 36.74-117.60). The area under the curve was 0.9549. For white light endoscopy in diagnosing NPC, the pooled values were as follows: sensitivity, 0.79 (95% CI, 0.75-0.83); specificity, 0.87 (95% CI, 0.84-0.90); positive likelihood ratio, 5.02 (95% CI, 1.99-12.65); negative likelihood ratio, 0.34 (95% CI, 0.24-0.49); and diagnostic odds ratio, 16.89 (95% CI, 5.98-47.66). The area under the curve was 0.8627. The evaluation of heterogeneity, calculated per the diagnostic odds ratio, gave an I 2 of 0.326. No marked publication bias ( P = .68) existed in this meta-analysis. Conclusion The sensitivity and specificity of NBI for the diagnosis of NPC are similar to those of white light endoscopy, and the potential value of NBI for the diagnosis of NPC needs to be validated further.

  4. Combined diagnostic performance of coronary computed tomography angiography and computed tomography derived fractional flow reserve for the evaluation of myocardial ischemia: A meta-analysis.

    Science.gov (United States)

    Tan, Xiao Wei; Zheng, Qishi; Shi, Luming; Gao, Fei; Allen, John Carson; Coenen, Adriaan; Baumann, Stefan; Schoepf, U Joseph; Kassab, Ghassan S; Lim, Soo Teik; Wong, Aaron Sung Lung; Tan, Jack Wei Chieh; Yeo, Khung Keong; Chin, Chee Tang; Ho, Kay Woon; Tan, Swee Yaw; Chua, Terrance Siang Jin; Chan, Edwin Shih Yen; Tan, Ru San; Zhong, Liang

    2017-06-01

    To evaluate the combined diagnostic accuracy of coronary computed tomography angiography (CCTA) and computed tomography derived fractional flow reserve (FFRct) in patients with suspected or known coronary artery disease (CAD). PubMed, The Cochrane library, Embase and OpenGray were searched to identify studies comparing diagnostic accuracy of CCTA and FFRct. Diagnostic test measurements of FFRct were either extracted directly from the published papers or calculated from provided information. Bivariate models were conducted to synthesize the diagnostic performance of combined CCTA and FFRct at both "per-vessel" and "per-patient" levels. 7 articles were included for analysis. The combined diagnostic outcomes from "both positive" strategy, i.e. a subject was considered as "positive" only when both CCTA and FFRct were "positive", demonstrated relative high specificity (per-vessel: 0.91; per-patient: 0.81), high positive likelihood ratio (LR+, per-vessel: 7.93; per-patient: 4.26), high negative likelihood ratio (LR-, per-vessel: 0.30; per patient: 0.24) and high accuracy (per-vessel: 0.91; per-patient: 0.81) while "either positive" strategy, i.e. a subject was considered as "positive" when either CCTA or FFRct was "positive", demonstrated relative high sensitivity (per-vessel: 0.97; per-patient: 0.98), low LR+ (per-vessel: 1.50; per-patient: 1.17), low LR- (per-vessel: 0.07; per-patient: 0.09) and low accuracy (per-vessel: 0.57; per-patient: 0.54). "Both positive" strategy showed better diagnostic performance to rule in patients with non-significant stenosis compared to "either positive" strategy, as it efficiently reduces the proportion of testing false positive subjects. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Missed opportunities for diagnosis: lessons learned from diagnostic errors in primary care.

    Science.gov (United States)

    Goyder, Clare R; Jones, Caroline H D; Heneghan, Carl J; Thompson, Matthew J

    2015-12-01

    Because of the difficulties inherent in diagnosis in primary care, it is inevitable that diagnostic errors will occur. However, despite the important consequences associated with diagnostic errors and their estimated high prevalence, teaching and research on diagnostic error is a neglected area. To ascertain the key learning points from GPs' experiences of diagnostic errors and approaches to clinical decision making associated with these. Secondary analysis of 36 qualitative interviews with GPs in Oxfordshire, UK. Two datasets of semi-structured interviews were combined. Questions focused on GPs' experiences of diagnosis and diagnostic errors (or near misses) in routine primary care and out of hours. Interviews were audiorecorded, transcribed verbatim, and analysed thematically. Learning points include GPs' reliance on 'pattern recognition' and the failure of this strategy to identify atypical presentations; the importance of considering all potentially serious conditions using a 'restricted rule out' approach; and identifying and acting on a sense of unease. Strategies to help manage uncertainty in primary care were also discussed. Learning from previous examples of diagnostic errors is essential if these events are to be reduced in the future and this should be incorporated into GP training. At a practice level, learning points from experiences of diagnostic errors should be discussed more frequently; and more should be done to integrate these lessons nationally to understand and characterise diagnostic errors. © British Journal of General Practice 2015.

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  7. Diagnostic assessment of intraoperative cytology for papillary thyroid carcinoma: using a decision tree analysis.

    Science.gov (United States)

    Pyo, J-S; Sohn, J H; Kang, G

    2017-03-01

    The aim of this study was to elucidate the cytological characteristics and the diagnostic usefulness of intraoperative cytology (IOC) for papillary thyroid carcinoma (PTC). In addition, using decision tree analysis, effective features for accurate cytological diagnosis were sought. We investigated cellularity, cytological features and diagnosis based on the Bethesda System for Reporting Thyroid Cytopathology in IOC of 240 conventional PTCs. The cytological features were evaluated in terms of nuclear score with nuclear features, and additional figures such as presence of swirling sheets, psammoma bodies, and multinucleated giant cells. The nuclear score (range 0-7) was made via seven nuclear features, including (1) enlarged, (2) oval or irregularly shaped nuclei, (3) longitudinal nuclear grooves, (4) intranuclear cytoplasmic pseudoinclusion, (5) pale nuclei with powdery chromatin, (6) nuclear membrane thickening, and (7) marginally placed micronucleoli. Nuclear scores in PTC, suspicious for malignancy, and atypia of undetermined significance cases were 6.18 ± 0.80, 4.48 ± 0.82, and 3.15 ± 0.67, respectively. Additional figures more frequent in PTC than in other diagnostic categories were identified. Cellularity of IOC significantly correlated with tumor size, nuclear score, and presence of additional figures. Also, IOCs with higher nuclear scores (4-7) significantly correlated with larger tumor size and presence of additional figures. In decision tree analysis, IOCs with nuclear score >5 and swirling sheets could be considered diagnostic for PTCs. Our study suggests that IOCs using nuclear features and additional figures could be useful with decreasing the likelihood of inconclusive results.

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  9. Lectin-induced agglutination method of urinary exosomes isolation followed by mi-RNA analysis: Application for prostate cancer diagnostic.

    Science.gov (United States)

    Samsonov, Roman; Shtam, Tatiana; Burdakov, Vladimir; Glotov, Andrey; Tsyrlina, Evgenia; Berstein, Lev; Nosov, Alexander; Evtushenko, Vladimir; Filatov, Michael; Malek, Anastasia

    2016-01-01

    Prostate cancer is the most common cancer in men. Prostate-specific antigen has, however, insufficient diagnostic specificity. Novel complementary diagnostic approaches are greatly needed. MiRNAs are small regulatory RNAs which play an important role in tumorogenesis and are being investigated as a cancer biomarker. In addition to their intracellular regulatory functions, miRNAs are secreted into the extracellular space and can be found in various body fluids, including urine. The stability of extracellular miRNAs is defined by association with proteins, lipoprotein particles, and membrane vesicles. Among the known forms of miRNA packaging, tumour-derived exosome-enclosed miRNAs is thought to reflect the vital activity of cancer cells. The assessment of the exosomal fraction of urinary miRNA may present a new and highly specific method for prostate cancer diagnostics; however, this is challenged by the absence of reliable and inexpensive methods for isolation of exosomes. Prostate cancer (PC) cell lines and urine samples collected from 35 PC patients and 35 healthy donors were used in the study. Lectins, phytohemagglutinin, and concanavalin A were used to induce agglutination of exosomes. The efficiency of isolation process was evaluated by AFM and DLS assays. The protein content of isolated exosomes was analysed by western blotting. Exosomal RNA was assayed by automated electrophoresis and expression level of selected miRNAs was evaluated by RT-qPCR. The diagnostic potency of the urinary exosomal miRNA assessment was estimated by the ROC method. The formation of multi-vesicular agglutinates in urine can be induced by incubation with lectin at a final concentration of 2 mg/ml. These agglutinates contain urinary exosomes and may be pelleted by centrifugation with a relatively low G-force. The analysis of PC-related miRNA in urinary exosomes revealed significant up-regulation of miR-574-3p, miR-141-5p, and miR-21-5p associated with PC. Lectin-induced aggregation is a

  10. Study on the diagnostic value of combined determination of serum CA125, CA199 and SIL-2R levels in patients with endometriosis

    International Nuclear Information System (INIS)

    Yang Jingxiu; Shi Shaohong; Wang Yuping; Xie Xueqin; Qin Jibao

    2005-01-01

    Objective: To investigate the diagnostic values of combined determination of serum CA125, CA199 and SIL-2R levels in patients with endometriosis. Methods: Serum CA125, CA199 were measured with RIA and SIL-2R levels with ELISA in 54 patients with endometriosis and 35 controls. Results: The serum levels of CA125, CA199 and SIL-2R in patients with endometriosis were significantly higher than those in controls (P<0.01). The sensitivity and speciality of CA125 for endometriosis was 70.2% and 80.4% respectively, the sensitivity and speciality of CA199 for endometriosis was 62.4% and 71.8% respectively, the sensitivity and speciality of SIL-2R was 89.5% and 60.2% respectively. The sensitivity of the combined determination of CA125, CA199 and SIL-2R for endometriosis was 86.8% being significantly higher than that of CA125 and CA199 respectively. Conclusion: Combined determination of the serum CA125, CA199 and SIL-2R levels in serum can increase the diagnostic sensitivity for endometriosis. (authors)

  11. The diagnostic value of polymerase chain reaction for Mycobacterium tuberculosis to distinguish intestinal tuberculosis from crohn's disease: A meta-analysis.

    Science.gov (United States)

    Jin, Ting; Fei, Baoying; Zhang, Yu; He, Xujun

    2017-01-01

    Intestinal tuberculosis (ITB) and Crohn's disease (CD) are important differential diagnoses that can be difficult to distinguish. Polymerase chain reaction (PCR) for Mycobacterium tuberculosis (MTB) is an efficient and promising tool. This meta-analysis was performed to systematically and objectively assess the potential diagnostic accuracy and clinical value of PCR for MTB in distinguishing ITB from CD. We searched PubMed, Embase, Web of Science, Science Direct, and the Cochrane Library for eligible studies, and nine articles with 12 groups of data were identified. The included studies were subjected to quality assessment using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The summary estimates were as follows: sensitivity 0.47 (95% CI: 0.42-0.51); specificity 0.95 (95% CI: 0.93-0.97); the positive likelihood ratio (PLR) 10.68 (95% CI: 6.98-16.35); the negative likelihood ratio (NLR) 0.49 (95% CI: 0.33-0.71); and diagnostic odds ratio (DOR) 21.92 (95% CI: 13.17-36.48). The area under the curve (AUC) was 0.9311, with a Q* value of 0.8664. Heterogeneity was found in the NLR. The heterogeneity of the studies was evaluated by meta-regression analysis and subgroup analysis. The current evidence suggests that PCR for MTB is a promising and highly specific diagnostic method to distinguish ITB from CD. However, physicians should also keep in mind that negative results cannot exclude ITB for its low sensitivity. Additional prospective studies are needed to further evaluate the diagnostic accuracy of PCR.

  12. 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.

  13. Diagnostic significance of microRNAs as novel biomarkers for bladder cancer: a meta-analysis of ten articles.

    Science.gov (United States)

    Shi, Hong-Bin; Yu, Jia-Xing; Yu, Jian-Xiu; Feng, Zheng; Zhang, Chao; Li, Guang-Yong; Zhao, Rui-Ning; Yang, Xiao-Bo

    2017-08-03

    Previous studies have revealed the importance of microRNAs' (miRNAs) function as biomarkers in diagnosing human bladder cancer (BC). However, the results are discordant. Consequently, the possibility of miRNAs to be BC biomarkers was summarized in this meta-analysis. In this study, the relevant articles were systematically searched from CBM, PubMed, EMBASE, and Chinese National Knowledge Infrastructure (CNKI). The bivariate model was used to calculate the pooled diagnostic parameters and summary receiver operator characteristic (SROC) curve in this meta-analysis, thereby estimating the whole predictive performance. STATA software was used during the whole analysis. Thirty-one studies from 10 articles, including 1556 cases and 1347 controls, were explored in this meta-analysis. In short, the pooled sensitivity, area under the SROC curve, specificity, positive likelihood ratio, diagnostic odds ratio, and negative likelihood ratio were 0.72 (95%CI 0.66-0.76), 0.80 (0.77-0.84), 0.76 (0.71-0.81), 3.0 (2.4-3.8), 8 (5.0-12.0), and 0.37 (0.30-0.46) respectively. Additionally, sub-group and meta-regression analyses revealed that there were significant differences between ethnicity, miRNA profiling, and specimen sub-groups. These results suggested that Asian population-based studies, multiple-miRNA profiling, and blood-based assays might yield a higher diagnostic accuracy than their counterparts. This meta-analysis demonstrated that miRNAs, particularly multiple miRNAs in the blood, might be novel, useful biomarkers with relatively high sensitivity and specificity and can be used for the diagnosis of BC. However, further prospective studies with more samples should be performed for further validation.

  14. Meta-analysis for diagnostic accuracy studies: a new statistical model using beta-binomial distributions and bivariate copulas.

    Science.gov (United States)

    Kuss, Oliver; Hoyer, Annika; Solms, Alexander

    2014-01-15

    There are still challenges when meta-analyzing data from studies on diagnostic accuracy. This is mainly due to the bivariate nature of the response where information on sensitivity and specificity must be summarized while accounting for their correlation within a single trial. In this paper, we propose a new statistical model for the meta-analysis for diagnostic accuracy studies. This model uses beta-binomial distributions for the marginal numbers of true positives and true negatives and links these margins by a bivariate copula distribution. The new model comes with all the features of the current standard model, a bivariate logistic regression model with random effects, but has the additional advantages of a closed likelihood function and a larger flexibility for the correlation structure of sensitivity and specificity. In a simulation study, which compares three copula models and two implementations of the standard model, the Plackett and the Gauss copula do rarely perform worse but frequently better than the standard model. We use an example from a meta-analysis to judge the diagnostic accuracy of telomerase (a urinary tumor marker) for the diagnosis of primary bladder cancer for illustration. Copyright © 2013 John Wiley & Sons, Ltd.

  15. The Impact of Gas Turbine Component Leakage Fault on GPA Performance Diagnostics

    Directory of Open Access Journals (Sweden)

    E. L. Ntantis

    2016-01-01

    Full Text Available The leakage analysis is a key factor in determining energy loss from a gas turbine. Once the components assembly fails, air leakage through the opening increases resulting in a performance loss. Therefore, the performance efficiency of the engine cannot be reliably determined, without good estimates and analysis of leakage faults. Consequently, the implementation of a leakage fault within a gas turbine engine model is necessary for any performance diagnostic technique that can expand its diagnostics capabilities for more accurate predictions. This paper explores the impact of gas turbine component leakage fault on GPA (Gas Path Analysis Performance Diagnostics. The analysis is demonstrated with a test case where gas turbine performance simulation and diagnostics code TURBOMATCH is used to build a performance model of a model engine similar to Rolls-Royce Trent 500 turbofan engine, and carry out the diagnostic analysis with the presence of different component fault cases. Conclusively, to improve the reliability of the diagnostic results, a leakage fault analysis of the implemented faults is made. The diagnostic tool used to deal with the analysis of the gas turbine component implemented faults is a model-based method utilizing a non-linear GPA.

  16. A national physician survey of diagnostic error in paediatrics.

    Science.gov (United States)

    Perrem, Lucy M; Fanshawe, Thomas R; Sharif, Farhana; Plüddemann, Annette; O'Neill, Michael B

    2016-10-01

    This cross-sectional survey explored paediatric physician perspectives regarding diagnostic errors. All paediatric consultants and specialist registrars in Ireland were invited to participate in this anonymous online survey. The response rate for the study was 54 % (n = 127). Respondents had a median of 9-year clinical experience (interquartile range (IQR) 4-20 years). A diagnostic error was reported at least monthly by 19 (15.0 %) respondents. Consultants reported significantly less diagnostic errors compared to trainees (p value = 0.01). Cognitive error was the top-ranked contributing factor to diagnostic error, with incomplete history and examination considered to be the principal cognitive error. Seeking a second opinion and close follow-up of patients to ensure that the diagnosis is correct were the highest-ranked, clinician-based solutions to diagnostic error. Inadequate staffing levels and excessive workload were the most highly ranked system-related and situational factors. Increased access to and availability of consultants and experts was the most highly ranked system-based solution to diagnostic error. We found a low level of self-perceived diagnostic error in an experienced group of paediatricians, at variance with the literature and warranting further clarification. The results identify perceptions on the major cognitive, system-related and situational factors contributing to diagnostic error and also key preventative strategies. • Diagnostic errors are an important source of preventable patient harm and have an estimated incidence of 10-15 %. • They are multifactorial in origin and include cognitive, system-related and situational factors. What is New: • We identified a low rate of self-perceived diagnostic error in contrast to the existing literature. • Incomplete history and examination, inadequate staffing levels and excessive workload are cited as the principal contributing factors to diagnostic error in this study.

  17. The diagnostic test accuracy of ultrasound for the detection of lateral epicondylitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Latham, S K; Smith, T O

    2014-05-01

    The purpose of this study was to determine the diagnostic test accuracy of ultrasound for the detection of lateral epicondylitis. An electronic search of databases registering published (MEDLINE, EMBASE, CINAHL, AMED, Cochrane Library, ScienceDirect) and unpublished literature was conducted to January 2013. All diagnostic accuracy studies that compared the accuracy of ultrasound (index test) with a reference standard for lateral epicondylitis were included. The methodological quality of each of the studies was appraised using the QUADAS tool. When appropriate, the pooled sensitivity and specificity analysis was conducted. Ten studies investigating 711 participants and 1077 elbows were included in this review. Ultrasound had variable sensitivity and specificity (sensitivity: 64%-100%; specificity: 36%-100%). The available literature had modest methodological quality, and was limited in terms of sample sizes and blinding between index and reference test results. There is evidence to support the use of ultrasound in the detection of lateral epicondylitis. However, its accuracy appears to be highly dependent on numerous variables, such as operator experience, equipment and stage of pathology. Judgement should be used when considering the benefit of ultrasound for use in clinical practice. Further research assessing variables such a transducer frequency independently is specifically warranted. Level II. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  18. Clinical diagnostic value of combined determination of serum tPSA, cPSA and IGF-I levels in patients with prostatic disorders

    International Nuclear Information System (INIS)

    Zhang Bashan; Zhang Zigang; Lai Fudi

    2008-01-01

    Objective: To investigate the diagnostic value of combined determination of serum total prostatic specific antigen (tPSA), complex prostatic specific antigen (cPSA) and IGF-I levels in patients with prostatic disorders. Methods: Serum tPSA, cPSA (with CLIA) and IGF-I (with IRMA) levels were determined in 41 patients with prostatic carcinoma, 60 patients with benign prosta- tic hypertrophy (BPH) and 55 controls. Results: The serum tPSA, cPSA and IGF-I levels in patients with prostatic cancer were significantly higher than those in patients with BPH and controls (P<0.01). Taking the cut-off values of 4ng/ml, 3.6ng/ml and 150 for tPSA, cPSA and IGF-I respectively, the combined determination of these three items would yield a sensitivity of 88.6%, specificity of 84.9%, positive predicative value of 83% and negative predicative value of 90.0% for diagnosis of prostatic cancer. Conclusion: Combined determination of tPSA, cPSA and IGF-I would yield better sensitive and accurate diagnostic rate in patients with prostatic cancer, especially in those with laboratory values within the 'grey zone'. (authors)

  19. MOLECULAR DIAGNOSTICS OF YERSINIA RUCKERI

    Directory of Open Access Journals (Sweden)

    Yu. Rud

    2014-06-01

    Full Text Available Purpose. The analysis of nucleotide sequences of the 16S rDNA gene of virulent strains of Yersinia ruckeri and to develop the method of molecular diagnostic of enteric redmouth disease. Methodology. By the method of CLUSTALW algorithm in MEGA software version 6.0 the nucleotide sequences of the 16S rDNA gene of virulent strains of Yersinia ruckeri were analysed. For development of molecular diagnostic of Y. ruckeri the method of polymerase chain reaction (PCR was used. Primer selection was carried out in software VectorNTI11 and on-line-service BLAST. The PCR products were investigated by the methods of sequencing and nucleotide analysis. Findings. Based on PCR assay the method of molecular diagnostic of enteric redmouth disease agent, bacterium Y. ruckeri was developed. It was shown that specific oligonucleotide primers generated PCR products in size of 600 base pairs. PCR products were investigated by the sequencing that showed right targeting of primers in reaction. Originality. Among high-conservative gene of 16S rDNA of Y. ruckeri the fragment of DNA was determined to which the specific primers for rapid diagnostic of virulent strains were selected. Practical Value. Rapid diagnostic of yersiniosis will allow to identify an agent of this infectious disease, bacterium Y. ruckeri, and to provide the prophylactic or medical measures in the fish farming of Ukraine.

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

    Data.gov (United States)

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

  1. System diagnostics using qualitative analysis and component functional classification

    International Nuclear Information System (INIS)

    Reifman, J.; Wei, T.Y.C.

    1993-01-01

    A method for detecting and identifying faulty component candidates during off-normal operations of nuclear power plants involves the qualitative analysis of macroscopic imbalances in the conservation equations of mass, energy and momentum in thermal-hydraulic control volumes associated with one or more plant components and the functional classification of components. The qualitative analysis of mass and energy is performed through the associated equations of state, while imbalances in momentum are obtained by tracking mass flow rates which are incorporated into a first knowledge base. The plant components are functionally classified, according to their type, as sources or sinks of mass, energy and momentum, depending upon which of the three balance equations is most strongly affected by a faulty component which is incorporated into a second knowledge base. Information describing the connections among the components of the system forms a third knowledge base. The method is particularly adapted for use in a diagnostic expert system to detect and identify faulty component candidates in the presence of component failures and is not limited to use in a nuclear power plant, but may be used with virtually any type of thermal-hydraulic operating system. 5 figures

  2. Comparative cost analysis -- computed tomography vs. alternative diagnostic procedures, 1977-1980

    International Nuclear Information System (INIS)

    Gempel, P.A.; Harris, G.H.; Evans, R.G.

    1977-12-01

    In comparing the total national cost of utilizing computed tomography (CT) for medically indicated diagnoses with that of conventional x-ray, ultrasonography, nuclear medicine, and exploratory surgery, this investigation concludes that there was little, if any, added net cost from CT use in 1977 or will there be in 1980. Computed tomography, generally recognized as a reliable and useful diagnostic modality, has the potential to reduce net costs provided that an optimal number of units can be made available to physicians and patients to achieve projected reductions in alternative procedures. This study examines the actual cost impact of CT on both cranial and body diagnostic procedures. For abdominal and mediastinal disorders, CT scanning is just beginning to emerge as a diagnostic modality. As such, clinical experience is somewhat limited and the authors assume that no significant reduction in conventional procedures took place in 1977. It is estimated that the approximately 375,000 CT body procedures performed in 1977 represent only a 5 percent cost increase over use of other diagnostic modalities. It is projected that 2,400,000 CT body procedures will be performed in 1980 and, depending on assumptions used, total body diagnostic costs will increase only slightly or be reduced. Thirty-one tables appear throughout the text presenting cost data broken down by types of diagnostic procedures used and projections by years. Appendixes present technical cost components for diagnostic procedures, the comparative efficacy of CT as revealed in abstracts of published literature, selected medical diagnoses, and references

  3. Comparison of exercise perfusion and ventricular function imaging: an analysis of factors affecting the diagnostic accuracy of each technique

    International Nuclear Information System (INIS)

    Osbakken, M.D.; Okada, R.D.; Boucher, C.A.; Strauss, H.W.; Pohost, G.M.

    1984-01-01

    Exercise thallium-201 perfusion scans and gated equilibrium blood pool scans were performed in 120 catheterized patients with a chest pain syndrome. Eighty-six patients had coronary artery disease and 34 patients did not. The effects of gender, propranolol, exercise level, exercise ischemia, history of typical angina, history of previous myocardial infarction, electrocardiographic Q waves, number of diseases vessels and extent of coronary artery obstruction on diagnostic accuracy were evaluated. Thallium scans and anginal history were less sensitive for detecting coronary disease in women (men: thallium 79%; angina 77%; women: 54 and 46%, respectively; p less than 0.05). Exercise level did not significantly affect the diagnostic accuracy of either scan. Thallium and gated scans were both highly sensitive (95%) in detecting disease in 20 patients with a prior myocardial infarction, angina and a positive electrocardiogram. The sensitivity of the thallium scan significantly decreased as the number of diseased vessels decreased. Both thallium and gated scans were less frequently positive in patients with atypical angina or no Q waves, but were not significantly influenced by electrocardiographic ischemia. The sensitivity and specificity of both scans were low in 57 patients with the combination of atypical angina, no history of infarction and equivocal stress electrocardiogram thallium. When stress thallium scan evaluation included the electrocardiogram and thallium scan interpretation, the diagnostic accuracy was 81%. When all the information from gated scans (wall motion, ejection fraction, pulmonary blood volume) was combined for final gated scan evaluation, the diagnostic accuracy was 83%. When electrocardiographic data were added to all three gated scan variables, diagnostic accuracy was 77%

  4. Diagnostic Value of Nineteen Different Imaging Methods for Patients with Breast Cancer: a Network Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Xiao-Hong Zhang

    2018-04-01

    Full Text Available Background/Aims: We performed a network meta-analysis (NMA to investigate and compare the diagnostic value of 19 different imaging methods used for breast cancer (BC. Methods: Cochrane Library, PubMed and EMBASE were searched to collect the relevant literature from the inception of the study until November 2016. A combination of direct and indirect comparisons was performed using an NMA to evaluate the combined odd ratios (OR and draw the surface under the cumulative ranking curves (SUCRA of the diagnostic value of different imaging methods for BC. Results: A total of 39 eligible diagnostic tests regarding 19 imaging methods (mammography [MG], breast-specific gamma imaging [BSGI], color Doppler sonography [CD], contrast-enhanced magnetic resonance imaging [CE-MRI], digital breast tomosynthesis [DBT], fluorodeoxyglucose positron-emission tomography/computed tomography [FDG PET/CT], fluorodeoxyglucose positron-emission tomography [FDG-PET], full field digital mammography [FFDM], handheld breast ultrasound [HHUS], magnetic resonance imaging [MRI], automated breast volume scanner [ABUS], magnetic resonance mammography [MRM], scintimammography [SMM], single photon emission computed tomography scintimammography [SPECT SMM], ultrasound elastography [UE], ultrasonography [US], mammography + ultrasonography [MG + US], mammography + scintimammography [MG + SMM], and ultrasound elastography + ultrasonography [UE + US] were included in the study. According to this network meta-analysis, in comparison to the MG method, the CE-MRI, MRI, MRM, MG + SMM and UE + US methods exhibited relatively higher sensitivity, and the specificity of the FDG PET/CT method was higher, while the BSGI and MRI methods exhibited higher accuracy. Conclusion: The results from this NMA indicate that the diagnostic value of the BSGI, MG + SMM, MRI and CE-MRI methods for BC were relatively higher in terms of sensitivity, specificity and accuracy.

  5. Diagnostic value of urinary kidney injury molecule 1 for acute kidney injury: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Xinghua Shao

    Full Text Available BACKGROUND: Urinary Kidney Injury Molecule 1 (KIM-1 is a proximal tubular injury biomarker for early detection of acute kidney injury (AKI, with variable performance characteristics depending on clinical and population settings. METHODS: Meta-analysis was performed to assess the diagnostic value of urinary KIM-1 in AKI. Relevant studies were searched from MEDLINE, EMBASE, Pubmed, Elsevier Science Direct, Scopus, Web of Science, Google Scholar and Cochrane Library. Meta-analysis methods were used to pool sensitivity and specificity and to construct summary receiver operating characteristic (SROC curves. RESULTS: A total of 2979 patients from 11 eligible studies were enrolled in the analysis. Five prospective cohorts, two cross-sectional and four case-control studies were identified for meta-analysis. The estimated sensitivity of urinary KIM-1 for the diagnosis of AKI was 74.0% (95% CI, 61.0%-84.0%, and specificity was 86.0% (95% CI, 74.0%-93.0%. The SROC analysis showed an area under the curve of 0.86(0.83-0.89. Subgroup analysis suggested that population settings and detection time were the key factors affecting the efficiency of KIM-1 for AKI diagnosis. LIMITATION: Various population settings, different definition of AKI and Serum creatinine level used as the standard might have influence on AKI diagnosis. The relatively small number of studies and heterogeneity between them also affected the evaluation. CONCLUSION: Urinary KIM-1 may be a promising biomarker for early detection of AKI with considerable predictive value, especially for cardiac surgery patients, and its potential value needs to be validated in large studies and across a broader scope of clinical settings.

  6. Correlation measurements for fusion plasma diagnostics

    International Nuclear Information System (INIS)

    Pazsit, I.

    1995-01-01

    A list of a few methods for plasma diagnostics via fluctuations (noise) analysis of random (both temporally and spatially) system parameters is reviewed. Analogy is drawn with certain noise analysis methods, used in the diagnostics of fission reactors. These methods have been applied also to fusion measurements to some extent. However, the treatment of fusion plasma fluctuations is dominated by an approach that allows for temporal randomness, but assumes periodicity in space. This approach suits well a large class of phenomena such as magnetic fluctuations (MHD effects), but is much less suited to treat localised effects such as turbulence and density fluctuations. This paper discusses the potentials of the former approach, i.e. ordinary noise analysis methods of non-periodic variables in fusion plasma diagnostics. A new recommendation is to use the crossed beam correlation analysis of soft X-ray signals for determining the local short-range correlations in the plasma and to perform a systematic exploration of the plasma spatial correlation structure with that and other methods. 16 refs, 7 figs

  7. Design Features of the Neutral Particle Diagnostic System for the ITER Tokamak

    Science.gov (United States)

    Petrov, S. Ya.; Afanasyev, V. I.; Melnik, A. D.; Mironov, M. I.; Navolotsky, A. S.; Nesenevich, V. G.; Petrov, M. P.; Chernyshev, F. V.; Kedrov, I. V.; Kuzmin, E. G.; Lyublin, B. V.; Kozlovski, S. S.; Mokeev, A. N.

    2017-12-01

    The control of the deuterium-tritium (DT) fuel isotopic ratio has to ensure the best performance of the ITER thermonuclear fusion reactor. The diagnostic system described in this paper allows the measurement of this ratio analyzing the hydrogen isotope fluxes (performing neutral particle analysis (NPA)). The development and supply of the NPA diagnostics for ITER was delegated to the Russian Federation. The diagnostics is being developed at the Ioffe Institute. The system consists of two analyzers, viz., LENPA (Low Energy Neutral Particle Analyzer) with 10-200 keV energy range and HENPA (High Energy Neutral Particle Analyzer) with 0.1-4.0MeV energy range. Simultaneous operation of both analyzers in different energy ranges enables researchers to measure the DT fuel ratio both in the central burning plasma (thermonuclear burn zone) and at the edge as well. When developing the diagnostic complex, it was necessary to account for the impact of several factors: high levels of neutron and gamma radiation, the direct vacuum connection to the ITER vessel, implying high tritium containment, strict requirements on reliability of all units and mechanisms, and the limited space available for accommodation of the diagnostic hardware at the ITER tokamak. The paper describes the design of the diagnostic complex and the engineering solutions that make it possible to conduct measurements under tokamak reactor conditions. The proposed engineering solutions provide a safe—with respect to thermal and mechanical loads—common vacuum channel for hydrogen isotope atoms to pass to the analyzers; ensure efficient shielding of the analyzers from the ITER stray magnetic field (up to 1 kG); provide the remote control of the NPA diagnostic complex, in particular, connection/disconnection of the NPA vacuum beamline from the ITER vessel; meet the ITER radiation safety requirements; and ensure measurements of the fuel isotopic ratio under high levels of neutron and gamma radiation.

  8. Molecular tools for diagnosis of visceral leishmaniasis: systematic review and meta-analysis of diagnostic test accuracy

    NARCIS (Netherlands)

    de Ruiter, C. M.; van der Veer, C.; Leeflang, M. M. G.; Deborggraeve, S.; Lucas, C.; Adams, E. R.

    2014-01-01

    Molecular methods have been proposed as highly sensitive tools for the detection of Leishmania parasites in visceral leishmaniasis (VL) patients. Here, we evaluate the diagnostic accuracy of these tools in a meta-analysis of the published literature. The selection criteria were original studies that

  9. Technology Issues of Burning Plasma Diagnostics

    International Nuclear Information System (INIS)

    Kaye, A. S.

    2008-01-01

    The ITER Tokamak will require many diagnostics both for safe and reliable operation of the machine and for understanding of the physics underlying the performance. The design of these diagnostics raises many challenging technical issues not faced on smaller machines. These arise partly from the increase demands on established diagnostics arising from the increased size, higher magnetic field, large heating power, and in particular the dramatically longer pulse duration of ITER, which make issue such as power loading on first wall components more challenging. The demands on reliability and availability of the machine in order to achieve the objectives within the agreed time schedule also place severe additional demands on the design, quality assurance and maintainability of diagnostics. ITER will produce many orders of magnitude more neutrons than previous Tokamaks and will be a licensed nuclear facility. This has important implications for the traceability, quality assurance and availability of safety critical diagnostics, and for the control of the design and procurement of all diagnostics. The high neutron flux/fluence also constrains the design of diagnostics, which must offer shielding consistent with the allowable dose rates on critical components of the Tokamak, and themselves be tolerant of the radiation level at the diagnostic. This paper presents an overview of the more critical issues for ITER diagnostics

  10. ANALYSIS OF THE POSSIBILITY OF INTEGRATING A MINING RIGHT-ANGLE PLANETARY GEARBOX WITH TECHNICAL DIAGNOSTICS SYSTEMS

    Directory of Open Access Journals (Sweden)

    Andrzej WIECZOREK

    2016-12-01

    Full Text Available A key factor enabling the achievement of the required capacity by longwall mining systems is to obtain a satisfactory service life for individual components of such systems. Such components include right-angle planetary gearboxes for armoured face conveyors. An increase in the service life of such equipment can be achieved by ensuring adequacy in terms of design, materials and organization. As a part of organizational changes, the use of individual diagnostics systems may have the greatest impact on the service life of mining gearboxes; however, their widespread implementation is limited by economic and operational barriers. This paper presents an analysis of the possibility of integrating mining gearboxes with electronic systems of technical diagnostics, as well as expanding the scope of the technical condition monitoring by the machines operating together with these gearboxes. As a result of the calculation and design work performed, it has been demonstrated that it is possible to integrate technical diagnostics systems with advanced data transmission capabilities inside gearboxes.

  11. Proceedings on US-Japan workshop A-56 'irradiation effects on plasma diagnostic equipment'

    International Nuclear Information System (INIS)

    1986-06-01

    This is a collection of abstracts and papers for the US-Japan Workshop A-56 on ''Irradiation Effects on Plasma Diagnostic Equipments'' held at the Institute of Plasma Physics, Nagoya University, on January 28 through 30, 1986. The topics presented at the workshop are classified as follows: 1) Definition of the problems and general views. 2) Radiation levels estimated from recent experiments and analysis on large tokamaks. 3) Radiation sensitivities of diagnostic components. 4) Neutron sources for irradiation testing. 5) Discussion on suggested experiments on radiation hardening and conclusions. The conclusions summarized by Dr. K. M. Young are also included. (author)

  12. Evidence-Based Diagnostic Algorithm for Glioma: Analysis of the Results of Pathology Panel Review and Molecular Parameters of EORTC 26951 and 26882 Trials.

    Science.gov (United States)

    Kros, Johan M; Huizer, Karin; Hernández-Laín, Aurelio; Marucci, Gianluca; Michotte, Alex; Pollo, Bianca; Rushing, Elisabeth J; Ribalta, Teresa; French, Pim; Jaminé, David; Bekka, Nawal; Lacombe, Denis; van den Bent, Martin J; Gorlia, Thierry

    2015-06-10

    With the rapid discovery of prognostic and predictive molecular parameters for glioma, the status of histopathology in the diagnostic process should be scrutinized. Our project aimed to construct a diagnostic algorithm for gliomas based on molecular and histologic parameters with independent prognostic values. The pathology slides of 636 patients with gliomas who had been included in EORTC 26951 and 26882 trials were reviewed using virtual microscopy by a panel of six neuropathologists who independently scored 18 histologic features and provided an overall diagnosis. The molecular data for IDH1, 1p/19q loss, EGFR amplification, loss of chromosome 10 and chromosome arm 10q, gain of chromosome 7, and hypermethylation of the promoter of MGMT were available for some of the cases. The slides were divided in discovery (n = 426) and validation sets (n = 210). The diagnostic algorithm resulting from analysis of the discovery set was validated in the latter. In 66% of cases, consensus of overall diagnosis was present. A diagnostic algorithm consisting of two molecular markers and one consensus histologic feature was created by conditional inference tree analysis. The order of prognostic significance was: 1p/19q loss, EGFR amplification, and astrocytic morphology, which resulted in the identification of four diagnostic nodes. Validation of the nodes in the validation set confirmed the prognostic value (P diagnostic algorithm for anaplastic glioma based on multivariable analysis of consensus histopathology and molecular parameters. © 2015 by American Society of Clinical Oncology.

  13. Noninvasive analysis of skin iron and zinc levels in beta-thalassemia major and intermedia

    International Nuclear Information System (INIS)

    Gorodetsky, R.; Goldfarb, A.; Dagan, I.; Rachmilewitz, E.A.

    1985-01-01

    Diagnostic x-ray spectrometry, a method based on x-ray fluorescence analysis, was used for noninvasive determination of iron and zinc in two distinct skin areas, representing predominantly dermal and epidermal tissues, in 56 patients with beta-thalassemia major and intermedia. The mean iron levels in the skin of patients with beta-thalassemia major and intermedia were elevated by greater than 200% and greater than 50%, respectively, compared with control values. The zinc levels of both skin areas examined were within the normal range. The data indicate that the rate and number of blood transfusions, which correlated well with serum ferritin levels (r . 0.8), are not the only factors that determine the amount of iron deposition in the skin (r less than 0.6). Other sources of iron intake contribute to the total iron load in the tissues, particularly in patients who are not given multiple transfusions. The noninvasive quantitation of skin levels may reflect the extent of iron deposition in major parenchymal organs. Repeated DXS examinations of the skin could monitor the clearance of iron from the tissues of patients with iron overload in the course of therapy with chelating agents

  14. Target Diagnostics Supports NIF's Path to Ignition

    International Nuclear Information System (INIS)

    Shelton, R.

    2011-01-01

    The physics requirements derived from the National Ignition Facility (NIF) experimental campaigns are leading to a wide variety of target diagnostics. Software development for the control and analysis of these diagnostics is included in the NIF Integrated Computer Control System, Diagnostic Control System and Data Visualization. These projects implement the configuration, controls, data analysis and visual representation of most of these diagnostics. To date, over 40 target diagnostics have been developed to support NIF experiments. In 2011 diagnostics were developed or enhanced to measure Ignition performance in a high neutron yield environment. Performance is optimized around four key variables: Adiabat (a) which is the strength and timing of four shocks delivered to the target, Velocity (V) of the imploding target, Mix (M) is the uniformity of the burn, and the Shape (S) of the imploding Deuterium Tritium (DT) hot spot. The diagnostics used to measure each of these parameters is shown in figure 1. Adiabat is measured using the Velocity Interferometer System for Any Reflector (VISAR) diagnostic consisting of three streak cameras. To provide for more accurate adiabat measurements the VISAR streak cameras were enhanced in FY11 with a ten comb fiducial signal controller to allow for post shot correction of the streak camera sweep non-linearity. Mix is measured by the Neutron Time of Flight (NTOF) and Radiochemical Analysis of Gaseous Samples (RAGS) diagnostics. To accommodate high neutron yield shots, NTOF diagnostic controls are being modified to use Mach Zehnder interferometer signals to allow the digitizers to be moved from near the target chamber to the neutron shielded diagnostic mezzanine. In December 2011 the first phase of RAGS diagnostic commissioning will be completed. This diagnostic will analyze the tracers that are added to NIF target capsules that undergo nuclear reactions during the shot. These gases are collected and purified for nuclear counting by

  15. Recent diagnostic developments on LHD

    International Nuclear Information System (INIS)

    Sudo, S; Ozaki, T; Ashikawa, N; Emoto, M; Goto, M; Hamada, Y; Ida, K; Ido, T; Iguchi, H; Inagaki, S; Isobe, M; Kawahata, K; Khlopenkov, K; Kobuchi, T; Liang, Y; Masuzaki, S; Minami, T; Morita, S; Muto, S; Nagayama, Y; Nakanishi, H; Narihara, K; Nishizawa, A; Ohdachi, S; Osakabe, M; Peterson, B J; Sakakibara, S; Sasao, M; Sato, K; Shoji, M; Tamura, N; Tanaka, K; Toi, K; Tokuzawa, T; Watanabe, K; Watanabe, T; Yamada, I; Goncharov, P; Ejiri, A; Okajima, S; Mase, A; Tsuji-Iio, S; Akiyama, T; Lyon, J F; Vyacheslavov, L N; Sanin, A

    2003-01-01

    The recent diagnostic developments on the large helical device (LHD) are described briefly. LHD is the largest helical machine with all superconducting coils, and its purpose is to prove the ability of a helical system to confine a fusion-relevant plasma in steady state. According to the missions of LHD research, the diagnostic devices are categorized as follows: diagnostics for (i) high nτ E T plasmas and transport physics; (ii) magnetohydrodynamic stability; (iii) long pulse operation and divertor function; and (iv) energetic particles. These are briefly described focusing on the recent developments of the devices. Since the LHD experiment started in March 1998, five series of experimental campaigns have been carried out. The LHD diagnostics during these periods were operated successfully, and contributed to the analysis of the experimental results

  16. 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.

  17. Tissue preservation with mass spectroscopic analysis: Implications for cancer diagnostics.

    Science.gov (United States)

    Hall, O Morgan; Peer, Cody J; Figg, William D

    2018-05-17

    Surgical intervention is a common treatment modality for localized cancer. Post-operative analysis involves evaluation of surgical margins to assess whether all malignant tissue has been resected because positive surgical margins lead to a greater likelihood of recurrence. Secondary treatments are utilized to minimize the negative effects of positive surgical margins. Recently, in Science Translational Medicine, Zhang et al describe a new mass spectroscopic technique that could potentially decrease the likelihood of positive surgical margins. Their nondestructive in vivo tissue sampling leads to a highly accurate and rapid cancer diagnosis with great precision between healthy and malignant tissue. This new tool has the potential to improve surgical margins and accelerate cancer diagnostics by analyzing biomolecular signatures of various tissues and diseases.

  18. Knowledge based diagnostics in nuclear power plants

    International Nuclear Information System (INIS)

    Baldeweg, F.; Fiedler, U.; Weiss, F.P.; Werner, M.

    1987-01-01

    In this paper a special process diagnostic system (PDS) is presented. It must be seen as the result of a long term work on computerized process surveillance and control; it includes a model based system for noise analysis of mechanical vibrations, which has recently been enhanced by using of knowledge based technique (expert systems). The paper discusses the process diagnostic frame concept and emphasize the vibration analysis expert system

  19. In-service diagnostics of pumping facilities

    International Nuclear Information System (INIS)

    Jaros, I.

    1987-01-01

    The potential is discussed of technical diagnostics in increasing operating reliability of pumping facilities of conventional and nuclear power plants, and in rationalizing the system of their maintenance. Attention is focused on the selection of diagnostic parameters in which the so-called subjective expert methodology is applied, and on the diagnostic system design. At this stage, the construction of the respective facility and the analysis of the failure rate of its individual assemblies should be considered. The selection of diagnostic means directly depends on the selection of diagnostic parameters and is conditional on other factors, such as availability, cost, technical service, and operator's training. Briefly characterized are Czechoslovak standards assessing the mechanical condition of rotary machines from the measurement of the effective value of the rate of their oscillations. (Z.M.)

  20. Diagnostic accuracy of ultrasound for rotator cuff tears in adults: A systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Smith, T.O., E-mail: toby.smith@uea.ac.uk [Department of Physiotherapy, University of East Anglia (United Kingdom); Back, T. [Department of Physiotherapy, Norfolk and Norwich University Hospital, London (United Kingdom); Toms, A.P. [Department of Radiology, Norfolk and Norwich University Hospital, London (United Kingdom); Hing, C.B. [Department of Orthopaedic Surgery, St George' s Hospital, London (United Kingdom)

    2011-11-15

    Aim: To determine the diagnostic accuracy of ultrasound to detect partial and complete thickness rotator cuff tears based on all available clinical trials. Materials and methods: An electronic search of databases registering published and unpublished literature was conducted. All diagnostic accuracy studies that directly compared the accuracy of ultrasound (the index test) to either arthroscopic or open surgical findings (the reference test) for rotator cuff tear were included. The methodological quality of each included study was assessed using the QUADAS form. When appropriate, pooled sensitivity and specificity analysis was conducted, with an assessment of the summary receiver operating characteristic (ROC) curve for each analysis. Results: Sixty-two studies assessing 6007 patients and 6066 shoulders were included. Ultrasonography had good sensitivity and specificity for the assessment of partial thickness (sensitivity 0.84; specificity 0.89), and full-thickness rotator cuff tears (sensitivity 0.96; specificity 0.93). However, the literature poorly described population characteristics, assessor blinding, and was based on limited sample sizes. The literature assessing transducer frequency was particularly small in size. Conclusion: Ultrasonography is an appropriate radiological technique for the assessment of rotator cuff tears with an acceptable sensitivity and specificity. The diagnostic test accuracy of ultrasound is superior for the detection of full-thickness compared to partial-thickness cuff tears. Further study assessing the effect of transducer frequency is warranted.

  1. Diagnostic accuracy of ultrasound for rotator cuff tears in adults: A systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Smith, T.O.; Back, T.; Toms, A.P.; Hing, C.B.

    2011-01-01

    Aim: To determine the diagnostic accuracy of ultrasound to detect partial and complete thickness rotator cuff tears based on all available clinical trials. Materials and methods: An electronic search of databases registering published and unpublished literature was conducted. All diagnostic accuracy studies that directly compared the accuracy of ultrasound (the index test) to either arthroscopic or open surgical findings (the reference test) for rotator cuff tear were included. The methodological quality of each included study was assessed using the QUADAS form. When appropriate, pooled sensitivity and specificity analysis was conducted, with an assessment of the summary receiver operating characteristic (ROC) curve for each analysis. Results: Sixty-two studies assessing 6007 patients and 6066 shoulders were included. Ultrasonography had good sensitivity and specificity for the assessment of partial thickness (sensitivity 0.84; specificity 0.89), and full-thickness rotator cuff tears (sensitivity 0.96; specificity 0.93). However, the literature poorly described population characteristics, assessor blinding, and was based on limited sample sizes. The literature assessing transducer frequency was particularly small in size. Conclusion: Ultrasonography is an appropriate radiological technique for the assessment of rotator cuff tears with an acceptable sensitivity and specificity. The diagnostic test accuracy of ultrasound is superior for the detection of full-thickness compared to partial-thickness cuff tears. Further study assessing the effect of transducer frequency is warranted.

  2. T-scan III system diagnostic tool for digital occlusal analysis in orthodontics - a modern approach.

    Science.gov (United States)

    Trpevska, Vesna; Kovacevska, Gordana; Benedeti, Alberto; Jordanov, Bozidar

    2014-01-01

    This systematic literature review was performed to establish the mechanism, methodology, characteristics, clinical application and opportunities of the T-Scan III System as a diagnostic tool for digital occlusal analysis in different fields of dentistry, precisely in orthodontics. Searching of electronic databases, using MEDLINE and PubMed, hand searching of relevant key journals, and screening of reference lists of included studies with no language restriction was performed. Publications providing statistically examined data were included for systematic review. Twenty potentially relevant Randomized Controlled Trials (RCTs) were identified. Only ten met the inclusion criteria. The literature demonstrates that using digital occlusal analysis with T-Scan III System in orthodontics has significant advantage with regard to the capability of measuring occlusal parameters in static positions and during dynamic of the mandible. Within the scope of this systematic review, there is evidence to support that T-Scan system is rapid and accurate in identifying the distribution of the tooth contacts and it shows great promise as a clinical diagnostic screening device for occlusion and for improving the occlusion after various dental treatments. Additional clinical studies are required to advance the indication filed of this system. Importance of using digital occlusal T-Scan analysis in orthodontics deserves further investigation.

  3. Development of Multi-perspective Diagnostics and Analysis Algorithms with Applications to Subsonic and Supersonic Combustors

    Science.gov (United States)

    Wickersham, Andrew Joseph

    There are two critical research needs for the study of hydrocarbon combustion in high speed flows: 1) combustion diagnostics with adequate temporal and spatial resolution, and 2) mathematical techniques that can extract key information from large datasets. The goal of this work is to address these needs, respectively, by the use of high speed and multi-perspective chemiluminescence and advanced mathematical algorithms. To obtain the measurements, this work explored the application of high speed chemiluminescence diagnostics and the use of fiber-based endoscopes (FBEs) for non-intrusive and multi-perspective chemiluminescence imaging up to 20 kHz. Non-intrusive and full-field imaging measurements provide a wealth of information for model validation and design optimization of propulsion systems. However, it is challenging to obtain such measurements due to various implementation difficulties such as optical access, thermal management, and equipment cost. This work therefore explores the application of FBEs for non-intrusive imaging to supersonic propulsion systems. The FBEs used in this work are demonstrated to overcome many of the aforementioned difficulties and provided datasets from multiple angular positions up to 20 kHz in a supersonic combustor. The combustor operated on ethylene fuel at Mach 2 with an inlet stagnation temperature and pressure of approximately 640 degrees Fahrenheit and 70 psia, respectively. The imaging measurements were obtained from eight perspectives simultaneously, providing full-field datasets under such flow conditions for the first time, allowing the possibility of inferring multi-dimensional measurements. Due to the high speed and multi-perspective nature, such new diagnostic capability generates a large volume of data and calls for analysis algorithms that can process the data and extract key physics effectively. To extract the key combustion dynamics from the measurements, three mathematical methods were investigated in this work

  4. Error tolerance analysis of wave diagnostic based on coherent modulation imaging in high power laser system

    Science.gov (United States)

    Pan, Xingchen; Liu, Cheng; Zhu, Jianqiang

    2018-02-01

    Coherent modulation imaging providing fast convergence speed and high resolution with single diffraction pattern is a promising technique to satisfy the urgent demands for on-line multiple parameter diagnostics with single setup in high power laser facilities (HPLF). However, the influence of noise on the final calculated parameters concerned has not been investigated yet. According to a series of simulations with twenty different sampling beams generated based on the practical parameters and performance of HPLF, the quantitative analysis based on statistical results was first investigated after considering five different error sources. We found the background noise of detector and high quantization error will seriously affect the final accuracy and different parameters have different sensitivity to different noise sources. The simulation results and the corresponding analysis provide the potential directions to further improve the final accuracy of parameter diagnostics which is critically important to its formal applications in the daily routines of HPLF.

  5. Diagnostic development and support of MHD test facilities

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    The Diagnostic Instrumentation and Analysis Laboratory (DIAL) at Mississippi State University (MSU) is developing diagnostic instruments for MHD power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for Heat Recovery/Seed Recovery support, are being refined, and new systems to measure temperatures and gas-seed-slag stream characteristics are being developed. To further data acquisition and analysis capabilities, the diagnostic systems are being interfaced with DIAL's computers. Technical support for the diagnostic needs of the national MHD research effort is being provided. DIAL personnel will also cooperate with government agencies and private industries to improve the transformation of research and development results into processes, products and services applicable to their needs. 25 figs., 6 tabs.

  6. Diagnostic development and support of MHD test facilities

    International Nuclear Information System (INIS)

    Shepard, W.S.; Cook, R.L.

    1990-01-01

    The Diagnostic Instrumentation and Analysis Laboratory (DIAL) at Mississippi State University (MSU) is developing diagnostic instruments for MHD power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for Heat Recovery/ Seed Recovery support, are being refined, and new systems to measure temperatures and gas-seed-slag stream characteristics are being developed. To further data acquisition and analysis capabilities, the diagnostic systems are being interfaced with DIAL's computers. Technical support for the diagnostic needs of the national MHD research effort is being provided. DIAL personnel will also cooperate with government agencies and private industries to improve the transformation of research and development results into processes, products and services applicable to their needs

  7. 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.

  8. 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

  9. Empirical likelihood-based confidence intervals for the sensitivity of a continuous-scale diagnostic test at a fixed level of specificity.

    Science.gov (United States)

    Gengsheng Qin; Davis, Angela E; Jing, Bing-Yi

    2011-06-01

    For a continuous-scale diagnostic test, it is often of interest to find the range of the sensitivity of the test at the cut-off that yields a desired specificity. In this article, we first define a profile empirical likelihood ratio for the sensitivity of a continuous-scale diagnostic test and show that its limiting distribution is a scaled chi-square distribution. We then propose two new empirical likelihood-based confidence intervals for the sensitivity of the test at a fixed level of specificity by using the scaled chi-square distribution. Simulation studies are conducted to compare the finite sample performance of the newly proposed intervals with the existing intervals for the sensitivity in terms of coverage probability. A real example is used to illustrate the application of the recommended methods.

  10. Parent-Child Diagnostic Agreement on Anxiety Symptoms with a Structured Diagnostic Interview for Mental Disorders in Children

    Science.gov (United States)

    Popp, Lukka; Neuschwander, Murielle; Mannstadt, Sandra; In-Albon, Tina; Schneider, Silvia

    2017-01-01

    Objective: In clinical structured diagnostic interviews, diagnoses based on parent and child reports have low to moderate agreement. The aims of the present study are (1) to examine diagnostic agreement on anxiety disorders between parents and children on the levels of current and lifetime diagnostic category and diagnoses focusing in particular on diagnostic criteria and (2) to identify parent- and child-related predictors for diagnostic agreement. Method: The sample consisted of 166 parent-child dyads interviewed with the Structured Diagnostic Interview for Mental Disorders in Children (Kinder-DIPS, Schneider et al., 2009). The children (51.8% girls) were between the ages of 7 and 18 years (M = 10.94; SD = 2.22). Results: Overall, parent-child agreement on the diagnostic category of anxiety disorder (k = 0.21; k = 0.22) and the specific anxiety diagnoses (base rate > 10%) of social phobia, specific phobia and separation anxiety disorder (k = 0.24–0.52; k = 0.19–0.43) and corresponding diagnostic criteria (k = 0.22–0.67; k = 0.24–0.41) were low to moderate with the highest agreement on separation anxiety disorder (k > 0.43). Lower maternal depression, and higher social support reported by mother and father were associated with higher parent-child agreement. Maternal depression was indicated as the strongest predictor. Parental sense of competence, parental anxiety, the amount of parent-child interaction and the child's age and gender had no predictive value. Conclusions: Parent-child agreement can be expected to be higher on the level of anxiety criteria compared to specific anxiety diagnoses and diagnostic anxiety category. Psychological strains in the family—especially maternal depression and low social support—lower the parent-child agreement on anxiety symptoms. Child- and relation-related variables (age, gender, amount of time parent(s) and children interact) play no role in the prediction of low parent-child agreement. PMID:28396644

  11. A web-based test of residents' skills in diagnostic radiology

    International Nuclear Information System (INIS)

    Finlay, K.; Norman, G.R.; Keane, D.R.; Stolberg, H.

    2006-01-01

    To develop an objective, Web-based tool for evaluating residents' knowledge of diagnostic radiology. We developed and tested a Web-based evaluation tool (the Diagnostic Radiology Skills Test) that consists of 3 tests, one in each of 3 domains of diagnostic radiology: chest, gastrointestinal, and musculoskeletal imaging. Each test comprises 30 cases representing a range of difficulty in the domain, including normal states, normal variants, typical cases of common diagnoses, and cases with more subtle findings. Cases are presented with a long menu of domain-specific possible diagnoses (response options), each coded for diagnostic appropriateness. Our subjects were 21 residents in postgraduate year (PGY) 2 to 5 and 11 experts in diagnostic radiology. Subjects accessed the tool via a Web site on our Web server. Residents test results were compared for reliability and validity across domain, case, and training level. In addition, results were correlated with commonly used established and objective evaluation tools. The tool demonstrated consistent monotonic improvement in performance with training level. It showed acceptable reliability in discriminating between residents at different performance levels, both within and across training levels (r = 0.53 within level and 0.69 across levels). Test results also had concurrent validity against the American College of Radiology In-Training Examination, a widely accepted objective assessment tool (r = 0.65, P < 0.01), and 2 Objective Structured Clinical Examinations (OSCEs) focusing on diagnostic skills (r = 0.78 and r 0.69, P < 0.01, respectively). Our study demonstrates the feasibility of a Web-based, standardized, objective assessment method for evaluating residents' performance. (author)

  12. Systematic Review of the Diagnostic Accuracy and Therapeutic Effectiveness of Sacroiliac Joint Interventions.

    Science.gov (United States)

    Simopoulos, Thomas T; Manchikanti, Laxmaiah; Gupta, Sanjeeva; Aydin, Steve M; Kim, Chong Hwan; Solanki, Daneshvari; Nampiaparampil, Devi E; Singh, Vijay; Staats, Peter S; Hirsch, Joshua A

    2015-01-01

    The sacroiliac joint is well known as a cause of low back and lower extremity pain. Prevalence estimates are 10% to 25% in patients with persistent axial low back pain without disc herniation, discogenic pain, or radiculitis based on multiple diagnostic studies and systematic reviews. However, at present there are no definitive management options for treating sacroiliac joint pain. To evaluate the diagnostic accuracy and therapeutic effectiveness of sacroiliac joint interventions. A systematic review of the diagnostic accuracy and therapeutic effectiveness of sacroiliac joint interventions. The available literature on diagnostic and therapeutic sacroiliac joint interventions was reviewed. The quality assessment criteria utilized were the Quality Appraisal of Reliability Studies (QAREL) checklist for diagnostic accuracy studies, Cochrane review criteria to assess sources of risk of bias, and Interventional Pain Management Techniques-Quality Appraisal of Reliability and Risk of Bias Assessment (IPM-QRB) criteria for randomized therapeutic trials and Interventional Pain Management Techniques-Quality Appraisal of Reliability and Risk of Bias Assessment for Nonrandomized Studies (IPM-QRBNR) for observational therapeutic assessments. The level of evidence was based on a best evidence synthesis with modified grading of qualitative evidence from Level I to Level V. Data sources included relevant literature published from 1966 through March 2015 that were identified through searches of PubMed and EMBASE, manual searches of the bibliographies of known primary and review articles, and all other sources. For the diagnostic accuracy assessment, and for the therapeutic modalities, the primary outcome measure of pain relief and improvement in functional status were utilized. A total of 11 diagnostic accuracy studies and 14 therapeutic studies were included. The evidence for diagnostic accuracy is Level II for dual diagnostic blocks with at least 70% pain relief as the criterion

  13. Comparative guide to emerging diagnostic tools for large commercial HVAC systems

    Energy Technology Data Exchange (ETDEWEB)

    Friedman, Hannah; Piette, Mary Ann

    2001-05-01

    This guide compares emerging diagnostic software tools that aid detection and diagnosis of operational problems for large HVAC systems. We have evaluated six tools for use with energy management control system (EMCS) or other monitoring data. The diagnostic tools summarize relevant performance metrics, display plots for manual analysis, and perform automated diagnostic procedures. Our comparative analysis presents nine summary tables with supporting explanatory text and includes sample diagnostic screens for each tool.

  14. ITER diagnostics ex-vessel engineering services

    Energy Technology Data Exchange (ETDEWEB)

    Arumugam, A.P., E-mail: arun.prakash@iter.org; Walker, C.I.; Andrew, P.; Barnsley, R.; Beltran, D.; Bertalot, L.; Dammann, A.; Direz, M.F.; Drevon, J.M.; Encheva, A.; Giacomin, T.; Hourtoule, J.; Kuehn, I.; Lanza, R.; Levesy, B.; Maquet, P.; Patel, K.M.; Patisson, L.; Pitcher, C.S.; Portales, M.; and others

    2013-10-15

    as well as the total requirements to a significant level of definition. It demonstrates the impact of this as a design restraint and requirement on both the diagnostics and the service systems as they are further specified, designed and procured.

  15. ITER diagnostics ex-vessel engineering services

    International Nuclear Information System (INIS)

    Arumugam, A.P.; Walker, C.I.; Andrew, P.; Barnsley, R.; Beltran, D.; Bertalot, L.; Dammann, A.; Direz, M.F.; Drevon, J.M.; Encheva, A.; Giacomin, T.; Hourtoule, J.; Kuehn, I.; Lanza, R.; Levesy, B.; Maquet, P.; Patel, K.M.; Patisson, L.; Pitcher, C.S.; Portales, M.

    2013-01-01

    as well as the total requirements to a significant level of definition. It demonstrates the impact of this as a design restraint and requirement on both the diagnostics and the service systems as they are further specified, designed and procured

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  17. 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

  18. The Mini-Mental State Examination as a diagnostic and screening test for delirium: systematic review and meta-analysis.

    Science.gov (United States)

    Mitchell, Alex J; Shukla, Deepak; Ajumal, Hafsa A; Stubbs, Brendon; Tahir, Tayyeb A

    2014-01-01

    To analyse the evidence concerning the accuracy of the Mini-Mental State Examination (MMSE) as a diagnostic and screening test for the presence of delirium in adults. Two authors searched MEDLINE, PsychINFO and EMBASE from inception till March 2014. Articles were included that investigated the diagnostic validity of the MMSE to detect delirium against standardised criteria. A diagnostic validity meta-analysis was conducted. Thirteen studies were included representing 2017 patients in medical settings of whom 29.4% had delirium. The meta-analysis revealed the MMSE had an overall sensitivity and specificity estimate of 84.1% and 73.0%, but this was 81.1% and 82.8% in a subgroup analysis involving robust high quality studies. Sensitivity was unchanged but specificity was 68.4% (95% CI = 50.9-83.5%) in studies using a predefined cutoff of <24 to signify a case. In high-risk samples where delirium was present in 25% of patients, then the Positive predictive value and Negative predictive value would be 50.9% (48.3-66.2%) and 93.2% (90.0-96.5%). The MMSE cannot be recommended as a case-finding confirmatory test of delirium, but may be used as an initial screen to rule out high scorers who are unlikely to have delirium with approximately 93% accuracy. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Vega, Walter Flores

    1999-04-01

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

  1. MOVES regional level sensitivity analysis

    Science.gov (United States)

    2012-01-01

    The MOVES Regional Level Sensitivity Analysis was conducted to increase understanding of the operations of the MOVES Model in regional emissions analysis and to highlight the following: : the relative sensitivity of selected MOVES Model input paramet...

  2. Diagnostic value of serum squamous cell carcinoma antigen for hepatocellular carcinoma: a systematic review and meta-analysis.

    Science.gov (United States)

    Yu, Jing; Wang, Zhao-Juan; Chen, Long-Hua; Dong, Wen-Zhu

    2017-02-01

    The aim of this study was to ascertain the diagnostic value of serum squamous cell carcinoma antigen (SCCA) and SCCA-IgM for hepatocellular carcinoma (HCC). After a comprehensive search of PubMed and Web of Science databases, we identified eligible studies on the diagnostic value serum SCCAs for HCC. The quality of the eligible studies was assessed using the revised Quality Assessment for Studies of Diagnostic Accuracy (QUADAS-2) tool. The overall diagnostic value of SCCAs for HCC was pooled using a bivariate model. Twelve studies were included in this systematic review and meta-analysis. The pooled sensitivities for SCCA and SCCA-IgM were 0.61 (95% confidence interval [CI], 0.37-0.81) and 0.70 (95% CI, 0.55-0.82), respectively. The corresponding specificities were 0.80 (95% CI, 0.52-0.94) and 0.62 (95% CI, 0.51-0.72), respectively. The areas under summary receiver operating characteristic (sROC) curves for SCCA and SCCA-IgM were 0.76 (95% CI, 0.72-0.80) and 0.70 (95% CI, 0.66-0.74), respectively. Major design deficiencies of the included studies were two-gate design and partial verification bias. Therefore, we concluded that both serum SCCA and SCCA-IgM have a fair diagnostic value for HCC.

  3. Diagnostic accuracy of the STRATIFY clinical prediction rule for falls: A systematic review and meta-analysis

    LENUS (Irish Health Repository)

    Billington, Jennifer

    2012-08-07

    AbstractBackgroundThe STRATIFY score is a clinical prediction rule (CPR) derived to assist clinicians to identify patients at risk of falling. The purpose of this systematic review and meta-analysis is to determine the overall diagnostic accuracy of the STRATIFY rule across a variety of clinical settings.MethodsA literature search was performed to identify all studies that validated the STRATIFY rule. The methodological quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. A STRATIFY score of ≥2 points was used to identify individuals at higher risk of falling. All included studies were combined using a bivariate random effects model to generate pooled sensitivity and specificity of STRATIFY at ≥2 points. Heterogeneity was assessed using the variance of logit transformed sensitivity and specificity.ResultsSeventeen studies were included in our meta-analysis, incorporating 11,378 patients. At a score ≥2 points, the STRATIFY rule is more useful at ruling out falls in those classified as low risk, with a greater pooled sensitivity estimate (0.67, 95% CI 0.52–0.80) than specificity (0.57, 95% CI 0.45 – 0.69). The sensitivity analysis which examined the performance of the rule in different settings and subgroups also showed broadly comparable results, indicating that the STRATIFY rule performs in a similar manner across a variety of different ‘at risk’ patient groups in different clinical settings.ConclusionThis systematic review shows that the diagnostic accuracy of the STRATIFY rule is limited and should not be used in isolation for identifying individuals at high risk of falls in clinical practice.

  4. Ambient diagnostics

    CERN Document Server

    Cai, Yang

    2014-01-01

    Part I. FundamentalsIntroductionWhat is Ambient Diagnostics?Diagnostic ModelsMultimedia IntelligenceCrowd SourcingSoft SensorsScience of SimplicityPersonal DiagnosesBasic AlgorithmsBasic ToolsSummaryProblemsTransformationEarly Discoveries of Heartbeat PatternsTransforms, Features, and AttributesSequential FeaturesSpatiotemporal FeaturesShape FeaturesImagery FeaturesFrequency Domain FeaturesMulti-Resolution FeaturesSummaryProblemsPattern RecognitionSimilarities and DistancesClustering MethodsClassification MethodsClassifier Accuracy MeasuresSummaryProblemsPart II. Multimedia IntelligenceSound RecognitionMicrophone AppsModern Acoustic Transducers (Microphones)Frequency Response CharacteristicsDigital Audio File FormatsHeart Sound SensingLung Sound SensingSnore MeterSpectrogram (STFT)Ambient Sound AnalysisSound RecognitionRecognizing Asthma SoundPeak ShiftFeature CompressionRegroupingNoise IssuesFuture ApplicationsSummaryProblemsColor SensorsColor SensingHuman Color VisionColor SensorsColor Matching ExperimentsC...

  5. 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.

  6. Dental and dental hygiene students' diagnostic accuracy in oral radiology: effect of diagnostic strategy and instructional method.

    Science.gov (United States)

    Baghdady, Mariam T; Carnahan, Heather; Lam, Ernest W N; Woods, Nicole N

    2014-09-01

    There has been much debate surrounding diagnostic strategies and the most appropriate training models for novices in oral radiology. It has been argued that an analytic approach, using a step-by-step analysis of the radiographic features of an abnormality, is ideal. Alternative research suggests that novices can successfully employ non-analytic reasoning. Many of these studies do not take instructional methodology into account. This study evaluated the effectiveness of non-analytic and analytic strategies in radiographic interpretation and explored the relationship between instructional methodology and diagnostic strategy. Second-year dental and dental hygiene students were taught four radiographic abnormalities using basic science instructions or a step-by-step algorithm. The students were tested on diagnostic accuracy and memory immediately after learning and one week later. A total of seventy-three students completed both immediate and delayed sessions and were included in the analysis. Students were randomly divided into two instructional conditions: one group provided a diagnostic hypothesis for the image and then identified specific features to support it, while the other group first identified features and then provided a diagnosis. Participants in the diagnosis-first condition (non-analytic reasoning) had higher diagnostic accuracy then those in the features-first condition (analytic reasoning), regardless of their learning condition. No main effect of learning condition or interaction with diagnostic strategy was observed. Educators should be mindful of the potential influence of analytic and non-analytic approaches on the effectiveness of the instructional method.

  7. DR6 as a diagnostic and predictive biomarker in adult sarcoma.

    Directory of Open Access Journals (Sweden)

    Kun Yang

    Full Text Available The Death Receptor 6 (DR6 protein is elevated in the serum of ovarian cancer patients. We tested DR6 serum protein levels as a diagnostic/predictive biomarker in several epithelial tumors and sarcomas.DR6 gene expression profiles were screened in publically available arrays of solid tumors. A quantitative immunofluorescent western blot analysis was developed to test the serum of healthy controls and patients with sarcoma, uterine carcinosarcoma, bladder, liver, and pancreatic carcinomas. Change in DR6 serum levels was used to assay the ability of DR6 to predict the response to therapy of sarcoma patients.DR6 mRNA is highly expressed in all tumor types assayed. Western blot analysis of serum DR6 protein demonstrated high reproducibility (r = 0.97. Compared to healthy donor controls, DR6 serum levels were not elevated in patients with uterine carcinosarcoma, bladder, liver, or pancreatic cancers. Serum DR6 protein levels from adult sarcoma patients were significantly elevated (p<0.001. This was most evident for patients with synovial sarcoma. Change in serum DR6 levels during therapy correlated with clinical benefit from therapy (sensitivity 75%, and positive predictive value 87%.DR6 may be a clinically useful diagnostic and predictive serum biomarker for some adult sarcoma subtypes.Diagnosis of sarcoma can be difficult and can lead to improper management of these cancers. DR6 serum protein may be a tool to aid in the diagnosis of some sarcomatous tumors to improve treatment planning. For patients with advanced disease, rising DR6 levels predict non-response to therapy and may expedite therapeutic decision making and reduce reliance on radiologic imaging.

  8. 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.

  9. Electrophysiological evidence for colour effects on the naming of colour diagnostic and noncolour diagnostic objects

    OpenAIRE

    Bramão, I.; Francisco, A.; Inácio , F.; Faísca, L.; Reis, A.; Petersson, K.

    2012-01-01

    In this study, we investigated the level of visual processing at which surface colour information improves the naming of colour diagnostic and noncolour diagnostic objects. Continuous electroencephalograms were recorded while participants performed a visual object naming task in which coloured and black-and-white versions of both types of objects were presented. The black-and-white and the colour presentations were compared in two groups of event-related potentials (ERPs): (1) The P1 and N1 c...

  10. Domain knowledge patterns in pedagogical diagnostics

    Science.gov (United States)

    Miarka, Rostislav

    2017-07-01

    This paper shows a proposal of representation of knowledge patterns in RDF(S) language. Knowledge patterns are used for reuse of knowledge. They can be divided into two groups - Top-level knowledge patterns and Domain knowledge patterns. Pedagogical diagnostics is aimed at testing of knowledge of students at primary and secondary school. An example of domain knowledge pattern from pedagogical diagnostics is part of this paper.

  11. Biomedical analysis of formalin-fixed, paraffin-embedded tissue samples: The Holy Grail for molecular diagnostics.

    Science.gov (United States)

    Donczo, Boglarka; Guttman, Andras

    2018-06-05

    More than a century ago in 1893, a revolutionary idea about fixing biological tissue specimens was introduced by Ferdinand Blum, a German physician. Since then, a plethora of fixation methods have been investigated and used. Formalin fixation with paraffin embedment became the most widely used types of fixation and preservation method, due to its proper architectural conservation of tissue structures and cellular shape. The huge collection of formalin-fixed, paraffin-embedded (FFPE) sample archives worldwide holds a large amount of unearthed information about diseases that could be the Holy Grail in contemporary biomarker research utilizing analytical omics based molecular diagnostics. The aim of this review is to critically evaluate the omics options for FFPE tissue sample analysis in the molecular diagnostics field. Copyright © 2018. Published by Elsevier B.V.

  12. 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.

  13. The ITER bolometer diagnostic: Status and plans

    International Nuclear Information System (INIS)

    Meister, H.; Giannone, L.; Horton, L. D.; Raupp, G.; Zeidner, W.; Grunda, G.; Kalvin, S.; Fischer, U.; Serikov, A.; Stickel, S.; Reichle, R.

    2008-01-01

    A consortium consisting of four EURATOM Associations has been set up to develop the project plan for the full development of the ITER bolometer diagnostic and to continue urgent R and D activities. An overview of the current status is given, including detector development, line-of-sight optimization, performance analysis as well as the design of the diagnostic components and their integration in ITER. This is complemented by the presentation of plans for future activities required to successfully implement the bolometer diagnostic, ranging from the detector development over diagnostic design and prototype testing to RH tools for calibration.

  14. The ITER bolometer diagnostic: Status and plansa)

    Science.gov (United States)

    Meister, H.; Giannone, L.; Horton, L. D.; Raupp, G.; Zeidner, W.; Grunda, G.; Kalvin, S.; Fischer, U.; Serikov, A.; Stickel, S.; Reichle, R.

    2008-10-01

    A consortium consisting of four EURATOM Associations has been set up to develop the project plan for the full development of the ITER bolometer diagnostic and to continue urgent R&D activities. An overview of the current status is given, including detector development, line-of-sight optimization, performance analysis as well as the design of the diagnostic components and their integration in ITER. This is complemented by the presentation of plans for future activities required to successfully implement the bolometer diagnostic, ranging from the detector development over diagnostic design and prototype testing to RH tools for calibration.

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

    Data.gov (United States)

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

  16. Towards diagnostics for a fusion reactor

    International Nuclear Information System (INIS)

    Costley, A. E.

    2009-01-01

    The requirements for measurements on modern tokamak fusion plasmas are outlined, and the techniques and systems used to make the measurements, usually referred to as 'diagnostics', are introduced. The basics of three particular diagnostics - magnetics, neutron systems and a laser based optical system - are outlined as examples of modern diagnostic systems, and the implementation of these diagnostics on a current tokamak (JET) are described. The next major step in magnetic confinement fusion is the construction and operation of the International Thermonuclear Experimental Reactor (ITER), which is a joint project of China, Europe, Japan, India, Korea, the Russian Federation, and the United States. Construction has begun in Cadarache, France. It is expected that ITER will operate at the 500 MW level. Because of the harsh environment in the vacuum vessel where many diagnostic components are located, the development of diagnostics for ITER is a major challenge - arguably the most difficult challenge ever undertaken in the field of diagnostics. The main elements in the diagnostic step are outlined using the three chosen techniques as examples. Finally, the step beyond ITER to a demonstration reactor, DEMO, that is expected to produce several GWs of fusion power is considered and the impact on diagnostics outlined. It is shown that the applicability and development steps needed for the individual diagnostics techniques will differ. The challenges for DEMO diagnostics are substantial and a dedicated effort should be made to find and develop new techniques, and especially techniques appropriate to the DEMO environment. It is argued that the limitations and difficulties in diagnostics should be a consideration in the optimization and designs of DEMO. (author)

  17. Diffuse Infiltrative Splenic Lymphoma: Diagnostic Efficacy of Arterial-Phase CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Eun; Cho, June-Sik; Shin, Kyung Sook; Kim, Song Soo; You, Sun Kyoung; Park, Jae Woo; Shin, Hye Soo; Yoon, Yeo Chang [Department of Radiology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon 35015 (Korea, Republic of)

    2016-11-01

    To evaluate the diagnostic performance of obliteration of normal heterogeneous enhancement of the spleen (ONHES) on arterial phase (AP) computed tomography (CT) images in diffuse infiltrative splenic lymphoma (DISL). One hundred and thirty-six patients with lymphoma who had undergone two-phase (arterial and portal venous) abdominal CT were included in this study. We retrospectively evaluated the diagnostic performance of ONHES on AP CT in diagnosing DISL. Two observers evaluated ONHES on AP CT using the 5-point confidence level and assessed the presence or absence of subjective splenomegaly on axial CT images. Another two observers measured the splenic index as proposed by objective CT criteria. Statistical analysis included interobserver agreement and diagnostic performance of CT findings. Eleven of the 136 patients with lymphoma had DISL. The area under the receiver operating characteristic curve of ONHES (0.948 for observer 1 and 0.922 for observer 2) was superior to that of the splenic index (0.872 for observer 3 and 0.877 for observer 4), but the difference was not statistically significant (p > 0.05). The diagnostic performance of ONHES in conjunction with subjective splenomegaly showed higher diagnostic performance, as compared with subjective splenomegaly alone (accuracy: 100% and 85.3% for observer 1, 98.5% and 87.5% for observer 2; positive predictive value: 100% and 35.5% for observer 1, 90.9% and 39.3% for observer 2, respectively). Obliteration of normal heterogeneous enhancement of the spleen in conjunction with subjective splenomegaly can improve the diagnostic performance for DISL. Our results suggest that ONHES on AP CT images could be useful as an adjunctive diagnostic indicator of DISL in patients with lymphoma.

  18. Diffuse infiltrative splenic lymphoma; Diagnostic efficacy of arterial-phase CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Eun; Cho, June Sik; Shin, Kyung Sook; Kim, Song Soo; You, Sun Kyoung; Park, Jae Woo; Shin, Hye Soo; Yoon, Yeo Chang [Dept. of Radiology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    2016-09-15

    To evaluate the diagnostic performance of obliteration of normal heterogeneous enhancement of the spleen (ONHES) on arterial phase (AP) computed tomography (CT) images in diffuse infiltrative splenic lymphoma (DISL). One hundred and thirty-six patients with lymphoma who had undergone two-phase (arterial and portal venous) abdominal CT were included in this study. We retrospectively evaluated the diagnostic performance of ONHES on AP CT in diagnosing DISL. Two observers evaluated ONHES on AP CT using the 5-point confidence level and assessed the presence or absence of subjective splenomegaly on axial CT images. Another two observers measured the splenic index as proposed by objective CT criteria. Statistical analysis included interobserver agreement and diagnostic performance of CT findings. Eleven of the 136 patients with lymphoma had DISL. The area under the receiver operating characteristic curve of ONHES (0.948 for observer 1 and 0.922 for observer 2) was superior to that of the splenic index (0.872 for observer 3 and 0.877 for observer 4), but the difference was not statistically significant (p > 0.05). The diagnostic performance of ONHES in conjunction with subjective splenomegaly showed higher diagnostic performance, as compared with subjective splenomegaly alone (accuracy: 100% and 85.3% for observer 1, 98.5% and 87.5% for observer 2; positive predictive value: 100% and 35.5% for observer 1, 90.9% and 39.3% for observer 2, respectively). Obliteration of normal heterogeneous enhancement of the spleen in conjunction with subjective splenomegaly can improve the diagnostic performance for DISL. Our results suggest that ONHES on AP CT images could be useful as an adjunctive diagnostic indicator of DISL in patients with lymphoma.

  19. Diffuse Infiltrative Splenic Lymphoma: Diagnostic Efficacy of Arterial-Phase CT

    International Nuclear Information System (INIS)

    Lee, Jeong Eun; Cho, June-Sik; Shin, Kyung Sook; Kim, Song Soo; You, Sun Kyoung; Park, Jae Woo; Shin, Hye Soo; Yoon, Yeo Chang

    2016-01-01

    To evaluate the diagnostic performance of obliteration of normal heterogeneous enhancement of the spleen (ONHES) on arterial phase (AP) computed tomography (CT) images in diffuse infiltrative splenic lymphoma (DISL). One hundred and thirty-six patients with lymphoma who had undergone two-phase (arterial and portal venous) abdominal CT were included in this study. We retrospectively evaluated the diagnostic performance of ONHES on AP CT in diagnosing DISL. Two observers evaluated ONHES on AP CT using the 5-point confidence level and assessed the presence or absence of subjective splenomegaly on axial CT images. Another two observers measured the splenic index as proposed by objective CT criteria. Statistical analysis included interobserver agreement and diagnostic performance of CT findings. Eleven of the 136 patients with lymphoma had DISL. The area under the receiver operating characteristic curve of ONHES (0.948 for observer 1 and 0.922 for observer 2) was superior to that of the splenic index (0.872 for observer 3 and 0.877 for observer 4), but the difference was not statistically significant (p > 0.05). The diagnostic performance of ONHES in conjunction with subjective splenomegaly showed higher diagnostic performance, as compared with subjective splenomegaly alone (accuracy: 100% and 85.3% for observer 1, 98.5% and 87.5% for observer 2; positive predictive value: 100% and 35.5% for observer 1, 90.9% and 39.3% for observer 2, respectively). Obliteration of normal heterogeneous enhancement of the spleen in conjunction with subjective splenomegaly can improve the diagnostic performance for DISL. Our results suggest that ONHES on AP CT images could be useful as an adjunctive diagnostic indicator of DISL in patients with lymphoma

  20. Application of diagnostics to determine operational readiness of aged motor-operated valves

    International Nuclear Information System (INIS)

    Eissenberg, D.M.

    1987-01-01

    Oak Ridge National Laboratory (ORNL) has been carrying out an aging assessment of motor-operated valves (MOVs) with the primary objective of recommending diagnostic methods for detecting and trending aging. As a result of experimental investigations at ORNL, it was discovered that the motor current during a valve stroke was a very useful diagnostic parameter for detecting and trending many MOV drive train load variations. The motor current signatures were analyzed at four levels: mean value for a stroke, gross trends during a stroke, transients, and noise frequency spectra. Examples illustrating the use of this technique are presented. The use of motor current signature analysis was also shown to apply to other electric motor driven equipment. Future work includes developing a data base of MOV diagnostics, including criteria for determining the extent of degradation and application of the technique to other LWR motor driven safety equipment

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

    International Nuclear Information System (INIS)

    Su Li; Huang Chenggang; Niu Wenqiang; Wu Liwen

    2010-01-01

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

  2. Disparities in the diagnostic process of Duchenne and Becker muscular dystrophy.

    Science.gov (United States)

    Holtzer, Caleb; Meaney, F John; Andrews, Jennifer; Ciafaloni, Emma; Fox, Deborah J; James, Katherine A; Lu, Zhenqiang; Miller, Lisa; Pandya, Shree; Ouyang, Lijing; Cunniff, Christopher

    2011-11-01

    To determine whether sociodemographic factors are associated with delays at specific steps in the diagnostic process of Duchenne and Becker muscular dystrophy. We examined abstracted medical records for 540 males from population-based surveillance sites in Arizona, Colorado, Georgia, Iowa, and western New York. We used linear regressions to model the association of three sociodemographic characteristics with age at initial medical evaluation, first creatine kinase measurement, and earliest DNA analysis while controlling for changes in the diagnostic process over time. The analytical dataset included 375 males with information on family history of Duchenne and Becker muscular dystrophy, neighborhood poverty levels, and race/ethnicity. Black and Hispanic race/ethnicity predicted older ages at initial evaluation, creatine kinase measurement, and DNA testing (P Becker muscular dystrophy predicted younger ages at initial evaluation, creatine kinase measurement and DNA testing (P Becker muscular dystrophy are evident even after adjustment for family history of Duchenne and Becker muscular dystrophy and changes in the diagnostic process over time. Black and Hispanic children are initially evaluated at older ages than white children, and the gap widens at later steps in the diagnostic process.

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

    International Nuclear Information System (INIS)

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

    2017-01-01

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

  4. The diagnostic accuracy of multi-frequency bioelectrical impedance analysis in diagnosing dehydration after stroke

    Science.gov (United States)

    Kafri, Mohannad W.; Myint, Phyo Kyaw; Doherty, Danielle; Wilson, Alexander Hugh; Potter, John F.; Hooper, Lee

    2013-01-01

    Background Non-invasive methods for detecting water-loss dehydration following acute stroke would be clinically useful. We evaluated the diagnostic accuracy of multi-frequency bioelectrical impedance analysis (MF-BIA) against reference standards serum osmolality and osmolarity. Material/Methods Patients admitted to an acute stroke unit were recruited. Blood samples for electrolytes and osmolality were taken within 20 minutes of MF-BIA. Total body water (TBW%), intracellular (ICW%) and extracellular water (ECW%), as percentages of total body weight, were calculated by MF-BIA equipment and from impedance measures using published equations for older people. These were compared to hydration status (based on serum osmolality and calculated osmolarity). The most promising Receiver Operating Characteristics curves were plotted. Results 27 stroke patients were recruited (mean age 71.3, SD10.7). Only a TBW% cut-off at 46% was consistent with current dehydration (serum osmolality >300 mOsm/kg) and TBW% at 47% impending dehydration (calculated osmolarity ≥295–300 mOsm/L) with sensitivity and specificity both >60%. Even here diagnostic accuracy of MF-BIA was poor, a third of those with dehydration were wrongly classified as hydrated and a third classified as dehydrated were well hydrated. Secondary analyses assessing diagnostic accuracy of TBW% for men and women separately, and using TBW as a percentage of lean body mass showed some promise, but did not provide diagnostically accurate measures across the population. Conclusions MF-BIA appears ineffective at diagnosing water-loss dehydration after stroke and cannot be recommended as a test for dehydration, but separating assessment by sex, and using TBW as a percentage of lean body weight may warrant further investigation. PMID:23839255

  5. Patients exposure assessment for radiographic procedures in diagnostic radiology

    International Nuclear Information System (INIS)

    Arandjic, D.; Ciraj-Bjelac, O.; Stankovic, K.; Lazarevic, Dj.; Ciraj-Bjelac, O.)

    2007-01-01

    In this work the results of dose assessment for the most frequent radiographic procedures in diagnostic radiology are shown. Entrance surface doses were assessed for 7 radiographic procedures. Three hospitals, six x-ray units in total, were enrolled in investigation. Patient doses were estimated based on results of x-ray tube output measurements. Finally, doses were compared with Diagnostic reference level. Higher dose values were observed for chest examinations. In comparison with results from other countries, doses from this procedure in Serbia are significantly higher. Estimated doses for other procedures were well below Diagnostic reference levels [sr

  6. Diagnostic properties of C-reactive protein for detecting pneumonia in children.

    Science.gov (United States)

    Koster, Madieke J; Broekhuizen, Berna D L; Minnaard, Margaretha C; Balemans, Walter A F; Hopstaken, Rogier M; de Jong, Pim A; Verheij, Theo J M

    2013-07-01

    The diagnostic value of C-reactive protein (CRP) level for pneumonia in children is unknown. As a first step in the assessment of the value of CRP, a diagnostic study was performed in children at an emergency department (ED). In this cross-sectional study, data were retrospectively collected from children presenting with suspected pneumonia at the ED of Antonius Hospital Nieuwegein in The Netherlands between January 2007 and January 2012. Diagnostic outcome was pneumonia yes/no according to independent radiologist. (Un)adjusted association between CRP level and pneumonia and diagnostic value of CRP were calculated. Of 687 presenting children, 286 underwent both CRP measurement and chest radiography. 148 had pneumonia (52%). The proportion of pneumonia increased with CRP level. Negative predictive values declined, but positive predictive values increased with higher CRP thresholds. Univariable odds ratio for the association between CRP level and pneumonia was 1.2 (95% CI 1.11-1.21) per 10 mg/L increase. After adjustment for baseline characteristics CRP level remained associated with pneumonia. CRP level has independent diagnostic value for pneumonia in children presenting at the ED with suspected pneumonia, but low levels do not exclude pneumonia in this setting. These results prompt evaluation of CRP in primary care children with LRTI. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Plasma diagnostics surface analysis and interactions

    CERN Document Server

    Auciello, Orlando

    2013-01-01

    Plasmas and their interaction with materials have become subjects of major interest because of their importance in modern forefront technologies such as microelectronics, fusion energy, and space. Plasmas are used in microelectronics to process semiconductors (etching of patterns for microcircuits, plasma-induced deposition of thin films, etc.); plasmas produce deleterious erosion effects on surfaces of materials used for fusion devices and spaceships exposed to the low earth environment.Diagnostics of plasmas and materials exposed to them are fundamental to the understanding of the physical a

  8. [CONTEMPORARY MOLECULAR-GENETIC METHODS USED FOR ETIOLOGIC DIAGNOSTICS OF SEPSIS].

    Science.gov (United States)

    Gavrilov, S N; Skachkova, T S; Shipulina, O Yu; Savochkina, Yu A; Shipulin, G A; Maleev, V V

    2016-01-01

    Etiologic diagnostics of sepsis is one of the most difficult problems of contemporary medicine due to a wide variety of sepsis causative agents, many of which are components of normal human microflora. Disadvantages of contemporary "golden standard" of microbiologic diagnostics of sepsis etiology by seeding of blood for sterility are duration of cultivation, limitation in detection of non-cultivable forms of microorganisms, significant effect of preliminary empiric antibiotics therapy on results of the analysis. Methods of molecular diagnostics that are being actively developed and integrated during the last decade are deprived of these disadvantages. Main contemporary methods of molecular-biological diagnostics are examined in the review, actualdata on their diagnostic characteristic are provided. Special attention is given to methods of PCR-diagnostics, including novel Russian developments. Methods of nucleic acid hybridization and proteomic analysis are examined in comparative aspect. Evaluation of application and perspectives of development of methods of molecular diagnostics of sepsis is given.

  9. Diagnostic staging laparoscopy in gastric cancer treatment: A cost-effectiveness analysis.

    Science.gov (United States)

    Li, Kevin; Cannon, John G D; Jiang, Sam Y; Sambare, Tanmaya D; Owens, Douglas K; Bendavid, Eran; Poultsides, George A

    2018-05-01

    Accurate preoperative staging helps avert morbidity, mortality, and cost associated with non-therapeutic laparotomy in gastric cancer (GC) patients. Diagnostic staging laparoscopy (DSL) can detect metastases with high sensitivity, but its cost-effectiveness has not been previously studied. We developed a decision analysis model to assess the cost-effectiveness of preoperative DSL in GC workup. Analysis was based on a hypothetical cohort of GC patients in the U.S. for whom initial imaging shows no metastases. The cost-effectiveness of DSL was measured as cost per quality-adjusted life-year (QALY) gained. Drivers of cost-effectiveness were assessed in sensitivity analysis. Preoperative DSL required an investment of $107 012 per QALY. In sensitivity analysis, DSL became cost-effective at a threshold of $100 000/QALY when the probability of occult metastases exceeded 31.5% or when test sensitivity for metastases exceeded 86.3%. The likelihood of cost-effectiveness increased from 46% to 93% when both parameters were set at maximum reported values. The cost-effectiveness of DSL for GC patients is highly dependent on patient and test characteristics, and is more likely when DSL is used selectively where procedure yield is high, such as for locally advanced disease or in detecting peritoneal and superficial versus deep liver lesions. © 2017 Wiley Periodicals, Inc.

  10. Logical Entity Level Sentiment Analysis

    DEFF Research Database (Denmark)

    Petersen, Niklas Christoffer; Villadsen, Jørgen

    2017-01-01

    We present a formal logical approach using a combinatory categorial grammar for entity level sentiment analysis that utilizes machine learning techniques for efficient syntactical tagging and performs a deep structural analysis of the syntactical properties of texts in order to yield precise resu...

  11. Diagnostics of movement predispositions in fitnness centre

    OpenAIRE

    Vojtíšek, Petr

    2011-01-01

    Title: Diagnostics of movement predispositions in fitness Objectives: The objective of bachelor thesis is to summarize the findings of the initial diagnostics od movement predispositions in fitness and then serve as a resource for those interested in education in this field. The aim of the practical part of this work is to obtain information about the diagnostic methods used to assess physical assumptions in the fitness centers. Methods: In this thesis was used the method of analysis of scien...

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  13. Using Fault Trees to Advance Understanding of Diagnostic Errors.

    Science.gov (United States)

    Rogith, Deevakar; Iyengar, M Sriram; Singh, Hardeep

    2017-11-01

    Diagnostic errors annually affect at least 5% of adults in the outpatient setting in the United States. Formal analytic techniques are only infrequently used to understand them, in part because of the complexity of diagnostic processes and clinical work flows involved. In this article, diagnostic errors were modeled using fault tree analysis (FTA), a form of root cause analysis that has been successfully used in other high-complexity, high-risk contexts. How factors contributing to diagnostic errors can be systematically modeled by FTA to inform error understanding and error prevention is demonstrated. A team of three experts reviewed 10 published cases of diagnostic error and constructed fault trees. The fault trees were modeled according to currently available conceptual frameworks characterizing diagnostic error. The 10 trees were then synthesized into a single fault tree to identify common contributing factors and pathways leading to diagnostic error. FTA is a visual, structured, deductive approach that depicts the temporal sequence of events and their interactions in a formal logical hierarchy. The visual FTA enables easier understanding of causative processes and cognitive and system factors, as well as rapid identification of common pathways and interactions in a unified fashion. In addition, it enables calculation of empirical estimates for causative pathways. Thus, fault trees might provide a useful framework for both quantitative and qualitative analysis of diagnostic errors. Future directions include establishing validity and reliability by modeling a wider range of error cases, conducting quantitative evaluations, and undertaking deeper exploration of other FTA capabilities. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  14. Diagnostic accuracy in virtual dermatopathology

    DEFF Research Database (Denmark)

    Mooney, E.; Kempf, W.; Jemec, G.B.E.

    2012-01-01

    Background Virtual microscopy is used for teaching medical students and residents and for in-training and certification examinations in the United States. However, no existing studies compare diagnostic accuracy using virtual slides and photomicrographs. The objective of this study was to compare...... diagnostic accuracy of dermatopathologists and pathologists using photomicrographs vs. digitized images, through a self-assessment examination, and to elucidate assessment of virtual dermatopathology. Methods Forty-five dermatopathologists and pathologists received a randomized combination of 15 virtual...... slides and photomicrographs with corresponding clinical photographs and information in a self-assessment examination format. Descriptive data analysis and comparison of groups were performed using a chi-square test. Results Diagnostic accuracy in dermatopathology using virtual dermatopathology...

  15. Methodical Approach to Diagnostics of Efficiency of Production Economic Activity of an Enterprise

    Directory of Open Access Journals (Sweden)

    Zhukov Andrii V.

    2014-03-01

    Full Text Available The article offers developments of a methodical approach to diagnostics of efficiency of production economic activity of an enterprise, which, unlike the existing ones, is realised through the following stages: analysis of the enterprise external environment; analysis of the enterprise internal environment; identification of components of efficiency of production economic activity for carrying out complex diagnostics by the following directions: efficiency of subsystems of the enterprise production economic activity, efficiency of use of separate types of resources and socio-economic efficiency; scorecard formation; study of tendencies of change of indicators; identification of cause-effect dependencies between the main components of efficiency for diagnosing reasons of its level; diagnosing deviations of indicator values from their optimal values; development of a managerial decision on preserving and increasing efficiency of production economic activity of the enterprise.

  16. Advanced Diagnostic and Prognostic Testbed (ADAPT) Testability Analysis Report

    Science.gov (United States)

    Ossenfort, John

    2008-01-01

    As system designs become more complex, determining the best locations to add sensors and test points for the purpose of testing and monitoring these designs becomes more difficult. Not only must the designer take into consideration all real and potential faults of the system, he or she must also find efficient ways of detecting and isolating those faults. Because sensors and cabling take up valuable space and weight on a system, and given constraints on bandwidth and power, it is even more difficult to add sensors into these complex designs after the design has been completed. As a result, a number of software tools have been developed to assist the system designer in proper placement of these sensors during the system design phase of a project. One of the key functions provided by many of these software programs is a testability analysis of the system essentially an evaluation of how observable the system behavior is using available tests. During the design phase, testability metrics can help guide the designer in improving the inherent testability of the design. This may include adding, removing, or modifying tests; breaking up feedback loops, or changing the system to reduce fault propagation. Given a set of test requirements, the analysis can also help to verify that the system will meet those requirements. Of course, a testability analysis requires that a software model of the physical system is available. For the analysis to be most effective in guiding system design, this model should ideally be constructed in parallel with these efforts. The purpose of this paper is to present the final testability results of the Advanced Diagnostic and Prognostic Testbed (ADAPT) after the system model was completed. The tool chosen to build the model and to perform the testability analysis with is the Testability Engineering and Maintenance System Designer (TEAMS-Designer). The TEAMS toolset is intended to be a solution to span all phases of the system, from design and

  17. Synchronous Analysis for Diagnostics of Rolling Bearings in the Turbojet Engine

    Directory of Open Access Journals (Sweden)

    Gosiewski Zdzisław

    2005-01-01

    Full Text Available Designed in the Aviation Institute, the K-15 turbojet engine has got rolling bearings, which answers with frequency 5.87 × ω r the unbalance excitation. The signal with such frequency indicates a fault of the outer race of the rolling bearing. A set of the digital synchronous filters was used for the K-15 vibration spectrum analysis. A procedure of filtration was performed by the computer software. The sychronous summation of the measured signals was carried out before the spectrum analysis. Two cases were considered: the engine with a small force due to unbalance (a small angular velocity of the rotor, and the engine with a big unbalance force (high angular velocity. In the first case, the outer race frequency was not observed, despite the existence of the vibration amplitude (caused by unknown disturbances with such frequency before the synchronous summation. In the second case, the outer race frequency after synchronous summation has enlarged amplitude while other spectrum components in its vicinity have been damped. It underlines the usefulness of the synchronous analysis in the vibration diagnostics of the rotating machinery.

  18. Does MR imaging effectively replace diagnostic arthroscopy

    International Nuclear Information System (INIS)

    Ruwe, P.; McCarthy, S.; Wright, J.; Randall, L.; Lynch, K.; Jokyl, P.

    1990-01-01

    This paper determines if MR imaging reduces the number of diagnostic arthroscopic procedures required in patients with knee complaints and if MR imaging is cost-effective compared with diagnostic arthroscopy. The cohort analysis consists of 100 patients seen in a sports medicine clinic by two orthopedic surgeons who agreed on well-defined criteria for performing MR imaging and arthroscopy. Each orthopedic surgeon referring a patient for MR imaging checked a form regarding the plans for arthroscopy. Outcome analysis was conducted at 6 months

  19. [An exploratory study on the diagnostic cutoff value of International HIV-associated Dementia Scale in minority ethnic groups with different educational levels, in Guangxi].

    Science.gov (United States)

    Zhao, Ting-ting; Feng, Qi-ming; Liang, Hao; Tang, Xian-yan; Wei, Bo

    2011-11-01

    Using Intelligence Scale of Mini Mental State Estimated (MMSE) as the gold standard to determine the relevance of International HIV-associated Dementia Scale (IHDS) in minority ethnic areas in Guangxi populations with different cultural values. Corresponding boundary value related to the authenticity and reliability on IHDS were also evaluated. 200 patients with HIV infection were randomly selected from the minority ethnic groups in Guangxi. For each infected person, MMSE and IHDS blind scale were tested at the same period. Using the results from MMSE scale test as the gold standard, ROC curve and IHDS scale in Guangxi minority populations with different education levels which related to the diagnosis of dementia-HIV values were determined. The value of a specific sector under the IHDS sensitivity, specificity, and internal consistency coefficients was also evaluated. When considering the infected person did not differ on their educational level, the IHDS scale diagnostic cutoff appeared as 8.25, while IHDS sensitivity as 0.925, specificity as 0.731 and Kappa as 0.477 (P education groups showed different IHDS diagnostic cutoff values. People with high school, secondary school or higher education levels, the IHDS diagnosis appeared to be 8.25, when sensitivity was 0.917, specificity was 0.895 and Kappa was 0.722 (P education level, the IHDS appeared to be 7.25. When sensitivity was 0.875, specificity was 0.661 and Kappa was 0.372 (P value (IHDS ≤ 10 points). When using IHDS to perform the HIV related dementia screening program, in the minority areas of Guangxi, culture context, the degree and difference of HIV infection should be considered, especially in using IHDS diagnostic cutoff values.

  20. Diagnostic confidence analysis in the magnetic resonance imaging of ovarian and deep endometriosis: comparison with surgical results

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Sulcis, Rosa; Ibba, Giannina; Piga, Mario [Azienda Ospedaliero Universitaria, Department of Radiology, Monserrato (Italy); Melis, Gian Benedetto; Guerriero, Stefano [Azienda Ospedaliero Universitaria, Department of Gynecology, Monserrato (Italy); Alcazar, Juan Luis [University of Navarra, Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Pamplona (Spain)

    2014-02-15

    To assess the diagnostic confidence of multiple readers in the magnetic resonance imaging (MRI) diagnosis of endometriosis. Sixty-five patients (mean age 33; range 19-45 years) who had undergone MRI were retrospectively evaluated. Five regions were analysed and the presence of endometriosis was scored on a five-point scale in order to assess the diagnostic confidence. Statistical analysis included receiver operating characteristic (ROC) curve analysis, the Cohen weighted test and sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, positive likelihood ratio (LR+) and negative likelihood ratio (LR-). The areas under the curve (AUC) in the detection of ovarian endometrioma were 0.942, 0.893 and 0.883 for readers 1, 2 and 3, respectively; in the uterosacral ligament (USL) AUCs were 0.907, 0.804 and 0.842; in the vaginal fornix (VF) 0.819, 0.733 and 0.69; in the anterior compartment 0.916, 0.833 and 0.873; and in the rectum/sigma/pouch of Douglas (RSD) 0.936, 0.856 and 0.834. Diagnostic confidence of the observers is different according to the region of the nodules of endometriosis and it can be challenging in the VF and for the less experience readers also in the AC and RSD. Moreover the degree of uncertain diagnosis for the less expert readers may reach up to one third of the examinations. (orig.)

  1. Diagnostic confidence analysis in the magnetic resonance imaging of ovarian and deep endometriosis: comparison with surgical results

    International Nuclear Information System (INIS)

    Saba, Luca; Sulcis, Rosa; Ibba, Giannina; Piga, Mario; Melis, Gian Benedetto; Guerriero, Stefano; Alcazar, Juan Luis

    2014-01-01

    To assess the diagnostic confidence of multiple readers in the magnetic resonance imaging (MRI) diagnosis of endometriosis. Sixty-five patients (mean age 33; range 19-45 years) who had undergone MRI were retrospectively evaluated. Five regions were analysed and the presence of endometriosis was scored on a five-point scale in order to assess the diagnostic confidence. Statistical analysis included receiver operating characteristic (ROC) curve analysis, the Cohen weighted test and sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, positive likelihood ratio (LR+) and negative likelihood ratio (LR-). The areas under the curve (AUC) in the detection of ovarian endometrioma were 0.942, 0.893 and 0.883 for readers 1, 2 and 3, respectively; in the uterosacral ligament (USL) AUCs were 0.907, 0.804 and 0.842; in the vaginal fornix (VF) 0.819, 0.733 and 0.69; in the anterior compartment 0.916, 0.833 and 0.873; and in the rectum/sigma/pouch of Douglas (RSD) 0.936, 0.856 and 0.834. Diagnostic confidence of the observers is different according to the region of the nodules of endometriosis and it can be challenging in the VF and for the less experience readers also in the AC and RSD. Moreover the degree of uncertain diagnosis for the less expert readers may reach up to one third of the examinations. (orig.)

  2. Chronic Meningitis: Simplifying a Diagnostic Challenge.

    Science.gov (United States)

    Baldwin, Kelly; Whiting, Chris

    2016-03-01

    Chronic meningitis can be a diagnostic dilemma for even the most experienced clinician. Many times, the differential diagnosis is broad and encompasses autoimmune, neoplastic, and infectious etiologies. This review will focus on a general approach to chronic meningitis to simplify the diagnostic challenges many clinicians face. The article will also review the most common etiologies of chronic meningitis in some detail including clinical presentation, diagnostic testing, treatment, and outcomes. By using a case-based approach, we will focus on the key elements of clinical presentation and laboratory analysis that will yield the most rapid and accurate diagnosis in these complicated cases.

  3. Diagnostic value of sTREM-1 in bronchoalveolar lavage fluid in ICU patients with bacterial lung infections: a bivariate meta-analysis.

    Science.gov (United States)

    Shi, Jia-Xin; Li, Jia-Shu; Hu, Rong; Li, Chun-Hua; Wen, Yan; Zheng, Hong; Zhang, Feng; Li, Qin

    2013-01-01

    The serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) is a useful biomarker in differentiating bacterial infections from others. However, the diagnostic value of sTREM-1 in bronchoalveolar lavage fluid (BALF) in lung infections has not been well established. We performed a meta-analysis to assess the accuracy of sTREM-1 in BALF for diagnosis of bacterial lung infections in intensive care unit (ICU) patients. We searched PUBMED, EMBASE and Web of Knowledge (from January 1966 to October 2012) databases for relevant studies that reported diagnostic accuracy data of BALF sTREM-1 in the diagnosis of bacterial lung infections in ICU patients. Pooled sensitivity, specificity, and positive and negative likelihood ratios were calculated by a bivariate regression analysis. Measures of accuracy and Q point value (Q*) were calculated using summary receiver operating characteristic (SROC) curve. The potential between-studies heterogeneity was explored by subgroup analysis. Nine studies were included in the present meta-analysis. Overall, the prevalence was 50.6%; the sensitivity was 0.87 (95% confidence interval (CI), 0.72-0.95); the specificity was 0.79 (95% CI, 0.56-0.92); the positive likelihood ratio (PLR) was 4.18 (95% CI, 1.78-9.86); the negative likelihood ratio (NLR) was 0.16 (95% CI, 0.07-0.36), and the diagnostic odds ratio (DOR) was 25.60 (95% CI, 7.28-89.93). The area under the SROC curve was 0.91 (95% CI, 0.88-0.93), with a Q* of 0.83. Subgroup analysis showed that the assay method and cutoff value influenced the diagnostic accuracy of sTREM-1. BALF sTREM-1 is a useful biomarker of bacterial lung infections in ICU patients. Further studies are needed to confirm the optimized cutoff value.

  4. Comparative guide to emerging diagnostic tools for large commercial HVAC systems; TOPICAL

    International Nuclear Information System (INIS)

    Friedman, Hannah; Piette, Mary Ann

    2001-01-01

    This guide compares emerging diagnostic software tools that aid detection and diagnosis of operational problems for large HVAC systems. We have evaluated six tools for use with energy management control system (EMCS) or other monitoring data. The diagnostic tools summarize relevant performance metrics, display plots for manual analysis, and perform automated diagnostic procedures. Our comparative analysis presents nine summary tables with supporting explanatory text and includes sample diagnostic screens for each tool

  5. Human reliability analysis during PSA at Trillo NPP: main characteristics and analysis of diagnostic errors

    International Nuclear Information System (INIS)

    Barquin, M.A.; Gomez, F.

    1998-01-01

    The design difference between Trillo NPP and other Spanish nuclear power plants (basic Westinghouse and General Electric designs) were made clear in the Human Reliability Analysis of the Probabilistic Safety Analysis (PSA) for Trillo NPP. The object of this paper is to describe the most significant characteristics of the Human Reliability Analysis carried out in the PSA, with special emphasis on the possible diagnostic errors and their consequences, based on the characteristics in the Emergency Operations Manual for Trillo NPP. - In the case of human errors before the initiating event (type 1), the existence of four redundancies in most of the plant safety systems, means that the impact of this type or error on the final results of the PSA is insignificant. However, in the case common cause errors, especially in certain calibration errors, some actions are significant in the final equation for core damage - The number of human actions that the operator has to carry out during the accidents (type 3) modelled, is relatively small in comparison with this value in other PSAs. This is basically due to the high level of automation at Rillo NPP - The Plant Operations Manual cannot be strictly considered to be a symptoms-based procedure. The operation Group must select the chapter from the Operations Manual to be followed, after having diagnosed the perturbing event, using for this purpose and Emergency and Anomaly Decision Tree (M.O.3.0.1) based on the different indications, alarms and symptoms present in the plant after the perturbing event. For this reason, it was decided to analyse the possible diagnosis errors. In the bibliography on diagnosis and commission errors available at the present time, there is no precise methodology for the analysis of this type of error and its incorporation into PSAs. The method used in the PSA for Trillo y NPP to evaluate this type of interaction, is to develop a Diagnosis Error Table, the object of which is to identify the situations in

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

    Science.gov (United States)

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

    2015-09-01

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

  7. Image analysis as an adjunct to manual HER-2 immunohistochemical review: a diagnostic tool to standardize interpretation.

    LENUS (Irish Health Repository)

    Dobson, Lynne

    2010-07-01

    AIMS: Accurate determination of HER-2 status is critical to identify patients for whom trastuzumab treatment will be of benefit. Although the recommended primary method of evaluation is immunohistochemistry, numerous reports of variability in interpretation have raised uncertainty about the reliability of results. Recent guidelines have suggested that image analysis could be an effective tool for achieving consistent interpretation, and this study aimed to assess whether this technology has potential as a diagnostic support tool. METHODS AND RESULTS: Across a cohort of 275 cases, image analysis could accurately classify HER-2 status, with 91% agreement between computer-aided classification and the pathology review. Assessment of the continuity of membranous immunoreactivity in addition to intensity of reactivity was critical to distinguish between negative and equivocal cases and enabled image analysis to report a lower referral rate of cases for confirmatory fluorescence in situ hybridization (FISH) testing. An excellent concordance rate of 95% was observed between FISH and the automated review across 136 informative cases. CONCLUSIONS: This study has validated that image analysis can robustly and accurately evaluate HER-2 status in immunohistochemically stained tissue. Based on these findings, image analysis has great potential as a diagnostic support tool for pathologists and biomedical scientists, and may significantly improve the standardization of HER-2 testing by providing a quantitative reference method for interpretation.

  8. Can we better predict the biologic behavior of incidental IPMN? A comprehensive analysis of molecular diagnostics and biomarkers in intraductal papillary mucinous neoplasms of the pancreas.

    Science.gov (United States)

    Tulla, Kiara A; Maker, Ajay V

    2018-03-01

    Predicting the biologic behavior of intraductal papillary mucinous neoplasm (IPMN) remains challenging. Current guidelines utilize patient symptoms and imaging characteristics to determine appropriate surgical candidates. However, the majority of resected cysts remain low-risk lesions, many of which may be feasible to have under surveillance. We herein characterize the most promising and up-to-date molecular diagnostics in order to identify optimal components of a molecular signature to distinguish levels of IPMN dysplasia. A comprehensive systematic review of pertinent literature, including our own experience, was conducted based on the PRISMA guidelines. Molecular diagnostics in IPMN patient tissue, duodenal secretions, cyst fluid, saliva, and serum were evaluated and organized into the following categories: oncogenes, tumor suppressor genes, glycoproteins, markers of the immune response, proteomics, DNA/RNA mutations, and next-generation sequencing/microRNA. Specific targets in each of these categories, and in aggregate, were identified by their ability to both characterize a cyst as an IPMN and determine the level of cyst dysplasia. Combining molecular signatures with clinical and imaging features in this era of next-generation sequencing and advanced computational analysis will enable enhanced sensitivity and specificity of current models to predict the biologic behavior of IPMN.

  9. Diagnostic value of circulating microRNAs for gastric cancer in Asian populations: a meta-analysis.

    Science.gov (United States)

    Liu, Lihua; Wang, Shan; Cao, Xiutang; Liu, Jianchao

    2014-12-01

    Gastric cancer (GC) accounts for one of the highest mortality worldwide and particularly in East Asia. Many studies have reported on the potential value of microRNAs (miRNAs) detection for diagnosing GC, but their results have proven inconclusive. The present meta-analysis was conducted to assess the diagnostic value of circulating miRNAs for GC diagnosis. A literature search was carried out in databases (PubMed, Embase, Web of Science, The Cochrane Library, and CNKI) and other sources using combinations of keywords relating to GC, miRNAs, and diagnosis. The values of sensitivity, specificity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), and diagnostic odds ratio (DOR) reported in individual studies were pooled using random-effects models. Potential sources of heterogeneity were assessed with subgroup and meta-regression analyses. The summary receiver operating characteristic (SROC) curve and the area under the curve (AUC) were used to assess the diagnosis accuracy of miRNAs. This meta-analysis included 1,279 patients with GC and 954 healthy controls from 20 publications. The pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 0.78 (95 % CI: 0.73-0.81), 0.80 (95 % CI: 0.76-0.84), 4.0 (95 % CI: 3.1-6.0), 0.28 (95 % CI: 0.23-0.34), 14 (95 % CI: 10-21), and 0.86 (95 % CI: 0.83-0.89), respectively. Subgroup analyses showed that early stages (I and II) GC were more easily detected than later stages and that multiple miRNAs assays were more accurate than single miRNA assays. Our meta-analysis suggests that miRNAs have a high diagnostic value for GC, especially in its early stages (I and II). In addition, multiple miRNAs assays have a better diagnosis value than single miRNA assays. In conclusion, circulating miRNAs might be used as noninvasive biomarkers for the confirmation of GC detection in Asian populations.

  10. Time efficiency and diagnostic accuracy of new automated myocardial perfusion analysis software in 320-row CT cardiac imaging

    Energy Technology Data Exchange (ETDEWEB)

    Rief, Matthias; Stenzei, Fabian; Kranz, Anisha; Schlattmann, Peter; Dewey, Marc [Dept. of Radiology, Charite - Universiteitsmedizin Berlin, Berlin (Greece)

    2013-01-15

    We aimed to evaluate the time efficiency and diagnostic accuracy of automated myocardial computed tomography perfusion (CTP) image analysis software. 320-row CTP was performed in 30 patients, and analyses were conducted independently by three different blinded readers by the use of two recent software releases (version 4.6 and novel version 4.71GR001, Toshiba, Tokyo, Japan). Analysis times were compared, and automated epi- and endocardial contour detection was subjectively rated in five categories (excellent, good, fair, poor and very poor). As semi-quantitative perfusion parameters, myocardial attenuation and transmural perfusion ratio (TPR) were calculated for each myocardial segment and agreement was tested by using the intraclass correlation coefficient (ICC). Conventional coronary angiography served as reference standard. The analysis time was significantly reduced with the novel automated software version as compared with the former release (Reader 1: 43:08 ± 11:39 min vs. 09:47 ± 04:51 min, Reader 2: 42:07 ± 06:44 min vs. 09:42 ± 02:50 min and Reader 3: 21:38 ± 3:44 min vs. 07:34 ± 02:12 min; p < 0.001 for all). Epi- and endocardial contour detection for the novel software was rated to be significantly better (p < 0.001) than with the former software. ICCs demonstrated strong agreement (≥ 0.75) for myocardial attenuation in 93% and for TPR in 82%. Diagnostic accuracy for the two software versions was not significantly different (p 0.169) as compared with conventional coronary angiography. The novel automated CTP analysis software offers enhanced time efficiency with an improvement by a factor of about four, while maintaining diagnostic accuracy.

  11. Combination of interferometry and thermography data for cultural heritage structural diagnostic research

    Science.gov (United States)

    Tornari, Vivi; Andrianakis, Michalis; Hatzigiannakis, Kostas; Kosma, Kiki; Detalle, Vincent; Giovanacci, David

    2017-07-01

    The demand for non destructive and non invasive structural diagnostic techniques able to perform on field remote structural evaluation of historical structures and works of art it faces an increased demand. The techniques must have some basic important characteristics The non destructivity, accuracy, repeatability, non physical contact, portability, resolution, broad range of applicability depending on the type of artwork and the question at hand, are all among the important requirements underlying the requirement for on-field structural diagnostics. In this respect there are two known techniques that have been developed at full to provide a suited structural diagnostic application in artwork conservation. The systems presented here but discussed in detail elsewhere are stimulated infrared thermography (SIRT) and digital holographic speckle pattern interferometry (DHSPI) the prior can be found n market at commercial devise level while the latter is at laboratory prototype level. The two systems are being exploited for their complimentary advantages and in this paper are used in combined testing on art related targets according to the above criteria to confirm the enhanced diagnostic information that their complimentary use provides. Results confirm the effectiveness of each technique alone and the combination of data of both techniques in the conservation field. Each system is first briefly described and examples are given with the aim to present the suitability and appropriateness for use in structural documentation analysis and reports. The experimental work is in laboratory work-in-progress focusing on the hybriding of data synthesis.

  12. Diagnostic shift in patients diagnosed with schizoaffective disorder: a systematic review and meta-analysis of rediagnosis studies.

    Science.gov (United States)

    Santelmann, Hanno; Franklin, Jeremy; Bußhoff, Jana; Baethge, Christopher

    2016-05-01

    The diagnosis of schizoaffective disorder (SAD) is well established in clinical practice but is heavily disputed on theoretical grounds. We analyzed the extent and direction of diagnostic shift in SAD patients. We searched Medline, Embase, and PsycINFO systematically for all studies documenting two diagnostic assessments at different points in time (rediagnosis studies) and used meta-analytic methods to quantify diagnostic shift. Multiple prespecified and post-hoc subgroup analyses (e.g., rater blinding) and meta-regressions (e.g., year of publication) were carried out. We included 31 studies out of 4,415 articles screened: 27 studies on the shift from and 23 studies on the shift to SAD (median time span was two years). A total of 36% of patients with a diagnosis of SAD at first assessment switch, many to schizophrenia (19%), 14% to affective disorders, and 6% to other disorders. Among patients diagnosed with SAD at second assessment, 55% had received a different diagnosis at first assessment, a large portion of whom had been initially diagnosed with affective disorder (24%), schizophrenia (18%), and other disorders (12%). Diagnostic shift in SAD patients is substantial. Psychiatrists need to reassess the diagnosis during the course of the illness and to adjust treatment. Slightly more diagnoses of SAD are changed to schizophrenia than to affective disorders, and among patients rediagnosed with SAD, fewer have been diagnosed with schizophrenia than with affective disorders. Thus, at the diagnostic level, there seems to be a slight trend toward schizophrenia during the course of functional psychoses. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Analysis of errors during medical and computerized diagnostics of spherical lung neoplasms

    International Nuclear Information System (INIS)

    Pozmogov, A.I.; Petruk, D.A.

    1985-01-01

    Reasons for errors in medical and computerized diagnostics of spherical lung neoplasms are studied based on material of 212 case records and clinicoroentgenological data; it should promote improvement of their diagnostics

  14. Structure induction in diagnostic causal reasoning.

    Science.gov (United States)

    Meder, Björn; Mayrhofer, Ralf; Waldmann, Michael R

    2014-07-01

    Our research examines the normative and descriptive adequacy of alternative computational models of diagnostic reasoning from single effects to single causes. Many theories of diagnostic reasoning are based on the normative assumption that inferences from an effect to its cause should reflect solely the empirically observed conditional probability of cause given effect. We argue against this assumption, as it neglects alternative causal structures that may have generated the sample data. Our structure induction model of diagnostic reasoning takes into account the uncertainty regarding the underlying causal structure. A key prediction of the model is that diagnostic judgments should not only reflect the empirical probability of cause given effect but should also depend on the reasoner's beliefs about the existence and strength of the link between cause and effect. We confirmed this prediction in 2 studies and showed that our theory better accounts for human judgments than alternative theories of diagnostic reasoning. Overall, our findings support the view that in diagnostic reasoning people go "beyond the information given" and use the available data to make inferences on the (unobserved) causal rather than on the (observed) data level. (c) 2014 APA, all rights reserved.

  15. Scaling-Up the Functional Diagnostic Systems

    International Nuclear Information System (INIS)

    Mohamed, A.H.

    2008-01-01

    Functional diagnostic systems received a lot of attention in the last decade. They have proven their powerful for diagnosis the new faults of some complex systems. But, they still have some complexity in both the representation and reasoning about the large-scale systems. This paper introduces a new functional diagnostic system that can divide its small functions into main and auxiliary ones. This process enables the diagnostic system to scale -up the representation of the tested system and simplify the diagnostic mechanism tasks. Thus, it can improve both the representation and reasoning complexity. Also,it can decrease the required analysis, cost, and time. Proposed system can be applied for a wide area of the large-scale systems. It has been proven its acceptance to be applied practically for the Complex real-time systems

  16. Progress in development of the advanced Thomson scattering diagnostics

    International Nuclear Information System (INIS)

    Hatae, T; Naito, O; Howard, J; Ebizuka, N; Yoshida, H; Nakatsuka, M; Fujita, H; Kajita, S; Narihara, K; Yamada, I; Funaba, H; Hirano, Y; Koguchi, H

    2010-01-01

    We have been studied the advanced Thomson scattering diagnostics from viewpoints of new concepts, laser technology and spectrum analysis. This paper summarizes results of development on technologies for advanced Thomson scattering diagnostics.

  17. Cross-national diagnostic analysis of patient empowerment in England and Greece

    Directory of Open Access Journals (Sweden)

    Graham Lister

    2012-01-01

    Full Text Available Background: Different NHS patient empowerment policies have been adopted in England and Greece; the voluntary sector development and its influence also differ. Although various aspects of patient empowerment have been explored in England, the patient empowerment systems’ application is under-researched. In Greece, the few relevant attempts looking at patients’ experiences focus on patient satisfaction, with only one study exploring the public hospitals managers’ perspectives on user involvement. However, patient empowerment questions may be similar in both countries.Aims and Objectives:The study aimed to explore and compare the general patient empowerment settings in the two countries, with main objectives to:a. identify and explore the relationships of national voluntary and governmental organisations,b. explore the cross-national challenges and facilitators, and make cross-national recommendations.Methodology: This is a cross-national comparative research study. A ‘diagnostic analysis’ approach, an assessment of potential and actual barriers and facilitators, including the context and potential change, was chosen. The methods used were:a. a network analysis of national voluntary and governmental organisations;b. semi-structured interviews with key representatives of these, andc. documentary analysis.Results: The network analysis revealed the potential of English organisations to influence more people, withextensive memberships and stronger interrelationship between them than the Greek organisations. Different levels of awareness, knowledge and perceptions of application of the national patient empowerment policies, systems and mechanisms were identified; being generally good in England, limited in Greece. Variable generalinformation provision, with good verbal information in England, and limited, written and verbal, information in Greece was also identified. Although the commonest cross-national perceived challenges were

  18. Combining principles of Cognitive Load Theory and diagnostic error analysis for designing job aids: Effects on motivation and diagnostic performance in a process control task.

    Science.gov (United States)

    Kluge, Annette; Grauel, Britta; Burkolter, Dina

    2013-03-01

    Two studies are presented in which the design of a procedural aid and the impact of an additional decision aid for process control were assessed. In Study 1, a procedural aid was developed that avoids imposing unnecessary extraneous cognitive load on novices when controlling a complex technical system. This newly designed procedural aid positively affected germane load, attention, satisfaction, motivation, knowledge acquisition and diagnostic speed for novel faults. In Study 2, the effect of a decision aid for use before the procedural aid was investigated, which was developed based on an analysis of diagnostic errors committed in Study 1. Results showed that novices were able to diagnose both novel faults and practised faults, and were even faster at diagnosing novel faults. This research contributes to the question of how to optimally support novices in dealing with technical faults in process control. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  19. Diagnostic and therapeutic implications of genetic heterogeneity in myeloid neoplasms uncovered by comprehensive mutational analysis

    Directory of Open Access Journals (Sweden)

    Sarah M. Choi

    2017-01-01

    Full Text Available While growing use of comprehensive mutational analysis has led to the discovery of innumerable genetic alterations associated with various myeloid neoplasms, the under-recognized phenomenon of genetic heterogeneity within such neoplasms creates a potential for diagnostic confusion. Here, we describe two cases where expanded mutational testing led to amendment of an initial diagnosis of chronic myelogenous leukemia with subsequent altered treatment of each patient. We demonstrate the power of comprehensive testing in ensuring appropriate classification of genetically heterogeneous neoplasms, and emphasize thoughtful analysis of molecular and genetic data as an essential component of diagnosis and management.

  20. The diagnostic performance of magnetic resonance spectroscopy in differentiating high-from low-grade gliomas: A systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Wang, Qun; Zhang, JiaShu; Wu, Chen; Li, FangYe; Chen, XiaoLei; Xu, BaiNan; Zhang, Hui; Zhu, WeiJie

    2016-01-01

    Magnetic resonance spectroscopy (MRS) is a powerful tool for preoperative grading of gliomas. We performed a meta-analysis to evaluate the diagnostic performance of MRS in differentiating high-grade gliomas (HGGs) from low-grade gliomas (LGGs). PubMed and Embase databases were systematically searched for relevant studies of glioma grading assessed by MRS through 27 March 2015. Based on the data from eligible studies, pooled sensitivity, specificity, diagnostic odds ratio and areas under summary receiver operating characteristic curve (SROC) of different metabolite ratios were obtained. Thirty articles comprising a total sample size of 1228 patients were included in our meta-analysis. Quantitative synthesis of studies showed that the pooled sensitivity/specificity of Cho/Cr, Cho/NAA and NAA/Cr ratios was 0.75/0.60, 0.80/0.76 and 0.71/0.70, respectively. The area under the curve (AUC) of the SROC was 0.83, 0.87 and 0.78, respectively. MRS demonstrated moderate diagnostic performance in distinguishing HGGs from LGGs using tumoural metabolite ratios including Cho/Cr, Cho/NAA and NAA/Cr. Although there was no significant difference in AUC between Cho/Cr and Cho/NAA groups, Cho/NAA ratio showed higher sensitivity and specificity than Cho/Cr ratio and NAA/Cr ratio. We suggest that MRS should combine other advanced imaging techniques to improve diagnostic accuracy in differentiating HGGs from LGGs. (orig.)

  1. Image diagnostic of colonic diseases - controversial questions

    International Nuclear Information System (INIS)

    Pomakov, P.; Rizov, A.; Stancheva, I.

    2013-01-01

    In the system of colonic diseases' diagnostic algorithm, fibrocolonoscopy (FCS) is defined as 'Golden Standard'. By this reason some X-ray diagnostic methods - irrigography, etc. are currently not being used in a number of health institutions. The aim of this study is a comparative analysis of FCS and irrigography diagnostic efficacy in various colonic diseases. For 10-years period, in cooperation with a gastroenterologist-gastroscopist, 2151 patients with various colonic diseases were evaluated by FCS and irrigography with pharmaco-diagnostics/when necessary. Advantage of FCS was established in diagnosing diseases with patho-morfologic changes on the inner surface of the colon - benign and malignant neoplastic processes, chronic inflammatory diseases, etc. At the same time functional changes - irritated colon syndrome, changes in defecation act, etc., are not an object of diagnosis through FCS. Correction in colonic diseases diagnostic algorithm is necessary. FCS should be mandatory. If result is negative - irrigography with pharmaco-diagnostics should be done. (authors)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-03-15

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

  3. Trace element analysis: a diagnostic tool

    International Nuclear Information System (INIS)

    Qureshi, I.H.; Cheema, M.N.

    1976-09-01

    The human mody continuously assimilates a variety of elements from the environment, and the concentration of these elements in the blood is regulated by means of various homeostatic mechanisms. Some of the elements, though present in very small amounts, have highly specialized functions in initiating many biochemical reactions. These elements, known as essential trace elements, are closely related to human diseases since their deficiency or excess induces physiological changes. Many diseases such as hypertension, atherosclerosis, diabetes, etc., are related to an imbalance in trace element. The measurement of trace elements in body fluids and tissues can, therefore, be effectively employed for diagnostic tests

  4. The Application of Cognitive Diagnostic Approaches via Neural Network Analysis of Serious Educational Games

    Science.gov (United States)

    Lamb, Richard L.

    Serious Educational Games (SEGs) have been a topic of increased popularity within the educational realm since the early millennia. SEGs are generalized form of Serious Games to mean games for purposes other than entertainment but, that also specifically include training, educational purpose and pedagogy within their design. This rise in popularity (for SEGs) has occurred at a time when school systems have increased the type, number, and presentations of student achievement tests for decision-making purposes. These tests often task the form of end of course (year) tests and periodic benchmark testing. As the use of these tests, has increased policymakers have suggested their use as a measure for teacher accountability. The change in testing resulted from a push by school districts and policy makers at various component levels for a data-driven decision-making (D3M) approach. With the data-driven decision making approaches by school districts, there has been an increased focus on the measurement and assessment of student content knowledge with little focus on the contributing factors and cognitive attributes within learning that cross multiple-content areas. One-way to increase the focus on these aspects of learning (factors and attributes) that are additional to content learning is through assessments based in cognitive diagnostics. Cognitive diagnostics are a family of methodological approaches in which tasks tie to specific cognitive attributes for analytical purposes. This study explores data derived from computer data logging (n=158,000) in an observational design, using traditional statistical techniques such as clustering (exploratory and confirmatory), item response theory and through data mining techniques such as artificial neural network analysis. From these analyses, a model of student learning emerges illustrating student thinking and learning while engaged in SEG Design. This study seeks to use cognitive diagnostic type approaches to measure student

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

    International Nuclear Information System (INIS)

    Strauss, Keith J.

    2014-01-01

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

  6. Preanalytical blood sample workup for cell-free DNA analysis using Droplet Digital PCR for future molecular cancer diagnostics

    NARCIS (Netherlands)

    van Ginkel, Joost H.; van den Broek, Daan A.; van Kuik, Joyce; Linders, Dorothé; de Weger, Roel; Willems, Stefan M.; Huibers, Manon M.H.

    2017-01-01

    In current molecular cancer diagnostics, using blood samples of cancer patients for the detection of genetic alterations in plasma (cell-free) circulating tumor DNA (ctDNA) is an emerging practice. Since ctDNA levels in blood are low, highly sensitive Droplet Digital PCR (ddPCR) can be used for

  7. The nuclear interaction analysis methods for diagnostics of high power ion beam technologies

    Energy Technology Data Exchange (ETDEWEB)

    Ryzhkov, V A; Grushin, I I; Remnev, G E [Nuclear Physics Inst., Tomsk (Russian Federation)

    1997-12-31

    The complex of Nuclear Interaction Analysis Methods including charged particle activation analysis (CPAA and HIAA), spectrometry of ion induced gamma-emission (PIGE and HIIGE) , characteristic X-ray emission (PIXE), and Rutherford Backscattering Spectrometry (RBS), have been used for diagnostics of the High Power Ion Beam (HPIB) assisted technologies. Accelerated ion beams from the EG-2.5 electrostatic generator and U-120 cyclotron were used for implementation of the techniques. The complex allows a lot of problems of elemental and isotopic analysis to be addressed. First, it is the determination of micro- and macrocomponents of modified materials; second, determination of surface density of thin films, multilayers and coatings, total surface gaseous contamination and amounts of the elements implanted in specimens; third, measurement of concentration depth profiles of the elements. Experiments have shown that the preferable application of nuclear analysis methods allows us to avoid the considerable errors arising when the concentration depth profiles of elements are measured by SIMS or AES in studies of mass transfer processes induced by HPIBs. (author). 1 tab., 2 figs., 3 refs.

  8. Mechatronics in design of monitoring and diagnostic systems

    Energy Technology Data Exchange (ETDEWEB)

    Uhl, T.; Barszcz, T. [Univ. of Mining and Metallurgy, Krakow (Poland); Hanc, A. [Energocontrol Ltd., Krakow (Poland)

    2003-07-01

    Nowadays development of computer engineering in area of hardware and software gives new possibilities of monitoring and diagnostics system design. The paper presents analysis of new possible solutions for design of monitoring and diagnostic systems including; smart sensor design, modular software design and communication modules. New concept of monitoring system based on home page server solution (nano-server) is presented. Smart sensor design concept with embedded hardware for diagnostic application is shown. New software concept for monitoring and diagnostics automation and examples of applications of new design for condition monitoring based on proposed solution are carefully discussed. (orig.)

  9. Evidence assessing the diagnostic performance of medical smartphone apps: a systematic review and exploratory meta-analysis.

    Science.gov (United States)

    Buechi, Rahel; Faes, Livia; Bachmann, Lucas M; Thiel, Michael A; Bodmer, Nicolas S; Schmid, Martin K; Job, Oliver; Lienhard, Kenny R

    2017-12-14

    The number of mobile applications addressing health topics is increasing. Whether these apps underwent scientific evaluation is unclear. We comprehensively assessed papers investigating the diagnostic value of available diagnostic health applications using inbuilt smartphone sensors. Systematic Review-MEDLINE, Scopus, Web of Science inclusive Medical Informatics and Business Source Premier (by citation of reference) were searched from inception until 15 December 2016. Checking of reference lists of review articles and of included articles complemented electronic searches. We included all studies investigating a health application that used inbuilt sensors of a smartphone for diagnosis of disease. The methodological quality of 11 studies used in an exploratory meta-analysis was assessed with the Quality Assessment of Diagnostic Accuracy Studies 2 tool and the reporting quality with the 'STAndards for the Reporting of Diagnostic accuracy studies' (STARD) statement. Sensitivity and specificity of studies reporting two-by-two tables were calculated and summarised. We screened 3296 references for eligibility. Eleven studies, most of them assessing melanoma screening apps, reported 17 two-by-two tables. Quality assessment revealed high risk of bias in all studies. Included papers studied 1048 subjects (758 with the target conditions and 290 healthy volunteers). Overall, the summary estimate for sensitivity was 0.82 (95 % CI 0.56 to 0.94) and 0.89 (95 %CI 0.70 to 0.97) for specificity. The diagnostic evidence of available health apps on Apple's and Google's app stores is scarce. Consumers and healthcare professionals should be aware of this when using or recommending them. 42016033049. © 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.

  10. A Novel UAV Electric Propulsion Testbed for Diagnostics and Prognostics

    Science.gov (United States)

    Gorospe, George E., Jr.; Kulkarni, Chetan S.

    2017-01-01

    This paper presents a novel hardware-in-the-loop (HIL) testbed for systems level diagnostics and prognostics of an electric propulsion system used in UAVs (unmanned aerial vehicle). Referencing the all electric, Edge 540T aircraft used in science and research by NASA Langley Flight Research Center, the HIL testbed includes an identical propulsion system, consisting of motors, speed controllers and batteries. Isolated under a controlled laboratory environment, the propulsion system has been instrumented for advanced diagnostics and prognostics. To produce flight like loading on the system a slave motor is coupled to the motor under test (MUT) and provides variable mechanical resistance, and the capability of introducing nondestructive mechanical wear-like frictional loads on the system. This testbed enables the verification of mathematical models of each component of the propulsion system, the repeatable generation of flight-like loads on the system for fault analysis, test-to-failure scenarios, and the development of advanced system level diagnostics and prognostics methods. The capabilities of the testbed are extended through the integration of a LabVIEW-based client for the Live Virtual Constructive Distributed Environment (LVCDC) Gateway which enables both the publishing of generated data for remotely located observers and prognosers and the synchronization the testbed propulsion system with vehicles in the air. The developed HIL testbed gives researchers easy access to a scientifically relevant portion of the aircraft without the overhead and dangers encountered during actual flight.

  11. THE ROLE AND PLACE OF LOGISTIC REGRESSION AND ROC ANALYSIS IN SOLVING MEDICAL DIAGNOSTIC TASK

    Directory of Open Access Journals (Sweden)

    S. G. Grigoryev

    2016-01-01

    Full Text Available Diagnostics, equally with  prevention and  treatment, is a basis of medical science and practice. For its history the medicine  has accumulated a great variety  of diagnostic methods for different diseases and  pathologic conditions. Nevertheless, new  tests,  methods and  tools are being  developed and recommended to application nowadays. Such  indicators as sensitivity and  specificity which  are defined on the basis  of fourfold contingency  tables   construction or  ROC-analysis method with  ROC  – curve  modelling (Receiver operating characteristic are used  as the  methods to estimate the  diagnostic capability. Fourfold  table  is used  with  the purpose to estimate the method which confirms or denies the diagnosis, i.e. a quality indicator. ROC-curve, being a graph, allows making the estimation of model  quality by subdivision of two classes  on the  basis  of identifying the  point  of cutting off a continuous or discrete quantitative attribute.The method of logistic regression technique is introduced as a tool to develop some  mathematical-statistical forecasting model  of probability of the event the researcher is interested in if there are two possible variants of the outcome. The method of ROC-analysis is chosen and described in detail as a tool to estimate the  model  quality. The capabilities of the named methods are demonstrated by a real example of creation  and  efficiency estimation (sensitivity and  specificity of a forecasting model  of probability of complication development in the form of pyodermatitis in children with  atopic dermatitis.

  12. Clinical diagnostic evaluation for scaphoid fractures: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Mallee, Wouter H.; Henny, Erik P.; van Dijk, C. Niek; Kamminga, Sjoerd P.; van Enst, Wynanda A.; Kloen, Peter

    2014-01-01

    To provide an overview of available clinical evaluation tests for scaphoid fractures and to compare their diagnostic accuracies. PWe performed a systematic review of all studies assessing diagnostic characteristics of clinical evaluation in scaphoid fractures by searching MEDLINE, EMBASE, Cochrane,

  13. Proposed Diagnostic Criteria for the DSM-5 of Nonsuicidal Self-Injury in Female Adolescents: Diagnostic and Clinical Correlates

    Directory of Open Access Journals (Sweden)

    Tina In-Albon

    2013-01-01

    Full Text Available Nonsuicidal self-injury (NSSI is included as conditions for further study in the DSM-5. Therefore, it is necessary to investigate the proposed diagnostic criteria and the diagnostic and clinical correlates for the validity of a diagnostic entity. The authors investigated the characteristics of NSSI disorder and the proposed diagnostic criteria. A sample of 73 female inpatient adolescents and 37 nonclinical adolescents (aged 13 to 19 years was recruited. Patients were classified into 4 groups (adolescents with NSSI disorder, adolescents with NSSI without impairment/distress, clinical controls without NSSI, and nonclinical controls. Adolescents were compared on self-reported psychopathology and diagnostic cooccurrences. Results indicate that adolescents with NSSI disorder have a higher level of impairment than adolescents with other mental disorders without NSSI. Most common comorbid diagnoses were major depression, social phobia, and PTSD. There was some overlap of adolescents with NSSI disorder and suicidal behaviour and borderline personality disorder, but there were also important differences. Results further suggest that the proposed DSM-5 diagnostic criteria for NSSI are useful and necessary. In conclusion, NSSI is a highly impairing disorder characterized by high comorbidity with various disorders, providing further evidence that NSSI should be a distinct diagnostic entity.

  14. Diagnostic performance of CT and MRI on the detection of symptomatic intracranial dural arteriovenous fistula: a meta-analysis with indirect comparison

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yen-Heng [National Taiwan University, Institute of Epidemiology and Preventive Medicine, Taipei (China); National Taiwan University Hospital in Taipei and Yuan-Lin Branch, Department of Medical Imaging and Radiology, Hospital and Medical College, Taipei (China); Lin, Hsien-Ho [National Taiwan University, Institute of Epidemiology and Preventive Medicine, Taipei (China); Liu, Hon-Man; Lee, Chung-Wei; Chen, Ya-Fang [National Taiwan University Hospital in Taipei and Yuan-Lin Branch, Department of Medical Imaging and Radiology, Hospital and Medical College, Taipei (China)

    2016-08-15

    This study aims to review the diagnostic performance of computed tomography (CT) and magnetic resonance imaging (MRI) in symptomatic dural arteriovenous fistula (DAVF). EMBASE, PubMed, and Cochrane Library were searched until April 2015 for studies which compared CT, MRI, or both with angiography for the detection of DAVF. The diagnostic performances of MRI and CT were indirectly compared using modality as a covariate in the analysis. Thirteen studies met our inclusion criteria. MRI had a sensitivity of 0.90 (95 % confidence interval (CI) = 0.83-0.94) and specificity of 0.94 (95 % CI = 0.90-0.96). CT had a sensitivity of 0.80 (95 % CI = 0.62-0.90) and specificity of 0.87 (95 % CI = 0.74-0.94). MRI showed better diagnostic performance than CT (p = 0.02). Contrast medium use and time-resolved MR angiography did not improve MRI diagnostic performance (p = 0.31 and 0.44, respectively). Both CT and MRI had good diagnostic performance. MRI was better than CT on the detection of symptomatic intracranial dural arteriovenous fistula in the indirect comparison. (orig.)

  15. 2012 HIV Diagnostics Conference: the molecular diagnostics perspective.

    Science.gov (United States)

    Branson, Bernard M; Pandori, Mark

    2013-04-01

    2012 HIV Diagnostic Conference Atlanta, GA, USA, 12-14 December 2012. This report highlights the presentations and discussions from the 2012 National HIV Diagnostic Conference held in Atlanta (GA, USA), on 12-14 December 2012. Reflecting changes in the evolving field of HIV diagnostics, the conference provided a forum for evaluating developments in molecular diagnostics and their role in HIV diagnosis. In 2010, the HIV Diagnostics Conference concluded with the proposal of a new diagnostic algorithm which included nucleic acid testing to resolve discordant screening and supplemental antibody test results. The 2012 meeting, picking up where the 2010 meeting left off, focused on scientific presentations that assessed this new algorithm and the role played by RNA testing and new developments in molecular diagnostics, including detection of total and integrated HIV-1 DNA, detection and quantification of HIV-2 RNA, and rapid formats for detection of HIV-1 RNA.

  16. Development of new diagnostics for WEST

    International Nuclear Information System (INIS)

    Lotte, P.; Moreau, P.; Gil, C.

    2015-01-01

    WEST, the upgraded superconducting tokamak Tore Supra, will be an international experimental platform aimed to support ITER Physics program. The main objective of WEST is to provide relevant plasma conditions for validating plasma facing component (PFC) technology, in particular the actively cooled Tungsten divertor monoblocks, and also assessing high heat flux and high fluence plasma wall interactions with Tungsten in order to prepare ITER divertor operation. In parallel, WEST will also open new experimental opportunities for developing integrated H mode operation and exploring steady state scenarios in a metallic environment. In order to fulfil the Scientific Program of WEST, new diagnostics have been developed in addition to the already existing diagnostics of Tore Supra, modified and improved during the shutdown. For the PFC technology validation program, new tools have been implemented, like a full infrared survey of the PFC, a new calorimetry system, local temperature measurements (thermocouple and Bragg grating optical fiber), and several sets of Langmuir probes. For the analysis of long pulse H mode operation, new plasma diagnostics will be implemented, among which the Visible Spectroscopy diagnostic for W sources and transport studies, the Soft-Xray diagnostic based on gas electron multiplier detectors for transport and MHD studies, the X-ray imaging crystal spectroscopy diagnostic with advanced solid state detector properties for ion temperature, ion density and plasma rotation velocity measurements, and the ECE Imaging diagnostic for MHD and turbulence studies. Most of these new diagnostics are developed with the participation of French Universities or through international collaborations. This paper focuses on the description of these four plasma diagnostics. (author)

  17. Diagnostic accuracy of 18F amyloid PET tracers for the diagnosis of Alzheimer's disease: a systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Morris, Elizabeth; Chalkidou, Anastasia; Hammers, Alexander; Peacock, Janet; Summers, Jennifer; Keevil, Stephen

    2016-01-01

    Imaging or tissue biomarker evidence has been introduced into the core diagnostic pathway for Alzheimer's disease (AD). PET using 18 F-labelled beta-amyloid PET tracers has shown promise for the early diagnosis of AD. However, most studies included only small numbers of participants and no consensus has been reached as to which radiotracer has the highest diagnostic accuracy. First, we performed a systematic review of the literature published between 1990 and 2014 for studies exploring the diagnostic accuracy of florbetaben, florbetapir and flutemetamol in AD. The included studies were analysed using the QUADAS assessment of methodological quality. A meta-analysis of the sensitivity and specificity reported within each study was performed. Pooled values were calculated for each radiotracer and for visual or quantitative analysis by population included. The systematic review identified nine studies eligible for inclusion. There were limited variations in the methods between studies reporting the same radiotracer. The meta-analysis results showed that pooled sensitivity and specificity values were in general high for all tracers. This was confirmed by calculating likelihood ratios. A patient with a positive ratio is much more likely to have AD than a patient with a negative ratio, and vice versa. However, specificity was higher when only patients with AD were compared with healthy controls. This systematic review and meta-analysis found no marked differences in the diagnostic accuracy of the three beta-amyloid radiotracers. All tracers perform better when used to discriminate between patients with AD and healthy controls. The sensitivity and specificity for quantitative and visual analysis are comparable to those of other imaging or biomarker techniques used to diagnose AD. Further research is required to identify the combination of tests that provides the highest sensitivity and specificity, and to identify the most suitable position for the tracer in the

  18. Deconstructing Bipolar Disorder and Schizophrenia: A cross-diagnostic cluster analysis of cognitive phenotypes.

    Science.gov (United States)

    Lee, Junghee; Rizzo, Shemra; Altshuler, Lori; Glahn, David C; Miklowitz, David J; Sugar, Catherine A; Wynn, Jonathan K; Green, Michael F

    2017-02-01

    Bipolar disorder (BD) and schizophrenia (SZ) show substantial overlap. It has been suggested that a subgroup of patients might contribute to these overlapping features. This study employed a cross-diagnostic cluster analysis to identify subgroups of individuals with shared cognitive phenotypes. 143 participants (68 BD patients, 39 SZ patients and 36 healthy controls) completed a battery of EEG and performance assessments on perception, nonsocial cognition and social cognition. A K-means cluster analysis was conducted with all participants across diagnostic groups. Clinical symptoms, functional capacity, and functional outcome were assessed in patients. A two-cluster solution across 3 groups was the most stable. One cluster including 44 BD patients, 31 controls and 5 SZ patients showed better cognition (High cluster) than the other cluster with 24 BD patients, 35 SZ patients and 5 controls (Low cluster). BD patients in the High cluster performed better than BD patients in the Low cluster across cognitive domains. Within each cluster, participants with different clinical diagnoses showed different profiles across cognitive domains. All patients are in the chronic phase and out of mood episode at the time of assessment and most of the assessment were behavioral measures. This study identified two clusters with shared cognitive phenotype profiles that were not proxies for clinical diagnoses. The finding of better social cognitive performance of BD patients than SZ patients in the Lowe cluster suggest that relatively preserved social cognition may be important to identify disease process distinct to each disorder. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Radiation effects in IFMIF Li target diagnostic systems

    International Nuclear Information System (INIS)

    Molla, J.; Vila, R.; Shikama, T.; Horiike, H.; Simakov, S.; Ciotti, M.; Ibarra, A.

    2009-01-01

    Diagnostics for the lithium target will be crucial for the operation of IFMIF. Several parameters as the lithium temperature, target thickness or wave pattern must be monitored during operation. Radiation effects may produce malfunctioning in any of these diagnostics due to the exposure to high radiation fields. The main diagnostic systems proposed for the operation of IFMIF are reviewed in this paper from the point of view of radiation damage. The main tools for the assessment of the performance of these diagnostics are the neutronics calculations by using specialised codes and the information accumulated during the last decades on the radiation effects in functional materials, components and diagnostics for ITER. This analysis allows to conclude that the design of some of the diagnostic systems must be revised to assure the high availability required for the target system.

  20. A Best-Evidence Systematic Appraisal of the Diagnostic Accuracy and Utility of Facet (Zygapophysial) Joint Injections in Chronic Spinal Pain.

    Science.gov (United States)

    Boswell, Mark V; Manchikanti, Laxmaiah; Kaye, Alan D; Bakshi, Sanjay; Gharibo, Christopher G; Gupta, Sanjeeva; Jha, Sachin Sunny; Nampiaparampil, Devi E; Simopoulos, Thomas T; Hirsch, Joshua A

    2015-01-01

    Spinal zygapophysial, or facet, joints are a source of axial spinal pain and referred pain in the extremities. Conventional clinical features and other noninvasive diagnostic modalities are unreliable in diagnosing zygapophysial joint pain. A systematic review of the diagnostic accuracy of spinal facet joint nerve blocks. To determine the diagnostic accuracy of spinal facet joint nerve blocks in chronic spinal pain. A methodological quality assessment of included studies was performed using Quality Appraisal of Reliability Studies (QAREL). Only diagnostic accuracy studies meeting at least 50% of the designated inclusion criteria were utilized for analysis. The level of evidence was classified as Level I to V based on the grading of evidence utilizing best evidence synthesis. Data sources included relevant literature identified through searches of PubMed and other electronic searches published from 1966 through March 2015, Cochrane reviews, and manual searches of the bibliographies of known primary and review articles. Studies must have been performed utilizing controlled local anesthetic blocks. The criterion standard must have been at least 50% pain relief from baseline scores and the ability to perform previously painful movements. The available evidence is Level I for lumbar facet joint nerve blocks with the inclusion of a total of 17 studies with dual diagnostic blocks, with at least 75% pain relief with an average prevalence of 16% to 41% and false-positive rates of 25% to 44%. The evidence for diagnosis of cervical facet joint pain with cervical facet joint nerve blocks is Level II based on a total of 11 controlled diagnostic accuracy studies, with significant variability among the prevalence in a heterogenous population with internal inconsistency. The prevalence rates ranged from 36% to 67% with at least 80% pain relief as the criterion standard and a false-positive rate of 27% to 63%. The level of evidence for the diagnostic accuracy of thoracic facet

  1. Potential hazards of diagnostic radiation

    Energy Technology Data Exchange (ETDEWEB)

    Houston, C S; Shokeir, M H

    1977-03-01

    There are no precise data for determining the extent of somatic damage from small doses of radiation used in diagnostic radiology. Diagnostic radiation given to pregnant women, knowingly or unknowingly, should rarely reach teratogenic levels causing brain and eye abnormalities. Evidence suggests that it does increase the risk of childhood malignancy, especially leukemia. Although rapidly growing tissues seem most susceptible, all radiation probably carries a very small risk of carcinogenesis. Genetic damage is equally difficult to estimate. Diagnostic radiation of females, even in childhood, may be related to an increased incidence of Down's syndrome in older mothers. Radiation also causes point mutations, which may explain the increase of some genetic abnormalities in progeny of older fathers. Whenever an abdominal or pelvic radiograph is ordered before the end of the reproductive period, there must be a potential benefit to balance the small risk involved.

  2. Single source dual energy CT: What is the optimal monochromatic energy level for the analysis of the lung parenchyma?

    Energy Technology Data Exchange (ETDEWEB)

    Ohana, M., E-mail: mickael.ohana@gmail.com [iCube Laboratory, Université de Strasbourg/CNRS, UMR 7357, 67400 Illkirch (France); Service de Radiologie B, Nouvel Hôpital Civil – Hôpitaux Universitaires de Strasbourg, 1 place de l’hôpital, 67000 Strasbourg (France); Labani, A., E-mail: aissam.labani@chru-strasbourg.fr [Service de Radiologie B, Nouvel Hôpital Civil – Hôpitaux Universitaires de Strasbourg, 1 place de l’hôpital, 67000 Strasbourg (France); Severac, F., E-mail: francois.severac@chru-strasbourg.fr [Département de Biostatistiques et d’Informatique Médicale, Hôpital Civil – Hôpitaux Universitaires de Strasbourg,1 place de l’hôpital, 67000 Strasbourg (France); Jeung, M.Y., E-mail: Mi-Young.Jeung@chru-strasbourg.fr [Service de Radiologie B, Nouvel Hôpital Civil – Hôpitaux Universitaires de Strasbourg, 1 place de l’hôpital, 67000 Strasbourg (France); Gaertner, S., E-mail: Sebastien.Gaertner@chru-strasbourg.fr [Service de Médecine Vasculaire, Nouvel Hôpital Civil – Hôpitaux Universitaires de Strasbourg,1 place de l’hôpital, 67000 Strasbourg (France); and others

    2017-03-15

    Highlights: • Lung parenchyma aspect varies with the monochromatic energy level in spectral CT. • Optimal diagnostic and image quality is obtained at 50–55 keV. • Mediastinum and parenchyma could be read on the same monochromatic energy level. - Abstract: Objective: To determine the optimal monochromatic energy level for lung parenchyma analysis in spectral CT. Methods: All 50 examinations (58% men, 64.8 ± 16yo) from an IRB-approved prospective study on single-source dual energy chest CT were retrospectively included and analyzed. Monochromatic images in lung window reconstructed every 5 keV from 40 to 140 keV were independently assessed by two chest radiologists. Based on the overall image quality and the depiction/conspicuity of parenchymal lesions, each reader had to designate for every patient the keV level providing the best diagnostic and image quality. Results: 72% of the examinations exhibited parenchymal lesions. Reader 1 picked the 55 keV monochromatic reconstruction in 52% of cases, 50 in 30% and 60 in 18%. Reader 2 chose 50 keV in 52% cases, 55 in 40%, 60 in 6% and 40 in 2%. The 50 and 55 keV levels were chosen by at least one reader in 64% and 76% of all patients, respectively. Merging 50 and 55 keV into one category results in an optimal setting selected by reader 1 in 82% of patients and by reader 2 in 92%, with a 74% concomitant agreement. Conclusion: The best image quality for lung parenchyma in spectral CT is obtained with the 50–55 keV monochromatic reconstructions.

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

    International Nuclear Information System (INIS)

    Rogers, A.T.

    2001-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Szederjesi Janos

    2015-10-01

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

  5. Aircraft gas turbine engine vibration diagnostics

    OpenAIRE

    Stanislav Fábry; Marek Češkovič

    2017-01-01

    In the Czech and Slovak aviation are in service elderly aircrafts, usually produced in former Soviet Union. Their power units can be operated in more efficient way, in case of using additional diagnostic methods that allow evaluating their health. Vibration diagnostics is one of the methods indicating changes of rotational machine dynamics. Ground tests of aircraft gas turbine engines allow vibration recording and analysis. Results contribute to airworthiness evaluation and making corrections...

  6. Modelling of JET diagnostics using Bayesian Graphical Models

    Energy Technology Data Exchange (ETDEWEB)

    Svensson, J. [IPP Greifswald, Greifswald (Germany); Ford, O. [Imperial College, London (United Kingdom); McDonald, D.; Hole, M.; Nessi, G. von; Meakins, A.; Brix, M.; Thomsen, H.; Werner, A.; Sirinelli, A.

    2011-07-01

    The mapping between physics parameters (such as densities, currents, flows, temperatures etc) defining the plasma 'state' under a given model and the raw observations of each plasma diagnostic will 1) depend on the particular physics model used, 2) is inherently probabilistic, from uncertainties on both observations and instrumental aspects of the mapping, such as calibrations, instrument functions etc. A flexible and principled way of modelling such interconnected probabilistic systems is through so called Bayesian graphical models. Being an amalgam between graph theory and probability theory, Bayesian graphical models can simulate the complex interconnections between physics models and diagnostic observations from multiple heterogeneous diagnostic systems, making it relatively easy to optimally combine the observations from multiple diagnostics for joint inference on parameters of the underlying physics model, which in itself can be represented as part of the graph. At JET about 10 diagnostic systems have to date been modelled in this way, and has lead to a number of new results, including: the reconstruction of the flux surface topology and q-profiles without any specific equilibrium assumption, using information from a number of different diagnostic systems; profile inversions taking into account the uncertainties in the flux surface positions and a substantial increase in accuracy of JET electron density and temperature profiles, including improved pedestal resolution, through the joint analysis of three diagnostic systems. It is believed that the Bayesian graph approach could potentially be utilised for very large sets of diagnostics, providing a generic data analysis framework for nuclear fusion experiments, that would be able to optimally utilize the information from multiple diagnostics simultaneously, and where the explicit graph representation of the connections to underlying physics models could be used for sophisticated model testing. This

  7. Metabolomics for laboratory diagnostics.

    Science.gov (United States)

    Bujak, Renata; Struck-Lewicka, Wiktoria; Markuszewski, Michał J; Kaliszan, Roman

    2015-09-10

    Metabolomics is an emerging approach in a systems biology field. Due to continuous development in advanced analytical techniques and in bioinformatics, metabolomics has been extensively applied as a novel, holistic diagnostic tool in clinical and biomedical studies. Metabolome's measurement, as a chemical reflection of a current phenotype of a particular biological system, is nowadays frequently implemented to understand pathophysiological processes involved in disease progression as well as to search for new diagnostic or prognostic biomarkers of various organism's disorders. In this review, we discussed the research strategies and analytical platforms commonly applied in the metabolomics studies. The applications of the metabolomics in laboratory diagnostics in the last 5 years were also reviewed according to the type of biological sample used in the metabolome's analysis. We also discussed some limitations and further improvements which should be considered taking in mind potential applications of metabolomic research and practice. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Diagnostics for PLX-alpha

    Science.gov (United States)

    Gilmore, Mark; Hsu, Scott

    2015-11-01

    The goal of the Plasma Liner eXperiment PLX-alpha at Los Alamos National Laboratory is to establish the viability of creating a spherically imploding plasma liner for MIF and HED applications, using a spherical array of supersonic plasma jets launched by innovative contoured-gap coaxial plasma guns. PLX- α experiments will focus in particular on establishing the ram pressure and uniformity scalings of partial and fully spherical plasma liners. In order to characterize these parameters experimentally, a suite of diagnostics is planned, including multi-camera fast imaging, a 16-channel visible interferometer (upgraded from 8 channels) with reconfigurable, fiber-coupled front end, and visible and VUV high-resolution and survey spectroscopy. Tomographic reconstruction and data fusion techniques will be used in conjunction with interferometry, imaging, and synthetic diagnostics from modeling to characterize liner uniformity in 3D. Diagnostic and data analysis design, implementation, and status will be presented. Supported by the Advanced Research Projects Agency - Energy - U.S. Department of Energy.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-08-15

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

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

    International Nuclear Information System (INIS)

    Bjarnason, Thorarin

    2016-01-01

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

  11. Image quality enhancement for skin cancer optical diagnostics

    Science.gov (United States)

    Bliznuks, Dmitrijs; Kuzmina, Ilona; Bolocko, Katrina; Lihachev, Alexey

    2017-12-01

    The research presents image quality analysis and enhancement proposals in biophotonic area. The sources of image problems are reviewed and analyzed. The problems with most impact in biophotonic area are analyzed in terms of specific biophotonic task - skin cancer diagnostics. The results point out that main problem for skin cancer analysis is the skin illumination problems. Since it is often not possible to prevent illumination problems, the paper proposes image post processing algorithm - low frequency filtering. Practical results show diagnostic results improvement after using proposed filter. Along that, filter do not reduces diagnostic results' quality for images without illumination defects. Current filtering algorithm requires empirical tuning of filter parameters. Further work needed to test the algorithm in other biophotonic applications and propose automatic filter parameter selection.

  12. Application of diagnostic system for diesel engines in nuclear power plant

    International Nuclear Information System (INIS)

    Yoshinaga, Takeshi

    2004-01-01

    The diagnostic system for diesel engines makes a diagnosis of secular change and abnormal indications of diesel engines (DG) by combination of characteristic analysis of engine, lubricating oil, fuel oil, and cooling water. The principles of diagnostic system for DG, results of confirmation of the efficiency and the maintenance plan for DG in the Japan Atomic Power Company are described. DG in the company is classified to a safety device in order to supply the power source to the Emergency Core Cooling System etc., when the power source in the plant is lost, for example, at lightning struck. Characteristics of DG, outline of the diagnostic system for DG, diagnostic technologies such as engine signature analysis, chemical analysis of samples, temperature measurement, degradation mode of DG, and training in the company are stated. (S.Y.)

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  14. IGFBP3 methylation is a novel diagnostic and predictive biomarker in colorectal cancer.

    Directory of Open Access Journals (Sweden)

    Lucia Perez-Carbonell

    Full Text Available Aberrant hypermethylation of cancer-related genes has emerged as a promising strategy for the development of diagnostic, prognostic and predictive biomarkers in human cancer, including colorectal cancer (CRC. The aim of this study was to perform a systematic and comprehensive analysis of a panel of CRC-specific genes as potential diagnostic, prognostic and predictive biomarkers in a large, population-based CRC cohort.Methylation status of the SEPT9, TWIST1, IGFBP3, GAS7, ALX4 and miR137 genes was studied by quantitative bisulfite pyrosequencing in a population-based cohort of 425 CRC patients.Methylation levels of all genes analyzed were significantly higher in tumor tissues compared to normal mucosa (p<0.0001; however, cancer-associated hypermethylation was most frequently observed for miR137 (86.7% and IGFBP3 (83% in CRC patients. Methylation analysis using the combination of these two genes demonstrated greatest accuracy for the identification of colonic tumors (sensitivity 95.5%; specificity 90.5%. Low levels of IGFBP3 promoter methylation emerged as an independent risk factor for predicting poor disease free survival in stage II and III CRC patients (HR = 0.49, 95% CI: 0.28-0.85, p = 0.01. Our results also suggest that stage II & III CRC patients with high levels of IGFBP3 methylation do not benefit from adjuvant 5FU-based chemotherapy.By analyzing a large, population-based CRC cohort, we demonstrate the potential clinical significance of miR137 and IGFBP3 hypermethylation as promising diagnostic biomarkers in CRC. Our data also revealed that IGFBP3 hypermethylation may serve as an independent prognostic and predictive biomarker in stage II and III CRC patients.

  15. Some aspects of diagnostic systems perspective

    International Nuclear Information System (INIS)

    Korosec, D.

    1998-01-01

    The integrity and safety of all nuclear power plant systems and components is guaranteed by the high requirements to quality assurance during all phases of design, fabrication, construction and operation. Many of the countries operating nuclear facilities, introduced advanced, sophisticated diagnostic systems for continuous monitoring safety important process parameters. The licensee should perform an assessment of the existing diagnostic systems, often supplied by the original design, their reliability and the need for the introduction of the additional monitoring/diagnostic systems. The operating experience should be taken into account and the assessment of the further needs. On this field has to be made on the results of PSA studies. In addition to the cost benefit analysis the evaluation of the new diagnostic systems in the light of nuclear safety should be also made. Experience, gained from the utilities, which have already installed this kind of the equipment should be very useful. Introducing new diagnostic systems will require often a safety assessment of the necessary modifications. Licensing process should be based on the existing nuclear legislation with certain additional requirements. (author)

  16. Searching for New Biomarkers and the Use of Multivariate Analysis in Gastric Cancer Diagnostics.

    Science.gov (United States)

    Kucera, Radek; Smid, David; Topolcan, Ondrej; Karlikova, Marie; Fiala, Ondrej; Slouka, David; Skalicky, Tomas; Treska, Vladislav; Kulda, Vlastimil; Simanek, Vaclav; Safanda, Martin; Pesta, Martin

    2016-04-01

    The first aim of this study was to search for new biomarkers to be used in gastric cancer diagnostics. The second aim was to verify the findings presented in literature on a sample of the local population and investigate the risk of gastric cancer in that population using a multivariant statistical analysis. We assessed a group of 36 patients with gastric cancer and 69 healthy individuals. We determined carcinoembryonic antigen, cancer antigen 19-9, cancer antigen 72-4, matrix metalloproteinases (-1, -2, -7, -8 and -9), osteoprotegerin, osteopontin, prothrombin induced by vitamin K absence-II, pepsinogen I, pepsinogen II, gastrin and Helicobacter pylori for each sample. The multivariate stepwise logistic regression identified the following biomarkers as the best gastric cancer predictors: CEA, CA72-4, pepsinogen I, Helicobacter pylori presence and MMP7. CEA and CA72-4 remain the best markers for gastric cancer diagnostics. We suggest a mathematical model for the assessment of risk of gastric cancer. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  17. Data and Analysis from a Time-Resolved Tomographic Optical Beam Diagnostic

    International Nuclear Information System (INIS)

    Frayer, Daniel K.; Johnson, Douglas; Ekdahl, Carl

    2010-01-01

    An optical tomographic diagnostic instrument developed for the acquisition of high-speed time-resolved images has been fielded at the Dual-Axis Radiographic Hydrodynamic Test (DARHT) Facility at Los Alamos National Laboratory. The instrument was developed for the creation of time histories of electron-beam cross section through the collection of Cerenkov light. Four optical lines of sight optically collapse an image and relay projections via an optical fiber relay to recording instruments; a tomographic reconstruction algorithm creates the time history. Because the instrument may be operated in an adverse environment, it may be operated, adjusted, and calibrated remotely. The instrument was operated over the course of various activities during and after DARHT commissioning, and tomographic reconstructions reported verifiable beam characteristics. Results from the collected data and reconstructions and analysis of the data are discussed.

  18. Progress in diagnostic techniques for sc cavities

    International Nuclear Information System (INIS)

    Reece, C.E.

    1988-01-01

    While routinely achieved performance characteristics of superconducting cavities have now reached a level which makes them useful in large scale applications, achieving this level has come only through the knowledge gained by systematic studies of performance limiting phenomena. Despite the very real progress that has been made, the routine performance of superconducting cavities still falls far short of both the theoretical expectations and the performance of a few exception examples. It is the task of systematically applied diagnostic techniques to reveal additional information concerning the response of superconducting surfaces to applied RF fields. Here recent developments in diagnostic techniques are discussed. 18 references, 12 figures

  19. Software for 3D diagnostic image reconstruction and analysis

    International Nuclear Information System (INIS)

    Taton, G.; Rokita, E.; Sierzega, M.; Klek, S.; Kulig, J.; Urbanik, A.

    2005-01-01

    Recent advances in computer technologies have opened new frontiers in medical diagnostics. Interesting possibilities are the use of three-dimensional (3D) imaging and the combination of images from different modalities. Software prepared in our laboratories devoted to 3D image reconstruction and analysis from computed tomography and ultrasonography is presented. In developing our software it was assumed that it should be applicable in standard medical practice, i.e. it should work effectively with a PC. An additional feature is the possibility of combining 3D images from different modalities. The reconstruction and data processing can be conducted using a standard PC, so low investment costs result in the introduction of advanced and useful diagnostic possibilities. The program was tested on a PC using DICOM data from computed tomography and TIFF files obtained from a 3D ultrasound system. The results of the anthropomorphic phantom and patient data were taken into consideration. A new approach was used to achieve spatial correlation of two independently obtained 3D images. The method relies on the use of four pairs of markers within the regions under consideration. The user selects the markers manually and the computer calculates the transformations necessary for coupling the images. The main software feature is the possibility of 3D image reconstruction from a series of two-dimensional (2D) images. The reconstructed 3D image can be: (1) viewed with the most popular methods of 3D image viewing, (2) filtered and processed to improve image quality, (3) analyzed quantitatively (geometrical measurements), and (4) coupled with another, independently acquired 3D image. The reconstructed and processed 3D image can be stored at every stage of image processing. The overall software performance was good considering the relatively low costs of the hardware used and the huge data sets processed. The program can be freely used and tested (source code and program available at

  20. In Depth Diagnostics for RF System Operation in the PEP-II B Factory

    International Nuclear Information System (INIS)

    Van Winkle, Daniel; Fox, John; Teytelman, Dmitry; SLAC

    2005-01-01

    The PEP-II RF systems incorporate numerous feedback loops in the low-level processing for impedance control and operating point regulation. The interaction of the multiple loops with the beam is complicated, and the systems incorporate online diagnostic tools to configure the feedback loops as well as to record fault files in the case of an RF abort. Rapid and consistent analysis of the RF-related beam aborts and other failures is critical to the reliable operation of the B-Factory, especially at the recently achieved high beam currents. Procedures and algorithms used to extract diagnostic information from time domain fault files are presented and illustrated via example interpretations of PEP-II fault file data. Example faults presented will highlight the subtle interpretation required to determine the root cause. Some such examples are: abort kicker firing asynchronously, klystron and cavity arcs, beam loss leading to longitudinal instability, tuner read back jumps and poorly configured low-level RF feedback loop

  1. Indications for computed tomography (CT-) diagnostics in proximal humeral fractures

    DEFF Research Database (Denmark)

    Bahrs, Christian; Rolauffs, Bernd; Südkamp, Norbert P

    2009-01-01

    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-rays (22 AP + axillary views, 22 AP + scapular Y-views) and CT (multi-planar reconstruction (MPR) and maximum...... diagnostic methods was assessed according to the number of fractured parts (Bonferroni-Holm adjustment). RESULTS: There was significantly more overlap of the fractured region on the scapular Y-views (mean 71.5%, range 45-90%) than on axillary views (mean 56.2%, range 10.5-100%). CT-diagnostics allowed...... a significantly better assessment of the relevant structures than conventional diagnostics (p diagnostics of the fracture...

  2. About the Big Graphs Arising when Forming the Diagnostic Models in a Reconfigurable Computing Field of Functional Monitoring and Diagnostics System of the Spacecraft Onboard Control Complex

    Directory of Open Access Journals (Sweden)

    L. V. Savkin

    2015-01-01

    Full Text Available One of the problems in implementation of the multipurpose complete systems based on the reconfigurable computing fields (RCF is the problem of optimum redistribution of logicalarithmetic resources in growing scope of functional tasks. Irrespective of complexity, all of them are transformed into an orgraph, which functional and topological structure is appropriately imposed on the RCF based, as a rule, on the field programmable gate array (FPGA.Due to limitation of the hardware configurations and functions realized by means of the switched logical blocks (SLB, the abovementioned problem becomes even more critical when there is a need, within the strictly allocated RCF fragment, to realize even more complex challenge in comparison with the problem which was solved during the previous computing step. In such cases it is possible to speak about graphs of big dimensions with respect to allocated RCF fragment.The article considers this problem through development of diagnostic algorithms to implement diagnostics and control of an onboard control complex of the spacecraft using RCF. It gives examples of big graphs arising with respect to allocated RCF fragment when forming the hardware levels of a diagnostic model, which, in this case, is any hardware-based algorithm of diagnostics in RCF.The article reviews examples of arising big graphs when forming the complicated diagnostic models due to drastic difference in formation of hardware levels on closely located RCF fragments. It also pays attention to big graphs emerging when the multichannel diagnostic models are formed.Three main ways to solve the problem of big graphs with respect to allocated RCF fragment are given. These are: splitting the graph into fragments, use of pop-up windows with relocating and memorizing intermediate values of functions of high hardware levels of diagnostic models, and deep adaptive update of diagnostic model.It is shown that the last of three ways is the most efficient

  3. [Advances of Molecular Diagnostic Techniques Application in Clinical Diagnosis.

    Science.gov (United States)

    Ying, Bin-Wu

    2016-11-01

    Over the past 20 years,clinical molecular diagnostic technology has made rapid development,and became the most promising field in clinical laboratory medicine.In particular,with the development of genomics,clinical molecular diagnostic methods will reveal the nature of clinical diseases in a deeper level,thus guiding the clinical diagnosis and treatments.Many molecular diagnostic projects have been routinely applied in clinical works.This paper reviews the advances on application of clinical diagnostic techniques in infectious disease,tumor and genetic disorders,including nucleic acid amplification,biochip,next-generation sequencing,and automation molecular system,and so on.

  4. Diagnostic Technologies in Practice

    Science.gov (United States)

    Steinberg, Malcolm; Kwag, Michael; Chown, Sarah A.; Doupe, Glenn; Trussler, Terry; Rekart, Michael; Gilbert, Mark

    2015-01-01

    Diagnosing HIV-positive gay men through enhanced testing technologies that detect acute HIV infection (AHI) or recent HIV infection provides opportunities for individual and population health benefits. We recruited 25 men in British Columbia who received an acute (n = 13) or recent (n = 12) HIV diagnosis to engage in a longitudinal multiple-methods study over one year or longer. Our thematic analysis of baseline qualitative interviews revealed insights within men’s accounts of technologically mediated processes of HIV discovery and diagnosis. Our analysis illuminated the dialectic of new HIV technologies in practice by considering the relationship between advances in diagnostics (e.g., nucleic acid amplification tests) and the users of these medical technologies in clinical settings (e.g., clients and practitioners). Technological innovations and testing protocols have shifted experiences of learning of one’s HIV-positive status; these innovations have created new diagnostic categories that require successful interpretation and translation to be rendered meaningful, to alleviate uncertainty, and to support public health objectives. PMID:25201583

  5. Improved Efficiency and Reliability of NGS Amplicon Sequencing Data Analysis for Genetic Diagnostic Procedures Using AGSA Software

    Directory of Open Access Journals (Sweden)

    Axel Poulet

    2016-01-01

    Full Text Available Screening for BRCA mutations in women with familial risk of breast or ovarian cancer is an ideal situation for high-throughput sequencing, providing large amounts of low cost data. However, 454, Roche, and Ion Torrent, Thermo Fisher, technologies produce homopolymer-associated indel errors, complicating their use in routine diagnostics. We developed software, named AGSA, which helps to detect false positive mutations in homopolymeric sequences. Seventy-two familial breast cancer cases were analysed in parallel by amplicon 454 pyrosequencing and Sanger dideoxy sequencing for genetic variations of the BRCA genes. All 565 variants detected by dideoxy sequencing were also detected by pyrosequencing. Furthermore, pyrosequencing detected 42 variants that were missed with Sanger technique. Six amplicons contained homopolymer tracts in the coding sequence that were systematically misread by the software supplied by Roche. Read data plotted as histograms by AGSA software aided the analysis considerably and allowed validation of the majority of homopolymers. As an optimisation, additional 250 patients were analysed using microfluidic amplification of regions of interest (Access Array Fluidigm of the BRCA genes, followed by 454 sequencing and AGSA analysis. AGSA complements a complete line of high-throughput diagnostic sequence analysis, reducing time and costs while increasing reliability, notably for homopolymer tracts.

  6. Analysis of the Level of Development of the Socio-labour Sphere of Ukrainian Regions

    Directory of Open Access Journals (Sweden)

    Bibikova Viktoriia V.

    2013-12-01

    Full Text Available The goal of the article is the study of the level of development of the socio-labour sphere of Ukrainian regions. In order to achieve the goal, the article develops a complex scorecard, which takes into account all elements of the socio-labour sphere (socio-labour relations, labour market system of labour reimbursement, social accompaniment of labour activity, professional development of economically active population, level and quality of labour life, safety and security of labour. On the basis of the use of the developed scorecard, the article conducts an integral assessment of the level of development of the socio-labour sphere of regions. In order to get more objective information about the state of the labour sphere of Ukraine, the article uses its subjective assessments by population. In the result of the analysis, it reveals a lack of progressive changes of the socio-labour sphere in majority (60% of Ukrainian regions, availability of significant differentiation of regions by the level of its development and the irregular character of changes of separate elements of the labour sphere both within one administrative and territorial unit and among different regions of Ukraine. The article justifies a necessity of conduct of regular diagnostics of the state of the socio-labour sphere of Ukrainian regions with the use of a developed scorecard.

  7. Impact of new diagnostic criteria of diabetes mellitus

    International Nuclear Information System (INIS)

    Khan, M.N.A.; Khan, F.A.; Sultan, S.; Ijaz, A.

    2007-01-01

    To compare the frequency of diabetic individuals diagnosed by fasting plasma glucose (FPG) 7.0 mmol/L with previous value i.e. 7.8 mmol/L and to determine the diagnostic accuracy of FPG 7.0 mmol/L. FPG of 5250 subjects was checked to compare the frequency of diabetic subjects diagnosed by FPG 7.0 mmol/L with 7.8 mmol/L. Of them, 301 symptom-free subjects were subjected to 75 g Oral Glucose Tolerance Test (OGTT) and their 2 hours post glucose (2-h PG) challenge level was taken as gold standard to determine the diagnostic accuracy of FPG at 7.0 mmol/L. By lowering the cut off point of FPG from 7.8 mmol/L to 7.0 mmol/L, the percentage of diagnosed diabetic subjects increased from 35% to 42%. Statistical analysis revealed a significant increase (p 7.0 mmol/L, will greatly facilitate the early diagnosis of diabetes mellitus (DM). An early diagnosis can be further facilitated by a combination of FPG and 2-h PG estimation. (author)

  8. Diagnostic radiation risks

    Energy Technology Data Exchange (ETDEWEB)

    Sherwood, T [Addenbrooke' s Hospital, Cambridge (UK)

    1980-04-01

    A brief discussion on diagnostic radiation risks is given. First some fundamental facts on the concepts and units of radiation measurement are clarified. Medical diagnostic radiation doses are also compared to the radiation doses received annually by man from natural background radiation. The controversy concerning the '10-day rule' in X-raying women of child-bearing age is discussed; it would appear that the risk of malformation in an unborn child due to X-radiation is very much less than the natural level of risk of malformation. The differences in the radiographic techniques and thus the different X-ray doses needed to make adequate X-ray images of different parts of the body are considered. The radiation burden of nuclear medicine investigations compared to X-ray procedures is also discussed. Finally, the problems of using volunteers in radiation research are aired.

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

    Directory of Open Access Journals (Sweden)

    I. B. Zhakun

    2017-12-01

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

  10. Flotation process diagnostics and modelling by coal grain analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ofori, P; O' Brien, G.; Firth, B.; Jenkins, B. [CSIRO Energy Technology, Brisbane, Qld. (Australia)

    2006-05-15

    In coal flotation, particles of different components of the coal such as maceral groups and mineral matter and their associations have different hydrophobicities and therefore different flotation responses. By using a new coal grain analysis method for characterising individual grains, more detailed flotation performance analysis and modelling approaches have been developed. The method involves the use of microscopic imaging techniques to obtain estimates of size, compositional and density information on individual grains of fine coal. The density and composition partitioning of coal processed through different flotation systems provides an avenue to pinpoint the actual cause of poor process performance so that corrective action may be initiated. The information on grain size, density and composition is being used as input data to develop more detailed flotation process models to provide better predictions of process performance for both mechanical and column flotation devices. A number of approaches may be taken to flotation modelling such as the probability approach and the kinetic model approach or a combination of the two. In the work reported here, a simple probability approach has been taken, which will be further refined in due course. The use of grain data to map the responses of different types of coal grains through various fine coal cleaning processes provided a more advanced diagnostic capability for fine coal cleaning circuits. This enabled flotation performance curves analogous to partition curves for density separators to be produced for flotation devices.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-09-15

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

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

    International Nuclear Information System (INIS)

    Musyurka, A. V.

    2016-01-01

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

  13. A novel diagnostic biomarker panel for obesity-related nonalcoholic steatohepatitis (NASH).

    Science.gov (United States)

    Younossi, Zobair M; Jarrar, Mohammed; Nugent, Clare; Randhawa, Manpreet; Afendy, Mariam; Stepanova, Maria; Rafiq, Nila; Goodman, Zachary; Chandhoke, Vikas; Baranova, Ancha

    2008-11-01

    Within the spectrum of nonalcoholic fatty liver disease (NAFLD), only patients with nonalcoholic steatohepatitis (NASH) show convincing evidence for progression. To date, liver biopsy remains the gold standard for the diagnosis of NASH; however, liver biopsy is expensive and associated with a small risk, emphasizing the urgent need for noninvasive diagnostic biomarkers. Recent findings suggest a role for apoptosis and adipocytokines in the pathogenesis of NASH. The aim of this study was to develop a noninvasive diagnostic biomarker for NASH. The study included 101 patients with liver biopsies who were tested with enzyme-linked immunosorbent assay (ELISA)-based assays. Of these, 69 were included in the biomarker development set and 32 were included in the biomarker validation set. Clinical data and serum samples were collected at the time of biopsy. Fasting serum samples were assayed for adiponectin, resistin, insulin, glucose, TNF-alpha, IL-6, IL-8, cytokeratin CK-18 (M65 antigen), and caspase-cleaved CK-18 (M30 antigen). Data analysis revealed that the levels of M30 antigen (cleaved CK-18) predicted histological NASH with 70% sensitivity and 83.7% specificity and area under the curve (AUC) = 0.711, p < 10(-4), whereas the predictive value of the levels of intact CK-18 (M65) was higher (63.6% sensitivity and 89.4% specificity and AUC = 0.814, p < 10(-4)). Histological NASH could be predicted by a combination of Cleaved CK-18, a product of the subtraction of Cleaved CK-18 level from intact CK-18 level, serum adiponectin, and serum resistin with a sensitivity of 95.45% sensitivity, specificity of 70.21%, and AUC of 0.908 (p < 10(-4)). Blinded validation of this model confirmed its reliability for separating NASH from simple steatosis. Four ELISA-based tests were combined to form a simple diagnostic biomarker for NASH.

  14. Digital diffraction analysis enables low-cost molecular diagnostics on a smartphone.

    Science.gov (United States)

    Im, Hyungsoon; Castro, Cesar M; Shao, Huilin; Liong, Monty; Song, Jun; Pathania, Divya; Fexon, Lioubov; Min, Changwook; Avila-Wallace, Maria; Zurkiya, Omar; Rho, Junsung; Magaoay, Brady; Tambouret, Rosemary H; Pivovarov, Misha; Weissleder, Ralph; Lee, Hakho

    2015-05-05

    The widespread distribution of smartphones, with their integrated sensors and communication capabilities, makes them an ideal platform for point-of-care (POC) diagnosis, especially in resource-limited settings. Molecular diagnostics, however, have been difficult to implement in smartphones. We herein report a diffraction-based approach that enables molecular and cellular diagnostics. The D3 (digital diffraction diagnosis) system uses microbeads to generate unique diffraction patterns which can be acquired by smartphones and processed by a remote server. We applied the D3 platform to screen for precancerous or cancerous cells in cervical specimens and to detect human papillomavirus (HPV) DNA. The D3 assay generated readouts within 45 min and showed excellent agreement with gold-standard pathology or HPV testing, respectively. This approach could have favorable global health applications where medical access is limited or when pathology bottlenecks challenge prompt diagnostic readouts.

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

    Directory of Open Access Journals (Sweden)

    Nao Takeuchi-Storm

    2017-11-01

    Full Text Available Abstract Background The prevalence of bovine fasciolosis in Denmark is increasing but appropriate guidelines for control are currently lacking. In order to help develop a control strategy for liver fluke, a risk factor study of farm management factors was conducted and the utility of bulk tank milk (BTM ELISA as a tool for diagnosis in Danish dairy cattle farms was assessed. Methods This case-control study aimed to identify farm-level risk factors for fasciolosis in Danish dairy farms (> 50 animals slaughtered in 2013 using two diagnostic methods: recordings of liver condemnation at slaughter, and farm-level Fasciola hepatica antibody levels in BTM. A case farm was defined as having a minimum of 3 incidents of liver condemnation due to liver fluke at slaughter (in any age group during 2013, and control farms were located within 10 km of at least one case farm and had no history of liver condemnation due to liver fluke during 2011–2013. The selected farmers were interviewed over telephone about grazing and control practices, and BTM from these farms was collected and analysed by ELISA in 2014. The final complete dataset consisting of 131 case and 63 control farms was analysed using logistic regression. Results Heifers grazing on wet pastures, dry cows grazing on wet pastures, herd size, breed and concurrent beef cattle production were identified as risk factors associated with being classified as a case farm. With the categorised BTM ELISA result as the response variable, heifers grazing on wet pastures, dry cows grazing on wet pastures, and purchase of cows were identified as risk factors. Within the case and control groups, 74.8 and 12.7% of farms were positive for fasciolosis on BTM ELISA, respectively. The differences are likely to be related to the detection limit of the farm-level prevalence by the BTM ELISA test, time span between slaughter data and BTM, and the relatively low sensitivity of liver inspection at slaughter. Conclusions

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

    Science.gov (United States)

    Takeuchi-Storm, Nao; Denwood, Matthew; Hansen, Tina Vicky Alstrup; Halasa, Tariq; Rattenborg, Erik; Boes, Jaap; Enemark, Heidi Larsen; Thamsborg, Stig Milan

    2017-11-09

    The prevalence of bovine fasciolosis in Denmark is increasing but appropriate guidelines for control are currently lacking. In order to help develop a control strategy for liver fluke, a risk factor study of farm management factors was conducted and the utility of bulk tank milk (BTM ELISA) as a tool for diagnosis in Danish dairy cattle farms was assessed. This case-control study aimed to identify farm-level risk factors for fasciolosis in Danish dairy farms (> 50 animals slaughtered in 2013) using two diagnostic methods: recordings of liver condemnation at slaughter, and farm-level Fasciola hepatica antibody levels in BTM. A case farm was defined as having a minimum of 3 incidents of liver condemnation due to liver fluke at slaughter (in any age group) during 2013, and control farms were located within 10 km of at least one case farm and had no history of liver condemnation due to liver fluke during 2011-2013. The selected farmers were interviewed over telephone about grazing and control practices, and BTM from these farms was collected and analysed by ELISA in 2014. The final complete dataset consisting of 131 case and 63 control farms was analysed using logistic regression. Heifers grazing on wet pastures, dry cows grazing on wet pastures, herd size, breed and concurrent beef cattle production were identified as risk factors associated with being classified as a case farm. With the categorised BTM ELISA result as the response variable, heifers grazing on wet pastures, dry cows grazing on wet pastures, and purchase of cows were identified as risk factors. Within the case and control groups, 74.8 and 12.7% of farms were positive for fasciolosis on BTM ELISA, respectively. The differences are likely to be related to the detection limit of the farm-level prevalence by the BTM ELISA test, time span between slaughter data and BTM, and the relatively low sensitivity of liver inspection at slaughter. Control of bovine fasciolosis in Denmark should target heifers and

  17. Diagnostic value of combined determination of serum AFP, CEA, CA199, SF levels in patients with primary hepatic carcinoma

    International Nuclear Information System (INIS)

    Wu Jiaming; Rui Zhilian

    2005-01-01

    Objective: To investigate the diagnostic value of combined detection of four tumor markers in patients with possible malignant change in liver disorders. Methods: Serum AFP, CEA, CA199 and SF levels were determined with chemiluminescence immunoassay (CLIA) in 49 patients with primary liver carcinoma, 7 patients with metastatic liver carcinoma, 40 patients with hepatic cirrhosis, 47 patients with HBV hepatitis and 30 controls. Results: The serum levels of AFP, CEA, SF in patients with primary hepatic cancer and serum levels of AFP, SF in patients with hepatic cirrhosis were all significantly higher than those in controls (P 0.05). Moreover, positive rate of combined determination of AFP, CEA, CA199, SF in patients with primary hepatic cancer was significantly higher than that in patients with metastatic liver cancer. Conclusion: With combined determination of these four tumor markers, the detection rate of primary hepatic carcinoma could be enhanced to above 95%. Also, differential diagnosis between primary and metastatic hepatic cancers could be facilitated. (authors)

  18. Diagnostic value of fecal tumor M2-pyruvate kinase for CRC screening: a systematic review and meta-analysis.

    Science.gov (United States)

    Li, Rui; Liu, Jianjun; Xue, Huiping; Huang, Gang

    2012-10-15

    The measurement of fecal tumor M2-pyruvate kinase (PKM2), overexpressed in tumor cells, has been proposed as a novel tool for detecting colorectal cancer (CRC). However, the sensitivity and specificity of this test varied among studies. The aim of this meta-analysis was to determine the diagnostic accuracy of fecal PKM2 for CRC and to evaluate its utility in the CRC screening. It was compared to guaiac fecal occult blood test (gFOBT) or immunological fecal occult blood test (iFOBT). Through comprehensive literature search, 10 studies met the inclusion criteria and were included. Summary estimates for sensitivity and specificity were calculated by using the bivariate random effect model. The hierarchical summary receiver operating characteristic curve was also undertaken. The overall sensitivity and specificity of fecal PKM2 for detecting CRC were 79% (95% CI = 75-83%) and 81% (95% CI = 73-87%), respectively. The summary positive predictive value and negative predictive value were 74% (95% CI = 56-87%) and 86% (95% CI = 79-91%), respectively. The pooled diagnostic odds ratio was 16 (95% CI = 10-26). In head-to-head comparison, the diagnostic odds ratio of PKM2 and gFOBT for CRC were 10.167 (95% CI = 5.992-17.250) and 6.557 (95% CI = 3.467-12.403), respectively. The diagnostic odds ratio of PKM2 and iFOBT for CRC were 9.542 (95% CI = 5.893-15.452) and 67.248 (95% CI = 16.194-279.26), respectively. The fecal PKM2 test was a diagnostic tool with moderate sensitivity and specificity for detecting CRC. Its diagnostic efficiency was similar to that of gFOBT. Because of its relatively low specificity and positive predict value, fecal PKM2 was not recommended used alone as a screening tool for CRC. Copyright © 2012 UICC.

  19. LC-HRMS Metabolomics for Untargeted Diagnostic Screening in Clinical Laboratories: A Feasibility Study

    Directory of Open Access Journals (Sweden)

    Bertrand Rochat

    2018-06-01

    Full Text Available Today’s high-resolution mass spectrometers (HRMS allow bioanalysts to perform untargeted/global determinations that can reveal unexpected compounds or concentrations in a patient’s sample. This could be performed for preliminary diagnosis attempts when usual diagnostic processes and targeted determinations fail. We have evaluated an untargeted diagnostic screening (UDS procedure. UDS is a metabolome analysis that compares one sample (e.g., a patient with control samples (a healthy population. Using liquid chromatography (LC-HRMS full-scan analysis of human serum extracts and unsupervised data treatment, we have compared individual samples that were spiked with one xenobiotic or a higher level of one endogenous compound with control samples. After the use of different filters that drastically reduced the number of metabolites detected, the spiked compound was eventually revealed in each test sample and ranked. The proposed UDS procedure appears feasible and reliable to reveal unexpected xenobiotics (toxicology or higher concentrations of endogenous metabolites. HRMS-based untargeted approaches could be useful as preliminary diagnostic screening when canonical processes do not reveal disease etiology nor establish a clear diagnosis and could reduce misdiagnosis. On the other hand, the risk of overdiagnosis of this approach should be reduced with mandatory biomedical interpretation of the patient’s UDS results and with confirmatory targeted and quantitative determinations.

  20. Receiver operating characteristic (ROC) curves and the definition of threshold levels to diagnose coronary artery disease on electrocardiographic stress testing. Part I: The use of ROC curves in diagnostic medicine and electrocardiographic markers of ischaemia.

    Science.gov (United States)

    Barnabei, Luca; Marazìa, Stefania; De Caterina, Raffaele

    2007-11-01

    A common problem in diagnostic medicine, when performing a diagnostic test, is to obtain an accurate discrimination between 'normal' cases and cases with disease, owing to the overlapping distributions of these populations. In clinical practice, it is exceedingly rare that a chosen cut point will achieve perfect discrimination between normal cases and those with disease, and one has to select the best compromise between sensitivity and specificity by comparing the diagnostic performance of different tests or diagnostic criteria available. Receiver operating characteristic (or receiver operator characteristic, ROC) curves allow systematic and intuitively appealing descriptions of the diagnostic performance of a test and a comparison of the performance of different tests or diagnostic criteria. This review will analyse the basic principles underlying ROC curves and their specific application to the choice of optimal parameters on exercise electrocardiographic (ECG) stress testing. Part I will focus on theoretical description and analysis along with reviewing the common problems related to the diagnosis of myocardial ischaemia by means of exercise ECG stress testing. Part II will be devoted to applying ROC curves to available diagnostic criteria through the analysis of ECG stress test parameters.

  1. Comparison of diagnostic efficacy between CLE, tissue sampling, and CLE combined with tissue sampling for undetermined pancreaticobiliary strictures: a meta-analysis.

    Science.gov (United States)

    Gao, Ya-Dong; Qu, Ya-Wei; Liu, Hai-Feng

    2018-04-01

    The accurate diagnosis of undetermined pancreaticobiliary strictures remains challenging. Current ERCP-guided tissue sampling methods are of low sensitivity. Confocal laser endomicroscopy (CLE) is a new procedure and allows real optical biopsies that may improve the diagnosis of undetermined pancreaticobiliary strictures. The aim of this meta-analysis was to determine the diagnostic yield of CLE, tissue sampling, and CLE combined with tissue sampling for undetermined pancreaticobiliary strictures. Pubmed, Embase, and the Cochrane Library database were reviewed for relevant studies. Pooled estimates of sensitivity and specificity with 95% confidence intervals (CIs) were calculated using the random-effects meta-analysis model. The summary receiver-operating characteristic (SROC) curve was constructed, and the area under the receiver operating characteristic curve (AUC) was calculated. Twelve studies involving 591 patients were enrolled in our analysis. The overall sensitivity and the specificity estimate of CLE for discriminating benign and malignant pancreaticobiliary strictures were 87% (95%CI, 83-91%) and 76% (95%CI, 70-81%), respectively. The AUC to assess the diagnostic efficacy was 0.8705. For tissue sampling, the overall sensitivity and the specificity estimate were 64% (95%CI, 57-70%) and 94% (95%CI, 90-97%), respectively. The AUC to assess the diagnostic efficacy was 0.8040. A combination of both methods increased the sensitivity (93%; 95%CI, 88-96%) with a specificity of 82% (95%CI, 74-89%). The AUC to assess the diagnostic efficacy was 0.9377. There was no publication bias by Deeks' Funnel Plot with p = .936. Compared with tissue sampling, CLE may increase the sensitivity for the diagnosis of malignant pancreaticobiliary strictures. A combination of both can effectively diagnose malignant pancreaticobiliary strictures.

  2. A Meta-Analysis of the Diagnostic Accuracy of Circular RNAs in Digestive System Malignancy.

    Science.gov (United States)

    Chen, Zhiqiang; Zhang, Long; Han, Guoyong; Zuo, Xueliang; Zhang, Yao; Zhu, Qin; Wu, Jindao; Wang, Xuehao

    2018-01-01

    Circular RNAs (circRNAs), a novel class of noncoding RNAs, have been found to be dysregulated in various cancers. However, the clinical application value of these circRNAs in digestive system cancers remains to be clarified. We aimed to comprehensively explore the potential role of circRNAs as diagnostic indicators in digestive system malignancies. Relevant studies were systematically retrieved from PubMed, Web of Science and the Cochrane Library. The data that were required to complete 2 × 2 contingency tables were obtained from the included studies. Stratified analyses by cancer type, sample size and publication year were performed. Thirteen studies with 2,276 individuals were included in the meta-analysis. The pooled sensitivity and specificity of circRNAs in the diagnosis of digestive system malignancy were 0.72 [95% confidence interval (CI): 0.65-0.77] and 0.77 (95% CI: 0.72-0.81), respectively. The overall positive likelihood ratio was 3.09 (95% CI: 2.64-3.62), and the overall negative likelihood ratio was 0.37 (95% CI: 0.31-0.44). The pooled diagnostic odds ratio was 8.38 (95% CI: 6.86-10.25), and the overall area under the curve was 0.81 (95% CI: 0.77-0.84), indicating good discriminative ability of circRNAs as biomarkers for digestive system malignancy. circRNAs distinguish patients with digestive system cancer from controls with relatively high diagnostic accuracy. circRNAs may be used as potential biomarkers for the diagnosis of digestive system malignancy. © 2018 The Author(s). Published by S. Karger AG, Basel.

  3. Inertial confinement fusion diagnostics

    International Nuclear Information System (INIS)

    Coleman, L.W.

    1986-10-01

    The concept and goals of ICF will be briefly reviewed and the new 100 kJ class Nova laser facility will be described. Experimental results obtained to date with Nova will be summarized, and the discussions of diagnostics will use examples on the present capabilities of Nova and new developments that are underway. The classes of diagnostic systems to be discussed fall into three basic categories: optical, x-ray, and particle. Examples of highly space resolved, time resolved, and spectrally resolved techniques as well as schemes involving combinations of these capabilities will be presented. A brief summary of the sophisticated acquisition and analysis system in use for Nova data will be provided

  4. Nanotechnology based diagnostics for neurological disorders

    Energy Technology Data Exchange (ETDEWEB)

    Kurek, Nicholas S; Chandra, Sathees B., E-mail: schandra@roosevelt.edu [Department of Biological, Chemical and Physical Sciences, Roosevelt University, Chicago, IL (United States)

    2012-07-01

    Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

  5. Nanotechnology based diagnostics for neurological disorders

    Energy Technology Data Exchange (ETDEWEB)

    Kurek, Nicholas S.; Chandra, Sathees B., E-mail: schandra@roosevelt.edu [Department of Biological, Chemical and Physical Sciences, Roosevelt University, Chicago, IL (United States)

    2012-07-01

    Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

  6. Nanotechnology based diagnostics for neurological disorders

    International Nuclear Information System (INIS)

    Kurek, Nicholas S.; Chandra, Sathees B.

    2012-01-01

    Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

  7. Breast-specific gamma camera imaging with 99mTc-MIBI has better diagnostic performance than magnetic resonance imaging in breast cancer patients: A meta-analysis.

    Science.gov (United States)

    Zhang, Aimi; Li, Panli; Liu, Qiufang; Song, Shaoli

    2017-01-01

    This study aimed to evaluate the diagnostic role of breast-specific gamma camera imaging (BSGI) with technetium-99m-methoxy isobutyl isonitrile ( 99m Tc-MIBI) and magnetic resonance imaging (MRI) in patients with breast cancer through a meta-analysis. Three reviewers searched articles published in medical journals before June 2016 in MEDLINE, EMBASE and Springer Databases; the references listed in original articles were also retrieved. We used the quality assessment of diagnostic accuracy studies (QUADAS) tool to assess the quality of the included studies. Heterogeneity, pooled sensitivity and specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR) and summary receiver operating characteristic (SROC) curves were calculated by Meta-DiSc software to estimate the diagnostic performance of BSGI and MRI. Ten studies with 517 patients were included after meeting the inclusion criteria. We did a subgroup analysis of the same data type. The pooled sensitivities of BSGI and MRI were: 0.84 (95% CI, 0.79-0.88) and 0.89 (95% CI, 0.84-0.92) respectively, and the pooled specificities of BSGI and MRI were: 0.82 (95% CI, 0.74-0.88) and 0.39 (95% CI, 0.30-0.49) respectively. The areas under the SROC curve of BSGI and MRI were 0.93 and 0.72 respectively. The results of our meta-analysis indicated that compared with MRI, BSGI has similar sensitivity, higher specificity, better diagnostic performance, and can be widely used in clinical practice.

  8. Novette diagnostic support. Final report

    International Nuclear Information System (INIS)

    Cirigliano, R.; Franco, E.; Koppel, L.; Rodrigues, B.; Smith, J.

    1985-02-01

    The primary research areas were the following: (1) contribute x-ray diagnostic, experimental, and data reduction and analysis support for the Novette DANTE x-ray spectrometer experiments. This effort was expanded to improve the overall quality of the Novette database; (2) experimental and calculational characterization of the x-ray imaging properties of an ellipsoidal x-ray collection optic serving as a sensitivity enhancing component of the Transmission Grating Streak Spectrometer; (3) performance simulation of the x-ray dispersion properties of candidate x-ray laser cavity, normal incidence end-mirror optics; (4) contribute x-ray diagnostic, experimental, and data reduction and analysis support for the Novette Henway crystal spectrometer and the MCPIGS microchannel plate intensified grazing incident spectrometer experiments; and (5) perform a technical performance vs cost evaluation of commercially available hardware required to perform the NOVA neutron time-of-flight experiments

  9. Diagnostic and interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, Thomas J. [Klinikum der Johann Wolfgang Goethe-Universitaet, Frankfurt am Main (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Reith, Wolfgang [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie; Rummeny, Ernst J. (ed.) [Technische Univ. Muenchen Klinikum rechts der Isar, Muenchen (Germany). Inst. fuer Radiologie

    2016-08-01

    This exceptional book covers all aspects of diagnostic and interventional radiology within one volume, at a level appropriate for the specialist. From the basics through diagnosis to intervention: the reader will find a complete overview of all areas of radiology. The clear, uniform structure, with chapters organized according to organ system, facilitates the rapid retrieval of information. Features include: Presentation of the normal radiological anatomy Classification of the different imaging procedures according to their diagnostic relevance Imaging diagnosis with many reference images Precise description of the interventional options The inclusion of many instructive aids will be of particular value to novices in decision making: Important take home messages and summaries of key radiological findings smooth the path through the jungle of facts Numerous tables on differential diagnosis and typical findings in the most common diseases offer a rapid overview and orientation Diagnostic flow charts outline the sequence of diagnostic evaluation All standard procedures within the field of interventional radiology are presented in a clinically relevant and readily understandable way, with an abundance of illustrations. This is a textbook, atlas, and reference in one: with more than 2500 images for comparison with the reader's own findings. This comprehensive and totally up-to-date book provides a superb overview of everything that the radiology specialist of today needs to know.

  10. Diagnostic accuracy of {sup 18}F amyloid PET tracers for the diagnosis of Alzheimer's disease: a systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Morris, Elizabeth; Chalkidou, Anastasia [St Thomas' Hospital, King' s Technology Evaluation Centre, King' s College London, London (United Kingdom); St Thomas' Hospital, Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King' s College London, London (United Kingdom); Hammers, Alexander [St Thomas' Hospital, Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King' s College London, London (United Kingdom); Peacock, Janet; Summers, Jennifer [St Thomas' Hospital, King' s Technology Evaluation Centre, King' s College London, London (United Kingdom); King' s College London, Division of Health and Social Care Research, London (United Kingdom); King' s College London, NIHR Biomedical Research Centre at Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom); Keevil, Stephen [St Thomas' Hospital, King' s Technology Evaluation Centre, King' s College London, London (United Kingdom); St Thomas' Hospital, Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King' s College London, London (United Kingdom); St Thomas' Hospital, Department of Medical Physics, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom)

    2016-02-15

    Imaging or tissue biomarker evidence has been introduced into the core diagnostic pathway for Alzheimer's disease (AD). PET using {sup 18}F-labelled beta-amyloid PET tracers has shown promise for the early diagnosis of AD. However, most studies included only small numbers of participants and no consensus has been reached as to which radiotracer has the highest diagnostic accuracy. First, we performed a systematic review of the literature published between 1990 and 2014 for studies exploring the diagnostic accuracy of florbetaben, florbetapir and flutemetamol in AD. The included studies were analysed using the QUADAS assessment of methodological quality. A meta-analysis of the sensitivity and specificity reported within each study was performed. Pooled values were calculated for each radiotracer and for visual or quantitative analysis by population included. The systematic review identified nine studies eligible for inclusion. There were limited variations in the methods between studies reporting the same radiotracer. The meta-analysis results showed that pooled sensitivity and specificity values were in general high for all tracers. This was confirmed by calculating likelihood ratios. A patient with a positive ratio is much more likely to have AD than a patient with a negative ratio, and vice versa. However, specificity was higher when only patients with AD were compared with healthy controls. This systematic review and meta-analysis found no marked differences in the diagnostic accuracy of the three beta-amyloid radiotracers. All tracers perform better when used to discriminate between patients with AD and healthy controls. The sensitivity and specificity for quantitative and visual analysis are comparable to those of other imaging or biomarker techniques used to diagnose AD. Further research is required to identify the combination of tests that provides the highest sensitivity and specificity, and to identify the most suitable position for the tracer in the

  11. Diagnostic Accuracy of Rating Scales for Attention-Deficit/Hyperactivity Disorder: A Meta-analysis.

    Science.gov (United States)

    Chang, Ling-Yin; Wang, Mei-Yeh; Tsai, Pei-Shan

    2016-03-01

    The Child Behavior Checklist-Attention Problem (CBCL-AP) scale and Conners Rating Scale-Revised (CRS-R) are commonly used behavioral rating scales for diagnosing attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. To evaluate and compare the diagnostic performance of CBCL-AP and CRS-R in diagnosing ADHD in children and adolescents. PubMed, Ovid Medline, and other relevant electronic databases were searched for articles published up to May 2015. We included studies evaluating the diagnostic performance of either CBCL-AP scale or CRS-R for diagnosing ADHD in pediatric populations in comparison with a defined reference standard. Bivariate random effects models were used for pooling and comparing diagnostic performance. We identified and evaluated 14 and 11 articles on CBCL-AP and CRS-R, respectively. The results revealed pooled sensitivities of 0.77, 0.75, 0.72, and 0.83 and pooled specificities of 0.73, 0.75, 0.84, and 0.84 for CBCL-AP, Conners Parent Rating Scale-Revised, Conners Teacher Rating Scale-Revised, and Conners Abbreviated Symptom Questionnaire (ASQ), respectively. No difference was observed in the diagnostic performance of the various scales. Study location, age of participants, and percentage of female participants explained the heterogeneity in the specificity of the CBCL-AP. CBCL-AP and CRS-R both yielded moderate sensitivity and specificity in diagnosing ADHD. According to the comparable diagnostic performance of all examined scales, ASQ may be the most effective diagnostic tool in assessing ADHD because of its brevity and high diagnostic accuracy. CBCL is recommended for more comprehensive assessments. Copyright © 2016 by the American Academy of Pediatrics.

  12. Assessment of effectiveness of ultrasonography in diagnosis of acute appendicitis: Correlation with level of initial clinical diagnostic confidence

    International Nuclear Information System (INIS)

    Song, Soon Young; Koo, Ja Hong; Lee, Eun Ja; Lee, Jong In; Jung, Jin Ho; Kim, Jin Young; Oh, Hwa Eun; Moon, Won Jin; Kim, Sam Soo; Heon, Han

    2002-01-01

    To evaluate effectiveness of ultrasonography (US) in the diagnosis of acute appendicitis by comparing with initial level of clinical diagnostic confidence. Graded compression US of one hundred forty eight with clinically suspected of acute appendicitis were prospectively evaluated. General surgeons classified patients into three groups bases on the clinical probability before US examination: group 1 as cases with low probability ( 75%). Two radiologists performed US examination. Statistical significance of ultrasonographic results in each group was assessed. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of sonography for all patients were 91.3%, 97%, 97.3%, 90.4%, and 93.9% respectively. Those of group 1 were 100%, 95.5%, 84.6%, 100%, and 96.4%, and those of group 2, 95.8%, 100%, 100%, 95%, and 97.7% while those of group 3, 86.4%, 100%, 100%, 50%, and 88%. There was no statistical difference in each parameter among three groups. The accuracy and NPV in group 3 was significantly higher than those in groups with the low and intermediate probability (group 1 and 2). Ultrasonography in the diagnosis of acute appendicitis is an useful and reliable method, especially in case of low clinical diagnostic confidence.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-12-15

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

  14. Diagnostic and prognostic value of high-sensitivity cardiac troponin T in patients with syncope.

    Science.gov (United States)

    Christ, Michael; Geier, Felicitas; Popp, Steffen; Singler, Katrin; Smolarsky, Alexander; Bertsch, Thomas; Müller, Christian; Greve, Yvonne

    2015-02-01

    We examined the diagnostic and predictive value of high-sensitivity cardiac troponin T (cTnThs) in patients with syncope. We performed an analysis of consecutive patients with syncope presenting to the emergency department. The primary end point was the accuracy to diagnose a cardiac syncope. In addition, the study explored the prognostic relevance of cTnThs in patients with cardiac and noncardiac syncope. A total of 360 patients were enrolled (median age, 70.5 years; male, 55.8%; 23.9% aged >80 years). Cardiac syncope was present in 22% of patients, reflex syncope was present in 40% of patients, syncope due to orthostatic hypotension was present in 20% of patients, and unexplained syncope was present in 17.5% of patients. A total of 148 patients (41%) had cTnThs levels above the 99% confidence interval (CI) (cutoff point). The diagnostic accuracy for cTnThs levels to determine the diagnosis of cardiac syncope was quantified by the area under the curve (0.77; CI, 0.72-0.83; P value of cTnThs levels within 30 days: Patients with increased cTnThs levels had a 52% likelihood for adverse events, patients with cTnThs levels below the cutoff point had a low risk (negative predictive value, 83.5%). Increased cTnThs levels indicate adverse prognosis in patients with noncardiac causes of syncope, but not in patients with cardiac syncope being a risk factor for adverse outcome by itself. Patients with syncope presenting to the emergency department have a high proportion of life-threatening conditions. cTnThs levels show a limited diagnostic and predictive accuracy for the identification of patients with syncope at high risk. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Secondary Low-Level Waste Treatment Strategy Analysis

    International Nuclear Information System (INIS)

    D.M. LaRue

    1999-01-01

    The objective of this analysis is to identify and review potential options for processing and disposing of the secondary low-level waste (LLW) that will be generated through operation of the Monitored Geologic Repository (MGR). An estimate of annual secondary LLW is generated utilizing the mechanism established in ''Secondary Waste Treatment Analysis'' (Reference 8.1) and ''Secondary Low-Level Waste Generation Rate Analysis'' (Reference 8.5). The secondary LLW quantities are based on the spent fuel and high-level waste (HLW) arrival schedule as defined in the ''Controlled Design Assumptions Document'' (CDA) (Reference 8.6). This analysis presents estimates of the quantities of LLW in its various forms. A review of applicable laws, codes, and standards is discussed, and a synopsis of those applicable laws, codes, and standards and their impacts on potential processing and disposal options is presented. The analysis identifies viable processing/disposal options in light of the existing laws, codes, and standards, and then evaluates these options in regard to: (1) Process and equipment requirements; (2) LLW disposal volumes; and (3) Facility requirements

  16. Beam diagnostics and control for SLC

    International Nuclear Information System (INIS)

    Ross, M.C.

    1987-01-01

    Construction of the SLAC Linear Collider has posed some new problems in beam diagnostic device design. Typical beam sizes are small when compared with conventional storage rings, orbit tolerances are tighter and the pulsed nature of the machine means that signal to noise enhancement by averaging is not always possible. Thus the diagnostics must have high resolution, high absolute accuracy and must deliver data from a single puls. In practice the required performance level depends on the function and dynamics of a given region in the collider. In this paper, the authors review the major beam diagnostic system and then discuss the global data acquisition schemes. Because space is limited each system is described only in a very cursory fashion. More details may be found in the cited papers

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  18. Knowledge acquisition for nuclear power plant unit diagnostic system

    International Nuclear Information System (INIS)

    Li Xiaodong; Xi Shuren

    2003-01-01

    The process of acquiring knowledge and building a knowledge base is critical to realize fault diagnostic system at unit level in a nuclear power plant. It directly determines whether the diagnostic system can be applied eventually in a commercial plant. A means to acquire knowledge and its procedures was presented in this paper for fault diagnostic system in a nuclear power plant. The work can be carried out step by step and it is feasible in a commercial nuclear power plant. The knowledge base of the fault diagnostic system for a nuclear power plant can be built after the staff finish the tasks according to the framework presented in this paper

  19. Risk analysis for working with an analyzer for gamma cameras diagnostic

    International Nuclear Information System (INIS)

    Oramas Polo, Ivon; Figueroa del Valle, Diana G.

    2014-01-01

    In this work, an analysis of the risks for working with an analyzer for gamma cameras diagnostic was made. The method employed is based on determining the Hazard Rating Number (HRN). The results showed that the risks with higher value of HRN are electrocution with 100 and touch source container with hands with 75. These risks were classified as 'Very High' and 'High' respectively. The following risks were classified as 'Important': Fall of the source container (HRN = 25), high dose of the sample in the container (HRN = 20) and fracture of glass detector (HRN = 30). The wrong shielding of the source container (HRN = 10) is a risk that was classified as L ow . Safety rules for use of the system are indicated. An action plan for risk management is also presented. (author)

  20. Cost-effectiveness analysis of introducing malaria diagnostic testing in drug shops

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Clarke, Siân E.; Lal, Sham

    2017-01-01

    Background Private sector drug shops are an important source of malaria treatment in Africa, yet diagnosis without parasitological testing is common among these providers. Accurate rapid diagnostic tests for malaria (mRDTs) require limited training and present an opportunity to increase access...... to correct diagnosis. The present study was a cost-effectiveness analysis of the introduction of mRDTs in Ugandan drug shops. Methods Drug shop vendors were trained to perform and sell subsidised mRDTs and artemisinin-based combination therapies (ACTs) in the intervention arm while vendors offered ACTs...... following presumptive diagnosis of malaria in the control arm. The effect on the proportion of customers with fever ‘appropriately treated of malaria with ACT’ was captured during a randomised trial in drug shops in Mukono District, Uganda. Health sector costs included: training of drug shop vendors...