WorldWideScience

Sample records for maintaining diagnostic confidence

  1. Maintaining public confidence in UK nuclear safety regulation

    International Nuclear Information System (INIS)

    Williams, L.

    2001-01-01

    The key to maintaining stake holder confidence is competence and having the resources necessary to not only carry out regulatory functions effectively, but also to keep the public informed and respond to their questions. This does not come cheap but it is a price well worth paying. (N.C.)

  2. Bronchoscopic Lung Cryobiopsy Increases Diagnostic Confidence in the Multidisciplinary Diagnosis of Idiopathic Pulmonary Fibrosis.

    Science.gov (United States)

    Tomassetti, Sara; Wells, Athol U; Costabel, Ulrich; Cavazza, Alberto; Colby, Thomas V; Rossi, Giulio; Sverzellati, Nicola; Carloni, Angelo; Carretta, Elisa; Buccioli, Matteo; Tantalocco, Paola; Ravaglia, Claudia; Gurioli, Christian; Dubini, Alessandra; Piciucchi, Sara; Ryu, Jay H; Poletti, Venerino

    2016-04-01

    Surgical lung biopsy is often required for a confident multidisciplinary diagnosis of idiopathic pulmonary fibrosis (IPF). Alternative, less-invasive biopsy methods, such as bronchoscopic lung cryobiopsy (BLC), are highly desirable. To address the impact of BLC on diagnostic confidence in the multidisciplinary diagnosis of IPF. In this cross-sectional study we selected 117 patients with fibrotic interstitial lung disease without a typical usual interstitial pneumonia pattern on high-resolution computed tomography. All cases underwent lung biopsies: 58 were BLC, and 59 were surgical lung biopsy (SLB). Two clinicians, two radiologists, and two pathologists sequentially reviewed clinical-radiologic findings and biopsy results, recording at each step in the process their diagnostic impressions and confidence levels. We observed a major increase in diagnostic confidence after the addition of BLC, similar to SLB (from 29 to 63%, P = 0.0003 and from 30 to 65%, P = 0.0016 of high confidence IPF diagnosis, in the BLC group and SLB group, respectively). The overall interobserver agreement in IPF diagnosis was similar for both approaches (BLC overall kappa, 0.96; SLB overall kappa, 0.93). IPF was the most frequent diagnosis (50 and 39% in the BLC and SLB group, respectively; P = 0.23). After the addition of histopathologic information, 17% of cases in the BLC group and 19% of cases in the SLB group, mostly idiopathic nonspecific interstitial pneumonia and hypersensitivity pneumonitis, were reclassified as IPF. BLC is a new biopsy method that has a meaningful impact on diagnostic confidence in the multidisciplinary diagnosis of interstitial lung disease and may prove useful in the diagnosis of IPF. This study provides a robust rationale for future studies investigating the diagnostic accuracy of BLC compared with SLB.

  3. Carotid artery dissection on non-contrast CT: Does color improve the diagnostic confidence?

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca, E-mail: lucasaba@tiscali.it [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Argiolas, Giovanni Maria [Department of Radiology, Azienda Ospedaliero Brotzu (A.O.B.), di Cagliari, Cagliari 09100 (Italy); Raz, Eytan [Department of Radiology, New York University School of Medicine, New York (United States); Department of Neurology and Psychiatry, Sapienza University of Rome (Italy); Sannia, Stefano [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Suri, Jasjit S. [Diagnostic and Monitoring Division, AtheroPointTM LLC, Roseville, CA (United States); Electrical Engineering Department (Aff.), Idaho State University, ID (United States); Siotto, Paolo [Department of Radiology, Azienda Ospedaliero Brotzu (A.O.B.), di Cagliari, Cagliari 09100 (Italy); Sanfilippo, Roberto; Montisci, Roberto [Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Piga, Mario [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Wintermark, Max [Department of Radiology, Neuroradiology Division, University of Virginia, Box 800170, Charlottesville, VA, 22908 (United States)

    2014-12-15

    Highlights: • The use of a color scale to display the non-contrast CT images in lieu of the classic grayscale improves the diagnostic confidence of the readers. • Radiologists should consider the use of a color scale, rather than the conventional grayscale, to assess non-contrast CT studies for possible carotid artery dissection. - Abstract: Purpose: The purpose of this work was to evaluate if the use of color maps, instead of conventional grayscale images, would improve the observer's diagnostic confidence in the non-contrast CT evaluation of internal carotid artery dissection (ICAD). Materials and methods: One hundred patients (61 men, 39 women; mean age, 51 years; range, 25–78 years), 40 with and 60 without ICAD, underwent non-contrast CT and were included in this the retrospective study. In this study, three groups of patients were considered: patients with MR confirmation of ICAD, n = 40; patients with MR confirmation of ICAD absence, n = 20; patients who underwent CT of the carotid arteries because of atherosclerotic disease, n = 40. Four blinded observers with different levels of expertise (expert, intermediate A, intermediate B and trainee) analyzed the non-contrast CT datasets using a cross model (one case grayscale and the following case using the color scale). The presence of ICAD was scored on a 5-point scale in order to assess the observer's diagnostic confidence. After 3 months the four observers evaluated the same datasets by using the same cross-model for the alternate readings (one case color scale and the following case using the grayscale). Statistical analysis included receiver operating characteristics (ROC) curve analysis, the Cohen weighted test and sensitivity, specificity, PPV, NPV, accuracy, LR+ and LR−. Results: The ROC curve analysis showed that, for all observers, the use of color scale resulted in an improved diagnostic confidence with AUC values increasing from 0.896 to 0.936, 0.823 to 0.849, 0.84 to 0.909 and 0

  4. The impact of communication barriers on diagnostic confidence and ancillary testing in the emergency department.

    Science.gov (United States)

    Garra, Gregory; Albino, Hiram; Chapman, Heather; Singer, Adam J; Thode, Henry C

    2010-06-01

    Communication barriers (CBs) compromise the diagnostic power of the medical interview and may result in increased reliance on diagnostic tests or incorrect test ordering. The prevalence and degree to which these barriers affect diagnosis, testing, and treatment are unknown. To quantify and characterize CBs encountered in the Emergency Department (ED), and assess the effect of CBs on initial diagnosis and perceived reliance on ancillary testing. This was a prospective survey completed by emergency physicians after initial adult patient encounters. CB severity, diagnostic confidence, and reliance on ancillary testing were quantified on a 100-mm Visual Analog Scale (VAS) from least (0) to most (100). Data were collected on 417 ED patient encounters. CBs were reported in 46%; with a mean severity of 50 mm on a 100-mm VAS with endpoints of "perfect communication and "no communication." Language was the most commonly reported form of CB (28%). More than one CB was identified in 6%. The 100-mm VAS rating of diagnostic confidence was lower in patients with perceived CBs (64 mm) vs. those without CBs (80 mm), p Communication barriers in our ED setting were common, and resulted in lower diagnostic confidence and increased perception that ancillary tests are needed to narrow the diagnosis. Copyright 2010 Elsevier Inc. All rights reserved.

  5. Attaining and Maintaining a Continuity of Knowledge to Draw Safeguards Conclusions with Confidence.

    Energy Technology Data Exchange (ETDEWEB)

    Bean, Robert [Purdue Univ., West Lafayette, IN (United States); Blair, Dianna S. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Pickett, Chris [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2014-11-01

    As the 21st century progresses, new nuclear facilities and the expansion of nuclear activities into new countries will require the International Atomic Energy Agency (IAEA) to place a higher reliance on attaining and maintaining a Continuity of Knowledge (CoK) of its safeguards information than is currently practiced. Additionally, a conceptual view of where and how CoK can be applied will need to evolve to support improved efficiency and efficacy of drawing a safeguards conclusion for each Member State. The ability to draw a safeguards conclusion for a Member State will be predicated on the confidence that CoK has been attained and subsequently maintained with respect to the data and information streams used by the IAEA. This confidence can be described as a function of factors such as elapsed time since the measurement, surveillance of attributes, authentication of information, historic knowledge of potential system failures, and the number and type of data collections. A set of general scenarios are further described for determining what is required to attain CoK and whether CoK has been maintained. A high-level analysis of example scenarios is presented to identify failures or gaps that could cause a loss of CoK. Potential areas for technological research and development are discussed for the next generation of CoK tools.

  6. How “consistent” is “consistent”? A clinician-based assessment of the reliability of expressions used by radiologists to communicate diagnostic confidence

    International Nuclear Information System (INIS)

    Rosenkrantz, A.B.; Kiritsy, M.; Kim, S.

    2014-01-01

    Aim: To evaluate the degree of variability in clinicians' interpretation of expressions used by radiologists to communicate their level of diagnostic confidence within radiological reports. Materials and methods: Clinicians were solicited to complete a prospective survey asking them to select the approximate perceived level of certainty, expressed as a percentage, associated with 20 expressions used by radiologists to communicate their level of diagnostic confidence within radiological reports. The median and inter-decile range (IDR) were computed for each expression, with a smaller IDR indicating greater reproducibility. Clinicians were also asked questions regarding their attitudes about radiologists' communication of diagnostic confidence. Results: Forty-nine surveys were completed. Median confidence associated with the expressions ranged from 10–90%. Reproducibility of the expressions was variable, as IDR ranged from 15–53%, although a median IDR of 40% indicated overall poor reproducibility. Expressions with relatively higher reproducibility included “most likely”, “likely”, and “unlikely” (IDR 15–20%), whereas expressions with relatively lower reproducibility included “compatible with”, “suspicious for”, “possibly,” and “can be seen in the setting of” (IDR ≥45%). Only 20% of clinicians agreed or strongly agreed that radiologists consistently use such expressions within their reports. Fifty-five percent of clinicians preferred that diagnostic confidence be communicated as a percentage rather than as a textual expression. Conclusion: There was poor reproducibility in clinicians' interpretations of many expressions used by radiologists to communicate their level of diagnostic confidence. Use of percentages to convey diagnostic confidence within reports may mitigate this source of ambiguity in radiologists' communication with clinicians. - Highlights: • Clinicians recorded certainty associated with

  7. Measuring the cortical silent period can increase diagnostic confidence for amyotrophic lateral sclerosis.

    NARCIS (Netherlands)

    Schelhaas, H.J.; Arts, I.M.P.; Overeem, S.; Houtman, C.J.; Janssen, H.; Kleine, B.U.; Munneke, M.; Zwarts, M.J.

    2007-01-01

    We evaluated a modified measurement of the cortical silent period (CSP) as a simple procedure to add further confidence in the diagnostic work-up for ALS. Thirty-seven consecutive patients with a suspicion of having ALS were included together with 25 healthy volunteers, and followed until a final

  8. The Confidence-Accuracy Relationship in Diagnostic Assessment: The Case of the Potential Difference in Parallel Electric Circuits

    Science.gov (United States)

    Saglam, Murat

    2015-01-01

    This study explored the relationship between accuracy of and confidence in performance of 114 prospective primary school teachers in answering diagnostic questions on potential difference in parallel electric circuits. The participants were required to indicate their confidence in their answers for each question. Bias and calibration indices were…

  9. An investigation of diagnostic accuracy and confidence related to diagnostic checklists as well as gender biases in relation to mental disorders

    Directory of Open Access Journals (Sweden)

    Jan Christopher Cwik

    2016-11-01

    Full Text Available This study examines the utility of checklists in attaining more accurate diagnoses in the context of diagnostic decision-making for mental disorders. The study also aimed to replicate results from a meta-analysis indicating that there is no association between patients’ gender and misdiagnoses. To this end, 475 psychotherapists were asked to judge three case vignettes describing patients with Major Depressive Disorder, Generalized Anxiety Disorder, and Borderline Personality Disorder. Therapists were randomly assigned to experimental conditions in a 2 (diagnostic method: with using diagnostic checklists vs. without using diagnostic checklists x 2 (gender: male vs. female case vignettes between-subjects design. Multinomial logistic and linear regression analyses were used to examine the association between the usage of diagnostic checklists as well as patients’ gender and diagnostic decisions.The results showed that when checklists were used, fewer incorrect co-morbid diagnoses were made, but clinicians were less likely to diagnose MDD even when the criteria were met. Additionally, checklists improved therapists’ confidence with diagnostic decisions, but were not associated with estimations of patients’ characteristics. As expected, there were no significant associations between gender and diagnostic decisions.

  10. An Investigation of Diagnostic Accuracy and Confidence Associated with Diagnostic Checklists as Well as Gender Biases in Relation to Mental Disorders.

    Science.gov (United States)

    Cwik, Jan C; Papen, Fabienne; Lemke, Jan-Erik; Margraf, Jürgen

    2016-01-01

    This study examines the utility of checklists in attaining more accurate diagnoses in the context of diagnostic decision-making for mental disorders. The study also aimed to replicate results from a meta-analysis indicating that there is no association between patients' gender and misdiagnoses. To this end, 475 psychotherapists were asked to judge three case vignettes describing patients with Major Depressive Disorder (MDD), Generalized Anxiety Disorder, and Borderline Personality Disorder. Therapists were randomly assigned to experimental conditions in a 2 (diagnostic method: with using diagnostic checklists vs. without using diagnostic checklists) × 2 (gender: male vs. female case vignettes) between-subjects design. Multinomial logistic and linear regression analyses were used to examine the association between the usage of diagnostic checklists as well as patients' gender and diagnostic decisions. The results showed that when checklists were used, fewer incorrect co-morbid diagnoses were made, but clinicians were less likely to diagnose MDD even when the criteria were met. Additionally, checklists improved therapists' confidence with diagnostic decisions, but were not associated with estimations of patients' characteristics. As expected, there were no significant associations between gender and diagnostic decisions.

  11. Exploration of analysis methods for diagnostic imaging tests: problems with ROC AUC and confidence scores in CT colonography.

    Science.gov (United States)

    Mallett, Susan; Halligan, Steve; Collins, Gary S; Altman, Doug G

    2014-01-01

    Different methods of evaluating diagnostic performance when comparing diagnostic tests may lead to different results. We compared two such approaches, sensitivity and specificity with area under the Receiver Operating Characteristic Curve (ROC AUC) for the evaluation of CT colonography for the detection of polyps, either with or without computer assisted detection. In a multireader multicase study of 10 readers and 107 cases we compared sensitivity and specificity, using radiological reporting of the presence or absence of polyps, to ROC AUC calculated from confidence scores concerning the presence of polyps. Both methods were assessed against a reference standard. Here we focus on five readers, selected to illustrate issues in design and analysis. We compared diagnostic measures within readers, showing that differences in results are due to statistical methods. Reader performance varied widely depending on whether sensitivity and specificity or ROC AUC was used. There were problems using confidence scores; in assigning scores to all cases; in use of zero scores when no polyps were identified; the bimodal non-normal distribution of scores; fitting ROC curves due to extrapolation beyond the study data; and the undue influence of a few false positive results. Variation due to use of different ROC methods exceeded differences between test results for ROC AUC. The confidence scores recorded in our study violated many assumptions of ROC AUC methods, rendering these methods inappropriate. The problems we identified will apply to other detection studies using confidence scores. We found sensitivity and specificity were a more reliable and clinically appropriate method to compare diagnostic tests.

  12. 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.)

  13. 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.)

  14. Maintaining Quality and Confidence in Open-Source, Evolving Software: Lessons Learned with PFLOTRAN

    Science.gov (United States)

    Frederick, J. M.; Hammond, G. E.

    2017-12-01

    Software evolution in an open-source framework poses a major challenge to a geoscientific simulator, but when properly managed, the pay-off can be enormous for both the developers and the community at large. Developers must juggle implementing new scientific process models, adopting increasingly efficient numerical methods and programming paradigms, changing funding sources (or total lack of funding), while also ensuring that legacy code remains functional and reported bugs are fixed in a timely manner. With robust software engineering and a plan for long-term maintenance, a simulator can evolve over time incorporating and leveraging many advances in the computational and domain sciences. In this positive light, what practices in software engineering and code maintenance can be employed within open-source development to maximize the positive aspects of software evolution and community contributions while minimizing its negative side effects? This presentation will discusses steps taken in the development of PFLOTRAN (www.pflotran.org), an open source, massively parallel subsurface simulator for multiphase, multicomponent, and multiscale reactive flow and transport processes in porous media. As PFLOTRAN's user base and development team continues to grow, it has become increasingly important to implement strategies which ensure sustainable software development while maintaining software quality and community confidence. In this presentation, we will share our experiences and "lessons learned" within the context of our open-source development framework and community engagement efforts. Topics discussed will include how we've leveraged both standard software engineering principles, such as coding standards, version control, and automated testing, as well unique advantages of object-oriented design in process model coupling, to ensure software quality and confidence. We will also be prepared to discuss the major challenges faced by most open-source software teams, such

  15. Dose reduction in CT while maintaining diagnostic confidence: A feasibility/demonstration study

    International Nuclear Information System (INIS)

    2009-09-01

    In the last 30-40 years, the pace of innovation in medical imaging has increased, starting with the introduction of computed tomography (CT) in the early 1970s. During the last decade, the rate of change has accelerated further, both in terms of continuing innovation and of its global application. The great majority of patient exposure now arises from practices that barely existed two decades ago, and the technological basis for their successful dissemination only began to flourish in the last decade or so. This evolution is evident in the technology on which this publication is based, CT scanning and its widespread application throughout the world. However, this advance is often achieved at the cost of a large radiation burden to the individual patient, and to the community when the technology is widely deployed. Much effort will be required to ensure that the undoubted benefit to be gained will not be achieved at the cost of an undue level of detriment. For practitioners and regulators, it is evident that innovation has been driven by both the imaging industry and an increasing array of new applications validated in the clinical environment. It is evident that regulation, industrial standardization, safety procedures, and advice on best practice lag (inevitably) behind the industrial and clinical innovations. This TECDOC, reporting on a Coordinated Research Project (CRP), is designed to help both the medical community and equipment manufacturers/suppliers make their respective important contributions to dose reduction. In particular, it is possible that significant dose savings may be achieved in individual patients by tailoring the exposure they receive to their individual profile. It should be possible to achieve this without any loss in the level of confidence in the images produced, a possibility examined in this publication. This CRP and TECDOC were developed within the International Atomic Energy Agency's (IAEA) framework of statutory responsibility to

  16. Machine learning classification with confidence: application of transductive conformal predictors to MRI-based diagnostic and prognostic markers in depression.

    Science.gov (United States)

    Nouretdinov, Ilia; Costafreda, Sergi G; Gammerman, Alexander; Chervonenkis, Alexey; Vovk, Vladimir; Vapnik, Vladimir; Fu, Cynthia H Y

    2011-05-15

    There is rapidly accumulating evidence that the application of machine learning classification to neuroimaging measurements may be valuable for the development of diagnostic and prognostic prediction tools in psychiatry. However, current methods do not produce a measure of the reliability of the predictions. Knowing the risk of the error associated with a given prediction is essential for the development of neuroimaging-based clinical tools. We propose a general probabilistic classification method to produce measures of confidence for magnetic resonance imaging (MRI) data. We describe the application of transductive conformal predictor (TCP) to MRI images. TCP generates the most likely prediction and a valid measure of confidence, as well as the set of all possible predictions for a given confidence level. We present the theoretical motivation for TCP, and we have applied TCP to structural and functional MRI data in patients and healthy controls to investigate diagnostic and prognostic prediction in depression. We verify that TCP predictions are as accurate as those obtained with more standard machine learning methods, such as support vector machine, while providing the additional benefit of a valid measure of confidence for each prediction. Copyright © 2010 Elsevier Inc. All rights reserved.

  17. 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.

  18. Implementing an ultrasound-based protocol for diagnosingappendicitis while maintaining diagnostic accuracy

    International Nuclear Information System (INIS)

    Van Atta, Angela J.; Baskin, Henry J.; Maves, Connie K.; Dansie, David M.; Rollins, Michael D.; Bolte, Robert G.; Mundorff, Michael B.; Andrews, Seth P.

    2015-01-01

    The use of ultrasound to diagnose appendicitis in children is well-documented but not universally employed outside of pediatric academic centers, especially in the United States. Various obstacles make it difficult for institutions and radiologists to abandon a successful and accurate CT-based imaging protocol in favor of a US-based protocol. To describe how we overcame barriers to implementing a US-based appendicitis protocol among a large group of nonacademic private-practice pediatric radiologists while maintaining diagnostic accuracy and decreasing medical costs. A multidisciplinary team of physicians (pediatric surgery, pediatric emergency medicine and pediatric radiology) approved an imaging protocol using US as the primary modality to evaluate suspected appendicitis with CT for equivocal cases. The protocol addressed potential bias against US and accommodated for institutional limitations of radiologist and sonographer experience and availability. Radiologists coded US reports according to the probability of appendicitis. Radiology reports were compared with clinical outcomes to assess diagnostic accuracy. During the study period, physicians from each group were apprised of the interim US protocol accuracy results. Problematic cases were discussed openly. A total of 512 children were enrolled and underwent US for evaluation of appendicitis over a 30-month period. Diagnostic accuracy was comparable to published results for combined US/CT protocols. Comparing the first 12 months to the last 12 months of the study period, the proportion of children achieving an unequivocal US result increased from 30% (51/169) to 53% (149/282) and the proportion of children undergoing surgery based solely on US findings increased from 55% (23/42) to 84% (92/109). Overall, 63% (325/512) of patients in the protocol did not require a CT. Total patient costs were reduced by $30,182 annually. We overcame several barriers to implementing a US protocol. During the study period our

  19. Implementing an ultrasound-based protocol for diagnosingappendicitis while maintaining diagnostic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Van Atta, Angela J. [University of Utah School of Medicine, Salt Lake City, UT (United States); Baskin, Henry J.; Maves, Connie K.; Dansie, David M. [Primary Children' s Hospital, Department of Radiology, Salt Lake City, UT (United States); Rollins, Michael D. [University of Utah School of Medicine, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT (United States); Bolte, Robert G. [University of Utah School of Medicine, Department of Pediatrics, Division of Pediatric Emergency Medicine, Salt Lake City, UT (United States); Mundorff, Michael B.; Andrews, Seth P. [Primary Children' s Hospital, Systems Improvement, Salt Lake City, UT (United States)

    2015-05-01

    The use of ultrasound to diagnose appendicitis in children is well-documented but not universally employed outside of pediatric academic centers, especially in the United States. Various obstacles make it difficult for institutions and radiologists to abandon a successful and accurate CT-based imaging protocol in favor of a US-based protocol. To describe how we overcame barriers to implementing a US-based appendicitis protocol among a large group of nonacademic private-practice pediatric radiologists while maintaining diagnostic accuracy and decreasing medical costs. A multidisciplinary team of physicians (pediatric surgery, pediatric emergency medicine and pediatric radiology) approved an imaging protocol using US as the primary modality to evaluate suspected appendicitis with CT for equivocal cases. The protocol addressed potential bias against US and accommodated for institutional limitations of radiologist and sonographer experience and availability. Radiologists coded US reports according to the probability of appendicitis. Radiology reports were compared with clinical outcomes to assess diagnostic accuracy. During the study period, physicians from each group were apprised of the interim US protocol accuracy results. Problematic cases were discussed openly. A total of 512 children were enrolled and underwent US for evaluation of appendicitis over a 30-month period. Diagnostic accuracy was comparable to published results for combined US/CT protocols. Comparing the first 12 months to the last 12 months of the study period, the proportion of children achieving an unequivocal US result increased from 30% (51/169) to 53% (149/282) and the proportion of children undergoing surgery based solely on US findings increased from 55% (23/42) to 84% (92/109). Overall, 63% (325/512) of patients in the protocol did not require a CT. Total patient costs were reduced by $30,182 annually. We overcame several barriers to implementing a US protocol. During the study period our

  20. Faults Diagnostics of Railway Axle Bearings Based on IMF’s Confidence Index Algorithm for Ensemble EMD

    Science.gov (United States)

    Yi, Cai; Lin, Jianhui; Zhang, Weihua; Ding, Jianming

    2015-01-01

    As train loads and travel speeds have increased over time, railway axle bearings have become critical elements which require more efficient non-destructive inspection and fault diagnostics methods. This paper presents a novel and adaptive procedure based on ensemble empirical mode decomposition (EEMD) and Hilbert marginal spectrum for multi-fault diagnostics of axle bearings. EEMD overcomes the limitations that often hypothesize about data and computational efforts that restrict the application of signal processing techniques. The outputs of this adaptive approach are the intrinsic mode functions that are treated with the Hilbert transform in order to obtain the Hilbert instantaneous frequency spectrum and marginal spectrum. Anyhow, not all the IMFs obtained by the decomposition should be considered into Hilbert marginal spectrum. The IMFs’ confidence index arithmetic proposed in this paper is fully autonomous, overcoming the major limit of selection by user with experience, and allows the development of on-line tools. The effectiveness of the improvement is proven by the successful diagnosis of an axle bearing with a single fault or multiple composite faults, e.g., outer ring fault, cage fault and pin roller fault. PMID:25970256

  1. Factors affecting midwives' confidence in intrapartum care: a phenomenological study.

    Science.gov (United States)

    Bedwell, Carol; McGowan, Linda; Lavender, Tina

    2015-01-01

    midwives are frequently the lead providers of care for women throughout labour and birth. In order to perform their role effectively and provide women with the choices they require midwives need to be confident in their practice. This study explores factors which may affect midwives' confidence in their practice. hermeneutic phenomenology formed the theoretical basis for the study. Prospective longitudinal data collection was completed using diaries and semi-structured interviews. Twelve midwives providing intrapartum care in a variety of settings were recruited to ensure a variety of experiences in different contexts were captured. the principal factor affecting workplace confidence, both positively and negatively, was the influence of colleagues. Perceived autonomy and a sense of familiarity could also enhance confidence. However, conflict in the workplace was a critical factor in reducing midwives' confidence. Confidence was an important, but fragile, phenomenon to midwives and they used a variety of coping strategies, emotional intelligence and presentation management to maintain it. this is the first study to highlight both the factors influencing midwives' workplace confidence and the strategies midwives employed to maintain their confidence. Confidence is important in maintaining well-being and workplace culture may play a role in explaining the current low morale within the midwifery workforce. This may have implications for women's choices and care. Support, effective leadership and education may help midwives develop and sustain a positive sense of confidence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Optimum image compression rate maintaining diagnostic image quality of digital intraoral radiographs

    International Nuclear Information System (INIS)

    Song, Ju Seop; Koh, Kwang Joon

    2000-01-01

    The aims of the present study are to determine the optimum compression rate in terms of file size reduction and diagnostic quality of the images after compression and evaluate the transmission speed of original or each compressed images. The material consisted of 24 extracted human premolars and molars. The occlusal surfaces and proximal surfaces of the teeth had a clinical disease spectrum that ranged from sound to varying degrees of fissure discoloration and cavitation. The images from Digora system were exported in TIFF and the images from conventional intraoral film were scanned and digitalized in TIFF by Nikon SF-200 scanner(Nikon, Japan). And six compression factors were chosen and applied on the basis of the results from a pilot study. The total number of images to be assessed were 336. Three radiologists assessed the occlusal and proximal surfaces of the teeth with 5-rank scale. Finally diagnosed as either sound or carious lesion by one expert oral pathologist. And sensitivity and specificity and kappa value for diagnostic agreement was calculated. Also the area (Az) values under the ROC curve were calculated and paired t-test and oneway ANOVA test was performed. Thereafter, transmission time of the image files of the each compression level were compared with that of the original image files. No significant difference was found between original and the corresponding images up to 7% (1:14) compression ratio for both the occlusal and proximal caries (p<0.05). JPEG3 (1:14) image files are transmitted fast more than 10 times, maintained diagnostic information in image, compared with original image files. 1:14 compressed image file may be used instead of the original image and reduce storage needs and transmission time.

  3. 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.

  4. Decision time and confidence predict choosers' identification performance in photographic showups

    Science.gov (United States)

    Sagana, Anna; Sporer, Siegfried L.; Wixted, John T.

    2018-01-01

    In vast contrast to the multitude of lineup studies that report on the link between decision time, confidence, and identification accuracy, only a few studies looked at these associations for showups, with results varying widely across studies. We therefore set out to test the individual and combined value of decision time and post-decision confidence for diagnosing the accuracy of positive showup decisions using confidence-accuracy characteristic curves and Bayesian analyses. Three-hundred-eighty-four participants viewed a stimulus event and were subsequently presented with two showups which could be target-present or target-absent. As expected, we found a negative decision time-accuracy and a positive post-decision confidence-accuracy correlation for showup selections. Confidence-accuracy characteristic curves demonstrated the expected additive effect of combining both postdictors. Likewise, Bayesian analyses, taking into account all possible target-presence base rate values showed that fast and confident identification decisions were more diagnostic than slow or less confident decisions, with the combination of both being most diagnostic for postdicting accurate and inaccurate decisions. The postdictive value of decision time and post-decision confidence was higher when the prior probability that the suspect is the perpetrator was high compared to when the prior probability that the suspect is the perpetrator was low. The frequent use of showups in practice emphasizes the importance of these findings for court proceedings. Overall, these findings support the idea that courts should have most trust in showup identifications that were made fast and confidently, and least in showup identifications that were made slowly and with low confidence. PMID:29346394

  5. Confidence and clinical judgement in community nurses managing venous leg ulceration - A judgement analysis.

    Science.gov (United States)

    Adderley, Una J; Thompson, Carl

    2017-11-01

    The variation in the management of venous leg ulceration in the UK is partly attributable to an uncertain clinical environment but the quality of judgements is influenced by the how well nurses' confidence and accuracy are aligned. To assess UK community nurses' confidence in the accuracy of their diagnostic judgements and treatment choices when managing venous leg ulceration. Judgement Analysis. UK community and primary care nursing services. 18 community non-specialist nurses working in district (home) nursing teams and general practitioner services and 18 community tissue viability specialist nurses. Using judgement analysis methods, 18 community non-specialist nurses and 18 community tissue viability specialist nurses made diagnoses and treatment judgements about compression therapy for 110 clinical scenarios and indicated their confidence for each judgement. An expert panel made consensus judgements for the same scenarios and these judgements were used as a standard against which to compare the participants. Confidence analysis was used to assess the nurses' confidence about their diagnostic judgements and treatment choices. Despite being very experienced, both non-specialist nurses' and specialist tissue viability nurses' levels of confidence were not well calibrated with their levels of accuracy. The results of this study are important as errors resulting from both over and under-confidence at the diagnostic phase of management may influence treatment choices, and thus increase the chances of treatment error. Copyright © 2017 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  6. Joint confidence region estimation for area under ROC curve and Youden index.

    Science.gov (United States)

    Yin, Jingjing; Tian, Lili

    2014-03-15

    In the field of diagnostic studies, the area under the ROC curve (AUC) serves as an overall measure of a biomarker/diagnostic test's accuracy. Youden index, defined as the overall correct classification rate minus one at the optimal cut-off point, is another popular index. For continuous biomarkers of binary disease status, although researchers mainly evaluate the diagnostic accuracy using AUC, for the purpose of making diagnosis, Youden index provides an important and direct measure of the diagnostic accuracy at the optimal threshold and hence should be taken into consideration in addition to AUC. Furthermore, AUC and Youden index are generally correlated. In this paper, we initiate the idea of evaluating diagnostic accuracy based on AUC and Youden index simultaneously. As the first step toward this direction, this paper only focuses on the confidence region estimation of AUC and Youden index for a single marker. We present both parametric and non-parametric approaches for estimating joint confidence region of AUC and Youden index. We carry out extensive simulation study to evaluate the performance of the proposed methods. In the end, we apply the proposed methods to a real data set. Copyright © 2013 John Wiley & Sons, Ltd.

  7. Frontline nurse managers' confidence and self-efficacy.

    Science.gov (United States)

    Van Dyk, Jennifer; Siedlecki, Sandra L; Fitzpatrick, Joyce J

    2016-05-01

    This study was focused on determining relationships between confidence levels and self-efficacy among nurse managers. Frontline nurse managers have a pivotal role in delivering high-quality patient care while managing the associated costs and resources. The competency and skill of nurse managers affect every aspect of patient care and staff well-being as nurse managers are largely responsible for creating work environments in which clinical nurses are able to provide high-quality, patient-centred, holistic care. A descriptive, correlational survey design was used; 85 nurse managers participated. Years in a formal leadership role and confidence scores were found to be significant predictors of self-efficacy scores. Experience as a nurse manager is an important component of confidence and self-efficacy. There is a need to develop educational programmes for nurse managers to enhance their self-confidence and self-efficacy, and to maintain experienced nurse managers in the role. © 2016 John Wiley & Sons Ltd.

  8. Building Supervisory Confidence--A Key to Transfer of Training

    Science.gov (United States)

    Byham, William C.; Robinson, James

    1977-01-01

    A training concept is described which suggests that efforts toward maintaining and/or building the confidence of the participants in supervisory training programs can increase their likelihood of using the skills on the job. (TA)

  9. Summary of EPRI projects for improving power plant maintenance and maintainability

    International Nuclear Information System (INIS)

    Shugars, H.G.; Poole, D.N.; Pack, R.W.

    1979-01-01

    The Electric Power Research Institute is sponsoring projects to improve power plant maintenance and maintainability. Areas presently being emphasized are improvements in plant design for maintainability, improvements in performing nuclear plant refuelings, and development of on-line monitoring and diagnostic systems for various plant components. The seven projects are reviewed. They are: (1) human factors review of power plant maintainability; (2) refueling outage improvement; (3) on-line monitoring and diagnostics for power plant machinery; (4) acoustic emission and vibrati1on signature analysis of fossil fuel plant components; (5) acoustic monitoring of power plant valves; (6) on-line monitoring and diagnostics for generators; and (7) detection of water induction in steam turbines. Each project contractor and the project manager are listed for reference. 8 references

  10. North Dakota Leadership Training Boosts Confidence and Involvement

    Science.gov (United States)

    Flage, Lynette; Hvidsten, Marie; Vettern, Rachelle

    2012-01-01

    Effective leadership is critical for communities as they work to maintain their vitality and sustainability for years to come. The purpose of the study reported here was to assess confidence levels and community engagement of community leadership program participants in North Dakota State University Extension programs. Through a survey…

  11. Can the implementation of aerospace science in elementary school help girls maintain their confidence and engagement in science as they transition to middle school?

    Science.gov (United States)

    Solberg, Margot

    2018-06-01

    There is a global crisis due to a lack of qualified applicants entering STEM careers, especially in science. Add the fact that women are greatly underrepresented in science, and the solution becomes obvious. Go to the source, and find out why girls as young as 12 years old are losing an interest in scientific endeavors that they once found to be captivating. This action research project sought to find out if the implementation of aerospace science, embedded both in the classroom and in an after school Space Club, could assist girls in maintaining their confidence and engagement in science overall as they transition to middle school. Furthermore, girls in fifth through seventh grade, who had previously been the teacher researcher's students, were included in the study in order to discover if their previous participation in a variety of authentic and ongoing aerospace activities had any impact upon their engagement in science as they entered the notable years of declined interest. The research took place at an international American school, Academia Cotopaxi, in Quito, Ecuador from September 2015 through April 2016. Data was collected through both qualitative and quantitative sources, and included attitude surveys, parent questionnaires, a writing prompt, photos, video, interviews and observations. Additionally, a control group was utilized in grades five to seven for purposes of comparison. Innovative activities included engaging and first-hand experiences with the Ecuadorian Civilian Space Agency (EXA), the National Aeronautics Space Administration (NASA), Space X and the Canadian Space Agency (CSA). Inquiry-based activities included, but were not limited to, experiences with: speaking live with both astronauts and cosmonauts on the International Space Station, robotics, rocketry, Skype chats with aerospace professionals, utilizing the Design Process, online resources and more. Findings suggested that embedding aerospace science in grade four, both during and after

  12. Can follow-up controls improve the confidence of MR of the breast? A retrospective analysis of follow-up MR images of the breast

    International Nuclear Information System (INIS)

    Betsch, A.; Arndt, E.; Stern, W.; Claussen, C.D.; Mueller-Schimpfle, M.; Wallwiener, D.

    2001-01-01

    Purpose: To assess the change in diagnostic confidence between first and follow-up dynamic MR examination of the breast (MRM). Methods: The reports of a total of 175 MRM in 77 patients (mean age 50 years; 36-76) with 98 follow-up MRM were analyzed. All examinations were performed as a dynamic study (Gd-DTPA, 0.16 mmol/kg; 6-7 repetitive studies). The change in diagnostic confidence was retrospectively classified as follows: Controlled lesion vanished during follow-up (category I); diagnostic confidence increases during follow-up (II), more likely benign (IIa), more suspicious (IIb); no difference in diagnostic confidence (III). Long-term follow-up over an average of four years was obtained for 57 patients with category IIa/III findings. Results: In 98 follow-up examinations, only two lesions vanished (2%). In 77/98 cases a category IIa lesion was diagnosed, in 11 cases a category IIb lesion. In 8 cases (8%) there was no change in diagnostic confidence during follow-up. Lesions in category IIb underwent biopsy in 10/11 cases, in one case long-term follow-up proved a completely regredient inflammatory change. In 8/11 suspicious findings (IIb) a malignant tumor was detected. The mean time interval between first and follow-up MRM was 8 months for I-IIb lesions, and 4 months for category III lesions. In the longterm follow-up two patients with a category II a lesion developed a carcinoma in a different breast area after four and five years. Conclusion: MRM follow up increases the diagnostic confidence if the time interval is adequate (>4 months). A persistently or increasingly suspicious finding warrants biopsy. (orig.) [de

  13. Assessing confidence in management adaptation approaches for climate-sensitive ecosystems

    International Nuclear Information System (INIS)

    West, J M; Julius, S H; Weaver, C P

    2012-01-01

    A number of options are available for adapting ecosystem management to improve resilience in the face of climatic changes. However, uncertainty exists as to the effectiveness of these options. A report prepared for the US Climate Change Science Program reviewed adaptation options for a range of federally managed systems in the United States. The report included a qualitative uncertainty analysis of conceptual approaches to adaptation derived from the review. The approaches included reducing anthropogenic stressors, protecting key ecosystem features, maintaining representation, replicating, restoring, identifying refugia and relocating organisms. The results showed that the expert teams had the greatest scientific confidence in adaptation options that reduce anthropogenic stresses. Confidence in other approaches was lower because of gaps in understanding of ecosystem function, climate change impacts on ecosystems, and management effectiveness. This letter discusses insights gained from the confidence exercise and proposes strategies for improving future assessments of confidence for management adaptations to climate change. (letter)

  14. Building Public Confidence in Nuclear Activities

    International Nuclear Information System (INIS)

    Isaacs, T

    2002-01-01

    Achieving public acceptance has become a central issue in discussions regarding the future of nuclear power and associated nuclear activities. Effective public communication and public participation are often put forward as the key building blocks in garnering public acceptance. A recent international workshop in Finland provided insights into other features that might also be important to building and sustaining public confidence in nuclear activities. The workshop was held in Finland in close cooperation with Finnish stakeholders. This was most appropriate because of the recent successes in achieving positive decisions at the municipal, governmental, and Parliamentary levels, allowing the Finnish high-level radioactive waste repository program to proceed, including the identification and approval of a proposed candidate repository site. Much of the workshop discussion appropriately focused on the roles of public participation and public communications in building public confidence. It was clear that well constructed and implemented programs of public involvement and communication and a sense of fairness were essential in building the extent of public confidence needed to allow the repository program in Finland to proceed. It was also clear that there were a number of other elements beyond public involvement that contributed substantially to the success in Finland to date. And, in fact, it appeared that these other factors were also necessary to achieving the Finnish public acceptance. In other words, successful public participation and communication were necessary but not sufficient. What else was important? Culture, politics, and history vary from country to country, providing differing contexts for establishing and maintaining public confidence. What works in one country will not necessarily be effective in another. Nonetheless, there appear to be certain elements that might be common to programs that are successful in sustaining public confidence and some of

  15. Building Public Confidence in Nuclear Activities

    International Nuclear Information System (INIS)

    Isaacs, T

    2002-01-01

    Achieving public acceptance has become a central issue in discussions regarding the future of nuclear power and associated nuclear activities. Effective public communication and public participation are often put forward as the key building blocks in garnering public acceptance. A recent international workshop in Finland provided insights into other features that might also be important to building and sustaining public confidence in nuclear activities. The workshop was held in Finland in close cooperation with Finnish stakeholders. This was most appropriate because of the recent successes in achieving positive decisions at the municipal, governmental, and Parliamentary levels, allowing the Finnish high-level radioactive waste repository program to proceed, including the identification and approval of a proposed candidate repository site Much of the workshop discussion appropriately focused on the roles of public participation and public communications in building public confidence. It was clear that well constructed and implemented programs of public involvement and communication and a sense of fairness were essential in building the extent of public confidence needed to allow the repository program in Finland to proceed. It was also clear that there were a number of other elements beyond public involvement that contributed substantially to the success in Finland to date. And, in fact, it appeared that these other factors were also necessary to achieving the Finnish public acceptance. In other words, successful public participation and communication were necessary but not sufficient. What else was important? Culture, politics, and history vary from country to country, providing differing contexts for establishing and maintaining public confidence. What works in one country will not necessarily be effective in another. Nonetheless, there appear to be certain elements that might be common to programs that are successful in sustaining public confidence, and some of

  16. Assessment of cartilage-dedicated sequences at ultra-high-field MRI: comparison of imaging performance and diagnostic confidence between 3.0 and 7.0 T with respect to osteoarthritis-induced changes at the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Stahl, Robert [University of California, Musculoskeletal and Quantitative Imaging Group, Department of Radiology, San Francisco, CA (United States); University Hospitals - Campus Grosshadern, Ludwig Maximilians University of Munich, Department of Clinical Radiology, Munich (Germany); Krug, Roland; Zuo, Jin; Majumdar, Sharmila; Link, Thomas M. [University of California, Musculoskeletal and Quantitative Imaging Group, Department of Radiology, San Francisco, CA (United States); Kelley, Douglas A.C. [General Electrics Healthcare Technologies, San Francisco, CA (United States); Ma, C.B. [University of California, Department of Orthopedic Surgery, San Francisco, CA (United States)

    2009-08-15

    The objectives of the study were to optimize three cartilage-dedicated sequences for in vivo knee imaging at 7.0 T ultra-high-field (UHF) magnetic resonance imaging (MRI) and to compare imaging performance and diagnostic confidence concerning osteoarthritis (OA)-induced changes at 7.0 and 3.0 T MRI. Optimized MRI sequences for cartilage imaging at 3.0 T were tailored for 7.0 T: an intermediate-weighted fast spin-echo (IM-w FSE), a fast imaging employing steady-state acquisition (FIESTA) and a T1-weighted 3D high-spatial-resolution volumetric fat-suppressed spoiled gradient-echo (SPGR) sequence. Three healthy subjects and seven patients with mild OA were examined. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), diagnostic confidence in assessing cartilage abnormalities, and image quality were determined. Abnormalities were assessed with the whole organ magnetic resonance imaging score (WORMS). Focal cartilage lesions and bone marrow edema pattern (BMEP) were also quantified. At 7.0 T, SNR was increased (p<0.05) for all sequences. For the IM-w FSE sequence, limitations with the specific absorption rate (SAR) required modifications of the scan parameters yielding an incomplete coverage of the knee joint, extensive artifacts, and a less effective fat saturation. CNR and image quality were increased (p<0.05) for SPGR and FIESTA and decreased for IM-w FSE. Diagnostic confidence for cartilage lesions was highest (p<0.05) for FIESTA at 7.0 T. Evaluation of BMEP was decreased (p < 0.05) at 7.0 T due to limited performance of IM-w FSE. Gradient echo-based pulse sequences like SPGR and FIESTA are well suited for imaging at UHF which may improve early detection of cartilage lesions. However, UHF IM-w FSE sequences are less feasible for clinical use. (orig.)

  17. Assessment of cartilage-dedicated sequences at ultra-high-field MRI: comparison of imaging performance and diagnostic confidence between 3.0 and 7.0 T with respect to osteoarthritis-induced changes at the knee joint

    International Nuclear Information System (INIS)

    Stahl, Robert; Krug, Roland; Zuo, Jin; Majumdar, Sharmila; Link, Thomas M.; Kelley, Douglas A.C.; Ma, C.B.

    2009-01-01

    The objectives of the study were to optimize three cartilage-dedicated sequences for in vivo knee imaging at 7.0 T ultra-high-field (UHF) magnetic resonance imaging (MRI) and to compare imaging performance and diagnostic confidence concerning osteoarthritis (OA)-induced changes at 7.0 and 3.0 T MRI. Optimized MRI sequences for cartilage imaging at 3.0 T were tailored for 7.0 T: an intermediate-weighted fast spin-echo (IM-w FSE), a fast imaging employing steady-state acquisition (FIESTA) and a T1-weighted 3D high-spatial-resolution volumetric fat-suppressed spoiled gradient-echo (SPGR) sequence. Three healthy subjects and seven patients with mild OA were examined. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), diagnostic confidence in assessing cartilage abnormalities, and image quality were determined. Abnormalities were assessed with the whole organ magnetic resonance imaging score (WORMS). Focal cartilage lesions and bone marrow edema pattern (BMEP) were also quantified. At 7.0 T, SNR was increased (p<0.05) for all sequences. For the IM-w FSE sequence, limitations with the specific absorption rate (SAR) required modifications of the scan parameters yielding an incomplete coverage of the knee joint, extensive artifacts, and a less effective fat saturation. CNR and image quality were increased (p<0.05) for SPGR and FIESTA and decreased for IM-w FSE. Diagnostic confidence for cartilage lesions was highest (p<0.05) for FIESTA at 7.0 T. Evaluation of BMEP was decreased (p < 0.05) at 7.0 T due to limited performance of IM-w FSE. Gradient echo-based pulse sequences like SPGR and FIESTA are well suited for imaging at UHF which may improve early detection of cartilage lesions. However, UHF IM-w FSE sequences are less feasible for clinical use. (orig.)

  18. Functional Dissociation of Confident and Not-Confident Errors in the Spatial Delayed Response Task Demonstrates Impairments in Working Memory Encoding and Maintenance in Schizophrenia

    Directory of Open Access Journals (Sweden)

    Jutta S. Mayer

    2018-05-01

    Full Text Available Even though extensively investigated, the nature of working memory (WM deficits in patients with schizophrenia (PSZ is not yet fully understood. In particular, the contribution of different WM sub-processes to the severe WM deficit observed in PSZ is a matter of debate. So far, most research has focused on impaired WM maintenance. By analyzing different types of errors in a spatial delayed response task (DRT, we have recently demonstrated that incorrect yet confident responses (which we labeled as false memory errors rather than incorrect/not-confident responses reflect failures of WM encoding, which was also impaired in PSZ. In the present study, we provide further evidence for a functional dissociation between confident and not-confident errors by manipulating the demands on WM maintenance, i.e., the length over which information has to be maintained in WM. Furthermore, we investigate whether these functionally distinguishable WM processes are impaired in PSZ. Twenty-four PSZ and 24 demographically matched healthy controls (HC performed a spatial DRT in which the length of the delay period was varied between 1, 2, 4, and 6 s. In each trial, participants also rated their level of response confidence. Across both groups, longer delays led to increased rates of incorrect/not-confident responses, while incorrect/confident responses were not affected by delay length. This functional dissociation provides additional support for our proposal that false memory errors (i.e., confident errors reflect problems at the level of WM encoding, while not-confident errors reflect failures of WM maintenance. Schizophrenic patients showed increased numbers of both confident and not-confident errors, suggesting that both sub-processes of WM—encoding and maintenance—are impaired in schizophrenia. Combined with the delay length-dependent functional dissociation, we propose that these impairments in schizophrenic patients are functionally distinguishable.

  19. Effects of parental divorce on marital commitment and confidence.

    Science.gov (United States)

    Whitton, Sarah W; Rhoades, Galena K; Stanley, Scott M; Markman, Howard J

    2008-10-01

    Research on the intergenerational transmission of divorce has demonstrated that compared with offspring of nondivorced parents, those of divorced parents generally have more negative attitudes toward marriage as an institution and are less optimistic about the feasibility of a long-lasting, healthy marriage. It is also possible that when entering marriage themselves, adults whose parents divorced have less personal relationship commitment to their own marriages and less confidence in their own ability to maintain a happy marriage with their spouse. However, this prediction has not been tested. In the current study, we assessed relationship commitment and relationship confidence, as well as parental divorce and retrospectively reported interparental conflict, in a sample of 265 engaged couples prior to their first marriage. Results demonstrated that women's, but not men's, parental divorce was associated with lower relationship commitment and lower relationship confidence. These effects persisted when controlling for the influence of recalled interparental conflict and premarital relationship adjustment. The current findings suggest that women whose parents divorced are more likely to enter marriage with relatively lower commitment to, and confidence in, the future of those marriages, potentially raising their risk for divorce. Copyright 2008 APA, all rights reserved.

  20. The Relationship between Clinicians' Confidence and Accuracy, and the Influence of Child Characteristics, in the Screening of Autism Spectrum Disorder

    Science.gov (United States)

    Hedley, Darren; Brewer, Neil; Nevill, Rose; Uljarevic, Mirko; Butter, Eric; Mulick, James A.

    2016-01-01

    The study examined the confidence accuracy relationship, and the influence of child characteristics on clinician confidence, when predicting a diagnosis of Autism Spectrum Disorder during screening of 125 referred children aged under 3.5 years. The diagnostic process included observation, interview, language and developmental testing. Clinical…

  1. Multimodality Molecular Imaging (FDG-PET/CT, US Elastography, and DWI-MRI) as Complimentary Adjunct for Enhancing Diagnostic Confidence in Reported Intermediate Risk Category Thyroid Nodules on Bethesda Thyroid Cytopathology Reporting System

    International Nuclear Information System (INIS)

    Basu, Sandip; Mahajan, Abhishek; Arya, Supreeta

    2016-01-01

    The potential complimentary role of various molecular imaging modalities [fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT), ultrasound (US)-elastography, and diffusion weighted imaging-magnetic resonance imaging (DWI-MRI)] in characterizing thyroid nodules, which have been designated as “intermediate risk category” on the Bethesda thyroid cytopathology reporting system (BTCRS), is illustrated in this communication. The clinical cases described (category III thyroid nodules on BTCRS) show the imaging features and the final diagnostic impressions rendered by the interpreting physicians with the modalities that have been independently compared in a tabular format at the end; of particular note is the high negative predictive value of these (specifically FDG-PET/CT), which could aid in enhancing the diagnostic confidence in the reported “intermediate risk category” thyroid nodules, a “gray zone” from the patient management viewpoint

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-11-01

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

  4. Confidence interval procedures for Monte Carlo transport simulations

    International Nuclear Information System (INIS)

    Pederson, S.P.

    1997-01-01

    The problem of obtaining valid confidence intervals based on estimates from sampled distributions using Monte Carlo particle transport simulation codes such as MCNP is examined. Such intervals can cover the true parameter of interest at a lower than nominal rate if the sampled distribution is extremely right-skewed by large tallies. Modifications to the standard theory of confidence intervals are discussed and compared with some existing heuristics, including batched means normality tests. Two new types of diagnostics are introduced to assess whether the conditions of central limit theorem-type results are satisfied: the relative variance of the variance determines whether the sample size is sufficiently large, and estimators of the slope of the right tail of the distribution are used to indicate the number of moments that exist. A simulation study is conducted to quantify the relationship between various diagnostics and coverage rates and to find sample-based quantities useful in indicating when intervals are expected to be valid. Simulated tally distributions are chosen to emulate behavior seen in difficult particle transport problems. Measures of variation in the sample variance s 2 are found to be much more effective than existing methods in predicting when coverage will be near nominal rates. Batched means tests are found to be overly conservative in this regard. A simple but pathological MCNP problem is presented as an example of false convergence using existing heuristics. The new methods readily detect the false convergence and show that the results of the problem, which are a factor of 4 too small, should not be used. Recommendations are made for applying these techniques in practice, using the statistical output currently produced by MCNP

  5. Using the confidence interval confidently.

    Science.gov (United States)

    Hazra, Avijit

    2017-10-01

    Biomedical research is seldom done with entire populations but rather with samples drawn from a population. Although we work with samples, our goal is to describe and draw inferences regarding the underlying population. It is possible to use a sample statistic and estimates of error in the sample to get a fair idea of the population parameter, not as a single value, but as a range of values. This range is the confidence interval (CI) which is estimated on the basis of a desired confidence level. Calculation of the CI of a sample statistic takes the general form: CI = Point estimate ± Margin of error, where the margin of error is given by the product of a critical value (z) derived from the standard normal curve and the standard error of point estimate. Calculation of the standard error varies depending on whether the sample statistic of interest is a mean, proportion, odds ratio (OR), and so on. The factors affecting the width of the CI include the desired confidence level, the sample size and the variability in the sample. Although the 95% CI is most often used in biomedical research, a CI can be calculated for any level of confidence. A 99% CI will be wider than 95% CI for the same sample. Conflict between clinical importance and statistical significance is an important issue in biomedical research. Clinical importance is best inferred by looking at the effect size, that is how much is the actual change or difference. However, statistical significance in terms of P only suggests whether there is any difference in probability terms. Use of the CI supplements the P value by providing an estimate of actual clinical effect. Of late, clinical trials are being designed specifically as superiority, non-inferiority or equivalence studies. The conclusions from these alternative trial designs are based on CI values rather than the P value from intergroup comparison.

  6. [The relation of the patient's condition and outcome of drug maintainance therapy in schizophrenia (analysis of the curative effect in 324 cases)].

    Science.gov (United States)

    Zhang, Z

    1989-12-01

    Cf, the methodology and diagnostic standard of 12 collaborative units about "Epidemiological investigation" of 1982, we traced to investigate the relation between the patients' condition outcome and drug maintain therapy of 324 cases with schizophrenia in community. The investigative result showed the cure rate of insisting on taking medicine group was 25.21%, the effective rate was 97.48%, the cure rate of irregular taking medicine groups was 6.63%, the effective rate was 68.37%, there was remarkable difference between the cure rate and the effective rate in two groups. Otherwise we also compared the patients, condition of insisting on taking drug groups with during investigation. We found there was no remarkable change that showed insisting a drug maintain therapy out the hospital to the curative effect of the disease to possess on important meaning. The pattern also compared the curative effect of a time onset of disease group and many times. There was no remarkable difference about the statistical analysis of the curative effect among each group. It showed me never lose confidence to the patients. We should treat actively them.

  7. ITER diagnostic system: Vacuum interface

    Energy Technology Data Exchange (ETDEWEB)

    Patel, K.M., E-mail: Kaushal.Patel@iter.org [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-Lez-Durance (France); Udintsev, V.S.; Hughes, S.; Walker, C.I.; Andrew, P.; Barnsley, R.; Bertalot, L. [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-Lez-Durance (France); Drevon, J.M. [Bertin Technologies, BP 22, 13762 Aix-en Provence cedex 3 (France); Encheva, A. [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-Lez-Durance (France); Kashchuk, Y. [Institution “PROJECT CENTER ITER”, 1, Akademika Kurchatova pl., Moscow (Russian Federation); Maquet, Ph. [Bertin Technologies, BP 22, 13762 Aix-en Provence cedex 3 (France); Pearce, R.; Taylor, N.; Vayakis, G.; Walsh, M.J. [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-Lez-Durance (France)

    2013-10-15

    Diagnostics play an essential role for the successful operation of the ITER tokamak. They provide the means to observe control and to measure plasma during the operation of ITER tokamak. The components of the diagnostic system in the ITER tokamak will be installed in the vacuum vessel, in the cryostat, in the upper, equatorial and divertor ports, in the divertor cassettes and racks, as well as in various buildings. Diagnostic components that are placed in a high radiation environment are expected to operate for the life of ITER. There are approx. 45 diagnostic systems located on ITER. Some diagnostics incorporate direct or independently pumped extensions to maintain their necessary vacuum conditions. They require a base pressure less than 10{sup −7} Pa, irrespective of plasma operation, and a leak rate of less than 10{sup −10} Pa m{sup 3} s{sup −1}. In all the cases it is essential to maintain the ITER closed fuel cycle. These directly coupled diagnostic systems are an integral part of the ITER vacuum containment and are therefore subject to the same design requirements for tritium and active gas confinement, for all normal and accidental conditions. All the diagnostics, whether or not pumped, incorporate penetration of the vacuum boundary (i.e. window assembly, vacuum feedthrough etc.) and demountable joints. Monitored guard volumes are provided for all elements of the vacuum boundary that are judged to be vulnerable by virtue of their construction, material, load specification etc. Standard arrangements are made for their construction and for the monitoring, evacuating and leak testing of these volumes. Diagnostic systems are incorporated at more than 20 ports on ITER. This paper will describe typical and particular arrangements of pumped diagnostic and monitored guard volume. The status of the diagnostic vacuum systems, which are at the start of their detailed design, will be outlined and the specific features of the vacuum systems in ports and extensions

  8. ITER diagnostic system: Vacuum interface

    International Nuclear Information System (INIS)

    Patel, K.M.; Udintsev, V.S.; Hughes, S.; Walker, C.I.; Andrew, P.; Barnsley, R.; Bertalot, L.; Drevon, J.M.; Encheva, A.; Kashchuk, Y.; Maquet, Ph.; Pearce, R.; Taylor, N.; Vayakis, G.; Walsh, M.J.

    2013-01-01

    Diagnostics play an essential role for the successful operation of the ITER tokamak. They provide the means to observe control and to measure plasma during the operation of ITER tokamak. The components of the diagnostic system in the ITER tokamak will be installed in the vacuum vessel, in the cryostat, in the upper, equatorial and divertor ports, in the divertor cassettes and racks, as well as in various buildings. Diagnostic components that are placed in a high radiation environment are expected to operate for the life of ITER. There are approx. 45 diagnostic systems located on ITER. Some diagnostics incorporate direct or independently pumped extensions to maintain their necessary vacuum conditions. They require a base pressure less than 10 −7 Pa, irrespective of plasma operation, and a leak rate of less than 10 −10 Pa m 3 s −1 . In all the cases it is essential to maintain the ITER closed fuel cycle. These directly coupled diagnostic systems are an integral part of the ITER vacuum containment and are therefore subject to the same design requirements for tritium and active gas confinement, for all normal and accidental conditions. All the diagnostics, whether or not pumped, incorporate penetration of the vacuum boundary (i.e. window assembly, vacuum feedthrough etc.) and demountable joints. Monitored guard volumes are provided for all elements of the vacuum boundary that are judged to be vulnerable by virtue of their construction, material, load specification etc. Standard arrangements are made for their construction and for the monitoring, evacuating and leak testing of these volumes. Diagnostic systems are incorporated at more than 20 ports on ITER. This paper will describe typical and particular arrangements of pumped diagnostic and monitored guard volume. The status of the diagnostic vacuum systems, which are at the start of their detailed design, will be outlined and the specific features of the vacuum systems in ports and extensions will be described

  9. Indeterminate solid hepatic lesions identified on non-diagnostic contrast-enhanced computed tomography: Assessment of the additional diagnostic value of contrast-enhanced ultrasound in the non-cirrhotic liver

    International Nuclear Information System (INIS)

    Quaia, Emilio; De Paoli, Luca; Angileri, Roberta; Cabibbo, Biagio; Cova, Maria Assunta

    2014-01-01

    Objective: To assess the additional diagnostic value of contrast-enhanced ultrasound (CEUS) in the characterization of indeterminate solid hepatic lesions identified on non-diagnostic contrast-enhanced computed tomography (CT). Methods: Fifty-five solid hepatic lesions (1–4 cm in diameter) in 46 non-cirrhotic patients (26 female, 20 male; age ± SD, 55 ± 10 years) underwent CEUS after being detected on contrast-enhanced CT which was considered as non-diagnostic after on-site analysis. Two blinded independent readers assessed CT and CEUS scans and were asked to classify retrospectively each lesion as a malignant or benign based on reference diagnostic criteria for the different hepatic lesion histotypes. Diagnostic accuracy and confidence (area – A z – under ROC curve) were assessed by using gadobenate dimeglumine-enhanced magnetic resonance (MR) imaging (n = 30 lesions), histology (n = 7 lesions), or US follow-up (n = 18 lesions) as the reference standards. Results: Final diagnoses included 29 hemangiomas, 3 focal nodular hyperplasias, 1 hepatocellular adenoma, and 22 metastases. The additional review of CEUS after CT images improved significantly (P < .05) the diagnostic accuracy (before vs after CEUS review = 49% [20/55] vs 89% [49/55] – reader 1 and 43% [24/55] vs 92% [51/55] – reader 2) and confidence (A z , 95% Confidence Intervals before vs after CEUS review = .773 [.652–.895] vs .997 [.987–1] – reader 1 and .831 [.724–.938] vs .998 [.992–1] – reader 2). Conclusions: CEUS improved the characterization of indeterminate solid hepatic lesions identified on non-diagnostic contrast-enhanced CT by identifying some specific contrast enhancement patterns.

  10. Confidence interval estimation of the difference between two sensitivities to the early disease stage.

    Science.gov (United States)

    Dong, Tuochuan; Kang, Le; Hutson, Alan; Xiong, Chengjie; Tian, Lili

    2014-03-01

    Although most of the statistical methods for diagnostic studies focus on disease processes with binary disease status, many diseases can be naturally classified into three ordinal diagnostic categories, that is normal, early stage, and fully diseased. For such diseases, the volume under the ROC surface (VUS) is the most commonly used index of diagnostic accuracy. Because the early disease stage is most likely the optimal time window for therapeutic intervention, the sensitivity to the early diseased stage has been suggested as another diagnostic measure. For the purpose of comparing the diagnostic abilities on early disease detection between two markers, it is of interest to estimate the confidence interval of the difference between sensitivities to the early diseased stage. In this paper, we present both parametric and non-parametric methods for this purpose. An extensive simulation study is carried out for a variety of settings for the purpose of evaluating and comparing the performance of the proposed methods. A real example of Alzheimer's disease (AD) is analyzed using the proposed approaches. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Confidant Relations in Italy

    Directory of Open Access Journals (Sweden)

    Jenny Isaacs

    2015-02-01

    Full Text Available Confidants are often described as the individuals with whom we choose to disclose personal, intimate matters. The presence of a confidant is associated with both mental and physical health benefits. In this study, 135 Italian adults responded to a structured questionnaire that asked if they had a confidant, and if so, to describe various features of the relationship. The vast majority of participants (91% reported the presence of a confidant and regarded this relationship as personally important, high in mutuality and trust, and involving minimal lying. Confidants were significantly more likely to be of the opposite sex. Participants overall were significantly more likely to choose a spouse or other family member as their confidant, rather than someone outside of the family network. Familial confidants were generally seen as closer, and of greater value, than non-familial confidants. These findings are discussed within the context of Italian culture.

  12. Automatic volumetry on MR brain images can support diagnostic decision making

    Directory of Open Access Journals (Sweden)

    Aviv Richard I

    2008-05-01

    Full Text Available Abstract Background Diagnostic decisions in clinical imaging currently rely almost exclusively on visual image interpretation. This can lead to uncertainty, for example in dementia disease, where some of the changes resemble those of normal ageing. We hypothesized that extracting volumetric data from patients' MR brain images, relating them to reference data and presenting the results as a colour overlay on the grey scale data would aid diagnostic readers in classifying dementia disease versus normal ageing. Methods A proof-of-concept forced-choice reader study was designed using MR brain images from 36 subjects. Images were segmented into 43 regions using an automatic atlas registration-based label propagation procedure. Seven subjects had clinically probable AD, the remaining 29 of a similar age range were used as controls. Seven of the control subject data sets were selected at random to be presented along with the seven AD datasets to two readers, who were blinded to all clinical and demographic information except age and gender. Readers were asked to review the grey scale MR images and to record their choice of diagnosis (AD or non-AD along with their confidence in this decision. Afterwards, readers were given the option to switch on a false-colour overlay representing the relative size of the segmented structures. Colorization was based on the size rank of the test subject when compared with a reference group consisting of the 22 control subjects who were not used as review subjects. The readers were then asked to record whether and how the additional information had an impact on their diagnostic confidence. Results The size rank colour overlays were useful in 18 of 28 diagnoses, as determined by their impact on readers' diagnostic confidence. A not useful result was found in 6 of 28 cases. The impact of the additional information on diagnostic confidence was significant (p Conclusion Volumetric anatomical information extracted from brain

  13. A general model of confidence building: analysis and implications

    International Nuclear Information System (INIS)

    Kilgour, D.M.

    1998-01-01

    For more than two decades, security approaches in Europe have included confidence building. Many have argued that Confidence-Building Measures (CBMS) played an essential role in the enormous transformations that took place there. Thus, it is hardly,surprising that CBMs have been proposed as measures to reduce tensions and transform security relationships elsewhere in the world. The move toward wider application of CBMs has strengthened recently, as conventional military, diplomatic, and humanitarian approaches seem to have failed to address problems associated with peace-building and peace support operations. There is, however, a serious problem. We don't really know why, or even how, CBMs work. Consequently, we have no reliable way to design CBMs that would be appropriate in substance, form, and timing for regions culturally, geographically, and militarily different from Europe. Lacking a solid understanding of confidence building, we are handicapped in our efforts to extend its successes to the domain of peace building and peace support. To paraphrase Macintosh, if we don't know how CBMs succeeded in the past, then we are unlikely to be good at maintaining, improving, or extending them. The specific aim of this project is to step into this gap, using the methods of game theory to clarify some aspects of the underlying logic of confidence building. Formal decision models will be shown to contribute new and valuable insights that will assist in the design of CBMs to contribute to new problems and in new arenas. (author)

  14. A high confidence, manually validated human blood plasma protein reference set

    DEFF Research Database (Denmark)

    Schenk, Susann; Schoenhals, Gary J; de Souza, Gustavo

    2008-01-01

    BACKGROUND: The immense diagnostic potential of human plasma has prompted great interest and effort in cataloging its contents, exemplified by the Human Proteome Organization (HUPO) Plasma Proteome Project (PPP) pilot project. Due to challenges in obtaining a reliable blood plasma protein list......-trap-Fourier transform (LTQ-FT) and a linear ion trap-Orbitrap (LTQ-Orbitrap) for mass spectrometry (MS) analysis. Both instruments allow the measurement of peptide masses in the low ppm range. Furthermore, we employed a statistical score that allows database peptide identification searching using the products of two...... consecutive stages of tandem mass spectrometry (MS3). The combination of MS3 with very high mass accuracy in the parent peptide allows peptide identification with orders of magnitude more confidence than that typically achieved. RESULTS: Herein we established a high confidence set of 697 blood plasma proteins...

  15. Considering public confidence in developing regulatory programs

    International Nuclear Information System (INIS)

    Collins, S.J.

    2001-01-01

    In the area of public trust and in any investment, planning and strategy are important. While it is accepted in the United States that an essential part of our mission is to leverage our resources to improving Public Confidence this performance goal must be planned for, managed and measured. Similar to our premier performance goal of Maintaining Safety, a strategy must be developed and integrated with our external stake holders but with internal regulatory staff as well. In order to do that, business is to be conducted in an open environment, the basis for regulatory decisions has to be available through public documents and public meetings, communication must be done in clear and consistent terms. (N.C.)

  16. [Diagnostic imaging and acute abdominal pain].

    Science.gov (United States)

    Liljekvist, Mads Svane; Pommergaard, Hans-Christian; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-19

    Acute abdominal pain is a common clinical condition. Clinical signs and symptoms can be difficult to interpret, and diagnostic imaging may help to identify intra-abdominal disease. Conventional X-ray, ultrasound (US) and computed tomography (CT) of the abdomen vary in usability between common surgical causes of acute abdominal pain. Overall, conventional X-ray cannot confidently diagnose or rule out disease. US and CT are equally trustworthy for most diseases. US with subsequent CT may enhance diagnostic precision. Magnetic resonance seems promising for future use in acute abdominal imaging.

  17. Effect of immersive workplace experience on undergraduate nurses' mental health clinical confidence.

    Science.gov (United States)

    Patterson, Christopher; Moxham, Lorna; Taylor, Ellie K; Perlman, Dana; Brighton, Renee; Sumskis, Susan; Heffernan, Tim; Lee-Bates, Benjamin

    2017-12-01

    Preregistration education needs to ensure that student nurses are properly trained with the required skills and knowledge, and have the confidence to work with people who have a mental illness. With increased attention on non-traditional mental health clinical placements, further research is required to determine the effects of non-traditional mental health clinical placements on mental health clinical confidence. The aim of the present study was to investigate the impact of a non-traditional mental health clinical placement on mental health nursing clinical confidence compared to nursing students undergoing traditional clinical placements. Using the Mental Health Nursing Clinical Confidence Scale, the study investigated the relative effects of two placement programmes on the mental health clinical confidence of 79 nursing students. The two placement programmes included a non-traditional clinical placement of Recovery Camp and a comparison group that attended traditional clinical placements. Overall, the results indicated that, for both groups, mental health placement had a significant effect on improving mean mental health clinical confidence, both immediately upon conclusion of placement and at the 3-month follow up. Students who attended Recovery Camp reported a significant positive difference, compared to the comparison group, for ratings related to communicating effectively with clients with a mental illness, having a basic knowledge of antipsychotic medications and their side-effects, and providing client education regarding the effects and side-effects of medications. The findings suggest that a unique clinical placement, such as Recovery Camp, can improve and maintain facets of mental health clinical confidence for students of nursing. © 2017 Australian College of Mental Health Nurses Inc.

  18. Diagnostic and therapeutic impact of MR enterography in Crohn's disease

    Energy Technology Data Exchange (ETDEWEB)

    Hafeez, R. [Department of Surgery, University College London Hospitals, NW1 2BU (United Kingdom); Punwani, S. [Centre for Medical Imaging, University College London (United Kingdom); Department of Specialist X-Ray, University College London Hospitals, NW1 2BU (United Kingdom); Boulos, P. [Department of Surgery, University College London Hospitals, NW1 2BU (United Kingdom); Bloom, S.; McCartney, S. [Department of Gastroenterology, University College London Hospitals, NW1 2BU (United Kingdom); Halligan, S. [Centre for Medical Imaging, University College London (United Kingdom); Department of Specialist X-Ray, University College London Hospitals, NW1 2BU (United Kingdom); Taylor, S.A., E-mail: csytaylor@yahoo.co.uk [Centre for Medical Imaging, University College London (United Kingdom); Department of Specialist X-Ray, University College London Hospitals, NW1 2BU (United Kingdom)

    2011-12-15

    Aim: To assess the impact of magnetic resonance enterography (MRE) on clinician diagnostic confidence and therapeutic strategy in patients under investigation for small bowel Crohn's disease. Material and methods: Gastroenterologists completed a proforma before and following MRE in 51 patients (mean age 35 years, 26 female) under investigation for small bowel Crohn's disease, indicating percentage confidence for presence/absence of small bowel involvement. In suspected disease, diagnostic confidence (using a scoring system from 1 = no to 6 = yes) was scored for subcategories: extent >30 cm (DE), terminal ileum (lTI), jejunal (JD), colonic disease (CoD), strictures (ST), activity (AD), extraluminal complications (EL), and surgical need (NS). Therapeutic strategy was recorded. Patients were divided into three groups: 1 = suspected disease, MRE normal (n = 15); 2 = suspected disease, MRE abnormal (n = 30); 3 = no suspected disease, MRE normal (n = 6). Binomial exact and paired t-tests were use to compare confidence pre and post-MRE. Results: Mean percentage confidence for the presence/absence of small bowel disease increased from 62 to 84% (p = 0.003), 87 to 98% (p = 0.0001), and 83 to 98% (p = 0.005) after MRE for groups 1, 2, and 3, respectively. In suspected disease, confidence changed significantly for all of the subcategories (p < 0.001) except EL in group 1. The percentage of patients with a confidence change ranged from 40% (CoD) to 87% (lTI; group 1) and from 7% (EL) to 93% (DE; group 2). Therapeutic strategy changed in 31/51 (61%, 95% CI 47-74%), 14 with a reduction in planned therapy and 17 with an increase. Conclusion: MRE had a positive diagnostic impact in patients under investigation for small bowel Crohn's disease and this influenced therapeutic strategy in 61% of the patients.

  19. Smartphone-Based Fluorescent Diagnostic System for Highly Pathogenic H5N1 Viruses

    Science.gov (United States)

    Yeo, Seon-Ju; Choi, Kyunghan; Cuc, Bui Thi; Hong, Nguyen Ngoc; Bao, Duong Tuan; Ngoc, Nguyen Minh; Le, Mai Quynh; Hang, Nguyen Le Khanh; Thach, Nguyen Co; Mallik, Shyam Kumar; Kim, Hak Sung; Chong, Chom-Kyu; Choi, Hak Soo; Sung, Haan Woo; Yu, Kyoungsik; Park, Hyun

    2016-01-01

    Field diagnostic tools for avian influenza (AI) are indispensable for the prevention and controlled management of highly pathogenic AI-related diseases. More accurate, faster and networked on-site monitoring is demanded to detect such AI viruses with high sensitivity as well as to maintain up-to-date information about their geographical transmission. In this work, we assessed the clinical and field-level performance of a smartphone-based fluorescent diagnostic device with an efficient reflective light collection module using a coumarin-derived dendrimer-based fluorescent lateral flow immunoassay. By application of an optimized bioconjugate, a smartphone-based diagnostic device had a two-fold higher detectability as compared to that of the table-top fluorescence strip reader for three different AI subtypes (H5N3, H7N1, and H9N2). Additionally, in a clinical study of H5N1-confirmed patients, the smartphone-based diagnostic device showed a sensitivity of 96.55% (28/29) [95% confidence interval (CI): 82.24 to 99.91] and a specificity of 98.55% (68/69) (95% CI: 92.19 to 99.96). The measurement results from the distributed individual smartphones were wirelessly transmitted via short messaging service and collected by a centralized database system for further information processing and data mining. Smartphone-based diagnosis provided highly sensitive measurement results for H5N1 detection within 15 minutes. Because of its high sensitivity, portability and automatic reporting feature, the proposed device will enable agile identification of patients and efficient control of AI dissemination. PMID:26877781

  20. Smartphone-Based Fluorescent Diagnostic System for Highly Pathogenic H5N1 Viruses.

    Science.gov (United States)

    Yeo, Seon-Ju; Choi, Kyunghan; Cuc, Bui Thi; Hong, Nguyen Ngoc; Bao, Duong Tuan; Ngoc, Nguyen Minh; Le, Mai Quynh; Hang, Nguyen Le Khanh; Thach, Nguyen Co; Mallik, Shyam Kumar; Kim, Hak Sung; Chong, Chom-Kyu; Choi, Hak Soo; Sung, Haan Woo; Yu, Kyoungsik; Park, Hyun

    2016-01-01

    Field diagnostic tools for avian influenza (AI) are indispensable for the prevention and controlled management of highly pathogenic AI-related diseases. More accurate, faster and networked on-site monitoring is demanded to detect such AI viruses with high sensitivity as well as to maintain up-to-date information about their geographical transmission. In this work, we assessed the clinical and field-level performance of a smartphone-based fluorescent diagnostic device with an efficient reflective light collection module using a coumarin-derived dendrimer-based fluorescent lateral flow immunoassay. By application of an optimized bioconjugate, a smartphone-based diagnostic device had a two-fold higher detectability as compared to that of the table-top fluorescence strip reader for three different AI subtypes (H5N3, H7N1, and H9N2). Additionally, in a clinical study of H5N1-confirmed patients, the smartphone-based diagnostic device showed a sensitivity of 96.55% (28/29) [95% confidence interval (CI): 82.24 to 99.91] and a specificity of 98.55% (68/69) (95% CI: 92.19 to 99.96). The measurement results from the distributed individual smartphones were wirelessly transmitted via short messaging service and collected by a centralized database system for further information processing and data mining. Smartphone-based diagnosis provided highly sensitive measurement results for H5N1 detection within 15 minutes. Because of its high sensitivity, portability and automatic reporting feature, the proposed device will enable agile identification of patients and efficient control of AI dissemination.

  1. We will be champions: Leaders' confidence in 'us' inspires team members' team confidence and performance.

    Science.gov (United States)

    Fransen, K; Steffens, N K; Haslam, S A; Vanbeselaere, N; Vande Broek, G; Boen, F

    2016-12-01

    The present research examines the impact of leaders' confidence in their team on the team confidence and performance of their teammates. In an experiment involving newly assembled soccer teams, we manipulated the team confidence expressed by the team leader (high vs neutral vs low) and assessed team members' responses and performance as they unfolded during a competition (i.e., in a first baseline session and a second test session). Our findings pointed to team confidence contagion such that when the leader had expressed high (rather than neutral or low) team confidence, team members perceived their team to be more efficacious and were more confident in the team's ability to win. Moreover, leaders' team confidence affected individual and team performance such that teams led by a highly confident leader performed better than those led by a less confident leader. Finally, the results supported a hypothesized mediational model in showing that the effect of leaders' confidence on team members' team confidence and performance was mediated by the leader's perceived identity leadership and members' team identification. In conclusion, the findings of this experiment suggest that leaders' team confidence can enhance members' team confidence and performance by fostering members' identification with the team. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Coping under pressure: Strategies for maintaining confidence ...

    African Journals Online (AJOL)

    Soccer coaches face a number of challenges, frustrations, conflicts and tensions, the enormity of which is often underestimated. This notion is supported by the description of coaching as a perilous occupation in which coaches experience pressures like stress, conflict and tension, media pressure and intrusions into family ...

  3. Coping under pressure: Strategies for maintaining confidence ...

    African Journals Online (AJOL)

    2010-08-11

    Aug 11, 2010 ... Sport coaching can be a fulfilling and rewarding occupation, but can also be stressful because .... buffers against the negative effects of stress on individuals. ... them from psychological harm caused by problematic social.

  4. Raising Confident Kids

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body ... Videos for Educators Search English Español Raising Confident Kids KidsHealth / For Parents / Raising Confident Kids What's in ...

  5. Impact of molecular imaging on the diagnostic process in a memory clinic.

    Science.gov (United States)

    Ossenkoppele, Rik; Prins, Niels D; Pijnenburg, Yolande A L; Lemstra, Afina W; van der Flier, Wiesje M; Adriaanse, Sofie F; Windhorst, Albert D; Handels, Ron L H; Wolfs, Claire A G; Aalten, Pauline; Verhey, Frans R J; Verbeek, Marcel M; van Buchem, Mark A; Hoekstra, Otto S; Lammertsma, Adriaan A; Scheltens, Philip; van Berckel, Bart N M

    2013-07-01

    [(11)C]Pittsburgh compound B ([(11)C]PIB) and [(18)F]-2-fluoro-2-deoxy-D-glucose ([(18)F]FDG) PET measure fibrillar amyloid-β load and glucose metabolism, respectively. We evaluated the impact of these tracers on the diagnostic process in a memory clinic population. One hundred fifty-four patients underwent paired dynamic [(11)C]PIB and static [(18)F]FDG PET scans shortly after completing a standard dementia screening. Two-year clinical follow-up data were available for 39 patients. Parametric PET images were assessed visually and results were reported to the neurologists responsible for the initial diagnosis. Outcome measures were (change in) clinical diagnosis and confidence in that diagnosis before and after disclosing PET results. [(11)C]PIB scans were positive in 40 of 66 (61%) patients with a clinical diagnosis of Alzheimer's disease (AD), 5 of 18 (28%) patients with frontotemporal dementia (FTD), 4 of 5 (80%) patients with Lewy body dementia, and 3 of 10 (30%) patients with other dementias. [(18)F]FDG uptake patterns matched the clinical diagnosis in 38 of 66 (58%) of AD patients, and in 6 of 18 (33%) FTD patients. PET results led to a change in diagnosis in 35 (23%) patients. This only occurred when prior diagnostic certainty was Diagnostic confidence increased from 71 ± 17% before to 87 ± 16% after PET (p diagnostic work-up, especially when prior diagnostic confidence is low. Copyright © 2013 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  6. Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

    International Nuclear Information System (INIS)

    Chhabra, Avneesh; Belzberg, Allan J.; Rosson, Gedge D.; Shores, Jaimie T.; Deune, Gene; Thawait, Gaurav K.; Chalian, M.; Farahani, Sahar J.; Thawait, Shrey K.; Hashemi, Shar; Subhawong, Ty K.; Carrino, John A.

    2016-01-01

    To evaluate the impact of magnetic resonance neurography (MRN) on diagnostic thinking and therapeutic choices in patients with suspected peripheral neuropathy. IRB approval was obtained for this HIPAA-compliant study. Questionnaires were administered to six surgeons regarding the diagnosis and treatment in 85 patients suspected of having peripheral neuropathy, before (pretest) and after (posttest) MRN. Multiple outcome measures related to diagnostic confidence and surgical decision-making were assessed. The final cohort included 81 patients (30 men and 51 women, age 47 ± 17 years). The following changes were observed from pretest to posttest questionnaires: 23 % in nerve involvement (P < 0.05), 48 % in degree of confidence of nerve involvement (P < 0.01), 27 % in grade of injury (P < 0.05), 33 % in differential diagnosis (P < 0.05), 63 % in degree of confidence in need for surgery (P < 0.001), 41 % in timing of surgery (P < 0.01), 30 % in approach to surgery (P < 0.05), 58 % in degree of confidence in approach to surgery (P < 0.001), 30 % in estimated length of surgery (P < 0.05) and 27 % in length of incision (P < 0.05). The dichotomous decision regarding surgical or nonsurgical treatment changed from pro to con in 17 %. MRN results significantly influenced the diagnostic thinking and therapeutic recommendations of peripheral nerve surgeons. circle In patients with peripheral neuropathy, MRN significantly impacts diagnostic thinking. (orig.)

  7. Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

    Energy Technology Data Exchange (ETDEWEB)

    Chhabra, Avneesh [Southwestern Medical Center, Department of Radiology, Dallas, TX (United States); Johns Hopkins Hospital, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Belzberg, Allan J. [Johns Hopkins University School of Medicine, Department of Neurosurgery, Baltimore, MD (United States); Rosson, Gedge D.; Shores, Jaimie T.; Deune, Gene [Johns Hopkins University School of Medicine, Department of Plastic Surgery, Baltimore, MD (United States); Thawait, Gaurav K.; Chalian, M.; Farahani, Sahar J.; Thawait, Shrey K. [Johns Hopkins Hospital, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Hashemi, Shar [Dellon Institute, Towson, MD (United States); Subhawong, Ty K. [University of Miami Health System, Department of Radiology, Miami, FL (United States); Carrino, John A. [Weill Cornell Medical College, Hospital for Special Surgery, Department of Radiology and Imaging, New York, NY (United States)

    2016-05-15

    To evaluate the impact of magnetic resonance neurography (MRN) on diagnostic thinking and therapeutic choices in patients with suspected peripheral neuropathy. IRB approval was obtained for this HIPAA-compliant study. Questionnaires were administered to six surgeons regarding the diagnosis and treatment in 85 patients suspected of having peripheral neuropathy, before (pretest) and after (posttest) MRN. Multiple outcome measures related to diagnostic confidence and surgical decision-making were assessed. The final cohort included 81 patients (30 men and 51 women, age 47 ± 17 years). The following changes were observed from pretest to posttest questionnaires: 23 % in nerve involvement (P < 0.05), 48 % in degree of confidence of nerve involvement (P < 0.01), 27 % in grade of injury (P < 0.05), 33 % in differential diagnosis (P < 0.05), 63 % in degree of confidence in need for surgery (P < 0.001), 41 % in timing of surgery (P < 0.01), 30 % in approach to surgery (P < 0.05), 58 % in degree of confidence in approach to surgery (P < 0.001), 30 % in estimated length of surgery (P < 0.05) and 27 % in length of incision (P < 0.05). The dichotomous decision regarding surgical or nonsurgical treatment changed from pro to con in 17 %. MRN results significantly influenced the diagnostic thinking and therapeutic recommendations of peripheral nerve surgeons. circle In patients with peripheral neuropathy, MRN significantly impacts diagnostic thinking. (orig.)

  8. Diverse interpretations of confidence building

    International Nuclear Information System (INIS)

    Macintosh, J.

    1998-01-01

    This paper explores the variety of operational understandings associated with the term 'confidence building'. Collectively, these understandings constitute what should be thought of as a 'family' of confidence building approaches. This unacknowledged and generally unappreciated proliferation of operational understandings that function under the rubric of confidence building appears to be an impediment to effective policy. The paper's objective is to analyze these different understandings, stressing the important differences in their underlying assumptions. In the process, the paper underlines the need for the international community to clarify its collective thinking about what it means when it speaks of 'confidence building'. Without enhanced clarity, it will be unnecessarily difficult to employ the confidence building approach effectively due to the lack of consistent objectives and common operating assumptions. Although it is not the intention of this paper to promote a particular account of confidence building, dissecting existing operational understandings should help to identify whether there are fundamental elements that define what might be termed 'authentic' confidence building. Implicit here is the view that some operational understandings of confidence building may diverge too far from consensus models to count as meaningful members of the confidence building family. (author)

  9. Chinese Management Research Needs Self-Confidence but not Over-confidence

    DEFF Research Database (Denmark)

    Li, Xin; Ma, Li

    2018-01-01

    Chinese management research aims to contribute to global management knowledge by offering rigorous and innovative theories and practical recommendations both for managing in China and outside. However, two seemingly opposite directions that researchers are taking could prove detrimental......-confidence, limiting theoretical innovation and practical relevance. Yet going in the other direction of overly indigenous research reflects over-confidence, often isolating the Chinese management research from the mainstream academia and at times, even becoming anti-science. A more integrated approach of conducting...... to the healthy development of Chinese management research. We argue that the two directions share a common ground that lies in the mindset regarding the confidence in the work on and from China. One direction of simply following the American mainstream on academic rigor demonstrates a lack of self...

  10. The idiosyncratic nature of confidence.

    Science.gov (United States)

    Navajas, Joaquin; Hindocha, Chandni; Foda, Hebah; Keramati, Mehdi; Latham, Peter E; Bahrami, Bahador

    2017-11-01

    Confidence is the 'feeling of knowing' that accompanies decision making. Bayesian theory proposes that confidence is a function solely of the perceived probability of being correct. Empirical research has suggested, however, that different individuals may perform different computations to estimate confidence from uncertain evidence. To test this hypothesis, we collected confidence reports in a task where subjects made categorical decisions about the mean of a sequence. We found that for most individuals, confidence did indeed reflect the perceived probability of being correct. However, in approximately half of them, confidence also reflected a different probabilistic quantity: the perceived uncertainty in the estimated variable. We found that the contribution of both quantities was stable over weeks. We also observed that the influence of the perceived probability of being correct was stable across two tasks, one perceptual and one cognitive. Overall, our findings provide a computational interpretation of individual differences in human confidence.

  11. Attention deficit hyperactivity disorder in adults: diagnostic imperatives

    African Journals Online (AJOL)

    At present, no biological or psychological tests with sufficient sensitivity or specificity can replace the meticulous process of distilling the clinical characteristics of attention deficit hyperactivity disorder ( ADHD) in adulthood. The level of diagnostic confidence can be enhanced via a semi-structured interview, confirming the ...

  12. 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

  13. Development of procedures to ensure quality and integrity in Tandem Mirror Experiment-Upgrade (TMX-U) diagnostics systems

    International Nuclear Information System (INIS)

    Coutts, G.W.; Coon, M.L.; Hinz, A.F.; Hornady, R.S.; Lang, D.D.; Lund, N.P.

    1983-01-01

    The diagnostic systems for Tandem Mirror Experiment-Upgrade (TMX-U) have grown from eleven initial systems to more than twenty systems. During operation, diagnostic system modifications are sometimes required to complete experimental objectives. Also, during operations new diagnostic systems are being developed and implemented. To ensure and maintain the quality and integrity of the data signals, a set of plans and systematic actions are being developed. This paper reviews the procedures set in place to maintain the integrity of existing data systems and ensure the performance objectives of new diagnostics being added

  14. Nuclear energy communications in France: gaining public confidence

    International Nuclear Information System (INIS)

    Chaussade, J.-P.

    1990-01-01

    Nuclear power plants today are an accepted part of the French landscape; a total of 54 units have been constructed on some 20 different sites. They have been relatively well accepted by the general public and, in particular, by those people living in the vicinity of plants. This favourable situation, however, did not come about automatically - it required a great deal of effort in terms of public information, starting during the 1970s. This effort must be maintained, especially since public confidence in nuclear energy was severely shaken by the Chernobyl accident. Our success in pursuing France's planned construction programme depends on our ability to build on this confidence. Indeed, since 1987, we have had to rethink our communications strategy. However, Electricite de France (EDF) is not alone in this; public authorities, the SCSIN (an Industry Department equivalent to the NRC), CEA (French atomic energy commission), in its capacity as a research organisation, together with plant constructor Framatome and nuclear fuel company Cogema, all have a role to play in this communications drive. The key to our communications campaign lies in listening to public opinion. Opinion polls and qualitative surveys allow us to judge public awareness and pinpoint expectations and concerns. This article summarises the main surveys we have carried out. (3 figures) (Author)

  15. Bayesian Based Diagnostic Model for Condition Based Maintenance of Offshore Wind Farms

    Directory of Open Access Journals (Sweden)

    Masoud Asgarpour

    2018-01-01

    Full Text Available Operation and maintenance costs are a major contributor to the Levelized Cost of Energy for electricity produced by offshore wind and can be significantly reduced if existing corrective actions are performed as efficiently as possible and if future corrective actions are avoided by performing sufficient preventive actions. This paper presents an applied and generic diagnostic model for fault detection and condition based maintenance of offshore wind components. The diagnostic model is based on two probabilistic matrices; first, a confidence matrix, representing the probability of detection using each fault detection method, and second, a diagnosis matrix, representing the individual outcome of each fault detection method. Once the confidence and diagnosis matrices of a component are defined, the individual diagnoses of each fault detection method are combined into a final verdict on the fault state of that component. Furthermore, this paper introduces a Bayesian updating model based on observations collected by inspections to decrease the uncertainty of initial confidence matrix. The framework and implementation of the presented diagnostic model are further explained within a case study for a wind turbine component based on vibration, temperature, and oil particle fault detection methods. The last part of the paper will have a discussion of the case study results and present conclusions.

  16. Diagnostic Performance and Confidence of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Cystic and Cysticlike Liver Lesions.

    Science.gov (United States)

    Corvino, Antonio; Catalano, Orlando; Corvino, Fabio; Sandomenico, Fabio; Petrillo, Antonella

    2017-09-01

    The aims of this study were to assess the diagnostic performance of contrast-enhanced ultrasound (CEUS) in the characterization of atypical cystic and cysticlike focal liver lesions in comparison with conventional US and to determine whether the use of CEUS can reduce the need for further diagnostic workup. In a 3-year period 48 patients with 50 atypical cystic and cysticlike lesions found at conventional US underwent CEUS. Diagnostic confirmation was obtained in cytohistopathologic examinations, with other imaging modalities, and in follow-up. Overall, there were 24 cystic lesions and 26 cysticlike solid lesions, specifically 32 benign and 18 malignant lesions. The conventional US and CEUS images and cine loops were reviewed by two blinded readers independently. Sensitivity, specificity, area under the ROC curve (A z ), and interobserver agreement were calculated. Diagnostic performance improved after review of CEUS examinations by both readers (conventional US A z = 0.781 vs 0.972; CEUS A z = 0.734 vs 0.957). Interreader agreement increased, although slightly (conventional US weighted κ = 0.894; CEUS weighted κ = 0.953). In terms of differential diagnosis, the occurrence of correctly characterized lesions increased after CEUS for both readers (reader 1, 62% to 98%; reader 2, 56% to 96%). The development of low-acoustic-power CEUS has made it possible to identify several imaging features of cystic and cysticlike focal liver lesions that, in association with history and clinical findings, may help to correctly characterize them. Our data indicate the usefulness of CEUS in the evaluation of patients with these lesions.

  17. miRBase: annotating high confidence microRNAs using deep sequencing data.

    Science.gov (United States)

    Kozomara, Ana; Griffiths-Jones, Sam

    2014-01-01

    We describe an update of the miRBase database (http://www.mirbase.org/), the primary microRNA sequence repository. The latest miRBase release (v20, June 2013) contains 24 521 microRNA loci from 206 species, processed to produce 30 424 mature microRNA products. The rate of deposition of novel microRNAs and the number of researchers involved in their discovery continue to increase, driven largely by small RNA deep sequencing experiments. In the face of these increases, and a range of microRNA annotation methods and criteria, maintaining the quality of the microRNA sequence data set is a significant challenge. Here, we describe recent developments of the miRBase database to address this issue. In particular, we describe the collation and use of deep sequencing data sets to assign levels of confidence to miRBase entries. We now provide a high confidence subset of miRBase entries, based on the pattern of mapped reads. The high confidence microRNA data set is available alongside the complete microRNA collection at http://www.mirbase.org/. We also describe embedding microRNA-specific Wikipedia pages on the miRBase website to encourage the microRNA community to contribute and share textual and functional information.

  18. A systematic review of maternal confidence for physiologic birth: characteristics of prenatal care and confidence measurement.

    Science.gov (United States)

    Avery, Melissa D; Saftner, Melissa A; Larson, Bridget; Weinfurter, Elizabeth V

    2014-01-01

    Because a focus on physiologic labor and birth has reemerged in recent years, care providers have the opportunity in the prenatal period to help women increase confidence in their ability to give birth without unnecessary interventions. However, most research has only examined support for women during labor. The purpose of this systematic review was to examine the research literature for information about prenatal care approaches that increase women's confidence for physiologic labor and birth and tools to measure that confidence. Studies were reviewed that explored any element of a pregnant woman's interaction with her prenatal care provider that helped build confidence in her ability to labor and give birth. Timing of interaction with pregnant women included during pregnancy, labor and birth, and the postpartum period. In addition, we looked for studies that developed a measure of women's confidence related to labor and birth. Outcome measures included confidence or similar concepts, descriptions of components of prenatal care contributing to maternal confidence for birth, and reliability and validity of tools measuring confidence. The search of MEDLINE, CINAHL, PsycINFO, and Scopus databases provided a total of 893 citations. After removing duplicates and articles that did not meet inclusion criteria, 6 articles were included in the review. Three relate to women's confidence for labor during the prenatal period, and 3 describe tools to measure women's confidence for birth. Research about enhancing women's confidence for labor and birth was limited to qualitative studies. Results suggest that women desire information during pregnancy and want to use that information to participate in care decisions in a relationship with a trusted provider. Further research is needed to develop interventions to help midwives and physicians enhance women's confidence in their ability to give birth and to develop a tool to measure confidence for use during prenatal care. © 2014 by

  19. Sources of sport confidence, imagery type and performance among competitive athletes: the mediating role of sports confidence.

    Science.gov (United States)

    Levy, A R; Perry, J; Nicholls, A R; Larkin, D; Davies, J

    2015-01-01

    This study explored the mediating role of sport confidence upon (1) sources of sport confidence-performance relationship and (2) imagery-performance relationship. Participants were 157 competitive athletes who completed state measures of confidence level/sources, imagery type and performance within one hour after competition. Among the current sample, confirmatory factor analysis revealed appropriate support for the nine-factor SSCQ and the five-factor SIQ. Mediational analysis revealed that sport confidence had a mediating influence upon the achievement source of confidence-performance relationship. In addition, both cognitive and motivational imagery types were found to be important sources of confidence, as sport confidence mediated imagery type- performance relationship. Findings indicated that athletes who construed confidence from their own achievements and report multiple images on a more frequent basis are likely to benefit from enhanced levels of state sport confidence and subsequent performance.

  20. Diagnostic examination of the urethra in the female and double-balloon urethrography as a diagnostic method

    International Nuclear Information System (INIS)

    Madeja, C.; Mutze, S.; Poetzschke, B.; Tunn, R.; Heinrich, G.; Hamm, B.

    1997-01-01

    The double-balloon urethrography can be recommended as an efficient diagnostic method for examination of the urethra in the female patient. Because of its improved controllability, retrograde application of the contrast agent is superior to other techniques. Complications can be avoided by maintaining constant pressure during contrast agent application. The few commercially available double-balloon instruments suffer from a number of deficiencies which are the reason for this technique having met with low acceptance, thus being only rarely applied. In addition, application of the instrument is not easy. Nevertheless, this diagnostic technique would deserve much more frequent application. (orig.) [de

  1. Diagnostics for pellet experiments

    International Nuclear Information System (INIS)

    Johnson, R.R.

    1978-01-01

    The target diagnostics which are being used and planned in current laser driven ICF Experiments are described. Most of these diagnostics can be easily applied to future ion-beam fusion experiments. The status of laser fusion diagnostics has been much improved in the last 5 years and further improvements can be expected and should be available when the first ICF experiments using ion beams are performed. As an example, x-ray temporal and spatial resolutions are now approximately 5 psec and 3 μm, which is approximately a factor of 4 better than the resolution reported in the first implosion experiments. As one plans ahead for ion-beam fusion experiments it should be emphasized that high yield experiments are easier to diagnose provided adequate shielding is employed. However, in the event that the first high yield experiments fail it will be necessary to have diagnostics available to determine where the problems lie. In laser fusion it is interesting to note that higher laser powers are required now for breakeven experiments than first anticipated, mainly because some aspects of the laser-interaction physics were not recognized until the experiments were carefully diagnosed. Thus as has been pointed out, it may be necessary to increase the energy of the ion-beam driver to enable us to do breakeven experiments with high confidence

  2. Distinguishing highly confident accurate and inaccurate memory: insights about relevant and irrelevant influences on memory confidence.

    Science.gov (United States)

    Chua, Elizabeth F; Hannula, Deborah E; Ranganath, Charan

    2012-01-01

    It is generally believed that accuracy and confidence in one's memory are related, but there are many instances when they diverge. Accordingly it is important to disentangle the factors that contribute to memory accuracy and confidence, especially those factors that contribute to confidence, but not accuracy. We used eye movements to separately measure fluent cue processing, the target recognition experience, and relative evidence assessment on recognition confidence and accuracy. Eye movements were monitored during a face-scene associative recognition task, in which participants first saw a scene cue, followed by a forced-choice recognition test for the associated face, with confidence ratings. Eye movement indices of the target recognition experience were largely indicative of accuracy, and showed a relationship to confidence for accurate decisions. In contrast, eye movements during the scene cue raised the possibility that more fluent cue processing was related to higher confidence for both accurate and inaccurate recognition decisions. In a second experiment we manipulated cue familiarity, and therefore cue fluency. Participants showed higher confidence for cue-target associations for when the cue was more familiar, especially for incorrect responses. These results suggest that over-reliance on cue familiarity and under-reliance on the target recognition experience may lead to erroneous confidence.

  3. Patient dose with quality image under diagnostic reference levels

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  4. CT fluoroscopy-guided renal tumour cutting needle biopsy. Retrospective evaluation of diagnostic yield, safety, and risk factors for diagnostic failure

    International Nuclear Information System (INIS)

    Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Sakurai, Jun; Masaoka, Yoshihisa; Gobara, Hideo; Kanazawa, Susumu

    2018-01-01

    To evaluate retrospectively the diagnostic yield, safety, and risk factors for diagnostic failure of computed tomography (CT) fluoroscopy-guided renal tumour biopsy. Biopsies were performed for 208 tumours (mean diameter 2.3 cm; median diameter 2.1 cm; range 0.9-8.5 cm) in 199 patients. One hundred and ninety-nine tumours were ≤4 cm. All 208 initial procedures were divided into diagnostic success and failure groups. Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for diagnostic failure. After performing 208 initial and nine repeat biopsies, 180 malignancies and 15 benign tumours were pathologically diagnosed, whereas 13 were not diagnosed. In 117 procedures, 118 Grade I and one Grade IIIa adverse events (AEs) occurred. Neither Grade ≥IIIb AEs nor tumour seeding were observed within a median follow-up period of 13.7 months. Logistic regression analysis revealed only small tumour size (≤1.5 cm; odds ratio 3.750; 95% confidence interval 1.362-10.326; P = 0.011) to be a significant risk factor for diagnostic failure. CT fluoroscopy-guided renal tumour biopsy is a safe procedure with a high diagnostic yield. A small tumour size (≤1.5 cm) is a significant risk factor for diagnostic failure. (orig.)

  5. CT fluoroscopy-guided renal tumour cutting needle biopsy. Retrospective evaluation of diagnostic yield, safety, and risk factors for diagnostic failure

    Energy Technology Data Exchange (ETDEWEB)

    Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Sakurai, Jun; Masaoka, Yoshihisa; Gobara, Hideo; Kanazawa, Susumu [Okayama University Medical School, Department of Radiology, Okayama (Japan)

    2018-01-15

    To evaluate retrospectively the diagnostic yield, safety, and risk factors for diagnostic failure of computed tomography (CT) fluoroscopy-guided renal tumour biopsy. Biopsies were performed for 208 tumours (mean diameter 2.3 cm; median diameter 2.1 cm; range 0.9-8.5 cm) in 199 patients. One hundred and ninety-nine tumours were ≤4 cm. All 208 initial procedures were divided into diagnostic success and failure groups. Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for diagnostic failure. After performing 208 initial and nine repeat biopsies, 180 malignancies and 15 benign tumours were pathologically diagnosed, whereas 13 were not diagnosed. In 117 procedures, 118 Grade I and one Grade IIIa adverse events (AEs) occurred. Neither Grade ≥IIIb AEs nor tumour seeding were observed within a median follow-up period of 13.7 months. Logistic regression analysis revealed only small tumour size (≤1.5 cm; odds ratio 3.750; 95% confidence interval 1.362-10.326; P = 0.011) to be a significant risk factor for diagnostic failure. CT fluoroscopy-guided renal tumour biopsy is a safe procedure with a high diagnostic yield. A small tumour size (≤1.5 cm) is a significant risk factor for diagnostic failure. (orig.)

  6. Systematic Benchmarking of Diagnostic Technologies for an Electrical Power System

    Science.gov (United States)

    Kurtoglu, Tolga; Jensen, David; Poll, Scott

    2009-01-01

    Automated health management is a critical functionality for complex aerospace systems. A wide variety of diagnostic algorithms have been developed to address this technical challenge. Unfortunately, the lack of support to perform large-scale V&V (verification and validation) of diagnostic technologies continues to create barriers to effective development and deployment of such algorithms for aerospace vehicles. In this paper, we describe a formal framework developed for benchmarking of diagnostic technologies. The diagnosed system is the Advanced Diagnostics and Prognostics Testbed (ADAPT), a real-world electrical power system (EPS), developed and maintained at the NASA Ames Research Center. The benchmarking approach provides a systematic, empirical basis to the testing of diagnostic software and is used to provide performance assessment for different diagnostic algorithms.

  7. Self-confidence and metacognitive processes

    Directory of Open Access Journals (Sweden)

    Kleitman Sabina

    2005-01-01

    Full Text Available This paper examines the status of Self-confidence trait. Two studies strongly suggest that Self-confidence is a component of metacognition. In the first study, participants (N=132 were administered measures of Self-concept, a newly devised Memory and Reasoning Competence Inventory (MARCI, and a Verbal Reasoning Test (VRT. The results indicate a significant relationship between confidence ratings on the VRT and the Reasoning component of MARCI. The second study (N=296 employed an extensive battery of cognitive tests and several metacognitive measures. Results indicate the presence of robust Self-confidence and Metacognitive Awareness factors, and a significant correlation between them. Self-confidence taps not only processes linked to performance on items that have correct answers, but also beliefs about events that may never occur.

  8. Time-varying associations between confidence and motivation to abstain from marijuana during treatment among adolescents.

    Science.gov (United States)

    Chung, Tammy; Maisto, Stephen A

    2016-06-01

    An important goal of addictions treatment is to develop a positive association between high levels of confidence and motivation to abstain from substance use. This study modeled the time-varying association between confidence and motivation to abstain from marijuana use among youth in treatment, and the time-varying effect of pre-treatment covariates (marijuana abstinence goal and perceived peer marijuana use) on motivation to abstain. 150 adolescents (75% male, 83% White) in community-based intensive outpatient treatment in Pennsylvania completed a pre-treatment assessment of abstinence goal, perceived peer marijuana use, and motivation and confidence to abstain from marijuana. Ratings of motivation and confidence to abstain also were collected after each session. A time-varying effect model (TVEM) was used to characterize changes in the association between confidence and motivation to abstain (lagged), and included covariates representing pre-treatment abstinence goal and perceived peer marijuana use. Confidence and motivation to abstain from marijuana generally increased during treatment. The association between confidence and motivation strengthened across sessions 1-4, and was maintained through later sessions. Pre-treatment abstinence goal had an early time-limited effect (through session 6) on motivation to abstain. Pre-treatment perception of peer marijuana use had a significant effect on motivation to abstain only at session 2. Early treatment sessions represent a critical period during which the association between confidence and motivation to abstain generally increased. The time-limited effects of pre-treatment characteristics suggest the importance of early sessions in addressing abstinence goal and peer substance use that may impact motivation to abstain from marijuana. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. An Interview with Medical Diagnostics Scientist Bernhard Weigl

    Science.gov (United States)

    Sullivan, Megan

    2010-01-01

    Medical diagnostics help us evaluate a range of disorders, such as cancer and infectious diseases. In the United States and other developed countries, doctors have access to advanced equipment and laboratories that provide reliable diagnoses. As a result, when we are sick, we feel confident that we will get the treatment we need. Unfortunately,…

  10. Increasing Product Confidence-Shifting Paradigms.

    Science.gov (United States)

    Phillips, Marla; Kashyap, Vishal; Cheung, Mee-Shew

    2015-01-01

    Leaders in the pharmaceutical, medical device, and food industries expressed a unilateral concern over product confidence throughout the total product lifecycle, an unsettling fact for these leaders to manage given that their products affect the lives of millions of people each year. Fueled by the heparin incident of intentional adulteration in 2008, initial efforts for increasing product confidence were focused on improving the confidence of incoming materials, with a belief that supplier performance must be the root cause. As in the heparin case, concern over supplier performance extended deep into the supply chain to include suppliers of the suppliers-which is often a blind spot for pharmaceutical, device, and food manufacturers. Resolved to address the perceived lack of supplier performance, these U.S. Food and Drug Administration (FDA)-regulated industries began to adopt the supplier relationship management strategy, developed by the automotive industry, that emphasizes "management" of suppliers for the betterment of the manufacturers. Current product and supplier management strategies, however, have not led to a significant improvement in product confidence. As a result of the enduring concern by industry leaders over the lack of product confidence, Xavier University launched the Integrity of Supply Initiative in 2012 with a team of industry leaders and FDA officials. Through a methodical research approach, data generated by the pharmaceutical, medical device, and food manufacturers surprisingly pointed to themselves as a source of the lack of product confidence, and revealed that manufacturers either unknowingly increase the potential for error or can control/prevent many aspects of product confidence failure. It is only through this paradigm shift that manufacturers can work collaboratively with their suppliers as equal partners, instead of viewing their suppliers as "lesser" entities needing to be controlled. The basis of this shift provides manufacturers

  11. 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.

  12. Species delineation and hybrid identification using diagnostic nuclear markers for Plectropomus leopardus and Plectropomus maculatus

    KAUST Repository

    He, Song

    2018-06-01

    Diagnostic molecular markers are an essential tool in the study of species’ ecology and evolution, particularly in closely related and sympatric species. Furthermore, the increasing awareness of wild-hybrids has led to a renewed interest in rapid diagnostic assays. Here, we test the ability of two mitochondrial (Cytb and COI) and two nuclear markers (ETS2 and TMO-4c4) to confidently discriminate purebred P. leopardus and P. maculatus and their first-generation hybrids. A sample of 48 purebred individuals and 91 interspecific hybrids were used in this study and their delineation confirmed using a set of microsatellite markers. Our results indicate mitochondrial markers could not distinguish even between species but both nuclear markers confidently identified species and first-generation hybrids. However, later-generation hybrids could not always be confidently identified due to on-going introgression between species. Our findings provide a robust tool to distinguish purebred individuals and interspecific hybrids in a pair of species with an unexpectedly high incidence of hybridization. The quick species discrimination abilities provided by these diagnostic markers are important for stock assessment and recruitment studies of these important fishery species.

  13. Species delineation and hybrid identification using diagnostic nuclear markers for Plectropomus leopardus and Plectropomus maculatus

    KAUST Repository

    He, Song; Harrison, Hugo B.; Berumen, Michael L.

    2018-01-01

    Diagnostic molecular markers are an essential tool in the study of species’ ecology and evolution, particularly in closely related and sympatric species. Furthermore, the increasing awareness of wild-hybrids has led to a renewed interest in rapid diagnostic assays. Here, we test the ability of two mitochondrial (Cytb and COI) and two nuclear markers (ETS2 and TMO-4c4) to confidently discriminate purebred P. leopardus and P. maculatus and their first-generation hybrids. A sample of 48 purebred individuals and 91 interspecific hybrids were used in this study and their delineation confirmed using a set of microsatellite markers. Our results indicate mitochondrial markers could not distinguish even between species but both nuclear markers confidently identified species and first-generation hybrids. However, later-generation hybrids could not always be confidently identified due to on-going introgression between species. Our findings provide a robust tool to distinguish purebred individuals and interspecific hybrids in a pair of species with an unexpectedly high incidence of hybridization. The quick species discrimination abilities provided by these diagnostic markers are important for stock assessment and recruitment studies of these important fishery species.

  14. Distinguishing highly confident accurate and inaccurate memory: insights about relevant and irrelevant influences on memory confidence

    OpenAIRE

    Chua, Elizabeth F.; Hannula, Deborah E.; Ranganath, Charan

    2012-01-01

    It is generally believed that accuracy and confidence in one’s memory are related, but there are many instances when they diverge. Accordingly, it is important to disentangle the factors which contribute to memory accuracy and confidence, especially those factors that contribute to confidence, but not accuracy. We used eye movements to separately measure fluent cue processing, the target recognition experience, and relative evidence assessment on recognition confidence and accuracy. Eye movem...

  15. Balance and Gait Training With Augmented Feedback Improves Balance Confidence in People With Parkinson's Disease: A Randomized Controlled Trial.

    Science.gov (United States)

    Shen, Xia; Mak, Margaret K Y

    2014-07-01

    Background Fear of falling has been identified as an important and independent fall-risk predictor in patients with Parkinson's disease (PD). However, there are inconsistent findings on the effects of balance and gait training on balance confidence. Objective To explore whether balance and gait training with augmented feedback can enhance balance confidence in PD patients immediately after treatment and at 3- and 12-month follow-ups. Methods A total of 51 PD patients were randomly assigned to a balance and gait training (BAL) group or to an active control (CON) group. The BAL group received balance and gait training with augmented feedback, whereas CON participants received lower-limb strength training for 12 weeks. Outcome measures included Activities-Specific Balance Confidence (ABC) Scale, limits-of-stability test, single-leg-stance test, and spatiotemporal gait characteristics. All tests were administered before intervention (Pre), immediately after training (Post), and at 3 months (Post3m) and 12 months (Post12m) after treatment completion. Results The ABC score improved marginally at Post and significantly at Post3m and Post12m only in the BAL group (P point excursion at Post, but only the BAL group maintained the improvement at Post3m. The BAL group maintained significantly longer time-to-loss-of-balance during the single-leg stance test than the CON group at Post3m and Post12m (P balance confidence and balance and gait performance in patients with PD. © The Author(s) 2014.

  16. Sensitivity and specificity of proposed DSM-5 diagnostic criteria for autism spectrum disorder.

    Science.gov (United States)

    McPartland, James C; Reichow, Brian; Volkmar, Fred R

    2012-04-01

    This study evaluated the potential impact of proposed DSM-5 diagnostic criteria for autism spectrum disorder (ASD). The study focused on a sample of 933 participants evaluated during the DSM-IV field trial; 657 carried a clinical diagnosis of an ASD, and 276 were diagnosed with a non-autistic disorder. Sensitivity and specificity for proposed DSM-5 diagnostic criteria were evaluated using field trial symptom checklists as follows: individual field trial checklist items (e.g., nonverbal communication); checklist items grouped together as described by a single DSM-5 symptom (e.g., nonverbal and verbal communication); individual DSM-5 criterion (e.g., social-communicative impairment); and overall diagnostic criteria. When applying proposed DSM-5 diagnostic criteria for ASD, 60.6% (95% confidence interval: 57%-64%) of cases with a clinical diagnosis of an ASD met revised DSM-5 diagnostic criteria for ASD. Overall specificity was high, with 94.9% (95% confidence interval: 92%-97%) of individuals accurately excluded from the spectrum. Sensitivity varied by diagnostic subgroup (autistic disorder = 0.76; Asperger's disorder = 0.25; pervasive developmental disorder-not otherwise specified = 0.28) and cognitive ability (IQ criteria could substantially alter the composition of the autism spectrum. Revised criteria improve specificity but exclude a substantial portion of cognitively able individuals and those with ASDs other than autistic disorder. A more stringent diagnostic rubric holds significant public health ramifications regarding service eligibility and compatibility of historical and future research. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  17. Whole-body computed tomography in trauma patients: optimization of the patient scanning position significantly shortens examination time while maintaining diagnostic image quality

    Directory of Open Access Journals (Sweden)

    Hickethier T

    2018-05-01

    Full Text Available Tilman Hickethier,1,* Kamal Mammadov,1,* Bettina Baeßler,1 Thorsten Lichtenstein,1 Jochen Hinkelbein,2 Lucy Smith,3 Patrick Sven Plum,4 Seung-Hun Chon,4 David Maintz,1 De-Hua Chang1 1Department of Radiology, University Hospital of Cologne, Cologne, Germany; 2Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany; 3Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Canada; 4Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany *These authors contributed equally to this work Background: The study was conducted to compare examination time and artifact vulnerability of whole-body computed tomographies (wbCTs for trauma patients using conventional or optimized patient positioning. Patients and methods: Examination time was measured in 100 patients scanned with conventional protocol (Group A: arms positioned alongside the body for head and neck imaging and over the head for trunk imaging and 100 patients scanned with optimized protocol (Group B: arms flexed on a chest pillow without repositioning. Additionally, influence of two different scanning protocols on image quality in the most relevant body regions was assessed by two blinded readers. Results: Total wbCT duration was about 35% or 3:46 min shorter in B than in A. Artifacts in aorta (27 vs 6%, liver (40 vs 8% and spleen (27 vs 5% occurred significantly more often in B than in A. No incident of non-diagnostic image quality was reported, and no significant differences for lungs and spine were found. Conclusion: An optimized wbCT positioning protocol for trauma patients allows a significant reduction of examination time while still maintaining diagnostic image quality. Keywords: CT scan, polytrauma, acute care, time requirement, positioning

  18. The Model Confidence Set

    DEFF Research Database (Denmark)

    Hansen, Peter Reinhard; Lunde, Asger; Nason, James M.

    The paper introduces the model confidence set (MCS) and applies it to the selection of models. A MCS is a set of models that is constructed such that it will contain the best model with a given level of confidence. The MCS is in this sense analogous to a confidence interval for a parameter. The MCS......, beyond the comparison of models. We apply the MCS procedure to two empirical problems. First, we revisit the inflation forecasting problem posed by Stock and Watson (1999), and compute the MCS for their set of inflation forecasts. Second, we compare a number of Taylor rule regressions and determine...... the MCS of the best in terms of in-sample likelihood criteria....

  19. FEL components and diagnostics

    International Nuclear Information System (INIS)

    Carr, R.

    1997-01-01

    FEL hardware includes undulators, alignment systems, electron beam diagnostics, and mechanical and vacuum systems. While most FEL close-quote s employ conventional undulators, there is some interest in novel types, particularly where conventional designs cannot be used, as at very short periods and high fields. For these areas, superconducting technology is indicated. The most serious issue facing long FEL undulators is that of alignment; mechanical techniques may not be accurate enough, and beam-based strategies must be considered. To maintain alignment and control the electron trajectory, beam position monitors with micron precision are required. Beam size monitors are also required to assure control of emittance. The talks given in the working group sessions touch on undulators, alignment, and electron beam diagnostics, and they are summarized here. copyright 1997 American Institute of Physics

  20. Comparison of diagnostic performance between single- and multiphasic contrast-enhanced abdominopelvic computed tomography in patients admitted to the emergency department with abdominal pain: potential radiation dose reduction.

    Science.gov (United States)

    Hwang, Shin Hye; You, Je Sung; Song, Mi Kyong; Choi, Jin-Young; Kim, Myeong-Jin; Chung, Yong Eun

    2015-04-01

    To evaluate feasibility of radiation dose reduction by optimal phase selection of computed tomography (CT) in patients who visited the emergency department (ED) for abdominal pain. We included 253 patients who visited the ED for abdominal pain. They underwent multiphasic CT including precontrast, late arterial phase (LAP), and hepatic venous phase (HVP). Three image sets (HVP, precontrast + HVP, and precontrast + LAP + HVP) were reviewed. Two reviewers determined the most appropriate diagnosis with five-point confidence scale. Diagnostic performances were compared among image sets by weighted-least-squares method or DeLong's method. Linear mixed model was used to assess changes of diagnostic confidence and radiation dose. There was no difference in diagnostic performance among three image sets, although diagnostic confidence level was significantly improved after review of triphasic images compared with both HVP images only or HVP with precontrast images (confidence scale, 4.64 ± 0.05, 4.66 ± 0.05, and 4.76 ± 0.04 in the order of the sets; overall P = 0.0008). Similar trends were observed in the subgroup analysis for diagnosis of pelvic inflammatory disease and cholecystitis. There is no difference between HVP-CT alone and multiphasic CT for the diagnosis of causes of abdominal pain in patients admitted to the ED without prior chronic disease or neoplasia. • There was no difference in diagnostic performance of HVP CT and multiphasic CT. • The diagnostic confidence level was improved after review of the LAP images. • HVP CT can achieve diagnostic performance similar to that of multiphasic CT, while minimizing radiation.

  1. Confidence limits for regional cerebral blood flow values obtained with circular positron system, using krypton-77

    International Nuclear Information System (INIS)

    Meyer, E.; Yamamoto, Y.L.; Thompson, C.J.

    1978-01-01

    The 90% confidence limits have been determined for regional cerebral blood flow (rCBF) values obtained in each cm 2 of a cross section of the human head after inhalation of radioactive krypton-77, using the MNI circular positron emission tomography system (Positome). CBF values for small brain tissue elements are calculated by linear regression analysis on the semi-logarithmically transformed clearance curve. A computer program displays CBF values and their estimated error in numeric and gray scale forms. The following typical results have been obtained on a control subject: mean CBF in the entire cross section of the head: 54.6 + - 5 ml/min/100 g tissue, rCBF for small area of frontal gray matter: 75.8 + - 9 ml/min/100 g tissue. Confidence intervals for individual rCBF values varied between + - 13 and + - 55% except for areas pertaining to the ventricular system where particularly poor statistics have been obtained. Knowledge of confidence limits for rCBF values improves their diagnostic significance, particularly with respect to the assessment of reduced rCBF in stroke patients. A nomogram for convenient determination of 90% confidence limits for slope values obtained in linear regression analysis has been designed with the number of fitted points (n) and the correlation coefficient (r) as parameters. (author)

  2. Quality systems in veterinary diagnostics laboratories.

    Science.gov (United States)

    de Branco, Freitas Maia L M

    2007-01-01

    Quality assurance of services provided by veterinary diagnostics laboratories is a fundamental element promoted by international animal health organizations to establish trust, confidence and transparency needed for the trade of animals and their products at domestic and international levels. It requires, among other things, trained personnel, consistent and rigorous methodology, choice of suitable methods as well as appropriate calibration and traceability procedures. An important part of laboratory quality management is addressed by ISO/IEC 17025, which aims to facilitate cooperation among laboratories and their associated parties by assuring the generation of credible and consistent information derived from analytical results. Currently, according to OIE recommendation, veterinary diagnostics laboratories are only subject to voluntary compliance with standard ISO/IEC 17025; however, it is proposed here that OIE reference laboratories and collaboration centres strongly consider its adoption.

  3. Radial pseudoaneurysm following diagnostic coronary angiography

    Directory of Open Access Journals (Sweden)

    Shankar Laudari

    2015-06-01

    Full Text Available The radial artery access has gained popularity as a method of diagnostic coronary catheterization compared to femoral artery puncture in terms of vascular complications and early ambulation. However, very rare complication like radial artery pseudoaneurysm may occur following cardiac catheterization which may give rise to serious consequences. Here, we report a patient with radial pseudoaneurysm following diagnostic coronary angiography. Adequate and correct methodology of compression of radial artery following puncture for maintaining hemostasis is the key to prevention.DOI: http://dx.doi.org/10.3126/jcmsn.v10i3.12776 Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3, 48-50

  4. Confidence in critical care nursing.

    Science.gov (United States)

    Evans, Jeanne; Bell, Jennifer L; Sweeney, Annemarie E; Morgan, Jennifer I; Kelly, Helen M

    2010-10-01

    The purpose of the study was to gain an understanding of the nursing phenomenon, confidence, from the experience of nurses in the nursing subculture of critical care. Leininger's theory of cultural care diversity and universality guided this qualitative descriptive study. Questions derived from the sunrise model were used to elicit nurses' perspectives about cultural and social structures that exist within the critical care nursing subculture and the influence that these factors have on confidence. Twenty-eight critical care nurses from a large Canadian healthcare organization participated in semistructured interviews about confidence. Five themes arose from the descriptions provided by the participants. The three themes, tenuously navigating initiation rituals, deliberately developing holistic supportive relationships, and assimilating clinical decision-making rules were identified as social and cultural factors related to confidence. The remaining two themes, preserving a sense of security despite barriers and accommodating to diverse challenges, were identified as environmental factors related to confidence. Practice and research implications within the culture of critical care nursing are discussed in relation to each of the themes.

  5. Professional confidence: a concept analysis.

    Science.gov (United States)

    Holland, Kathlyn; Middleton, Lyn; Uys, Leana

    2012-03-01

    Professional confidence is a concept that is frequently used and or implied in occupational therapy literature, but often without specifying its meaning. Rodgers's Model of Concept Analysis was used to analyse the term "professional confidence". Published research obtained from a federated search in four health sciences databases was used to inform the concept analysis. The definitions, attributes, antecedents, and consequences of professional confidence as evidenced in the literature are discussed. Surrogate terms and related concepts are identified, and a model case of the concept provided. Based on the analysis, professional confidence can be described as a dynamic, maturing personal belief held by a professional or student. This includes an understanding of and a belief in the role, scope of practice, and significance of the profession, and is based on their capacity to competently fulfil these expectations, fostered through a process of affirming experiences. Developing and fostering professional confidence should be nurtured and valued to the same extent as professional competence, as the former underpins the latter, and both are linked to professional identity.

  6. CT fluoroscopy-guided renal tumour cutting needle biopsy: retrospective evaluation of diagnostic yield, safety, and risk factors for diagnostic failure.

    Science.gov (United States)

    Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Sakurai, Jun; Masaoka, Yoshihisa; Gobara, Hideo; Kanazawa, Susumu

    2018-01-01

    To evaluate retrospectively the diagnostic yield, safety, and risk factors for diagnostic failure of computed tomography (CT) fluoroscopy-guided renal tumour biopsy. Biopsies were performed for 208 tumours (mean diameter 2.3 cm; median diameter 2.1 cm; range 0.9-8.5 cm) in 199 patients. One hundred and ninety-nine tumours were ≤4 cm. All 208 initial procedures were divided into diagnostic success and failure groups. Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for diagnostic failure. After performing 208 initial and nine repeat biopsies, 180 malignancies and 15 benign tumours were pathologically diagnosed, whereas 13 were not diagnosed. In 117 procedures, 118 Grade I and one Grade IIIa adverse events (AEs) occurred. Neither Grade ≥IIIb AEs nor tumour seeding were observed within a median follow-up period of 13.7 months. Logistic regression analysis revealed only small tumour size (≤1.5 cm; odds ratio 3.750; 95% confidence interval 1.362-10.326; P = 0.011) to be a significant risk factor for diagnostic failure. CT fluoroscopy-guided renal tumour biopsy is a safe procedure with a high diagnostic yield. A small tumour size (≤1.5 cm) is a significant risk factor for diagnostic failure. • CT fluoroscopy-guided renal tumour biopsy has a high diagnostic yield. • CT fluoroscopy-guided renal tumour biopsy is safe. • Small tumour size (≤1.5 cm) is a risk factor for diagnostic failure.

  7. Self-Confidence and Quality of Life in Women Undergoing Treatment for Breast Cancer

    Science.gov (United States)

    Shafaee, Fahimeh Sehati; Mirghafourvand, Mojgan; Harischi, Sepideh; Esfahani, Ali; Amirzehni, Jalileh

    2018-01-01

    Introduction: Quality of life is an important topic in the study of chronic diseases, especially cancer which can have a major effect on patient self-confidence. This study was conducted to determine quality of life and its relationship with self-confidence in women undergoing treatment for breast cancer. Methods: This cross-sectional, descriptive, analytical study was conducted in 2016 on 166 women with breast cancer undergoing treatment at Ghazi, Al-Zahra, International and/or Shams hospitals in Tabriz. The subjects were selected through convenience sampling. A personal-demographic questionnaire, the Cancer Quality of Life Questionnaire (QLQ-C30), and the Rosenberg Self-Esteem Scale (RSES) were completed for each patient. The data obtained were analyzed using independent t-tests, one-way ANOVA, multivariate linear regression and Pearson’s correlation coefficients. Findings: The mean total score of quality of life was 59.1±17.4, ranging from 0 to 100. The highest mean score was obtained in the cognitive subscale (74.9±23.8) and the lowest in the emotional subscale (51.4±21.1). The mean score for self-confidence was 0.3 with a standard deviation of 0.1, ranging from -1 to +1. There was a significant positive relationship between self-confidence and quality of life, except in three symptom subscales for diarrhea, constipation and loss of appetite (Pquality of life. Discussion: Given the significant relationship between quality of life and self-confidence, health care providers may need to pay special attention to women undergoing treatment for breast cancer and perform timely measures to maintain their belief in themselves. PMID:29582628

  8. The year book of diagnostic radiology 1981

    International Nuclear Information System (INIS)

    Whitehouse, W.M.; Adams, D.F.; Bookstein, J.J.; Gabrielsen, T.O.; Holt, J.F.; Martel, W.; Silver, T.M.; Thornbury, J.R.

    1981-01-01

    The 1981 edition of the Year Book of Diagnostic Radiology fulfills the standards of excellence established by previous volumes in this series. The abstracts were carefully chosen, are concise, and are well illustrated. The book is recommended for all practicing radiologists: for the resident it is a good source from which to select articles to be carefully studied, and as review source before board examinations; for the subspecialist it provides a means to maintain contact with all areas of diagnostic radiology; and for the general radiologist, it is a convenient and reliable guide to new developments in the specialty

  9. Regional Competition for Confidence: Features of Formation

    Directory of Open Access Journals (Sweden)

    Irina Svyatoslavovna Vazhenina

    2016-09-01

    Full Text Available The increase in economic independence of the regions inevitably leads to an increase in the quality requirements of the regional economic policy. The key to successful regional policy, both during its development and implementation, is the understanding of the necessity of gaining confidence (at all levels, and the inevitable participation in the competition for confidence. The importance of confidence in the region is determined by its value as a competitive advantage in the struggle for partners, resources and tourists, and attracting investments. In today’s environment the focus of governments, regions and companies on long-term cooperation is clearly expressed, which is impossible without a high level of confidence between partners. Therefore, the most important competitive advantages of territories are intangible assets such as an attractive image and a good reputation, which builds up confidence of the population and partners. The higher the confidence in the region is, the broader is the range of potential partners, the larger is the planning horizon of long-term concerted action, the better are the chances of acquiring investment, the higher is the level of competitive immunity of the territories. The article defines competition for confidence as purposeful behavior of a market participant in economic environment, aimed at acquiring specific intangible competitive advantage – the confidence of the largest possible number of other market actors. The article also highlights the specifics of confidence as a competitive goal, presents factors contributing to the destruction of confidence, proposes a strategy to fight for confidence as a program of four steps, considers the factors which integrate regional confidence and offers several recommendations for the establishment of effective regional competition for confidence

  10. Irritable bowel syndrome: diagnostic approaches in clinical practice

    Directory of Open Access Journals (Sweden)

    Eugene J Burbige

    2010-09-01

    Full Text Available Eugene J BurbigeDivision of Gastroenterology, Gastrointestinal and Liver Research, John Muir Medical Center, Concord, CA, USABackground: Irritable bowel syndrome (IBS, a functional gastrointestinal disorder long considered a diagnosis of exclusion, has chronic symptoms that vary over time and overlap with those of non-IBS disorders. Traditional symptom-based criteria effectively identify IBS patients but are not easily applied in clinical practice, leaving >40% of patients to experience symptoms up to 5 years before diagnosis.Objective: To review the diagnostic evaluation of patients with suspected IBS, strengths and weaknesses of current methodologies, and newer diagnostic tools that can augment current symptom-based criteria.Methods: The peer-reviewed literature (PubMed was searched for primary reports and reviews using the limiters of date (1999–2009 and English language and the search terms irritable bowel syndrome, diagnosis, gastrointestinal disease, symptom-based criteria, outcome, serology, and fecal markers. Abstracts from Digestive Disease Week 2008–2009 and reference lists of identified articles were reviewed.Results: A disconnect is apparent between practice guidelines and clinical practice. The American Gastroenterological Association and American College of Gastroenterology recommend diagnosing IBS in patients without alarm features of organic disease using symptom-based criteria (eg, Rome. However, physicians report confidence in a symptom-based diagnosis without further testing only up to 42% of the time; many order laboratory tests and perform sigmoidoscopies or colonoscopies despite good evidence showing no utility for this work-up in uncomplicated cases. In the absence of diagnostic criteria easily usable in a busy practice, newer diagnostic methods, such as stool-form examination, fecal inflammatory markers, and serum biomarkers, have been proposed as adjunctive tools to aid in an IBS diagnosis by increasing physicians

  11. Dissociating Perceptual Confidence from Discrimination Accuracy Reveals No Influence of Metacognitive Awareness on Working Memory.

    Science.gov (United States)

    Samaha, Jason; Barrett, John J; Sheldon, Andrew D; LaRocque, Joshua J; Postle, Bradley R

    2016-01-01

    Visual awareness is hypothesized to be intimately related to visual working memory (WM), such that information present in WM is thought to have necessarily been represented consciously. Recent work has challenged this longstanding view by demonstrating that visual stimuli rated by observers as unseen can nevertheless be maintained over a delay period. These experiments have been criticized, however, on the basis that subjective awareness ratings may contain response bias (e.g., an observer may report no awareness when in fact they had partial awareness). We mitigated this issue by investigating WM for visual stimuli that were matched for perceptual discrimination capacity (d'), yet which varied in subjective confidence ratings (so-called relative blindsight). If the degree of initial subjective awareness of a stimulus facilitates later maintenance of that information, WM performance should improve for stimuli encoded with higher confidence. In contrast, we found that WM performance did not benefit from higher visual discrimination confidence. This relationship was observed regardless of WM load (1 or 3). Insofar as metacognitive ratings (e.g., confidence, visibility) reflect visual awareness, these results challenge a strong relationship between conscious perception and WM using a paradigm that controls for discrimination accuracy and is less subject to response bias (since confidence is manipulated within subjects). Methodologically, we replicate prior efforts to induce relative blindsight using similar stimulus displays, providing a general framework for isolating metacognitive awareness in order to examine the function of consciousness.

  12. Dissociating perceptual confidence from discrimination accuracy reveals no influence of metacognitive awareness on working memory

    Directory of Open Access Journals (Sweden)

    Jason eSamaha

    2016-06-01

    Full Text Available Visual awareness is hypothesized to be intimately related to visual working memory (WM, such that information present in WM is thought to have necessarily been represented consciously. Recent work has challenged this longstanding view by demonstrating that visual stimuli rated by observers as unseen can nevertheless be maintained over a delay period. These experiments have been criticized, however, on the basis that subjective awareness ratings may contain response bias (e.g., an observer may report no awareness when in fact they had partial awareness. We mitigated this issue by investigating WM for visual stimuli that were matched for perceptual discrimination capacity (d’, yet which varied in subjective confidence ratings (so called relative blindsight. If the degree of initial subjective awareness of a stimulus facilitates later maintenance of that information, WM performance should improve for stimuli encoded with higher confidence. In contrast, we found that WM performance did not benefit from higher visual discrimination confidence. This relationship was observed regardless of WM load (1 or 3. Insofar as metacognitive ratings (e.g., confidence, visibility reflect visual awareness, these results challenge a strong relationship between conscious perception and WM using a paradigm that controls for discrimination accuracy and is less subject to response bias (since confidence is manipulated within subjects. Methodologically, we replicate prior efforts to induce relative blindsight using similar stimulus displays, providing a general framework for isolating metacognitive awareness in order to examine the function of consciousness.

  13. Self-confidence of medical students in performing clinical skills acquired during their surgical rotation. Assessing clinical skills education in Kuwait.

    Science.gov (United States)

    Karim, Jumanah A; Marwan, Yousef A; Dawas, Ahmed M; Akhtar, Saeed

    2012-12-01

    To assess the self-confidence of clinical years` medical students in performing clinical skills/procedures. A cross-sectional study was conducted in April 2011 at the Department of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, Safat, Kuwait. A questionnaire was used to collect data from students who had completed their surgical rotation of their first clinical year. The students reported their level of self-confidence in performing specific skills/procedures related to that rotation. Data were presented using frequencies and percentages. A total score of confidence was calculated for each student. The Mann-Whitney and Kruskal-Wallis tests were used to assess the association between the students` sociodemographic characteristics and confidence score. Of the 122 students invited to participate in the study, only 15 (12.3%) declined to comply. Most students reported high confidence level (more than 75%) in performing 7 of the 13 history taking/physical examination skills, and 2 of the 39 diagnostic/treatment procedure skills. The highest confidence level was in performing abdominal examination, while the lowest level was in care of Jackson-Pratt drain site and emptying the drain bulb. The total confidence score was significantly higher among males (p=0.021), and students with higher monthly income (p=0.002). Medical students appeared to have poor self-confidence in performing clinical skills/procedures. Curriculum planners should explore potential reasons, and methods for the improvement of confidence level among medical students in performing skills/procedures they were expected to learn during their surgical rotation.

  14. What is 'confidence' and what could affect it?: A qualitative study of mothers who are hesitant about vaccines.

    Science.gov (United States)

    Mendel-Van Alstyne, Judith A; Nowak, Glen J; Aikin, Ann L

    2017-09-09

    Public confidence in immunization is critical to maintaining high vaccine-coverage rates needed to protect individuals and communities from vaccine-preventable diseases. Recent attention has been placed on factors influencing confidence in vaccination in the US and globally, but comprehensive understanding of what drives or hinders confidence in childhood vaccination is yet to be reached. As such, assessing parents' confidence in childhood vaccination and the ways in which educational materials affect confidence is needed. We sought to (1) learn how mothers who are hesitant about vaccination characterize confidence in health-related products for young children, including the recommended vaccines; (2) gain insights on what influences vaccine confidence beliefs; and (3) assess whether short, education materials affect parental confidence in childhood vaccinations. Eight moderator-lead focus groups (n=61), stratified by socioeconomic status, were undertaken with mothers of children 5years of age of less who are hesitant about vaccines. Four of the groups were held in the Philadelphia, PA area and four were held in the San Francisco/Oakland, CA area. Three educational material pairs, each consisting of a 2-3min video and an infographic poster about an immunization-related topic, were reviewed and assessed for influence on confidence. Qualitative data analysis was used to identify overarching themes across the focus groups. Themes, insights, and illustrative quotes were identified and provided for each of the major discussion areas: primary health concerns for young children; confidence beliefs and perceptions, including for recommended vaccines; facilitators and barriers to confidence; and reactions to the educational materials. Results provide helpful insights into how mothers who are hesitant about vaccines perceive confidence in childhood vaccines and health-related products, suggestions for how to improve confidence, and support for the value and use of short

  15. Generalized Confidence Intervals and Fiducial Intervals for Some Epidemiological Measures

    Directory of Open Access Journals (Sweden)

    Ionut Bebu

    2016-06-01

    Full Text Available For binary outcome data from epidemiological studies, this article investigates the interval estimation of several measures of interest in the absence or presence of categorical covariates. When covariates are present, the logistic regression model as well as the log-binomial model are investigated. The measures considered include the common odds ratio (OR from several studies, the number needed to treat (NNT, and the prevalence ratio. For each parameter, confidence intervals are constructed using the concepts of generalized pivotal quantities and fiducial quantities. Numerical results show that the confidence intervals so obtained exhibit satisfactory performance in terms of maintaining the coverage probabilities even when the sample sizes are not large. An appealing feature of the proposed solutions is that they are not based on maximization of the likelihood, and hence are free from convergence issues associated with the numerical calculation of the maximum likelihood estimators, especially in the context of the log-binomial model. The results are illustrated with a number of examples. The overall conclusion is that the proposed methodologies based on generalized pivotal quantities and fiducial quantities provide an accurate and unified approach for the interval estimation of the various epidemiological measures in the context of binary outcome data with or without covariates.

  16. [Sources of leader's confidence in organizations].

    Science.gov (United States)

    Ikeda, Hiroshi; Furukawa, Hisataka

    2006-04-01

    The purpose of this study was to examine the sources of confidence that organization leaders had. As potential sources of the confidence, we focused on fulfillment of expectations made by self and others, reflection on good as well as bad job experiences, and awareness of job experiences in terms of commonality, differentiation, and multiple viewpoints. A questionnaire was administered to 170 managers of Japanese companies. Results were as follows: First, confidence in leaders was more strongly related to fulfillment of expectations made by self and others than reflection on and awareness of job experiences. Second, the confidence was weakly related to internal processing of job experiences, in the form of commonality awareness and reflection on good job experiences. And finally, years of managerial experiences had almost no relation to the confidence. These findings suggested that confidence in leaders was directly acquired from fulfillment of expectations made by self and others, rather than indirectly through internal processing of job experiences. Implications of the findings for leadership training were also discussed.

  17. Low activation diagnostic equipment design studies

    International Nuclear Information System (INIS)

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

    1985-01-01

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

  18. Confidence-building and Canadian leadership

    International Nuclear Information System (INIS)

    Cleminson, F.R.

    1998-01-01

    Confidence-building has come into its own as a 'tool of choice' in facilitating the non-proliferation, arms control and disarmament (NACD) agenda, whether regional or global. From the Middle East Peace Process (MEPP) to the ASEAN Intersessional Group on Confidence-Building (ARF ISG on CBMS), confidence-building has assumed a central profile in regional terms. In the Four Power Talks begun in Geneva on December 9, 1997, the United States identified confidence-building as one of two subject areas for initial discussion as part of a structured peace process between North and South Korea. Thus, with CBMs assuming such a high profile internationally, it seems prudent for Canadians to pause and take stock of the significant role which Canada has already played in the conceptual development of the process over the last two decades. Since the Helsinki accords of 1975, Canada has developed a significant expertise in this area through an unbroken series of original, basic research projects. These have contributed to defining the process internationally from concept to implementation. Today, these studies represent a solid and unique Departmental investment in basic research from which to draw in meeting Canada's current commitments to multilateral initiatives in the area of confidence-building and to provide a 'step up' in terms of future-oriented leadership. (author)

  19. How trust in institutions and organizations builds general consumer confidence in the safety of food: a decomposition of effects.

    Science.gov (United States)

    de Jonge, J; van Trijp, J C M; van der Lans, I A; Renes, R J; Frewer, L J

    2008-09-01

    This paper investigates the relationship between general consumer confidence in the safety of food and consumer trust in institutions and organizations. More specifically, using a decompositional regression analysis approach, the extent to which the strength of the relationship between trust and general confidence is dependent upon a particular food chain actor (for example, food manufacturers) is assessed. In addition, the impact of specific subdimensions of trust, such as openness, on consumer confidence are analyzed, as well as interaction effects of actors and subdimensions of trust. The results confirm previous findings, which indicate that a higher level of trust is associated with a higher level of confidence. However, the results from the current study extend on previous findings by disentangling the effects that determine the strength of this relationship into specific components associated with the different actors, the different trust dimensions, and specific combinations of actors and trust dimensions. The results show that trust in food manufacturers influences general confidence more than trust in other food chain actors, and that care is the most important trust dimension. However, the contribution of a particular trust dimension in enhancing general confidence is actor-specific, suggesting that different actors should focus on different trust dimensions when the purpose is to enhance consumer confidence in food safety. Implications for the development of communication strategies that are designed to regain or maintain consumer confidence in the safety of food are discussed.

  20. On-line confidence monitoring during decision making.

    Science.gov (United States)

    Dotan, Dror; Meyniel, Florent; Dehaene, Stanislas

    2018-02-01

    Humans can readily assess their degree of confidence in their decisions. Two models of confidence computation have been proposed: post hoc computation using post-decision variables and heuristics, versus online computation using continuous assessment of evidence throughout the decision-making process. Here, we arbitrate between these theories by continuously monitoring finger movements during a manual sequential decision-making task. Analysis of finger kinematics indicated that subjects kept separate online records of evidence and confidence: finger deviation continuously reflected the ongoing accumulation of evidence, whereas finger speed continuously reflected the momentary degree of confidence. Furthermore, end-of-trial finger speed predicted the post-decisional subjective confidence rating. These data indicate that confidence is computed on-line, throughout the decision process. Speed-confidence correlations were previously interpreted as a post-decision heuristics, whereby slow decisions decrease subjective confidence, but our results suggest an adaptive mechanism that involves the opposite causality: by slowing down when unconfident, participants gain time to improve their decisions. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Interpersonal confidence as a factor in the prevention of disorganized interaction

    Directory of Open Access Journals (Sweden)

    Dontsov, Aleksander I.

    2014-03-01

    Full Text Available Human communities are based on a certain set of everyday attitudes, on the coordination of the actions of “the self ” in a group, and on the regulation of social practices. The results of this study show that a number of factors act as determinants of trust/ distrust ambivalence: the multidimensionality and the dynamics of interactions among people; the high level of subjectivity in evaluating risks resulting from openness and from confidence in partners involved in an interaction; and a subject’s contradictory attitude toward the personal traits of an interacting partner (power, activity, honesty, trustworthiness. Japanese scholars have proved the necessity of taking into account quality of life (QOL as one of the determinants of the development of interpersonal confidence. The study demonstrates that people try to bring trust into their daily routines as a way of organizing conscientious, emotionally open interactions that take into account the interests of all parties. Mistrust blocks access to the emotional, intellectual, and activity-related resources supporting life and undermines faith in the possibility of virtue and morality. Yet a supplementary study (using instant diagnostics indicates that in practice respondents did not demonstrate a high level of confidence (in two cities it was 0%; in one city, it was 4.6%. In spite of emotionally positive views regarding trust, as well as constructive estimates of its moral/behavioral potential, a considerable number of respondents were not open and oriented to the interests of others. A tendency toward caution, inwardness, and constrained sincerity leads to nonconformity in one’s actions in a group and to changes in the vector of social practices from socio-partner regulation to disorganized interaction.

  2. The potential impact of various diagnostic strategies in cases of chronic pain syndromes associated with lumbar spine degeneration

    Directory of Open Access Journals (Sweden)

    Bokov A

    2013-04-01

    Full Text Available Andrey Bokov, Olga Perlmutter, Alexander Aleynik, Marina Rasteryaeva, Sergey Mlyavykh Scientific Research Institute of Traumatology and Orthopedics, Nizhniy Novgorod, Russian Federation Purpose: To study the possible effects of various diagnostic strategies and the relative contribution of various structures in order to determine the optimal diagnostic strategy in treating patients with noncompressive pain syndromes. Study design: Prospective, nonrandomized cohort study of 83 consecutive patients with noncompressive pain syndromes resistant to repeated courses of conservative treatment. The follow-up period was 18 months. Results: Nucleoplasty was effective in cases of discogenic pain; the consequences related to false positive results of the discography were significant. The most specific criterion was 80% pain relief after facet joint blocks, whereas 50% pain relief and any subjective pain relief were not associated with a significant increase in the success rate. A considerable rate of false negative results was associated with 80% pain relief, whereas 50% pain relief after facet joint blocks showed the optimal ratio of sensitivity and specificity. Facet joint pain was detected in 50.6% of cases (95% confidence interval 44.1%–66.3%, discogenic pain in 16.9% cases (95% confidence interval 9.5%–26.7%, and sacroiliac joint pain in 7.2% cases (95% confidence interval 2.7%–15%. It was impossible to differentiate the main source of pain in 25.3% of cases. Conclusion: It is rational to adjust the diagnostic algorithm to the probability of detecting a particular pain source and, in doing so, reduce the number of invasive diagnostic measures to evaluate a pain source. False positive results of diagnostic measures can negatively affect the overall efficacy of a particular technology; therefore, all reasons for the failure should be studied in order to reach an unbiased conclusion. In choosing diagnostic criteria, not only should the success rate

  3. How do regulators measure public confidence?

    International Nuclear Information System (INIS)

    Schmitt, A.; Besenyei, E.

    2006-01-01

    The conclusions and recommendations of this session can be summarized this way. - There are some important elements of confidence: visibility, satisfaction, credibility and reputation. The latter can consist of trust, positive image and knowledge of the role the organisation plays. A good reputation is hard to achieve but easy to lose. - There is a need to define what public confidence is and what to measure. The difficulty is that confidence is a matter of perception of the public, so what we try to measure is the perception. - It is controversial how to take into account the results of confidence measurement because of the influence of the context. It is not an exact science, results should be examined cautiously and surveys should be conducted frequently, at least every two years. - Different experiences were explained: - Quantitative surveys - among the general public or more specific groups like the media; - Qualitative research - with test groups and small panels; - Semi-quantitative studies - among stakeholders who have regular contracts with the regulatory body. It is not clear if the results should be shared with the public or just with other authorities and governmental organisations. - Efforts are needed to increase visibility, which is a prerequisite for confidence. - A practical example of organizing an emergency exercise and an information campaign without taking into account the real concerns of the people was given to show how public confidence can be decreased. - We learned about a new method - the so-called socio-drama - which addresses another issue also connected to confidence - the notion of understanding between stakeholders around a nuclear site. It is another way of looking at confidence in a more restricted group. (authors)

  4. Method of reduction of diagnostic parameters during observation on the example of a combustion engine

    Directory of Open Access Journals (Sweden)

    Orczyk Malgorzata

    2017-01-01

    Full Text Available The article presents a method of selecting diagnostic parameters which map the process of damaging the object. This method consists in calculating, during the observation, the correlation coefficient between the intensity of damage and the individual diagnostic parameters; and discarding of those parameters whose correlation coefficient values are outside of the narrowest confidence interval of the correlation coefficient. The characteristic feature of this method is that the parameters are reduced during the diagnostic experiment. The essence of the proposed method is illustrated by the vibration diagnosis of an internal combustion engine.

  5. The Great Recession and confidence in homeownership

    OpenAIRE

    Anat Bracha; Julian Jamison

    2013-01-01

    Confidence in homeownership shifts for those who personally experienced real estate loss during the Great Recession. Older Americans are confident in the value of homeownership. Younger Americans are less confident.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  7. Confidence-building and Canadian leadership

    Energy Technology Data Exchange (ETDEWEB)

    Cleminson, F.R. [Dept. of Foreign Affairs and International Trade, Verification, Non-Proliferation, Arms Control and Disarmament Div (IDA), Ottawa, Ontario (Canada)

    1998-07-01

    Confidence-building has come into its own as a 'tool of choice' in facilitating the non-proliferation, arms control and disarmament (NACD) agenda, whether regional or global. From the Middle East Peace Process (MEPP) to the ASEAN Intersessional Group on Confidence-Building (ARF ISG on CBMS), confidence-building has assumed a central profile in regional terms. In the Four Power Talks begun in Geneva on December 9, 1997, the United States identified confidence-building as one of two subject areas for initial discussion as part of a structured peace process between North and South Korea. Thus, with CBMs assuming such a high profile internationally, it seems prudent for Canadians to pause and take stock of the significant role which Canada has already played in the conceptual development of the process over the last two decades. Since the Helsinki accords of 1975, Canada has developed a significant expertise in this area through an unbroken series of original, basic research projects. These have contributed to defining the process internationally from concept to implementation. Today, these studies represent a solid and unique Departmental investment in basic research from which to draw in meeting Canada's current commitments to multilateral initiatives in the area of confidence-building and to provide a 'step up' in terms of future-oriented leadership. (author)

  8. 256-MDCT for evaluation of urolithiasis: iterative reconstruction allows for a significant reduction of the applied radiation dose while maintaining high subjective and objective image quality

    International Nuclear Information System (INIS)

    Veldhoen, Simon; Laqmani, Azien; Derlin, Thorsten; Karul, Murat; Hammerle, Diego; Adam, Gerhard; Regier, Marc; Buhk, Jan-Hendrick; Sehner, Susanne; Nagel, Hans D.; Chun, Felix

    2014-01-01

    Multidetector CT (MDCT) is the established imaging modality in diagnostics of urolithiasis. The aim of iterative reconstruction (IR) is to allow for a radiation dose reduction while maintaining high image quality. This study evaluates its performance in MDCT for assessment of urolithiasis. Fifty-two patients underwent non-contrast abdominal MDCT. Twenty-six patients were referred to MDCT under suspicion of urolithiasis, and examined using a dose-reduced scan protocol (RDCT). Twenty-six patients, who had undergone standard-dose MDCT, served as reference for radiation dose comparison. RDCT images were reconstructed using an IR system (iDose4™, Philips Healthcare, Cleveland, OH, USA). Objective image noise (OIN) was recorded and five radiologists rated the subjective image quality independently. Radiation parameters were derived from the scan protocols. The CTDIvol could be reduced by 50% to 5.8 mGy (P < 0.0001). The same reduction was achieved for DLP and effective dose to 253 ± 27 mGy*cm (P < 0.0001) and 3.9 ± 0.4 mSv (P < 0.0001). IR led to a reduction of the OIN of up to 61% compared with classic filtered back projection (FBP) (P < 0.0001). The OIN declined with increasing IR levels. RDCT with FBP showed the lowest scores of subjective image quality (2.32 ± 0.04). Mean scores improved with increasing IR levels. iDose6 was rated with the best mean score (3.66 ± 0.04). The evaluated IR-tool and protocol may be applied to achieve a considerable radiation dose reduction in MDCT for diagnostics of urolithiasis while maintaining a confident image quality. Best image quality, suitable for evaluation of the entire abdomen concerning differential diagnoses, was achieved with iDose6.

  9. Study of methodology diversification in diagnostics

    International Nuclear Information System (INIS)

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

    1999-03-01

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

  10. Computer Vision Malaria Diagnostic Systems—Progress and Prospects

    Directory of Open Access Journals (Sweden)

    Joseph Joel Pollak

    2017-08-01

    Full Text Available Accurate malaria diagnosis is critical to prevent malaria fatalities, curb overuse of antimalarial drugs, and promote appropriate management of other causes of fever. While several diagnostic tests exist, the need for a rapid and highly accurate malaria assay remains. Microscopy and rapid diagnostic tests are the main diagnostic modalities available, yet they can demonstrate poor performance and accuracy. Automated microscopy platforms have the potential to significantly improve and standardize malaria diagnosis. Based on image recognition and machine learning algorithms, these systems maintain the benefits of light microscopy and provide improvements such as quicker scanning time, greater scanning area, and increased consistency brought by automation. While these applications have been in development for over a decade, recently several commercial platforms have emerged. In this review, we discuss the most advanced computer vision malaria diagnostic technologies and investigate several of their features which are central to field use. Additionally, we discuss the technological and policy barriers to implementing these technologies in low-resource settings world-wide.

  11. The 95% confidence intervals of error rates and discriminant coefficients

    Directory of Open Access Journals (Sweden)

    Shuichi Shinmura

    2015-02-01

    Full Text Available Fisher proposed a linear discriminant function (Fisher’s LDF. From 1971, we analysed electrocardiogram (ECG data in order to develop the diagnostic logic between normal and abnormal symptoms by Fisher’s LDF and a quadratic discriminant function (QDF. Our four years research was inferior to the decision tree logic developed by the medical doctor. After this experience, we discriminated many data and found four problems of the discriminant analysis. A revised Optimal LDF by Integer Programming (Revised IP-OLDF based on the minimum number of misclassification (minimum NM criterion resolves three problems entirely [13, 18]. In this research, we discuss fourth problem of the discriminant analysis. There are no standard errors (SEs of the error rate and discriminant coefficient. We propose a k-fold crossvalidation method. This method offers a model selection technique and a 95% confidence intervals (C.I. of error rates and discriminant coefficients.

  12. Added Diagnostic Value of 11C-PiB-PET in Memory Clinic Patients with Uncertain Diagnosis

    Directory of Open Access Journals (Sweden)

    K.S. Frederiksen

    2012-12-01

    Full Text Available Introduction: The added diagnostic value of 11C-PiB-PET for the assessment of the accumulation of cortical beta-amyloid in memory clinic patients with uncertain diagnosis remains undetermined. Methods: All patients who underwent PiB-PET at the Copenhagen Memory Clinic between March 2008 and November 2011 were included in this uncontrolled, retrospective study. The standard diagnostic evaluation program included physical and neurological examination, cognitive and functional assessment, a cranial CT or MRI, functional imaging and cerebrospinal fluid sampling. Based on anonymized case reports, three experienced clinicians reached a consensus diagnosis and rated their confidence in the diagnosis before and after disclosure of PiB-PET ratings. PiB-PET scans were rated as either positive or negative. Results: A total of 57 patients (17 females, 30 males; age 65.7 years, range 44.2–82.6 were included in the study. Twenty-seven had a positive PiB-PET scan. At the first diagnostic evaluation, 16 patients were given a clinical Alheimer’s disease diagnosis (14 PiB positive. Of the 57 patients, 13 (23% were diagnostically reclassified after PiB-PET ratings were disclosed. The clinicians’ overall confidence in their diagnosis increased in 28 (49% patients. Conclusion: PiB-PET adds to the specialist clinical evaluation and other supplemental diagnostic investigations in the diagnostic classification of patients with uncertain diagnosis in a specialized memory clinic.

  13. The role of computerized diagnostic proposals in the interpretation of the 12-lead electrocardiogram by cardiology and non-cardiology fellows.

    Science.gov (United States)

    Novotny, Tomas; Bond, Raymond; Andrsova, Irena; Koc, Lumir; Sisakova, Martina; Finlay, Dewar; Guldenring, Daniel; Spinar, Jindrich; Malik, Marek

    2017-05-01

    Most contemporary 12-lead electrocardiogram (ECG) devices offer computerized diagnostic proposals. The reliability of these automated diagnoses is limited. It has been suggested that incorrect computer advice can influence physician decision-making. This study analyzed the role of diagnostic proposals in the decision process by a group of fellows of cardiology and other internal medicine subspecialties. A set of 100 clinical 12-lead ECG tracings was selected covering both normal cases and common abnormalities. A team of 15 junior Cardiology Fellows and 15 Non-Cardiology Fellows interpreted the ECGs in 3 phases: without any diagnostic proposal, with a single diagnostic proposal (half of them intentionally incorrect), and with four diagnostic proposals (only one of them being correct) for each ECG. Self-rated confidence of each interpretation was collected. Availability of diagnostic proposals significantly increased the diagnostic accuracy (p<0.001). Nevertheless, in case of a single proposal (either correct or incorrect) the increase of accuracy was present in interpretations with correct diagnostic proposals, while the accuracy was substantially reduced with incorrect proposals. Confidence levels poorly correlated with interpretation scores (rho≈2, p<0.001). Logistic regression showed that an interpreter is most likely to be correct when the ECG offers a correct diagnostic proposal (OR=10.87) or multiple proposals (OR=4.43). Diagnostic proposals affect the diagnostic accuracy of ECG interpretations. The accuracy is significantly influenced especially when a single diagnostic proposal (either correct or incorrect) is provided. The study suggests that the presentation of multiple computerized diagnoses is likely to improve the diagnostic accuracy of interpreters. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Comparing Symptoms of Autism Spectrum Disorders Using the Current "DSM-IV-TR" Diagnostic Criteria and the Proposed "DSM-V" Diagnostic Criteria

    Science.gov (United States)

    Worley, Julie A.; Matson, Johnny L.

    2012-01-01

    The American Psychiatric Association has proposed major revisions for the diagnostic category encompassing Autism Spectrum Disorders (ASD), which will reportedly increase the specificity and maintain the sensitivity of diagnoses. As a result, the aim of the current study was to compare symptoms of ASD in children and adolescents (N = 208) who met…

  15. Diagnostic of dry rot in living trees

    International Nuclear Information System (INIS)

    Schaetzler, H.P.

    1978-01-01

    The γ-desorption method has been used in the early diagnosis of dry rot in trees. The attenuation of a 60 keV γ-beam ( 241 Am) has been measured on eleven healthy spruce disks. It is seen that early diagnostic of rotten trees is limited by natural density variation of the wood itself, but for a 95% confidence level that the wood is diseased, a tree must have an average of less than 0.59 g./cm 3 . (Auth/C.F.)

  16. Confidence Leak in Perceptual Decision Making.

    Science.gov (United States)

    Rahnev, Dobromir; Koizumi, Ai; McCurdy, Li Yan; D'Esposito, Mark; Lau, Hakwan

    2015-11-01

    People live in a continuous environment in which the visual scene changes on a slow timescale. It has been shown that to exploit such environmental stability, the brain creates a continuity field in which objects seen seconds ago influence the perception of current objects. What is unknown is whether a similar mechanism exists at the level of metacognitive representations. In three experiments, we demonstrated a robust intertask confidence leak-that is, confidence in one's response on a given task or trial influencing confidence on the following task or trial. This confidence leak could not be explained by response priming or attentional fluctuations. Better ability to modulate confidence leak predicted higher capacity for metacognition as well as greater gray matter volume in the prefrontal cortex. A model based on normative principles from Bayesian inference explained the results by postulating that observers subjectively estimate the perceptual signal strength in a stable environment. These results point to the existence of a novel metacognitive mechanism mediated by regions in the prefrontal cortex. © The Author(s) 2015.

  17. Procedural confidence in hospital based practitioners: implications for the training and practice of doctors at all grades

    Directory of Open Access Journals (Sweden)

    Tsagkaraki Petroula A

    2009-01-01

    Full Text Available Abstract Background Medical doctors routinely undertake a number of practical procedures and these should be performed competently. The UK Postgraduate Medical Education and Training Board (PMETB curriculum lists the procedures trainees should be competent in. We aimed to describe medical practitioner's confidence in their procedural skills, and to define which practical procedures are important in current medical practice. Methods A cross sectional observational study was performed measuring procedural confidence in 181 hospital practitioners at all grades from 2 centres in East Anglia, England. Results Both trainees and consultants provide significant service provision. SpR level doctors perform the widest range and the highest median number of procedures per year. Most consultants perform few if any procedures, however some perform a narrow range at high volume. Cumulative confidence for the procedures tested peaks in the SpR grade. Five key procedures (central line insertion, lumbar puncture, pleural aspiration, ascitic aspiration, and intercostal drain insertion are the most commonly performed, are seen as important generic skills, and correspond to the total number of procedures for which confidence can be maintained. Key determinants of confidence are gender, number of procedures performed in the previous year and total number of procedures performed. Conclusion The highest volume of service requirement is for six procedures. The procedural confidence is dependent upon gender, number of procedures performed in the previous year and total number of procedures performed. This has implications for those designing the training curriculum and with regards the move to shorten the duration of training.

  18. [Biomedical research, the market, clinicians, safety and corporate social responsibility post-phase III: maintaining confidence].

    Science.gov (United States)

    Marín-Gámez, N; Kessel-Sardiñas, H; Cervantes-Bonet, B; López-Palmero, S; Antón-Molina, F; Martínez-García, L

    2010-01-01

    - undoubtedly less costly and more rapid - without adequately knowing the safety of the strategy built to reach them. Only in this way we can be real guarantors of safety, and only in this way, and in absence of conflicts of interests we will be able to support the given confidence.

  19. A comparison of confidence/credible interval methods for the area under the ROC curve for continuous diagnostic tests with small sample size.

    Science.gov (United States)

    Feng, Dai; Cortese, Giuliana; Baumgartner, Richard

    2017-12-01

    The receiver operating characteristic (ROC) curve is frequently used as a measure of accuracy of continuous markers in diagnostic tests. The area under the ROC curve (AUC) is arguably the most widely used summary index for the ROC curve. Although the small sample size scenario is common in medical tests, a comprehensive study of small sample size properties of various methods for the construction of the confidence/credible interval (CI) for the AUC has been by and large missing in the literature. In this paper, we describe and compare 29 non-parametric and parametric methods for the construction of the CI for the AUC when the number of available observations is small. The methods considered include not only those that have been widely adopted, but also those that have been less frequently mentioned or, to our knowledge, never applied to the AUC context. To compare different methods, we carried out a simulation study with data generated from binormal models with equal and unequal variances and from exponential models with various parameters and with equal and unequal small sample sizes. We found that the larger the true AUC value and the smaller the sample size, the larger the discrepancy among the results of different approaches. When the model is correctly specified, the parametric approaches tend to outperform the non-parametric ones. Moreover, in the non-parametric domain, we found that a method based on the Mann-Whitney statistic is in general superior to the others. We further elucidate potential issues and provide possible solutions to along with general guidance on the CI construction for the AUC when the sample size is small. Finally, we illustrate the utility of different methods through real life examples.

  20. Targeting Low Career Confidence Using the Career Planning Confidence Scale

    Science.gov (United States)

    McAuliffe, Garrett; Jurgens, Jill C.; Pickering, Worth; Calliotte, James; Macera, Anthony; Zerwas, Steven

    2006-01-01

    The authors describe the development and validation of a test of career planning confidence that makes possible the targeting of specific problem issues in employment counseling. The scale, developed using a rational process and the authors' experience with clients, was tested for criterion-related validity against 2 other measures. The scale…

  1. Confidence Building Strategies in the Public Schools.

    Science.gov (United States)

    Achilles, C. M.; And Others

    1985-01-01

    Data from the Phi Delta Kappa Commission on Public Confidence in Education indicate that "high-confidence" schools make greater use of marketing and public relations strategies. Teacher attitudes were ranked first and administrator attitudes second by 409 respondents for both gain and loss of confidence in schools. (MLF)

  2. Confidence rating of marine eutrophication assessments

    DEFF Research Database (Denmark)

    Murray, Ciarán; Andersen, Jesper Harbo; Kaartokallio, Hermanni

    2011-01-01

    of the 'value' of the indicators on which the primary assessment is made. Such secondary assessment of confidence represents a first step towards linking status classification with information regarding their accuracy and precision and ultimately a tool for improving or targeting actions to improve the health......This report presents the development of a methodology for assessing confidence in eutrophication status classifications. The method can be considered as a secondary assessment, supporting the primary assessment of eutrophication status. The confidence assessment is based on a transparent scoring...

  3. Diagnostic accuracy of 201Tl SPECT·MRI in brain diseases and inter-reader variance of diagnostic performance

    International Nuclear Information System (INIS)

    Machida, Kikuo; Honda, Norinari; Matsumoto, Toru

    1996-01-01

    Fifteen-four studies of 201 Tl brain tumor SPECT were independently interpreted by 9 nuclear medicine physicians with and without reference magnetic resonance images in 2 separate sessions to define an effect of referring images, and inter-observer variations. The physicians were requested to detect foci of abnormal deposits, and to discriminate whether they were malignant or not according to 5-grade scaling of subjective diagnostic confidence. Receiver-operating characteristics (ROC) analysis was performed. Mean sensitivity for presence of lesions (SFP), and sensitivity and specificity for malignancy of 2 01 Tl SPECT were 84, and 53 and 55%, which were changed to 94 and 74 and 55% after referring to the MR images. The SFP was significantly improved (p 201 Tl brain tumor SPECT has moderate sensitivity and specificity for malignancy, which is not improved by addition of anatomical reference images, that additional MR images reduce inter-observer variation of confidence on lesion presence, and that SPECT localization of lesions has great inter-observer variations. (author)

  4. Renal cell carcinoma primary cultures maintain genomic and phenotypic profile of parental tumor tissues

    International Nuclear Information System (INIS)

    Cifola, Ingrid; Magni, Fulvio; Signorini, Stefano; Battaglia, Cristina; Perego, Roberto A; Bianchi, Cristina; Mangano, Eleonora; Bombelli, Silvia; Frascati, Fabio; Fasoli, Ester; Ferrero, Stefano; Di Stefano, Vitalba; Zipeto, Maria A

    2011-01-01

    Clear cell renal cell carcinoma (ccRCC) is characterized by recurrent copy number alterations (CNAs) and loss of heterozygosity (LOH), which may have potential diagnostic and prognostic applications. Here, we explored whether ccRCC primary cultures, established from surgical tumor specimens, maintain the DNA profile of parental tumor tissues allowing a more confident CNAs and LOH discrimination with respect to the original tissues. We established a collection of 9 phenotypically well-characterized ccRCC primary cell cultures. Using the Affymetrix SNP array technology, we performed the genome-wide copy number (CN) profiling of both cultures and corresponding tumor tissues. Global concordance for each culture/tissue pair was assayed evaluating the correlations between whole-genome CN profiles and SNP allelic calls. CN analysis was performed using the two CNAG v3.0 and Partek software, and comparing results returned by two different algorithms (Hidden Markov Model and Genomic Segmentation). A very good overlap between the CNAs of each culture and corresponding tissue was observed. The finding, reinforced by high whole-genome CN correlations and SNP call concordances, provided evidence that each culture was derived from its corresponding tissue and maintained the genomic alterations of parental tumor. In addition, primary culture DNA profile remained stable for at least 3 weeks, till to third passage. These cultures showed a greater cell homogeneity and enrichment in tumor component than original tissues, thus enabling a better discrimination of CNAs and LOH. Especially for hemizygous deletions, primary cultures presented more evident CN losses, typically accompanied by LOH; differently, in original tissues the intensity of these deletions was weaken by normal cell contamination and LOH calls were missed. ccRCC primary cultures are a reliable in vitro model, well-reproducing original tumor genetics and phenotype, potentially useful for future functional approaches

  5. Limitations of diagnostic precision and predictive utility in the individual case: a challenge for forensic practice.

    Science.gov (United States)

    Cooke, David J; Michie, Christine

    2010-08-01

    Knowledge of group tendencies may not assist accurate predictions in the individual case. This has importance for forensic decision making and for the assessment tools routinely applied in forensic evaluations. In this article, we applied Monte Carlo methods to examine diagnostic agreement with different levels of inter-rater agreement given the distributional characteristics of PCL-R scores. Diagnostic agreement and score agreement were substantially less than expected. In addition, we examined the confidence intervals associated with individual predictions of violent recidivism. On the basis of empirical findings, statistical theory, and logic, we conclude that predictions of future offending cannot be achieved in the individual case with any degree of confidence. We discuss the problems identified in relation to the PCL-R in terms of the broader relevance to all instruments used in forensic decision making.

  6. 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)

  7. Gouty arthritis: the diagnostic and therapeutic impact of dual-energy CT

    International Nuclear Information System (INIS)

    Finkenstaedt, Tim; Manoliou, Andrei; Higashigaito, Kai; Andreisek, Gustav; Guggenberger, Roman; Alkadhi, Hatem; Toniolo, Martin; Michel, Beat

    2016-01-01

    To determine the diagnostic and therapeutic impact of dual-energy computed tomography (DECT) in gout. Forty-three patients with (n = 20) and without a history of gout (n = 23) showing non-specific soft tissue deposits underwent DECT after unrewarding arthrocentesis. Two blinded, independent readers evaluated DECT for the presence of urate crystals. Clinical diagnosis, clinically suspected urate crystal locations, diagnostic thinking and therapeutic decisions were noted before and after DECT. Clinical 1-month follow-up was obtained. DECT showed urate in 26/43 patients (60 %). After DECT, clinical diagnosis of gout was withdrawn in 17/43 (40 %) and was maintained in 16/43 patients (37 %). In 10/43 patients (23 %) the diagnosis was maintained, but DECT revealed urate in clinically unsuspected locations. In 23/43 patients (53 %), a treatment-change based on DECT occurred. Changes in diagnostic thinking occurred more frequently in patients without a history of gout (p < 0.001), changes in therapeutic decisions more frequently in patients with a history of gout (p = 0.014). Clinical follow-up indicated beneficial effects of DECT-based diagnoses in 83 % of patients. In patients with or without a history of gout and a recent suspicion for gouty arthritis with an unrewarding arthrocentesis, DECT has a marked diagnostic and therapeutic impact when hyperdense soft-tissue deposits are present. (orig.)

  8. Gouty arthritis: the diagnostic and therapeutic impact of dual-energy CT

    Energy Technology Data Exchange (ETDEWEB)

    Finkenstaedt, Tim; Manoliou, Andrei; Higashigaito, Kai; Andreisek, Gustav; Guggenberger, Roman; Alkadhi, Hatem [University Hospital Zurich and University of Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Toniolo, Martin; Michel, Beat [University Hospital Zurich and University of Zurich, Department of Rheumatology, Zurich (Switzerland)

    2016-11-15

    To determine the diagnostic and therapeutic impact of dual-energy computed tomography (DECT) in gout. Forty-three patients with (n = 20) and without a history of gout (n = 23) showing non-specific soft tissue deposits underwent DECT after unrewarding arthrocentesis. Two blinded, independent readers evaluated DECT for the presence of urate crystals. Clinical diagnosis, clinically suspected urate crystal locations, diagnostic thinking and therapeutic decisions were noted before and after DECT. Clinical 1-month follow-up was obtained. DECT showed urate in 26/43 patients (60 %). After DECT, clinical diagnosis of gout was withdrawn in 17/43 (40 %) and was maintained in 16/43 patients (37 %). In 10/43 patients (23 %) the diagnosis was maintained, but DECT revealed urate in clinically unsuspected locations. In 23/43 patients (53 %), a treatment-change based on DECT occurred. Changes in diagnostic thinking occurred more frequently in patients without a history of gout (p < 0.001), changes in therapeutic decisions more frequently in patients with a history of gout (p = 0.014). Clinical follow-up indicated beneficial effects of DECT-based diagnoses in 83 % of patients. In patients with or without a history of gout and a recent suspicion for gouty arthritis with an unrewarding arthrocentesis, DECT has a marked diagnostic and therapeutic impact when hyperdense soft-tissue deposits are present. (orig.)

  9. 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

  10. Confidence bands for inverse regression models

    International Nuclear Information System (INIS)

    Birke, Melanie; Bissantz, Nicolai; Holzmann, Hajo

    2010-01-01

    We construct uniform confidence bands for the regression function in inverse, homoscedastic regression models with convolution-type operators. Here, the convolution is between two non-periodic functions on the whole real line rather than between two periodic functions on a compact interval, since the former situation arguably arises more often in applications. First, following Bickel and Rosenblatt (1973 Ann. Stat. 1 1071–95) we construct asymptotic confidence bands which are based on strong approximations and on a limit theorem for the supremum of a stationary Gaussian process. Further, we propose bootstrap confidence bands based on the residual bootstrap and prove consistency of the bootstrap procedure. A simulation study shows that the bootstrap confidence bands perform reasonably well for moderate sample sizes. Finally, we apply our method to data from a gel electrophoresis experiment with genetically engineered neuronal receptor subunits incubated with rat brain extract

  11. Nuclear power: restoring public confidence

    International Nuclear Information System (INIS)

    Arnold, L.

    1986-01-01

    The paper concerns a one day conference on nuclear power organised by the Centre for Science Studies and Science Policy, Lancaster, April 1986. Following the Chernobyl reactor accident, the conference concentrated on public confidence in nuclear power. Causes of lack of public confidence, public perceptions of risk, and the effect of Chernobyl in the United Kingdom, were all discussed. A Select Committee on the Environment examined the problems of radioactive waste disposal. (U.K.)

  12. Tracing the evolution of chiropractic students’ confidence in clinical and patient communication skills during a clinical internship: a multi-methods study

    Science.gov (United States)

    2012-01-01

    Background Anecdotal evidence points to variations in individual students’ evolving confidence in clinical and patient communication skills during a clinical internship. A better understanding of the specific aspects of internships that contribute to increasing or decreasing confidence is needed to best support students during the clinical component of their study. Methods A multi-method approach, combining two large-scale surveys with 269 students and three in-depth individual interviews with a sub-sample of 29 students, was used to investigate the evolution of change in student confidence during a 10-month long internship. Change in levels of confidence in patient communication and clinical skills was measured and relationship to demographic factors were explored. The interviews elicited students’ accounts and reflections on what affected the evolution of their confidence during the internship. Results At the start of their internship, students were more confident in their patient communication skills than their clinical skills but prior experience was significantly related to confidence in both. Initial confidence in patient communication skills was also related to age and prior qualification but not gender whilst confidence in clinical skills was related to gender but not age or prior qualification. These influences were maintained over time. Overall, students’ levels of confidence in patient communication and clinical skills confidence increased significantly over the duration of the internship with evidence that change over time in these two aspects were inter-related. To explore how specific aspects of the internship contributed to changing levels of confidence, two extreme sub-groups of interviewees were identified, those with the least increase and those with the highest increase in professional confidence over time. A number of key factors affecting the development of confidence were identified, including among others, interactions with clinicians

  13. Tracing the evolution of chiropractic students' confidence in clinical and patient communication skills during a clinical internship: a multi-methods study.

    Science.gov (United States)

    Hecimovich, Mark; Volet, Simone

    2012-06-19

    Anecdotal evidence points to variations in individual students' evolving confidence in clinical and patient communication skills during a clinical internship. A better understanding of the specific aspects of internships that contribute to increasing or decreasing confidence is needed to best support students during the clinical component of their study. A multi-method approach, combining two large-scale surveys with 269 students and three in-depth individual interviews with a sub-sample of 29 students, was used to investigate the evolution of change in student confidence during a 10-month long internship. Change in levels of confidence in patient communication and clinical skills was measured and relationship to demographic factors were explored. The interviews elicited students' accounts and reflections on what affected the evolution of their confidence during the internship. At the start of their internship, students were more confident in their patient communication skills than their clinical skills but prior experience was significantly related to confidence in both. Initial confidence in patient communication skills was also related to age and prior qualification but not gender whilst confidence in clinical skills was related to gender but not age or prior qualification. These influences were maintained over time. Overall, students' levels of confidence in patient communication and clinical skills confidence increased significantly over the duration of the internship with evidence that change over time in these two aspects were inter-related. To explore how specific aspects of the internship contributed to changing levels of confidence, two extreme sub-groups of interviewees were identified, those with the least increase and those with the highest increase in professional confidence over time. A number of key factors affecting the development of confidence were identified, including among others, interactions with clinicians and patients, personal agency and

  14. Organic labbeling systems and consumer confidence

    OpenAIRE

    Sønderskov, Kim Mannemar; Daugbjerg, Carsten

    2009-01-01

    A research analysis suggests that a state certification and labelling system creates confidence in organic labelling systems and consequently green consumerism. Danish consumers have higher levels of confidence in the labelling system than consumers in countries where the state plays a minor role in labelling and certification.

  15. A boost of confidence: The role of the ventromedial prefrontal cortex in memory, decision-making, and schemas.

    Science.gov (United States)

    Hebscher, Melissa; Gilboa, Asaf

    2016-09-01

    The ventromedial prefrontal cortex (vmPFC) has been implicated in a wide array of functions across multiple domains. In this review, we focus on the vmPFC's involvement in mediating strategic aspects of memory retrieval, memory-related schema functions, and decision-making. We suggest that vmPFC generates a confidence signal that informs decisions and memory-guided behaviour. Confidence is central to these seemingly diverse functions: (1) Strategic retrieval: lesions to the vmPFC impair an early, automatic, and intuitive monitoring process ("feeling of rightness"; FOR) often associated with confabulation (spontaneous reporting of erroneous memories). Critically, confabulators typically demonstrate high levels of confidence in their false memories, suggesting that faulty monitoring following vmPFC damage may lead to indiscriminate confidence signals. (2) Memory schemas: the vmPFC is critically involved in instantiating and maintaining contextually relevant schemas, broadly defined as higher level knowledge structures that encapsulate lower level representational elements. The correspondence between memory retrieval cues and these activated schemas leads to FOR monitoring. Stronger, more elaborate schemas produce stronger FOR and influence confidence in the veracity of memory candidates. (3) Finally, we review evidence on the vmPFC's role in decision-making, extending this role to decision-making during memory retrieval. During non-mnemonic and mnemonic decision-making the vmPFC automatically encodes confidence. Confidence signal in the vmPFC is revealed as a non-linear relationship between a first-order monitoring assessment and second-order action or choice. Attempting to integrate the multiple functions of the vmPFC, we propose a posterior-anterior organizational principle for this region. More posterior vmPFC regions are involved in earlier, automatic, subjective, and contextually sensitive functions, while more anterior regions are involved in controlled actions

  16. Comparison of diagnostic performance between single- and multiphasic contrast-enhanced abdominopelvic computed tomography in patients admitted to the emergency department with abdominal pain: potential radiation dose reduction

    International Nuclear Information System (INIS)

    Hwang, Shin Hye; You, Je Sung; Choi, Jin-Young; Kim, Myeong-Jin; Chung, Yong Eun; Song, Mi Kyong

    2015-01-01

    To evaluate feasibility of radiation dose reduction by optimal phase selection of computed tomography (CT) in patients who visited the emergency department (ED) for abdominal pain. We included 253 patients who visited the ED for abdominal pain. They underwent multiphasic CT including precontrast, late arterial phase (LAP), and hepatic venous phase (HVP). Three image sets (HVP, precontrast + HVP, and precontrast + LAP + HVP) were reviewed. Two reviewers determined the most appropriate diagnosis with five-point confidence scale. Diagnostic performances were compared among image sets by weighted-least-squares method or DeLong's method. Linear mixed model was used to assess changes of diagnostic confidence and radiation dose. There was no difference in diagnostic performance among three image sets, although diagnostic confidence level was significantly improved after review of triphasic images compared with both HVP images only or HVP with precontrast images (confidence scale, 4.64 ± 0.05, 4.66 ± 0.05, and 4.76 ± 0.04 in the order of the sets; overall P = 0.0008). Similar trends were observed in the subgroup analysis for diagnosis of pelvic inflammatory disease and cholecystitis. There is no difference between HVP-CT alone and multiphasic CT for the diagnosis of causes of abdominal pain in patients admitted to the ED without prior chronic disease or neoplasia. (orig.)

  17. Comparison of diagnostic performance between single- and multiphasic contrast-enhanced abdominopelvic computed tomography in patients admitted to the emergency department with abdominal pain: potential radiation dose reduction

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Shin Hye; You, Je Sung; Choi, Jin-Young; Kim, Myeong-Jin; Chung, Yong Eun [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Seodaemun-gu, Seoul (Korea, Republic of); Song, Mi Kyong [Yonsei University, Biostatistics Collaboration Unit, College of Medicine, Seoul (Korea, Republic of)

    2015-04-01

    To evaluate feasibility of radiation dose reduction by optimal phase selection of computed tomography (CT) in patients who visited the emergency department (ED) for abdominal pain. We included 253 patients who visited the ED for abdominal pain. They underwent multiphasic CT including precontrast, late arterial phase (LAP), and hepatic venous phase (HVP). Three image sets (HVP, precontrast + HVP, and precontrast + LAP + HVP) were reviewed. Two reviewers determined the most appropriate diagnosis with five-point confidence scale. Diagnostic performances were compared among image sets by weighted-least-squares method or DeLong's method. Linear mixed model was used to assess changes of diagnostic confidence and radiation dose. There was no difference in diagnostic performance among three image sets, although diagnostic confidence level was significantly improved after review of triphasic images compared with both HVP images only or HVP with precontrast images (confidence scale, 4.64 ± 0.05, 4.66 ± 0.05, and 4.76 ± 0.04 in the order of the sets; overall P = 0.0008). Similar trends were observed in the subgroup analysis for diagnosis of pelvic inflammatory disease and cholecystitis. There is no difference between HVP-CT alone and multiphasic CT for the diagnosis of causes of abdominal pain in patients admitted to the ED without prior chronic disease or neoplasia. (orig.)

  18. Consumer confidence or the business cycle

    DEFF Research Database (Denmark)

    Møller, Stig Vinther; Nørholm, Henrik; Rangvid, Jesper

    2014-01-01

    Answer: The business cycle. We show that consumer confidence and the output gap both excess returns on stocks in many European countries: When the output gap is positive (the economy is doing well), expected returns are low, and when consumer confidence is high, expected returns are also low...

  19. Communication confidence in persons with aphasia.

    Science.gov (United States)

    Babbitt, Edna M; Cherney, Leora R

    2010-01-01

    Communication confidence is a construct that has not been explored in the aphasia literature. Recently, national and international organizations have endorsed broader assessment methods that address quality of life and include participation, activity, and impairment domains as well as psychosocial areas. Individuals with aphasia encounter difficulties in all these areas on a daily basis in living with a communication disorder. Improvements are often reflected in narratives that are not typically included in standard assessments. This article illustrates how a new instrument measuring communication confidence might fit into a broad assessment framework and discusses the interaction of communication confidence, autonomy, and self-determination for individuals living with aphasia.

  20. Construction of joint confidence regions for the optimal true class fractions of Receiver Operating Characteristic (ROC) surfaces and manifolds.

    Science.gov (United States)

    Bantis, Leonidas E; Nakas, Christos T; Reiser, Benjamin; Myall, Daniel; Dalrymple-Alford, John C

    2017-06-01

    The three-class approach is used for progressive disorders when clinicians and researchers want to diagnose or classify subjects as members of one of three ordered categories based on a continuous diagnostic marker. The decision thresholds or optimal cut-off points required for this classification are often chosen to maximize the generalized Youden index (Nakas et al., Stat Med 2013; 32: 995-1003). The effectiveness of these chosen cut-off points can be evaluated by estimating their corresponding true class fractions and their associated confidence regions. Recently, in the two-class case, parametric and non-parametric methods were investigated for the construction of confidence regions for the pair of the Youden-index-based optimal sensitivity and specificity fractions that can take into account the correlation introduced between sensitivity and specificity when the optimal cut-off point is estimated from the data (Bantis et al., Biomet 2014; 70: 212-223). A parametric approach based on the Box-Cox transformation to normality often works well while for markers having more complex distributions a non-parametric procedure using logspline density estimation can be used instead. The true class fractions that correspond to the optimal cut-off points estimated by the generalized Youden index are correlated similarly to the two-class case. In this article, we generalize these methods to the three- and to the general k-class case which involves the classification of subjects into three or more ordered categories, where ROC surface or ROC manifold methodology, respectively, is typically employed for the evaluation of the discriminatory capacity of a diagnostic marker. We obtain three- and multi-dimensional joint confidence regions for the optimal true class fractions. We illustrate this with an application to the Trail Making Test Part A that has been used to characterize cognitive impairment in patients with Parkinson's disease.

  1. Sex differences in confidence influence patterns of conformity.

    Science.gov (United States)

    Cross, Catharine P; Brown, Gillian R; Morgan, Thomas J H; Laland, Kevin N

    2017-11-01

    Lack of confidence in one's own ability can increase the likelihood of relying on social information. Sex differences in confidence have been extensively investigated in cognitive tasks, but implications for conformity have not been directly tested. Here, we tested the hypothesis that, in a task that shows sex differences in confidence, an indirect effect of sex on social information use will also be evident. Participants (N = 168) were administered a mental rotation (MR) task or a letter transformation (LT) task. After providing an answer, participants reported their confidence before seeing the responses of demonstrators and being allowed to change their initial answer. In the MR, but not the LT, task, women showed lower levels of confidence than men, and confidence mediated an indirect effect of sex on the likelihood of switching answers. These results provide novel, experimental evidence that confidence is a general explanatory mechanism underpinning susceptibility to social influences. Our results have implications for the interpretation of the wider literature on sex differences in conformity. © 2016 The British Psychological Society.

  2. Diagnosis demystified: CT as diagnostic tool in endodontics

    Science.gov (United States)

    Shruthi, Nagaraja; Sreenivasa Murthy, B V; Sundaresh, K J; Mallikarjuna, Rachappa

    2013-01-01

    Diagnosis in endodontics is usually based on clinical and radiographical presentations, which are only empirical methods. The role of healing profession is to apply knowledge and skills towards maintaining and restoring the patient's health. Recent advances in imaging technologies have added to correct interpretation and diagnosis. CT is proving to be an effective tool in solving endodontic mysteries through its three-dimensional visualisation. CT imaging offers many diagnostic advantages to produce reconstructed images in selected projection and low-contrast resolution far superior to that of all other X-ray imaging modalities. This case report is an endeavour towards effective treatment planning of cases with root fracture, root resorption using spiral CT as an adjuvant diagnostic tool. PMID:23814212

  3. Comprehensive Plan for Public Confidence in Nuclear Regulator

    International Nuclear Information System (INIS)

    Choi, Kwang Sik; Choi, Young Sung; Kim, Ho ki

    2008-01-01

    Public confidence in nuclear regulator has been discussed internationally. Public trust or confidence is needed for achieving regulatory goal of assuring nuclear safety to the level that is acceptable by the public or providing public ease for nuclear safety. In Korea, public ease or public confidence has been suggested as major policy goal in the 'Nuclear regulatory policy direction' annually announced. This paper reviews theory of trust, its definitions and defines nuclear safety regulation, elements of public trust or public confidence developed based on the study conducted so far. Public ease model developed and 10 measures for ensuring public confidence are also presented and future study directions are suggested

  4. The Diagnostic Value of Gastrin-17 Detection in Atrophic Gastritis

    Science.gov (United States)

    Wang, Xu; Ling, Li; Li, Shanshan; Qin, Guiping; Cui, Wei; Li, Xiang; Ni, Hong

    2016-01-01

    Abstract A meta-analysis was performed to assess the diagnostic value of gastrin-17 (G-17) for the early detection of chronic atrophic gastritis (CAG). An extensive literature search was performed, with the aim of selecting publications that reported the accuracy of G-17 in predicting CAG, in the following databases: PubMed, Science Direct, Web of Science, Chinese Biological Medicine, Chinese National Knowledge Infrastructure, Wanfang, and VIP. To assess the diagnostic value of G-17, the following statistics were estimated and described: sensitivity, specificity, diagnostic odds ratios (DOR), summary receiver operating characteristic curves, area under the curve (AUC), and 95% confidence intervals (CIs). Thirteen studies that met the inclusion criteria were included in this meta-analysis, comprising 894 patients and 1950 controls. The pooled sensitivity and specificity of these studies were 0.48 (95% CI: 0.45–0.51) and 0.79 (95% CI: 0.77–0.81), respectively. The DOR was 5.93 (95% CI: 2.93–11.99), and the AUC was 0.82. G-17 may have potential diagnostic value because it has good specificity and a moderate DOR and AUC for CAG. However, more studies are needed to improve the sensitivity of this diagnostic tool in the future. PMID:27149493

  5. Economic crisis, institutional confidence and political leadership in Spain / Crisis económica, confianza institucional y liderazgos políticos en España

    Directory of Open Access Journals (Sweden)

    José Francisco Jiménez Díaz

    2013-10-01

    Full Text Available This paper analyzes the effects of the economic crisis in main political Spanish leaders in an exploratory way. For understanding the politics of the recent years is necessary to know the consequences of this crisis on leaders and political institutions that they manage. In representative democracies, political leaders have to maintain confidence with their followers to justify the political actions of the formers. Therefore, and according to theoretical interpretations and data presented in this paper, institutional confidence becomes a key factor to understand the effects of the economic crisis on the political leadership. Thus, the decline of institutional confidence is related with the increasing delegitimization of main political leaders and with the profound crisis of political legitimacy.

  6. Simultaneous confidence bands for the integrated hazard function

    OpenAIRE

    Dudek, Anna; Gocwin, Maciej; Leskow, Jacek

    2006-01-01

    The construction of the simultaneous confidence bands for the integrated hazard function is considered. The Nelson--Aalen estimator is used. The simultaneous confidence bands based on bootstrap methods are presented. Two methods of construction of such confidence bands are proposed. The weird bootstrap method is used for resampling. Simulations are made to compare the actual coverage probability of the bootstrap and the asymptotic simultaneous confidence bands. It is shown that the equal--tai...

  7. Patient dosimetry in diagnostic radiology

    International Nuclear Information System (INIS)

    Rweyemamu, M.

    2013-04-01

    The objective of this project was to review patient dosimetry aiming at reducing the patient dose during diagnostic procedures while maintaining the best image quality in order to protect patients from ionizing radiation. CT examination was selected in this study to represent imaging protocols with high patient doses used in diagnostic radiology. Dosimetric parameters in CT which are CTDI, CTDIW, DLP, MSAD, organ dose and effective dose were discussed. Parameters such as tube current, tube voltage, filtration, scan volume and slice thickness were found to affect patient dose, therefore proper management of these factors was recommended. For optimization of protection of the patient, application of the “as low as reasonably achievable” (ALARA) principle was recommended as an important key for avoiding overexposure and minimizing patient doses. Also it was recommended that CT examinations should be performed if and only if is the only suitable option when weighed against other options which do not involve ionizing radiation exposure. (author)

  8. Maintainability allocation

    International Nuclear Information System (INIS)

    Guyot, Christian.

    1980-06-01

    The author gives the general lines of a method for the allocation and for the evaluation of maintainability of complex systems which is to be developed during the conference. The maintainability objective is supposed to be formulated under the form of a mean time to repair (M.T.T.R.) [fr

  9. Beyond hypercorrection: remembering corrective feedback for low-confidence errors.

    Science.gov (United States)

    Griffiths, Lauren; Higham, Philip A

    2018-02-01

    Correcting errors based on corrective feedback is essential to successful learning. Previous studies have found that corrections to high-confidence errors are better remembered than low-confidence errors (the hypercorrection effect). The aim of this study was to investigate whether corrections to low-confidence errors can also be successfully retained in some cases. Participants completed an initial multiple-choice test consisting of control, trick and easy general-knowledge questions, rated their confidence after answering each question, and then received immediate corrective feedback. After a short delay, they were given a cued-recall test consisting of the same questions. In two experiments, we found high-confidence errors to control questions were better corrected on the second test compared to low-confidence errors - the typical hypercorrection effect. However, low-confidence errors to trick questions were just as likely to be corrected as high-confidence errors. Most surprisingly, we found that memory for the feedback and original responses, not confidence or surprise, were significant predictors of error correction. We conclude that for some types of material, there is an effortful process of elaboration and problem solving prior to making low-confidence errors that facilitates memory of corrective feedback.

  10. Smartphone-Based Fluorescent Diagnostic System for Highly Pathogenic H5N1 Viruses

    OpenAIRE

    Yeo, Seon-Ju; Choi, Kyunghan; Cuc, Bui Thi; Hong, Nguyen Ngoc; Bao, Duong Tuan; Ngoc, Nguyen Minh; Le, Mai Quynh; Hang, Nguyen Le Khanh; Thach, Nguyen Co; Mallik, Shyam Kumar; Kim, Hak Sung; Chong, Chom-Kyu; Choi, Hak Soo; Sung, Haan Woo; Yu, Kyoungsik

    2016-01-01

    Field diagnostic tools for avian influenza (AI) are indispensable for the prevention and controlled management of highly pathogenic AI-related diseases. More accurate, faster and networked on-site monitoring is demanded to detect such AI viruses with high sensitivity as well as to maintain up-to-date information about their geographical transmission. In this work, we assessed the clinical and field-level performance of a smartphone-based fluorescent diagnostic device with an efficient reflect...

  11. Maternal Confidence for Physiologic Childbirth: A Concept Analysis.

    Science.gov (United States)

    Neerland, Carrie E

    2018-06-06

    Confidence is a term often used in research literature and consumer media in relation to birth, but maternal confidence has not been clearly defined, especially as it relates to physiologic labor and birth. The aim of this concept analysis was to define maternal confidence in the context of physiologic labor and childbirth. Rodgers' evolutionary method was used to identify attributes, antecedents, and consequences of maternal confidence for physiologic birth. Databases searched included Ovid MEDLINE, CINAHL, PsycINFO, and Sociological Abstracts from the years 1995 to 2015. A total of 505 articles were retrieved, using the search terms pregnancy, obstetric care, prenatal care, and self-efficacy and the keyword confidence. Articles were identified for in-depth review and inclusion based on whether the term confidence was used or assessed in relationship to labor and/or birth. In addition, a hand search of the reference lists of the selected articles was performed. Twenty-four articles were reviewed in this concept analysis. We define maternal confidence for physiologic birth as a woman's belief that physiologic birth can be achieved, based on her view of birth as a normal process and her belief in her body's innate ability to birth, which is supported by social support, knowledge, and information founded on a trusted relationship with a maternity care provider in an environment where the woman feels safe. This concept analysis advances the concept of maternal confidence for physiologic birth and provides new insight into how women's confidence for physiologic birth might be enhanced during the prenatal period. Further investigation of confidence for physiologic birth across different cultures is needed to identify cultural differences in constructions of the concept. © 2018 by the American College of Nurse-Midwives.

  12. Self-Confidence in the Hospitality Industry

    Directory of Open Access Journals (Sweden)

    Michael Oshins

    2014-02-01

    Full Text Available Few industries rely on self-confidence to the extent that the hospitality industry does because guests must feel welcome and that they are in capable hands. This article examines the results of hundreds of student interviews with industry professionals at all levels to determine where the majority of the hospitality industry gets their self-confidence.

  13. ADAM SMITH: THE INVISIBLE HAND OR CONFIDENCE

    Directory of Open Access Journals (Sweden)

    Fernando Luis, Gache

    2010-01-01

    Full Text Available In 1776 Adam Smith raised the matter that an invisible hand was the one which moved the markets to obtain its efficiency. Despite in the present paper we are going to raise the hypothesis, that this invisible hand is in fact the confidence that each person feels when he is going to do business. That in addition it is unique, because it is different from the confidence of the others and that is a variable nonlinear that essentially is ligatured to respective personal histories. For that we are going to take as its bases the paper by Leopoldo Abadía (2009, with respect to the financial economy crisis that happened in 2007-2008, to evidence the form in which confidence operates. Therefore the contribution that we hope to do with this paper is to emphasize that, the level of confidence of the different actors, is the one which really moves the markets, (therefore the economy and that the crisis of the subprime mortgages is a confidence crisis at world-wide level.

  14. Use of the target diagnostic control system in the National Ignition Facility

    Energy Technology Data Exchange (ETDEWEB)

    Shelton, R; Lagin, L; Nelson, J

    2011-07-25

    The extreme physics of targets shocked by NIF's 192-beam laser are observed by a diverse suite of diagnostics including optical backscatter, time-integrated, time resolved and gated X-ray sensors, laser velocity interferometry, and neutron time of flight. Diagnostics to diagnose fusion ignition implosion and neutron emissions have been developed. A Diagnostic Control System (DCS) for both hardware and software facilitates development and eases integration. Each complex diagnostic typically uses an ensemble of electronic instruments attached to sensors, digitizers, cameras, and other devices. In the DCS architecture each instrument is interfaced to a low-cost Window XP processor and Java application. Instruments are aggregated as needed in the supervisory system to form an integrated diagnostic. The Java framework provides data management, control services and operator GUI generation. During the past several years, over thirty-six diagnostics have been deployed using this architecture in support of the National Ignition Campaign (NIC). The DCS architecture facilitates the expected additions and upgrades to diagnostics as more experiments are performed. This paper presents the DCS architecture, framework and our experiences in using it during the NIC to operate, upgrade and maintain a large set of diagnostic instruments.

  15. Use of the target diagnostic control system in the National Ignition Facility

    International Nuclear Information System (INIS)

    Shelton, R.; Lagin, L.; Nelson, J.

    2011-01-01

    The extreme physics of targets shocked by NIF's 192-beam laser are observed by a diverse suite of diagnostics including optical backscatter, time-integrated, time resolved and gated X-ray sensors, laser velocity interferometry, and neutron time of flight. Diagnostics to diagnose fusion ignition implosion and neutron emissions have been developed. A Diagnostic Control System (DCS) for both hardware and software facilitates development and eases integration. Each complex diagnostic typically uses an ensemble of electronic instruments attached to sensors, digitizers, cameras, and other devices. In the DCS architecture each instrument is interfaced to a low-cost Window XP processor and Java application. Instruments are aggregated as needed in the supervisory system to form an integrated diagnostic. The Java framework provides data management, control services and operator GUI generation. During the past several years, over thirty-six diagnostics have been deployed using this architecture in support of the National Ignition Campaign (NIC). The DCS architecture facilitates the expected additions and upgrades to diagnostics as more experiments are performed. This paper presents the DCS architecture, framework and our experiences in using it during the NIC to operate, upgrade and maintain a large set of diagnostic instruments.

  16. Optical fibres for fusion plasma diagnostics systems

    International Nuclear Information System (INIS)

    Brichard, B.

    2005-01-01

    The condition to achieve and maintain the ignition of a thermonuclear fusion plasma ignition calls for the construction of a large scale fusion reactor, namely ITER. This reactor is designed to deliver an average fusion power of 500 MW. The burning of fusion plasma at such high power level will release a tremendous amount of energy in the form of particle fluxes and ionising radiation. This energy release, primarily absorbed by the plasma facing components, can significantly degrade the performances of the plasma diagnostic equipment surrounding the machine. To ensure a correct operation of the Tokamak we need to develop highly radiation-resistance devices. In plasma diagnostic systems, optical fibre is viewed as a convenient tool to transport light from the plasma edge to the diagnostic area. Radiation affects the optical performances of the fibre mainly by the occurrence of radiation-induced absorption and luminescence. Both effects degrade the light signal used for plasma diagnostic. SCK-CEN is currently assessing radiation-resistant glasses for optical fibres and is developing the associated qualification procedure. The main objectives of this study were to increase the lifetime of optical components in high radiation background and to develop a radiation resistance optical fibre capable to operate in the radiation background of ITER

  17. The european approach to quality assurance in diagnostic radiology

    International Nuclear Information System (INIS)

    Benini, A.

    1997-01-01

    The european and increasingly the international organizations are emphasizing the importance of appropriate quality assurance programmes in diagnostic radiology. The European Directive (particularly the directive 84/466/EURATOM). the various publications of the International Commission for radiation protection (ICRP), related to protection of the patients and workers and the Basic Safety Standards of the International Atomic Energy Agency (IAEA) might be considered the landmarks of the new approach to the problems of dose reduction and quality in diagnostic radiology. In particular ICRP maintains a watching brief on all aspects related to radiation protection and makes recommendations concerning basic principles. Since ICRP 26 (1977), several ICRP publications have dealt with all the principal fields of diagnostic radiology. The IAEA has recently published the new Basic Safety Standards including guidance levels for the most common diagnostic investigations.Within the European countries the European Union and the European legislation have strong influence of the implementation of radiation protection and Q A at a national level. This has led to a substantial effort in the european countries to establish national standards and basic quality requirements. (author)

  18. Access to diphtheria antitoxin for therapy and diagnostics.

    Science.gov (United States)

    Both, L; White, J; Mandal, S; Efstratiou, A

    2014-06-19

    The most effective treatment for diphtheria is swift administration of diphtheria antitoxin (DAT) with conjunct antibiotic therapy. DAT is an equine immunoglobulin preparation and listed among the World Health Organization Essential Medicines. Essential Medicines should be available in functioning health systems at all times in adequate amounts, in appropriate dosage forms, with assured quality, and at prices individuals and the community can afford. However, DAT is in scarce supply and frequently unavailable to patients because of discontinued production in several countries, low economic viability, and high regulatory requirements for the safe manufacture of blood-derived products. DAT is also a cornerstone of diphtheria diagnostics but several diagnostic reference laboratories across the European Union (EU) and elsewhere routinely face problems in sourcing DAT for toxigenicity testing. Overall, global access to DAT for both therapeutic and diagnostic applications seems inadequate. Therefore--besides efforts to improve the current supply of DAT--accelerated research and development of alternatives including monoclonal antibodies for therapy and molecular-based methods for diagnostics are required. Given the rarity of the disease, it would be useful to organise a small stockpile centrally for all EU countries and to maintain an inventory of DAT availability within and between countries.

  19. Trust, confidence, and the 2008 global financial crisis.

    Science.gov (United States)

    Earle, Timothy C

    2009-06-01

    The 2008 global financial crisis has been compared to a "once-in-a-century credit tsunami," a disaster in which the loss of trust and confidence played key precipitating roles and the recovery from which will require the restoration of these crucial factors. Drawing on the analogy between the financial crisis and environmental and technological hazards, recent research on the role of trust and confidence in the latter is used to provide a perspective on the former. Whereas "trust" and "confidence" are used interchangeably and without explicit definition in most discussions of the financial crisis, this perspective uses the TCC model of cooperation to clearly distinguish between the two and to demonstrate how this distinction can lead to an improved understanding of the crisis. The roles of trust and confidence-both in precipitation and in possible recovery-are discussed for each of the three major sets of actors in the crisis, the regulators, the banks, and the public. The roles of trust and confidence in the larger context of risk management are also examined; trust being associated with political approaches, confidence with technical. Finally, the various stances that government can take with regard to trust-such as supportive or skeptical-are considered. Overall, it is argued that a clear understanding of trust and confidence and a close examination of the specific, concrete circumstances of a crisis-revealing when either trust or confidence is appropriate-can lead to useful insights for both recovery and prevention of future occurrences.

  20. The ICF National Diagnostic Plan (NDP) 9/19/17

    Energy Technology Data Exchange (ETDEWEB)

    Kilkenny, J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Richau, G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Sangster, C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Batha, S. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Bell, P. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Larson, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Bradley, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Leeper, R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Herrmann, H. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Bourdon, C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hilsabeck, T. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-10-02

    A major goal of the Stockpile Stewardship Program (SSP) is to deliver validated numerical models, benchmarked against experiments that address relevant and important issues and provide data that stress the codes and our understanding. DOENNSA has made significant investments in major facilities and high-performance computing to successfully execute the SSP. The more information obtained about the physical state of the plasmas produced, the more stringent the test of theories, models, and codes can be, leading to increased confidence in our predictive capability. To fully exploit the world-leading capabilities of the ICF program, a multi-year program to develop and deploy advanced diagnostics has been developed by the expert scientific community. To formalize these activities NNSA’s Acting Director for the Inertial Confinement Fusion Program directed the formation and duties of the National Diagnostics Working Group (NDWG) in a Memorandum 11/3/16 (Appendix A). The NDWG identified eight transformational diagnostics, shown in Table 1, that will provide unprecedented information from experiments in support of the SSP at NIF, Z and OMEGA. Table 1 shows how the missions of the SSP experiments including materials, complex hydrodynamics, radiation flow and effects and thermo-nuclear burn and boost will produce new observables, which will be measured using a variety of largely new diagnostic technologies used in the eight transformational diagnostics. The data provided by these diagnostics will validate and improve the physics contained within the SSP’s simulations and both uncover and quantify important phenomena that lie beyond our present understanding.

  1. 49 CFR 1103.23 - Confidences of a client.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Confidences of a client. 1103.23 Section 1103.23... Responsibilities Toward A Client § 1103.23 Confidences of a client. (a) The practitioner's duty to preserve his client's confidence outlasts the practitioner's employment by the client, and this duty extends to the...

  2. Confidence assessment. Site-descriptive modelling SDM-Site Laxemar

    International Nuclear Information System (INIS)

    2009-06-01

    The objective of this report is to assess the confidence that can be placed in the Laxemar site descriptive model, based on the information available at the conclusion of the surface-based investigations (SDM-Site Laxemar). In this exploration, an overriding question is whether remaining uncertainties are significant for repository engineering design or long-term safety assessment and could successfully be further reduced by more surface-based investigations or more usefully by explorations underground made during construction of the repository. Procedures for this assessment have been progressively refined during the course of the site descriptive modelling, and applied to all previous versions of the Forsmark and Laxemar site descriptive models. They include assessment of whether all relevant data have been considered and understood, identification of the main uncertainties and their causes, possible alternative models and their handling, and consistency between disciplines. The assessment then forms the basis for an overall confidence statement. The confidence in the Laxemar site descriptive model, based on the data available at the conclusion of the surface based site investigations, has been assessed by exploring: - Confidence in the site characterization data base, - remaining issues and their handling, - handling of alternatives, - consistency between disciplines and - main reasons for confidence and lack of confidence in the model. Generally, the site investigation database is of high quality, as assured by the quality procedures applied. It is judged that the Laxemar site descriptive model has an overall high level of confidence. Because of the relatively robust geological model that describes the site, the overall confidence in the Laxemar Site Descriptive model is judged to be high, even though details of the spatial variability remain unknown. The overall reason for this confidence is the wide spatial distribution of the data and the consistency between

  3. Confidence assessment. Site-descriptive modelling SDM-Site Laxemar

    Energy Technology Data Exchange (ETDEWEB)

    2008-12-15

    The objective of this report is to assess the confidence that can be placed in the Laxemar site descriptive model, based on the information available at the conclusion of the surface-based investigations (SDM-Site Laxemar). In this exploration, an overriding question is whether remaining uncertainties are significant for repository engineering design or long-term safety assessment and could successfully be further reduced by more surface-based investigations or more usefully by explorations underground made during construction of the repository. Procedures for this assessment have been progressively refined during the course of the site descriptive modelling, and applied to all previous versions of the Forsmark and Laxemar site descriptive models. They include assessment of whether all relevant data have been considered and understood, identification of the main uncertainties and their causes, possible alternative models and their handling, and consistency between disciplines. The assessment then forms the basis for an overall confidence statement. The confidence in the Laxemar site descriptive model, based on the data available at the conclusion of the surface based site investigations, has been assessed by exploring: - Confidence in the site characterization data base, - remaining issues and their handling, - handling of alternatives, - consistency between disciplines and - main reasons for confidence and lack of confidence in the model. Generally, the site investigation database is of high quality, as assured by the quality procedures applied. It is judged that the Laxemar site descriptive model has an overall high level of confidence. Because of the relatively robust geological model that describes the site, the overall confidence in the Laxemar Site Descriptive model is judged to be high, even though details of the spatial variability remain unknown. The overall reason for this confidence is the wide spatial distribution of the data and the consistency between

  4. High Confidence Software and Systems Research Needs

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — This White Paper presents a survey of high confidence software and systems research needs. It has been prepared by the High Confidence Software and Systems...

  5. Confidence in Alternative Dispute Resolution: Experience from Switzerland

    Directory of Open Access Journals (Sweden)

    Christof Schwenkel

    2014-06-01

    Full Text Available Alternative Dispute Resolution plays a crucial role in the justice system of Switzerland. With the unified Swiss Code of Civil Procedure, it is required that each litigation session shall be preceded by an attempt at conciliation before a conciliation authority. However, there has been little research on conciliation authorities and the public's perception of the authorities. This paper looks at public confidence in conciliation authorities and provides results of a survey conducted with more than 3,400 participants. This study found that public confidence in Swiss conciliation authorities is generally high, exceeds the ratings for confidence in cantonal governments and parliaments, but is lower than confidence in courts.Since the institutional models of the conciliation authorities (meaning the organization of the authorities and the selection of the conciliators differ widely between the 26 Swiss cantons, the influence of the institutional models on public confidence is analyzed. Contrary to assumptions based on New Institutional-ism approaches, this study reports that the institutional models do not impact public confidence. Also, the relationship between a participation in an election of justices of the peace or conciliators and public confidence in these authorities is found to be at most very limited (and negative. Similar to common findings on courts, the results show that general contacts with conciliation authorities decrease public confidence in these institutions whereas a positive experience with a conciliation authority leads to more confidence.The Study was completed as part of the research project 'Basic Research into Court Management in Switzerland', supported by the Swiss National Science Foundation (SNSF. Christof Schwenkel is a PhD student at the University of Lucerne and a research associate and project manager at Interface Policy Studies. A first version of this article was presented at the 2013 European Group for Public

  6. Food skills confidence and household gatekeepers' dietary practices.

    Science.gov (United States)

    Burton, Melissa; Reid, Mike; Worsley, Anthony; Mavondo, Felix

    2017-01-01

    Household food gatekeepers have the potential to influence the food attitudes and behaviours of family members, as they are mainly responsible for food-related tasks in the home. The aim of this study was to determine the role of gatekeepers' confidence in food-related skills and nutrition knowledge on food practices in the home. An online survey was completed by 1059 Australian dietary gatekeepers selected from the Global Market Insite (GMI) research database. Participants responded to questions about food acquisition and preparation behaviours, the home eating environment, perceptions and attitudes towards food, and demographics. Two-step cluster analysis was used to identify groups based on confidence regarding food skills and nutrition knowledge. Chi-square tests and one-way ANOVAs were used to compare the groups on the dependent variables. Three groups were identified: low confidence, moderate confidence and high confidence. Gatekeepers in the highest confidence group were significantly more likely to report lower body mass index (BMI), and indicate higher importance of fresh food products, vegetable prominence in meals, product information use, meal planning, perceived behavioural control and overall diet satisfaction. Gatekeepers in the lowest confidence group were significantly more likely to indicate more perceived barriers to healthy eating, report more time constraints and more impulse purchasing practices, and higher convenience ingredient use. Other smaller associations were also found. Household food gatekeepers with high food skills confidence were more likely to engage in several healthy food practices, while those with low food skills confidence were more likely to engage in unhealthy food practices. Food education strategies aimed at building food-skills and nutrition knowledge will enable current and future gatekeepers to make healthier food decisions for themselves and for their families. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. XML Diagnostics Description Standard

    International Nuclear Information System (INIS)

    Neto, A.; Fernandes, H.; Varandas, C.; Lister, J.; Yonekawa, I.

    2006-01-01

    A standard for the self-description of fusion plasma diagnostics will be presented, based on the Extensible Markup Language (XML). The motivation is to maintain and organise the information on all the components of a laboratory experiment, from the hardware to the access security, to save time and money when problems arises. Since there is no existing standard to organise this kind of information, every Association stores and organises each experiment in different ways. This can lead to severe problems when the organisation schema is poorly documented or written in national languages. The exchange of scientists, researchers and engineers between laboratories is a common practice nowadays. Sometimes they have to install new diagnostics or to update existing ones and frequently they lose a great deal of time trying to understand the currently installed system. The most common problems are: no documentation available; the person who understands it has left; documentation written in the national language. Standardisation is the key to solving all the problems mentioned. From the commercial information on the diagnostic (component supplier; component price) to the hardware description (component specifications; drawings) to the operation of the equipment (finite state machines) through change control (who changed what and when) and internationalisation (information at least in the native language and in English), a common XML schema will be proposed. This paper will also discuss an extension of these ideas to the self-description of ITER plant systems, since the problems will be identical. (author)

  8. Diminishing self-disclosure to maintain security in partners' care.

    Science.gov (United States)

    Lemay, Edward P; Melville, Michael C

    2014-01-01

    Six studies demonstrate that perceivers' desire to bond with targets motivates perceivers to misconstrue their own self-disclosure in ways that maintain perceivers' security in targets' care and commitment. Perceivers who strongly valued relationships with targets reported high levels of global self-disclosure, consistent with many findings suggesting salutary effects of disclosure. However, these same perceivers reported low self-disclosure of needs and desires in hypothetical (Study 1) and actual (Study 2) situations characterized by targets' unresponsive behavior. Similarly, in daily report (Study 3) and behavioral observation (Study 4) studies, perceivers who valued relationships with targets perceived high levels of self-disclosure when targets were responsive, but they perceived low self-disclosure when targets were unresponsive, and these perceptions seemed partly illusory. In turn, these perceptions of low self-disclosure in situations characterized by partners' unresponsive behavior predicted decreased perceptions of diagnosticity of targets' behavior (Studies 1-3) and buffered the negative affective and interpersonal effects of unresponsive behavior (Study 4). Experimental manipulations (Studies 5 and 6) demonstrated the motivational nature of perceived self-disclosure. Collectively, the results suggest that a desire to bond with targets motivates perceivers to downplay the diagnosticity of targets' unresponsive behavior through diminishing their self-disclosure, in turn preserving perceivers' trust in targets' care and commitment.

  9. Communication Strategies of the Chinese Dairy Industry Manufacturers to Rebuild Reputation and Maintain a Quality Relationship

    Directory of Open Access Journals (Sweden)

    Dashi Zhang

    2013-10-01

    Full Text Available After the Sanlu tainted milk powder crisis in China in 2008, the entire powdered milk manufacturing industry, and in many ways the food industry as a whole, faced a crisis of reputation and consumer confidence. Through a study of the organisation and public relationships of dairy companies, the crisis communication strategies they used, and how they cultivated relationships, this paper explores how companies within the milk industry rebuilt their reputations to a point where customers and other key elements of the public once again felt confident about their products. This study explores the organisation­-public relationships (OPRs cultivation strategies of the dairy companies and the communication strategies they used to rebuild the industry's reputation after the Sanlu crisis. The author interviewed dairy company personnel and consumers in China (N=18 and conducted secondary document research. The communication strategies that dairy companies used to maintain their relationship with the public are analysed. This study develops the theory of relationship management and provides suggestions for other companies to utilise should they face an industry crisis in the future. The cultivation strategies the dairy companies use to maintain their relationship with the public is hard to separate from communication strategy employed after the crisis.

  10. Cost-effectiveness of using a molecular diagnostic test to improve preoperative diagnosis of thyroid cancer.

    Science.gov (United States)

    Najafzadeh, Mehdi; Marra, Carlo A; Lynd, Larry D; Wiseman, Sam M

    2012-12-01

    Fine-needle aspiration biopsy (FNAB) is a safe and inexpensive diagnostic procedure for evaluating thyroid nodules.Up to 25% of the results from an FNAB, however, may not be diagnostic or may be indeterminate, leading to a subsequent diagnostic thyroid surgery. A new molecularly based diagnostic test could potentially reduce indeterminate cytological results and, with high accuracy, provide a definitive diagnosis for cancer in thyroid nodules. The aim of the study was to estimate the cost-effectiveness of utilizing a molecular diagnostic (DX) test as an adjunct to FNAB, compared with NoDX, to improve the preoperative diagnosis of thyroid nodules. We constructed a patient-level simulation model to estimate the clinical and economic outcomes of using a DX test compared with current practice (NoDX) for the diagnosis of thyroid nodules. By using a cost-effectiveness framework, we measured incremental clinical benefits in terms of quality-adjusted life-years and incremental costs over a 10-year time horizon. Assuming 95% sensitivity and specificity of the Dx test when used as an adjunct to FNAB, the utilization of the DX test resulted in a gain of 0.046 quality-adjusted life-years (95% confidence interval 0.019-0.078) and a saving of $1087 (95% confidence interval $691-$1533) in direct costs per patient. If the cost of the Dx test is less than $1087 per test, we expect to save quality-adjusted life-years and reduce costs when it is utilized. Sensitivity of the DX test, compared with specificity, had a larger influence on the overall outcomes. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. 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

  12. Diagnostic x-ray equipment and its use

    International Nuclear Information System (INIS)

    1993-01-01

    The guide contains the requirements for the use, structure and operation of diagnostic x-ray equipment necessary to ensure the radiation safety of workers and patients. The guide is intended for the party responsible for operating the x-ray units, the staff operating, installing and maintaining x-ray examination equipment, and companies manufacturing and selling such equipment. Special requirements for mammographic and dental x-ray equipments are given in separate ST guides. (5 refs., 1 figs., 2 tabs.)

  13. Recent advances in control and diagnostics development and application

    International Nuclear Information System (INIS)

    Monson, L.R.; King, R.W.; Lindsay, R.W.; Staffon, J.D.

    1989-01-01

    The power industry is undergoing rapid technological advances and cultural changes. Technologies are advancing and evolving so rapidly that the industry is hard pressed to keep up and take full advantage of the many developments now in progress. Recent advantages in state-of-the-art computer technology are making in-roads in the form of advanced computer control, expert systems, on-line performance monitoring and diagnostics. Validation and verification schemes are being developed which provide increased confidence in the correctness and reliability of both computer hardware and software. Our challenge in the nuclear community is to effectively apply these new technologies to improve the operation, safety, and reliability of our plants. This presentation discusses two areas of development that are essential to advanced control strategies: application of diagnostic systems to improve fault-tolerance, and model-based graphic displays. 4 refs., 4 figs

  14. Ergonomics Contribution in Maintainability

    Science.gov (United States)

    Teymourian, Kiumars; Seneviratne, Dammika; Galar, Diego

    2017-09-01

    The objective of this paper is to describe an ergonomics contribution in maintainability. The economical designs, inputs and training helps to increase the maintainability indicators for industrial devices. This analysis can be helpful, among other cases, to compare systems, to achieve a better design regarding maintainability requirements, to improve this maintainability under specific industrial environment and to foresee maintainability problems due to eventual changes in a device operation conditions. With this purpose, this work first introduces the notion of ergonomics and human factors, maintainability and the implementation of assessment of human postures, including some important postures to perform maintenance activities. A simulation approach is used to identify the critical posture of the maintenance personnel and implements the defined postures with minimal loads on the personnel who use the equipment in a practical scenario. The simulation inputs are given to the designers to improve the workplace/equipment in order to high level of maintainability. Finally, the work concludes summarizing the more significant aspects and suggesting future research.

  15. Music educators : their artistry and self-confidence

    NARCIS (Netherlands)

    Lion-Slovak, Brigitte; Stöger, Christine; Smilde, Rineke; Malmberg, Isolde; de Vugt, Adri

    2013-01-01

    How does artistic identity influence the self-confidence of music educators? What is the interconnection between the artistic and the teacher identity? What is actually meant by artistic identity in music education? What is a fruitful environment for the development of artistic self-confidence of

  16. Financial Literacy, Confidence and Financial Advice Seeking

    NARCIS (Netherlands)

    Kramer, Marc M.

    2016-01-01

    We find that people with higher confidence in their own financial literacy are less likely to seek financial advice, but no relation between objective measures of literacy and advice seeking. The negative association between confidence and advice seeking is more pronounced among wealthy households.

  17. Confidence building in implementation of geological disposal

    International Nuclear Information System (INIS)

    Umeki, Hiroyuki

    2004-01-01

    Long-term safety of the disposal system should be demonstrated to the satisfaction of the stakeholders. Convincing arguments are therefore required that instil in the stakeholders confidence in the safety of a particular concept for the siting and design of a geological disposal, given the uncertainties that inevitably exist in its a priori description and in its evolution. The step-wise approach associated with making safety case at each stage is a key to building confidence in the repository development programme. This paper discusses aspects and issues on confidence building in the implementation of HLW disposal in Japan. (author)

  18. Elevation angle alignment of quasi optical receiver mirrors of collective Thomson scattering diagnostic by sawtooth measurements

    DEFF Research Database (Denmark)

    Moseev, D.; Meo, Fernando; Korsholm, Søren Bang

    2012-01-01

    require a good alignment of the optical path in the transmission line. Monitoring the alignment during the experiment greatly benefits the confidence in the CTS measurements. An in situ technique for the assessment of the elevation angle alignment of the receiver is developed. Using the CTS diagnostic...

  19. Bayesian based Diagnostic Model for Condition based Maintenance of Offshore Wind Farms

    DEFF Research Database (Denmark)

    Asgarpour, Masoud; Sørensen, John Dalsgaard

    2018-01-01

    Operation and maintenance costs are a major contributor to the Levelized Cost of Energy for electricity produced by offshore wind and can be significantly reduced if existing corrective actions are performed as efficiently as possible and if future corrective actions are avoided by performing...... sufficient preventive actions. This paper presents an applied and generic diagnostic model for fault detection and condition based maintenance of offshore wind components. The diagnostic model is based on two probabilistic matrices; first, a confidence matrix, representing the probability of detection using...... for a wind turbine component based on vibration, temperature, and oil particle fault detection methods. The last part of the paper will have a discussion of the case study results and present conclusions....

  20. Weighting Mean and Variability during Confidence Judgments

    Science.gov (United States)

    de Gardelle, Vincent; Mamassian, Pascal

    2015-01-01

    Humans can not only perform some visual tasks with great precision, they can also judge how good they are in these tasks. However, it remains unclear how observers produce such metacognitive evaluations, and how these evaluations might be dissociated from the performance in the visual task. Here, we hypothesized that some stimulus variables could affect confidence judgments above and beyond their impact on performance. In a motion categorization task on moving dots, we manipulated the mean and the variance of the motion directions, to obtain a low-mean low-variance condition and a high-mean high-variance condition with matched performances. Critically, in terms of confidence, observers were not indifferent between these two conditions. Observers exhibited marked preferences, which were heterogeneous across individuals, but stable within each observer when assessed one week later. Thus, confidence and performance are dissociable and observers’ confidence judgments put different weights on the stimulus variables that limit performance. PMID:25793275

  1. Renal cell carcinoma primary cultures maintain genomic and phenotypic profile of parental tumor tissues.

    Science.gov (United States)

    Cifola, Ingrid; Bianchi, Cristina; Mangano, Eleonora; Bombelli, Silvia; Frascati, Fabio; Fasoli, Ester; Ferrero, Stefano; Di Stefano, Vitalba; Zipeto, Maria A; Magni, Fulvio; Signorini, Stefano; Battaglia, Cristina; Perego, Roberto A

    2011-06-13

    Clear cell renal cell carcinoma (ccRCC) is characterized by recurrent copy number alterations (CNAs) and loss of heterozygosity (LOH), which may have potential diagnostic and prognostic applications. Here, we explored whether ccRCC primary cultures, established from surgical tumor specimens, maintain the DNA profile of parental tumor tissues allowing a more confident CNAs and LOH discrimination with respect to the original tissues. We established a collection of 9 phenotypically well-characterized ccRCC primary cell cultures. Using the Affymetrix SNP array technology, we performed the genome-wide copy number (CN) profiling of both cultures and corresponding tumor tissues. Global concordance for each culture/tissue pair was assayed evaluating the correlations between whole-genome CN profiles and SNP allelic calls. CN analysis was performed using the two CNAG v3.0 and Partek software, and comparing results returned by two different algorithms (Hidden Markov Model and Genomic Segmentation). A very good overlap between the CNAs of each culture and corresponding tissue was observed. The finding, reinforced by high whole-genome CN correlations and SNP call concordances, provided evidence that each culture was derived from its corresponding tissue and maintained the genomic alterations of parental tumor. In addition, primary culture DNA profile remained stable for at least 3 weeks, till to third passage. These cultures showed a greater cell homogeneity and enrichment in tumor component than original tissues, thus enabling a better discrimination of CNAs and LOH. Especially for hemizygous deletions, primary cultures presented more evident CN losses, typically accompanied by LOH; differently, in original tissues the intensity of these deletions was weaken by normal cell contamination and LOH calls were missed. ccRCC primary cultures are a reliable in vitro model, well-reproducing original tumor genetics and phenotype, potentially useful for future functional approaches

  2. Confidence and self-attribution bias in an artificial stock market

    Science.gov (United States)

    Bertella, Mario A.; Pires, Felipe R.; Rego, Henio H. A.; Vodenska, Irena; Stanley, H. Eugene

    2017-01-01

    Using an agent-based model we examine the dynamics of stock price fluctuations and their rates of return in an artificial financial market composed of fundamentalist and chartist agents with and without confidence. We find that chartist agents who are confident generate higher price and rate of return volatilities than those who are not. We also find that kurtosis and skewness are lower in our simulation study of agents who are not confident. We show that the stock price and confidence index—both generated by our model—are cointegrated and that stock price affects confidence index but confidence index does not affect stock price. We next compare the results of our model with the S&P 500 index and its respective stock market confidence index using cointegration and Granger tests. As in our model, we find that stock prices drive their respective confidence indices, but that the opposite relationship, i.e., the assumption that confidence indices drive stock prices, is not significant. PMID:28231255

  3. Improved realism of confidence for an episodic memory event

    Directory of Open Access Journals (Sweden)

    Sandra Buratti

    2012-09-01

    Full Text Available We asked whether people can make their confidence judgments more realistic (accurate by adjusting them, with the aim of improving the relationship between the level of confidence and the correctness of the answer. This adjustment can be considered to include a so-called second-order metacognitive judgment. The participants first gave confidence judgments about their answers to questions about a video clip they had just watched. Next, they attempted to increase their accuracy by identifying confidence judgments in need of adjustment and then modifying them. The participants managed to increase their metacognitive realism, thus decreasing their absolute bias and improving their calibration, although the effects were small. We also examined the relationship between confidence judgments that were adjusted and the retrieval fluency and the phenomenological memory quality participants experienced when first answering the questions; this quality was one of either Remember (associated with concrete, vivid details or Know (associated with a feeling of familiarity. Confidence judgments associated with low retrieval fluency and the memory quality of knowing were modified more often. In brief, our results provide evidence that people can improve the realism of their confidence judgments, mainly by decreasing their confidence for incorrect answers. Thus, this study supports the conclusion that people can perform successful second-order metacognitive judgments.

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. Design and integration of lower ports for ITER diagnostic systems

    Energy Technology Data Exchange (ETDEWEB)

    Casal, Natalia, E-mail: Natalia.casal@iter.org [ITER Organization, Route de Vinon-sur-Verdon – CS 90 046 – 13067 St Paul Lez Durance Cedex (France); Bertalot, Luciano; Cheng, Hao; Drevon, Jean Marc; Duckworth, Philip; Giacomin, Thibaud; Guirao, Julio; Iglesias, Silvia [ITER Organization, Route de Vinon-sur-Verdon – CS 90 046 – 13067 St Paul Lez Durance Cedex (France); Kochergin, Mikhail [IOFFE Institute, Saint Petersburg (Russian Federation); Martin, Alex [ITER Organization, Route de Vinon-sur-Verdon – CS 90 046 – 13067 St Paul Lez Durance Cedex (France); McCarron, Eddie [Oxford Technologies Ltd., Abingdon (United Kingdom); Mokeev, Alexander [Russian Federation Domestic Agency, Moscow (Russian Federation); Mota, Fernando [CIEMAT, Madrid (Spain); Penot, Christophe; Portales, Mickael [ITER Organization, Route de Vinon-sur-Verdon – CS 90 046 – 13067 St Paul Lez Durance Cedex (France); Kitazawa, Sin-iti [Japanese Domestic Agency, Naka (Japan); Sky, Jack [Oxford Technologies Ltd., Abingdon (United Kingdom); Suarez, Alejandro; Udintsev, Victor; Utin, Yuri [ITER Organization, Route de Vinon-sur-Verdon – CS 90 046 – 13067 St Paul Lez Durance Cedex (France); and others

    2015-10-15

    Highlights: • Lower port structures are in its conceptual design phase. • Electromagnetic and seismic loads, will dominate all other mechanical loads. • Design allows diagnostics support, neutron shielding while and signals transmission. • Installation and maintenance operations are fully remote handling compatible. - Abstract: All around the ITER vacuum vessel, forty-four ports will provide access to the vacuum vessel for remote handling operations, diagnostic systems, heating, and vacuum systems: 18 upper ports, 17 equatorial ports, and 9 lower ports. Among the lower ports, three of them will be used for the remote handling installation of the ITER divertor. Once the divertor is in place, these ports will host various diagnostic systems mounted in the so-called diagnostic racks. The diagnostic racks must allow the support and cooling of the diagnostics, extraction of the required diagnostic signals, and providing access and maintainability while minimizing the leakage of radiation toward the back of the port where the humans are allowed to enter. A fully integrated inner rack, carrying the near plasma diagnostic components, will be an stainless steel structure, 4.2 m long, with a maximum weight of 10 t. This structure brings water for cooling and baking at maximum temperature of 240 °C and provides connection with gas, vacuum and electric services. Additional racks (placed away from plasma and not requiring cooling) may be required for the support of some particular diagnostic components. The diagnostics racks and its associated ex vessel structures, which are in its conceptual design phase, are being designed to survive the lifetime of ITER of 20 years. This paper presents the current state of development including interfaces, diagnostic integration, operation and maintenance, shielding requirements, remote handling, loads cases and discussion of the main challenges coming from the severe environment and engineering requirements.

  9. Interpretation of Confidence Interval Facing the Conflict

    Science.gov (United States)

    Andrade, Luisa; Fernández, Felipe

    2016-01-01

    As literature has reported, it is usual that university students in statistics courses, and even statistics teachers, interpret the confidence level associated with a confidence interval as the probability that the parameter value will be between the lower and upper interval limits. To confront this misconception, class activities have been…

  10. Process management and controlling in diagnostic radiology

    International Nuclear Information System (INIS)

    Gocke, P.; Debatin, J.F.; Duerselen, L.F.J.

    2002-01-01

    Systematic process management and efficient quality control is rapidly gaining importance in our healthcare system. What does this mean for diagnostic radiology departments?To improve efficiency, quality and productivity the workflow within the department of diagnostic and interventional radiology at the University Hospital of Essen were restructured over the last two years. Furthermore, a controlling system was established. One of the pursued aims was to create a quality management system as a basis for the subsequent certification according to the ISO EN 9001:2000 norm.Central to the success of the workflow reorganisation was the training of selected members of the department's staff in process and quality management theory. Thereafter, a dedicated working group was created to prepare the reorganisation and the subsequent ISO certification with the support of a consulting partner. To assure a smooth implementation of the restructured workflow and create acceptance for the required ISO-9001 documentation, the entire staff was familiarized with the basic ideas of process- and quality-management in several training sessions.This manuscript summarizes the basic concepts of process and quality management as they were taught to our staff. A direct relationship towards diagnostic radiology is maintained throughout the text. (orig.) [de

  11. Is consumer confidence an indicator of JSE performance?

    OpenAIRE

    Kamini Solanki; Yudhvir Seetharam

    2014-01-01

    While most studies examine the impact of business confidence on market performance, we instead focus on the consumer because consumer spending habits are a natural extension of trading activity on the equity market. This particular study examines investor sentiment as measured by the Consumer Confidence Index in South Africa and its effect on the Johannesburg Stock Exchange (JSE). We employ Granger causality tests to investigate the relationship across time between the Consumer Confidence Ind...

  12. Confidence Interval Approximation For Treatment Variance In ...

    African Journals Online (AJOL)

    In a random effects model with a single factor, variation is partitioned into two as residual error variance and treatment variance. While a confidence interval can be imposed on the residual error variance, it is not possible to construct an exact confidence interval for the treatment variance. This is because the treatment ...

  13. Self-confidence of anglers in identification of freshwater sport fish

    Science.gov (United States)

    Chizinski, C.J.; Martin, D. R.; Pope, Kevin L.

    2014-01-01

    Although several studies have focused on how well anglers identify species using replicas and pictures, there has been no study assessing the confidence that can be placed in angler's ability to identify recreationally important fish. Understanding factors associated with low self-confidence will be useful in tailoring education programmes to improve self-confidence in identifying common species. The purposes of this assessment were to quantify the confidence of recreational anglers to identify 13 commonly encountered warm water fish species and to relate self-confidence to species availability and angler experience. Significant variation was observed in anglers self-confidence among species and levels of self-declared skill, with greater confidence associated with greater skill and with greater exposure. This study of angler self-confidence strongly highlights the need for educational programmes that target lower skilled anglers and the importance of teaching all anglers about less common species, regardless of skill level.

  14. A modified Wald interval for the area under the ROC curve (AUC) in diagnostic case-control studies.

    Science.gov (United States)

    Kottas, Martina; Kuss, Oliver; Zapf, Antonia

    2014-02-19

    The area under the receiver operating characteristic (ROC) curve, referred to as the AUC, is an appropriate measure for describing the overall accuracy of a diagnostic test or a biomarker in early phase trials without having to choose a threshold. There are many approaches for estimating the confidence interval for the AUC. However, all are relatively complicated to implement. Furthermore, many approaches perform poorly for large AUC values or small sample sizes. The AUC is actually a probability. So we propose a modified Wald interval for a single proportion, which can be calculated on a pocket calculator. We performed a simulation study to compare this modified Wald interval (without and with continuity correction) with other intervals regarding coverage probability and statistical power. The main result is that the proposed modified Wald intervals maintain and exploit the type I error much better than the intervals of Agresti-Coull, Wilson, and Clopper-Pearson. The interval suggested by Bamber, the Mann-Whitney interval without transformation and also the interval of the binormal AUC are very liberal. For small sample sizes the Wald interval with continuity has a comparable coverage probability as the LT interval and higher power. For large sample sizes the results of the LT interval and of the Wald interval without continuity correction are comparable. If individual patient data is not available, but only the estimated AUC and the total sample size, the modified Wald intervals can be recommended as confidence intervals for the AUC. For small sample sizes the continuity correction should be used.

  15. Diagnostic accuracy of insight intraoral film on dental caries

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Young Nam; Lee, Byung Do [Wonkwang University College of Medicine, Iksan (Korea, Republic of); Lee, Sang Rae [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    2004-03-15

    To compare the diagnostic accuracy of Kodak Insight film with other intra-oral films in the detection of dental caries. Periapical radiographs of 99 extracted human teeth with sound proximal surfaces and interproximal artificial cavities were made on Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Kodak Insight films and automatically processed. Six dentists examined the presence of dental caries using a five-point confidence rating scale and compared the diagnostic accuracy by ROC (Receiver Operating Characteristic) analysis and ANOVA test. The sensitivity of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.84, 0.77, 0.75 and 0.79 respectively. The specificity of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.97, 0.95, 0.96 and 0.94 respectively. The mean ROC areas (Az) of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.917, 0.910, 0.894, 0.909 respectively. There was no significant differences between Az of Insight film and other films (p = 0.178). Theses results suggested that Kodak Insight film have the comparative diagnostic accuracy of dental caries with Ultraspeed and Ektaspeed films. (77)

  16. Diagnostic accuracy of insight intraoral film on dental caries

    International Nuclear Information System (INIS)

    Yoon, Young Nam; Lee, Byung Do; Lee, Sang Rae

    2004-01-01

    To compare the diagnostic accuracy of Kodak Insight film with other intra-oral films in the detection of dental caries. Periapical radiographs of 99 extracted human teeth with sound proximal surfaces and interproximal artificial cavities were made on Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Kodak Insight films and automatically processed. Six dentists examined the presence of dental caries using a five-point confidence rating scale and compared the diagnostic accuracy by ROC (Receiver Operating Characteristic) analysis and ANOVA test. The sensitivity of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.84, 0.77, 0.75 and 0.79 respectively. The specificity of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.97, 0.95, 0.96 and 0.94 respectively. The mean ROC areas (Az) of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.917, 0.910, 0.894, 0.909 respectively. There was no significant differences between Az of Insight film and other films (p = 0.178). Theses results suggested that Kodak Insight film have the comparative diagnostic accuracy of dental caries with Ultraspeed and Ektaspeed films. (77)

  17. Effects of postidentification feedback on eyewitness identification and nonidentification confidence.

    Science.gov (United States)

    Semmler, Carolyn; Brewer, Neil; Wells, Gary L

    2004-04-01

    Two experiments investigated new dimensions of the effect of confirming feedback on eyewitness identification confidence using target-absent and target-present lineups and (previously unused) unbiased witness instructions (i.e., "offender not present" option highlighted). In Experiment 1, participants viewed a crime video and were later asked to try to identify the thief from an 8-person target-absent photo array. Feedback inflated witness confidence for both mistaken identifications and correct lineup rejections. With target-present lineups in Experiment 2, feedback inflated confidence for correct and mistaken identifications and lineup rejections. Although feedback had no influence on the confidence-accuracy correlation, it produced clear overconfidence. Confidence inflation varied with the confidence measure reference point (i.e., retrospective vs. current confidence) and identification response latency.

  18. Confidence Intervals from Normalized Data: A correction to Cousineau (2005

    Directory of Open Access Journals (Sweden)

    Richard D. Morey

    2008-09-01

    Full Text Available Presenting confidence intervals around means is a common method of expressing uncertainty in data. Loftus and Masson (1994 describe confidence intervals for means in within-subjects designs. These confidence intervals are based on the ANOVA mean squared error. Cousineau (2005 presents an alternative to the Loftus and Masson method, but his method produces confidence intervals that are smaller than those of Loftus and Masson. I show why this is the case and offer a simple correction that makes the expected size of Cousineau confidence intervals the same as that of Loftus and Masson confidence intervals.

  19. Doubly Bayesian Analysis of Confidence in Perceptual Decision-Making.

    Science.gov (United States)

    Aitchison, Laurence; Bang, Dan; Bahrami, Bahador; Latham, Peter E

    2015-10-01

    Humans stand out from other animals in that they are able to explicitly report on the reliability of their internal operations. This ability, which is known as metacognition, is typically studied by asking people to report their confidence in the correctness of some decision. However, the computations underlying confidence reports remain unclear. In this paper, we present a fully Bayesian method for directly comparing models of confidence. Using a visual two-interval forced-choice task, we tested whether confidence reports reflect heuristic computations (e.g. the magnitude of sensory data) or Bayes optimal ones (i.e. how likely a decision is to be correct given the sensory data). In a standard design in which subjects were first asked to make a decision, and only then gave their confidence, subjects were mostly Bayes optimal. In contrast, in a less-commonly used design in which subjects indicated their confidence and decision simultaneously, they were roughly equally likely to use the Bayes optimal strategy or to use a heuristic but suboptimal strategy. Our results suggest that, while people's confidence reports can reflect Bayes optimal computations, even a small unusual twist or additional element of complexity can prevent optimality.

  20. Registered nurse leadership style and confidence in delegation.

    Science.gov (United States)

    Saccomano, Scott J; Pinto-Zipp, Genevieve

    2011-05-01

      Leadership and confidence in delegation are two important explanatory constructs of nursing practice. The relationship between these constructs, however, is not clearly understood. To be successful in their roles as leaders, regardless of their experience, registered nurses (RNs) need to understand how to best delegate. The present study explored and described the relationship between RN leadership styles, demographic variables and confidence in delegation in a community teaching hospital. Utilizing a cross-sectional survey design, RNs employed in one acute care hospital completed questionnaires that measured leadership style [Path-Goal Leadership Questionnaire (PGLQ)] and confidence in delegating patient care tasks [Confidence and Intent to Delegate Scale (CIDS)]. Contrary to expectations, the data did not confirm a relationship between confidence in delegating tasks to unlicensed assistive personnel (UAPs) and leadership style. Nurses who were diploma or associate degree prepared were initially less confident in delegating tasks to UAPs as compared with RNs holding a bachelor's degree or higher. Further, after 5 years of clinical nursing experience, nurses with less educational experience reported more confidence in delegating tasks as compared with RNs with more educational experience. The lack of a relationship between leadership style and confidence in delegating patient care tasks were discussed in terms of the PGLQ classification criteria and hospital unit differences. As suggested by the significant two-way interaction between educational preparation and clinical nursing experience, changes in the nurse's confidence in delegating patient care tasks to UAPs was a dynamic changing variable that resulted from the interplay between amount of educational preparation and years of clinical nursing experience in this population of nurses. Clearly, generalizability of these findings to nurses outside the US is questionable, thus nurse managers must be familiar

  1. Implementing artificial neural networks in nuclear power plants diagnostic systems: issues and challenges

    International Nuclear Information System (INIS)

    Boger, Z.

    1998-01-01

    A recent review of artificial intelligence applications in nuclear power plants (NPP) diagnostics and fault detection finds that mostly expert systems (ES) and artificial neural networks (ANN) techniques were researched and proposed, but the number of actual implementations in NPP diagnostics systems is very small. It lists the perceived obstacles to the ANN-based system acceptance and implementation. This paper analyses this list. Some of ANN limitations relate to 'quantitative' difficulties of designing and training large-scale ANNs. The availability of an efficient large-scale ANN training algorithm may alleviate most of these concerns. Other perceived drawbacks refer to the 'qualitative' aspects of ANN acceptance - how and when can we rely on the quality of the advice given by the ANN model. Several techniques are available that help to brighten the 'black box' image of the ANN. Analysis of the trained ANN can identify the significant inputs. Calculation of the Causal Indices may reveal the magnitude and sign of the influence of each input on each output. Both these techniques increase the confidence of the users when they conform to known knowledge, or point to plausible relationships. Analysis of the behavior of the neurons in the hidden layer can identify false ANN classification when presented with noisy or corrupt data. Auto-associative NN can identify faulty sensors or data. Two examples of the ANN capabilities as possible diagnostic tools are given, using NPP data, one classifying internal reactor disturbances by neutron noise spectra analysis, the other identifying the faults causes of several transients. To use these techniques the ANN developers need large amount of training data of as many transients as possible. Such data is routinely generated in NPP simulators during the periodic qualification of NPP operators. The IAEA can help by encouraging the saving and distributing the transient data to developers of ANN diagnostic system, to serve as

  2. Detecting Disease in Radiographs with Intuitive Confidence

    Directory of Open Access Journals (Sweden)

    Stefan Jaeger

    2015-01-01

    Full Text Available This paper argues in favor of a specific type of confidence for use in computer-aided diagnosis and disease classification, namely, sine/cosine values of angles represented by points on the unit circle. The paper shows how this confidence is motivated by Chinese medicine and how sine/cosine values are directly related with the two forces Yin and Yang. The angle for which sine and cosine are equal (45° represents the state of equilibrium between Yin and Yang, which is a state of nonduality that indicates neither normality nor abnormality in terms of disease classification. The paper claims that the proposed confidence is intuitive and can be readily understood by physicians. The paper underpins this thesis with theoretical results in neural signal processing, stating that a sine/cosine relationship between the actual input signal and the perceived (learned input is key to neural learning processes. As a practical example, the paper shows how to use the proposed confidence values to highlight manifestations of tuberculosis in frontal chest X-rays.

  3. Dose and diagnostic image quality in digital tomosynthesis imaging of facial bones in pediatrics

    Science.gov (United States)

    King, J. M.; Hickling, S.; Elbakri, I. A.; Reed, M.; Wrogemann, J.

    2011-03-01

    The purpose of this study was to evaluate the use of digital tomosynthesis (DT) for pediatric facial bone imaging. We compared the eye lens dose and diagnostic image quality of DT facial bone exams relative to digital radiography (DR) and computed tomography (CT), and investigated whether we could modify our current DT imaging protocol to reduce patient dose while maintaining sufficient diagnostic image quality. We measured the dose to the eye lens for all three modalities using high-sensitivity thermoluminescent dosimeters (TLDs) and an anthropomorphic skull phantom. To assess the diagnostic image quality of DT compared to the corresponding DR and CT images, we performed an observer study where the visibility of anatomical structures in the DT phantom images were rated on a four-point scale. We then acquired DT images at lower doses and had radiologists indicate whether the visibility of each structure was adequate for diagnostic purposes. For typical facial bone exams, we measured eye lens doses of 0.1-0.4 mGy for DR, 0.3-3.7 mGy for DT, and 26 mGy for CT. In general, facial bone structures were visualized better with DT then DR, and the majority of structures were visualized well enough to avoid the need for CT. DT imaging provides high quality diagnostic images of the facial bones while delivering significantly lower doses to the lens of the eye compared to CT. In addition, we found that by adjusting the imaging parameters, the DT effective dose can be reduced by up to 50% while maintaining sufficient image quality.

  4. High confidence in falsely recognizing prototypical faces.

    Science.gov (United States)

    Sampaio, Cristina; Reinke, Victoria; Mathews, Jeffrey; Swart, Alexandra; Wallinger, Stephen

    2018-06-01

    We applied a metacognitive approach to investigate confidence in recognition of prototypical faces. Participants were presented with sets of faces constructed digitally as deviations from prototype/base faces. Participants were then tested with a simple recognition task (Experiment 1) or a multiple-choice task (Experiment 2) for old and new items plus new prototypes, and they showed a high rate of confident false alarms to the prototypes. Confidence and accuracy relationship in this face recognition paradigm was found to be positive for standard items but negative for the prototypes; thus, it was contingent on the nature of the items used. The data have implications for lineups that employ match-to-suspect strategies.

  5. Confidence mediates the sex difference in mental rotation performance.

    Science.gov (United States)

    Estes, Zachary; Felker, Sydney

    2012-06-01

    On tasks that require the mental rotation of 3-dimensional figures, males typically exhibit higher accuracy than females. Using the most common measure of mental rotation (i.e., the Mental Rotations Test), we investigated whether individual variability in confidence mediates this sex difference in mental rotation performance. In each of four experiments, the sex difference was reliably elicited and eliminated by controlling or manipulating participants' confidence. Specifically, confidence predicted performance within and between sexes (Experiment 1), rendering confidence irrelevant to the task reliably eliminated the sex difference in performance (Experiments 2 and 3), and manipulating confidence significantly affected performance (Experiment 4). Thus, confidence mediates the sex difference in mental rotation performance and hence the sex difference appears to be a difference of performance rather than ability. Results are discussed in relation to other potential mediators and mechanisms, such as gender roles, sex stereotypes, spatial experience, rotation strategies, working memory, and spatial attention.

  6. Aging and Confidence Judgments in Item Recognition

    Science.gov (United States)

    Voskuilen, Chelsea; Ratcliff, Roger; McKoon, Gail

    2018-01-01

    We examined the effects of aging on performance in an item-recognition experiment with confidence judgments. A model for confidence judgments and response time (RTs; Ratcliff & Starns, 2013) was used to fit a large amount of data from a new sample of older adults and a previously reported sample of younger adults. This model of confidence…

  7. Maximum-confidence discrimination among symmetric qudit states

    International Nuclear Information System (INIS)

    Jimenez, O.; Solis-Prosser, M. A.; Delgado, A.; Neves, L.

    2011-01-01

    We study the maximum-confidence (MC) measurement strategy for discriminating among nonorthogonal symmetric qudit states. Restricting to linearly dependent and equally likely pure states, we find the optimal positive operator valued measure (POVM) that maximizes our confidence in identifying each state in the set and minimizes the probability of obtaining inconclusive results. The physical realization of this POVM is completely determined and it is shown that after an inconclusive outcome, the input states may be mapped into a new set of equiprobable symmetric states, restricted, however, to a subspace of the original qudit Hilbert space. By applying the MC measurement again onto this new set, we can still gain some information about the input states, although with less confidence than before. This leads us to introduce the concept of sequential maximum-confidence (SMC) measurements, where the optimized MC strategy is iterated in as many stages as allowed by the input set, until no further information can be extracted from an inconclusive result. Within each stage of this measurement our confidence in identifying the input states is the highest possible, although it decreases from one stage to the next. In addition, the more stages we accomplish within the maximum allowed, the higher will be the probability of correct identification. We will discuss an explicit example of the optimal SMC measurement applied in the discrimination among four symmetric qutrit states and propose an optical network to implement it.

  8. Integrating molecular diagnostics into histopathology training: the Belfast model.

    Science.gov (United States)

    Flynn, C; James, J; Maxwell, P; McQuaid, S; Ervine, A; Catherwood, M; Loughrey, M B; McGibben, D; Somerville, J; McManus, D T; Gray, M; Herron, B; Salto-Tellez, M

    2014-07-01

    Molecular medicine is transforming modern clinical practice, from diagnostics to therapeutics. Discoveries in research are being incorporated into the clinical setting with increasing rapidity. This transformation is also deeply changing the way we practise pathology. The great advances in cell and molecular biology which have accelerated our understanding of the pathogenesis of solid tumours have been embraced with variable degrees of enthusiasm by diverse medical professional specialties. While histopathologists have not been prompt to adopt molecular diagnostics to date, the need to incorporate molecular pathology into the training of future histopathologists is imperative. Our goal is to create, within an existing 5-year histopathology training curriculum, the structure for formal substantial teaching of molecular diagnostics. This specialist training has two main goals: (1) to equip future practising histopathologists with basic knowledge of molecular diagnostics and (2) to create the option for those interested in a subspecialty experience in tissue molecular diagnostics to pursue this training. It is our belief that this training will help to maintain in future the role of the pathologist at the centre of patient care as the integrator of clinical, morphological and molecular information. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

    Directory of Open Access Journals (Sweden)

    Aleksandar Vodovnik

    2016-01-01

    , image size, number of cases, specimen type, network speed, and participant's level of confidence and experience in digital reporting. Further advancements in working stations and gained experience in digital reporting are expected to improve diagnostic time and widen routine applications of digital pathology.

  10. Understanding public confidence in government to prevent terrorist attacks.

    Energy Technology Data Exchange (ETDEWEB)

    Baldwin, T. E.; Ramaprasad, A,; Samsa, M. E.; Decision and Information Sciences; Univ. of Illinois at Chicago

    2008-04-02

    A primary goal of terrorism is to instill a sense of fear and vulnerability in a population and to erode its confidence in government and law enforcement agencies to protect citizens against future attacks. In recognition of its importance, the Department of Homeland Security includes public confidence as one of the principal metrics used to assess the consequences of terrorist attacks. Hence, a detailed understanding of the variations in public confidence among individuals, terrorist event types, and as a function of time is critical to developing this metric. In this exploratory study, a questionnaire was designed, tested, and administered to small groups of individuals to measure public confidence in the ability of federal, state, and local governments and their public safety agencies to prevent acts of terrorism. Data was collected from three groups before and after they watched mock television news broadcasts portraying a smallpox attack, a series of suicide bomber attacks, a refinery explosion attack, and cyber intrusions on financial institutions, resulting in identity theft. Our findings are: (a) although the aggregate confidence level is low, there are optimists and pessimists; (b) the subjects are discriminating in interpreting the nature of a terrorist attack, the time horizon, and its impact; (c) confidence recovery after a terrorist event has an incubation period; and (d) the patterns of recovery of confidence of the optimists and the pessimists are different. These findings can affect the strategy and policies to manage public confidence after a terrorist event.

  11. Effects of confidence and anxiety on flow state in competition.

    Science.gov (United States)

    Koehn, Stefan

    2013-01-01

    Confidence and anxiety are important variables that underlie the experience of flow in sport. Specifically, research has indicated that confidence displays a positive relationship and anxiety a negative relationship with flow. The aim of this study was to assess potential direct and indirect effects of confidence and anxiety dimensions on flow state in tennis competition. A sample of 59 junior tennis players completed measures of Competitive State Anxiety Inventory-2d and Flow State Scale-2. Following predictive analysis, results showed significant positive correlations between confidence (intensity and direction) and anxiety symptoms (only directional perceptions) with flow state. Standard multiple regression analysis indicated confidence as the only significant predictor of flow. The results confirmed a protective function of confidence against debilitating anxiety interpretations, but there were no significant interaction effects between confidence and anxiety on flow state.

  12. Preservice teachers' perceived confidence in teaching school violence prevention.

    Science.gov (United States)

    Kandakai, Tina L; King, Keith A

    2002-01-01

    To examine preservice teachers' perceived confidence in teaching violence prevention and the potential effect of violence-prevention training on preservice teachers' confidence in teaching violence prevention. Six Ohio universities participated in the study. More than 800 undergraduate and graduate students completed surveys. Violence-prevention training, area of certification, and location of student- teaching placement significantly influenced preservice teachers' perceived confidence in teaching violence prevention. Violence-prevention training positively influences preservice teachers' confidence in teaching violence prevention. The results suggest that such training should be considered as a requirement for teacher preparation programs.

  13. Self Confidence Spillovers and Motivated Beliefs

    DEFF Research Database (Denmark)

    Banerjee, Ritwik; Gupta, Nabanita Datta; Villeval, Marie Claire

    that success when competing in a task increases the performers’ self-confidence and competitiveness in the subsequent task. We also find that such spillovers affect the self-confidence of low-status individuals more than that of high-status individuals. Receiving good news under Affirmative Action, however......Is success in a task used strategically by individuals to motivate their beliefs prior to taking action in a subsequent, unrelated, task? Also, is the distortion of beliefs reinforced for individuals who have lower status in society? Conducting an artefactual field experiment in India, we show...

  14. Alternative confidence measure for local matching stereo algorithms

    CSIR Research Space (South Africa)

    Ndhlovu, T

    2009-11-01

    Full Text Available The authors present a confidence measure applied to individual disparity estimates in local matching stereo correspondence algorithms. It aims at identifying textureless areas, where most local matching algorithms fail. The confidence measure works...

  15. Coping skills: role of trait sport confidence and trait anxiety.

    Science.gov (United States)

    Cresswell, Scott; Hodge, Ken

    2004-04-01

    The current research assesses relationships among coping skills, trait sport confidence, and trait anxiety. Two samples (n=47 and n=77) of international competitors from surf life saving (M=23.7 yr.) and touch rugby (M=26.2 yr.) completed the Athletic Coping Skills Inventory, Trait Sport Confidence Inventory, and Sport Anxiety Scale. Analysis yielded significant correlations amongst trait anxiety, sport confidence, and coping. Specifically confidence scores were positively associated with coping with adversity scores and anxiety scores were negatively associated. These findings support the inclusion of the personality characteristics of confidence and anxiety within the coping model presented by Hardy, Jones, and Gould, Researchers should be aware that confidence and anxiety may influence the coping processes of athletes.

  16. Reclaim your creative confidence.

    Science.gov (United States)

    Kelley, Tom; Kelley, David

    2012-12-01

    Most people are born creative. But over time, a lot of us learn to stifle those impulses. We become warier of judgment, more cautious more analytical. The world seems to divide into "creatives" and "noncreatives," and too many people resign themselves to the latter category. And yet we know that creativity is essential to success in any discipline or industry. The good news, according to authors Tom Kelley and David Kelley of IDEO, is that we all can rediscover our creative confidence. The trick is to overcome the four big fears that hold most of us back: fear of the messy unknown, fear of judgment, fear of the first step, and fear of losing control. The authors use an approach based on the work of psychologist Albert Bandura in helping patients get over their snake phobias: You break challenges down into small steps and then build confidence by succeeding on one after another. Creativity is something you practice, say the authors, not just a talent you are born with.

  17. nigerian students' self-confidence in responding to statements

    African Journals Online (AJOL)

    Temechegn

    Altogether the test is made up of 40 items covering students' ability to recall definition ... confidence interval within which student have confidence in their choice of the .... is mentioned these equilibrium systems come to memory of the learner.

  18. Conquering Credibility for Monetary Policy Under Sticky Confidence

    Directory of Open Access Journals (Sweden)

    Jaylson Jair da Silveira

    2015-06-01

    Full Text Available We derive a best-reply monetary policy when the confidence by price setters on the monetary authority’s commitment to price level targeting may be both incomplete and sticky. We find that complete confidence (or full credibility is not a necessary condition for the achievement of a price level target even when heterogeneity in firms’ price level expectations is endogenously time-varying and may emerge as a long-run equilibrium outcome. In fact, in the absence of exogenous perturbations to the dynamic of confidence building, it is the achievement of a price level target for long enough that, due to stickiness in the state of confidence, rather ensures the conquering of full credibility. This result has relevant implications for the conduct of monetary policy in pursuit of price stability. One implication is that setting a price level target matters more as a means to provide monetary policy with a sharper focus on price stability than as a device to conquer credibility. As regards the conquering of credibility for monetary policy, it turns out that actions speak louder than words, as the continuing achievement of price stability is what ultimately performs better as a confidence-building device.

  19. 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.

  20. The antecedents and belief-polarized effects of thought confidence.

    Science.gov (United States)

    Chou, Hsuan-Yi; Lien, Nai-Hwa; Liang, Kuan-Yu

    2011-01-01

    This article investigates 2 possible antecedents of thought confidence and explores the effects of confidence induced before or during ad exposure. The results of the experiments indicate that both consumers' dispositional optimism and spokesperson attractiveness have significant effects on consumers' confidence in thoughts that are generated after viewing the advertisement. Higher levels of thought confidence will influence the quality of the thoughts that people generate, lead to either positively or negatively polarized message processing, and therefore induce better or worse advertising effectiveness, depending on the valence of thoughts. The authors posit the belief-polarization hypothesis to explain these findings.

  1. GPIB based instrumentation and control system for ADITYA Thomson Scattering Diagnostic

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Kiran, E-mail: kkpatel@ipr.res.in; Pillai, Vishal; Singh, Neha; Chaudhary, Vishnu; Thomas, Jinto; Kumar, Ajai

    2016-11-15

    The ADITYA Thomson Scattering Diagnostic is a single point Ruby laser based system with a spectrometer for spectral dispersion and photomultiplier tubes for the detection of scattered light. The system uses CAMAC (Computer Automated Measurement And Control) based control and data acquisition system, which synchronizes the Ruby laser, detectors and the digitizer. Previously used serial based CAMAC controller is upgraded to GPIB (General Purpose Interface Bus) based CAMAC controller for configuration and data transfer. The communication protocols for different instruments are converted to a single GPIB based for better interface. The entire control and data acquisition program is developed on LabVIEW platform for versatile operation of diagnostics with improved user friendly GUI (Graphical User Interfaces) and allows user to remotely update the laser firing time with respect to the plasma shot. The software is in handshake with the Tokamak main control program through network to minimize manual interventions for the operation of the diagnostics. The upgraded system improved the performance of the diagnostics in comparison to earlier in terms of better data transmission rate, easy to maintain and program is upgradable.

  2. GPIB based instrumentation and control system for ADITYA Thomson Scattering Diagnostic

    International Nuclear Information System (INIS)

    Patel, Kiran; Pillai, Vishal; Singh, Neha; Chaudhary, Vishnu; Thomas, Jinto; Kumar, Ajai

    2016-01-01

    The ADITYA Thomson Scattering Diagnostic is a single point Ruby laser based system with a spectrometer for spectral dispersion and photomultiplier tubes for the detection of scattered light. The system uses CAMAC (Computer Automated Measurement And Control) based control and data acquisition system, which synchronizes the Ruby laser, detectors and the digitizer. Previously used serial based CAMAC controller is upgraded to GPIB (General Purpose Interface Bus) based CAMAC controller for configuration and data transfer. The communication protocols for different instruments are converted to a single GPIB based for better interface. The entire control and data acquisition program is developed on LabVIEW platform for versatile operation of diagnostics with improved user friendly GUI (Graphical User Interfaces) and allows user to remotely update the laser firing time with respect to the plasma shot. The software is in handshake with the Tokamak main control program through network to minimize manual interventions for the operation of the diagnostics. The upgraded system improved the performance of the diagnostics in comparison to earlier in terms of better data transmission rate, easy to maintain and program is upgradable.

  3. Observations on stake holder confidence related to uranium mine waste management in the elliot lake region

    International Nuclear Information System (INIS)

    MacDonald, G.

    2003-01-01

    G. MacDonald, representing the Township of the North Shore and the Standing Environmental Committee (SEC) of the Serpent River Watershed, stated that she is a stakeholder living downstream from 175 million tonnes of acid-generating and radioactive uranium mine tailings. Public confidence in the Elliot Lake region is influenced by past mining issues: worker health concerns and difficulties in obtaining compensation; myriad observations of radium uptake; drinking water contamination issues and inequitable quality standards adverse to the Serpent River First Nation; loss of land use. Government failed to set aside funds for local monitoring of the decommissioned mining region, or to involve citizens in decisions as recommended by the Kirkwood Panel. These failures represent betrayals of trust and furthermore give public confidence little chance to improve. In these circumstances, the affected community has given attention on their own to mid- and long-term issues. At issue is not the current funding or management of the waste storage sites, but rather, creating and maintaining local knowledge and competence to monitor their management over the coming decades and generations. Concerned members of the community note that the federal government 'has done nothing long-lasting to ensure confidence', on this level. They highlight the importance of questions like: 'Do I have the knowledge to act in my best interest?' and 'Who can I trust to protect my interest?' - and have set out to answer them. (author)

  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. 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.

  6. 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.

  7. Impact of recombinant TSH on quality of life in thyroid carcinoma patients undergoing remnant ablation or diagnostic whole body scanning

    International Nuclear Information System (INIS)

    Schroeder, Pamela R.; Ladenson, Paul W.; for the Members of the Thyrogen Trials

    2005-01-01

    Full text: Thyroid remnant ablation with 131 I is often necessary in the initial treatment of thyroid carcinoma. A recent study demonstrated that use of recombinant TSH (rh TSH) was equivalently effective to withdrawal from levothyroxine (L-T 4 ) for postoperative remnant ablation. Quality of life was also shown to be negatively impacted in patients withdrawn from L-T 4 , but not those maintained euthyroid and treated after rh TSH. In this study, we compare the impact of rh TSH on quality of life in patients undergoing remnant ablation versus those undergoing diagnostic whole body scanning (WBS) in a previous trial. Health-related quality of life was measured using the SF-36 survey, which consists of 8 domains describing the physical and mental functioning of patients and 2 physical and mental summary domains, in both trials at baseline on L-T 4 , after rh TSH while on L-T 4 and after L-T 4 withdrawal. Mean SF-36 scores declined from the rh TSH treatment versus L-T 4 withdrawal in both trials to a similar extent in all 8 domains and the 2 summary domains, as evidenced by overlapping 95% confidence intervals. Further SF-6D scores, which summarize all 8 domains in a single zero-to-one metric, were used to characterize the overall quality of life among patients in the two trials. The SF-6D scores for patients after rh TSH administration in the diagnostic and ablation trials were 0.803 and 0.714, respectively. In contrast, SF-6D scores for patients undergoing L-T 4 withdrawal in the diagnostic and ablation trials were 0.637 and 0.548, respectively (p 4 withdrawal both experience a comparable decrease in quality of life, which can be prevented by use of rh TSH in the euthyroid state. (author)

  8. Consumer’s and merchant’s confidence in internet payments

    Directory of Open Access Journals (Sweden)

    Franc Bračun

    2003-01-01

    Full Text Available Performing payment transactions over the Internet is becoming increasingly important. Whenever one interacts with others, he or she faces the problem of uncertainty because in interacting with others, one makes him or herself vulnerable, i.e. one can be betrayed. Thus, perceived risk and confidence are of fundamental importance in electronic payment transactions. A higher risk leads to greater hesitance about entering into a business relationship with a high degree of uncertainty; and therefore, to an increased need for confidence. This paper has two objectives. First, it aims to introduce and test a theoretical model that predicts consumer and merchant acceptance of the Internet payment solution by explaining the complex set of relationships among the key factors influencing confidence in electronic payment transactions. Second, the paper attempts to shed light on the complex interrelationship among confidence, control and perceived risk. An empirical study was conducted to test the proposed model using data from consumers and merchants in Slovenia. The results show how perceived risk dimensions and post-transaction control influence consumer’s and merchant’s confidence in electronic payment transactions, and the impact of confidence on the adoption of mass-market on-line payment solutions.

  9. Non-Asymptotic Confidence Sets for Circular Means

    Directory of Open Access Journals (Sweden)

    Thomas Hotz

    2016-10-01

    Full Text Available The mean of data on the unit circle is defined as the minimizer of the average squared Euclidean distance to the data. Based on Hoeffding’s mass concentration inequalities, non-asymptotic confidence sets for circular means are constructed which are universal in the sense that they require no distributional assumptions. These are then compared with asymptotic confidence sets in simulations and for a real data set.

  10. An ROC-type measure of diagnostic accuracy when the gold standard is continuous-scale.

    Science.gov (United States)

    Obuchowski, Nancy A

    2006-02-15

    ROC curves and summary measures of accuracy derived from them, such as the area under the ROC curve, have become the standard for describing and comparing the accuracy of diagnostic tests. Methods for estimating ROC curves rely on the existence of a gold standard which dichotomizes patients into disease present or absent. There are, however, many examples of diagnostic tests whose gold standards are not binary-scale, but rather continuous-scale. Unnatural dichotomization of these gold standards leads to bias and inconsistency in estimates of diagnostic accuracy. In this paper, we propose a non-parametric estimator of diagnostic test accuracy which does not require dichotomization of the gold standard. This estimator has an interpretation analogous to the area under the ROC curve. We propose a confidence interval for test accuracy and a statistical test for comparing accuracies of tests from paired designs. We compare the performance (i.e. CI coverage, type I error rate, power) of the proposed methods with several alternatives. An example is presented where the accuracies of two quick blood tests for measuring serum iron concentrations are estimated and compared.

  11. Optimization of a middle atmosphere diagnostic scheme

    Science.gov (United States)

    Akmaev, Rashid A.

    1997-06-01

    A new assimilative diagnostic scheme based on the use of a spectral model was recently tested on the CIRA-86 empirical model. It reproduced the observed climatology with an annual global rms temperature deviation of 3.2 K in the 15-110 km layer. The most important new component of the scheme is that the zonal forcing necessary to maintain the observed climatology is diagnosed from empirical data and subsequently substituted into the simulation model at the prognostic stage of the calculation in an annual cycle mode. The simulation results are then quantitatively compared with the empirical model, and the above mentioned rms temperature deviation provides an objective measure of the `distance' between the two climatologies. This quantitative criterion makes it possible to apply standard optimization procedures to the whole diagnostic scheme and/or the model itself. The estimates of the zonal drag have been improved in this study by introducing a nudging (Newtonian-cooling) term into the thermodynamic equation at the diagnostic stage. A proper optimal adjustment of the strength of this term makes it possible to further reduce the rms temperature deviation of simulations down to approximately 2.7 K. These results suggest that direct optimization can successfully be applied to atmospheric model parameter identification problems of moderate dimensionality.

  12. Intelligent model-based diagnostics for vehicle health management

    Science.gov (United States)

    Luo, Jianhui; Tu, Fang; Azam, Mohammad S.; Pattipati, Krishna R.; Willett, Peter K.; Qiao, Liu; Kawamoto, Masayuki

    2003-08-01

    The recent advances in sensor technology, remote communication and computational capabilities, and standardized hardware/software interfaces are creating a dramatic shift in the way the health of vehicles is monitored and managed. These advances facilitate remote monitoring, diagnosis and condition-based maintenance of automotive systems. With the increased sophistication of electronic control systems in vehicles, there is a concomitant increased difficulty in the identification of the malfunction phenomena. Consequently, the current rule-based diagnostic systems are difficult to develop, validate and maintain. New intelligent model-based diagnostic methodologies that exploit the advances in sensor, telecommunications, computing and software technologies are needed. In this paper, we will investigate hybrid model-based techniques that seamlessly employ quantitative (analytical) models and graph-based dependency models for intelligent diagnosis. Automotive engineers have found quantitative simulation (e.g. MATLAB/SIMULINK) to be a vital tool in the development of advanced control systems. The hybrid method exploits this capability to improve the diagnostic system's accuracy and consistency, utilizes existing validated knowledge on rule-based methods, enables remote diagnosis, and responds to the challenges of increased system complexity. The solution is generic and has the potential for application in a wide range of systems.

  13. Experience with diagnostic instrumentation in nuclear power plants

    International Nuclear Information System (INIS)

    Gopal, R.; Ciaramitaro, W.

    1977-01-01

    Over the past several years, Westinghouse has developed a coordinated system of on-line diagnostic instrumentation for the acquisition and analysis of data for diagnostics and incipient failure detection of critical plant equipment and systems. Primary motivation for this work is to improve NSSS availability and Maintainability through the detection of malfunctions at their inception. These systems encompass the following areas: (1) Vibration Monitoring System for detection of changes in vibrational characteristics of the major components of Nuclear Steam Supply System (NSSS) and Balance of Plant (BOP); (2) Acoustic Monitoring System for detection and location of leaks in the primary system pressure boundary and other piping systems in PWRs; (3) Metal Impact Monitoring for detection of loose debris in the reactor vessel and steam generators; (4) Nuclear Noise Monitoring System for monitoring core barrel vibration; (5) Sensor Response Time Measurement System for detecting any degradation of process sensors; and (6) Transit Time Flow Meter for determining primary coolant flow rate. Summarized in this paper are some of the features of the systems and in-plant experience. These experiences demonstrate that diagnostic systems in combination with analytical and laboratory work for data interpretation do improve plant availability. (author)

  14. Methodology for building confidence measures

    Science.gov (United States)

    Bramson, Aaron L.

    2004-04-01

    This paper presents a generalized methodology for propagating known or estimated levels of individual source document truth reliability to determine the confidence level of a combined output. Initial document certainty levels are augmented by (i) combining the reliability measures of multiply sources, (ii) incorporating the truth reinforcement of related elements, and (iii) incorporating the importance of the individual elements for determining the probability of truth for the whole. The result is a measure of confidence in system output based on the establishing of links among the truth values of inputs. This methodology was developed for application to a multi-component situation awareness tool under development at the Air Force Research Laboratory in Rome, New York. Determining how improvements in data quality and the variety of documents collected affect the probability of a correct situational detection helps optimize the performance of the tool overall.

  15. Validation of Interobserver Agreement in Lung Cancer Assessment: Hematoxylin-Eosin Diagnostic Reproducibility for Non–Small Cell Lung Cancer

    Science.gov (United States)

    Grilley-Olson, Juneko E.; Hayes, D. Neil; Moore, Dominic T.; Leslie, Kevin O.; Wilkerson, Matthew D.; Qaqish, Bahjat F.; Hayward, Michele C.; Cabanski, Christopher R.; Yin, Xiaoying; Socinski, Mark A.; Stinchcombe, Thomas E.; Thorne, Leigh B.; Allen, Timothy Craig; Banks, Peter M.; Beasley, Mary B.; Borczuk, Alain C.; Cagle, Philip T.; Christensen, Rebecca; Colby, Thomas V.; Deblois, Georgean G.; Elmberger, Göran; Graziano, Paolo; Hart, Craig F.; Jones, Kirk D.; Maia, Diane M.; Miller, C. Ryan; Nance, Keith V.; Travis, William D.; Funkhouser, William K.

    2018-01-01

    Context Precise subtype diagnosis of non–small cell lung carcinoma is increasingly relevant, based on the availability of subtype-specific therapies, such as bevacizumab and pemetrexed, and based on the subtype-specific prevalence of activating epidermal growth factor receptor mutations. Objectives To establish a baseline measure of inter-observer reproducibility for non–small cell lung carcinoma diagnoses with hematoxylin-eosin for the current 2004 World Health Organization classification, to estimate interobserver reproducibility for the therapeutically relevant squamous/nonsquamous subsets, and to examine characteristics that improve interobserver reproducibility. Design Primary, resected lung cancer specimens were converted to digital (virtual) slides. Based on a single hematoxylin-eosin virtual slide, pathologists were asked to assign a diagnosis using the 2004 World Health Organization classification. Kappa statistics were calculated for each pathologist-pair for each slide and were summarized by classification scheme, pulmonary pathology expertise, diagnostic confidence, and neoplastic grade. Results The 12 pulmonary pathology experts and the 12 community pathologists each independently diagnosed 48 to 96 single hematoxylin-eosin digital slides derived from 96 cases of non–small cell lung carcinoma resection. Overall agreement improved with simplification from the comprehensive 44 World Health Organization diagnoses (κ = 0.25) to their 10 major header subtypes (κ = 0.48) and improved again with simplification into the therapeutically relevant squamous/nonsquamous dichotomy (κ = 0.55). Multivariate analysis showed that higher diagnostic agreement was associated with better differentiation, better slide quality, higher diagnostic confidence, similar years of pathology experience, and pulmonary pathology expertise. Conclusions These data define the baseline diagnostic agreement for hematoxylin-eosin diagnosis of non–small cell lung carcinoma

  16. The relationship between confidence in charitable organizations and volunteering revisited

    NARCIS (Netherlands)

    Bekkers, René H.F.P.; Bowman, Woods

    2009-01-01

    Confidence in charitable organizations (charitable confidence) would seem to be an important prerequisite for philanthropic behavior. Previous research relying on cross-sectional data has suggested that volunteering promotes charitable confidence and vice versa. This research note, using new

  17. Disconnections Between Teacher Expectations and Student Confidence in Bioethics

    Science.gov (United States)

    Hanegan, Nikki L.; Price, Laura; Peterson, Jeremy

    2008-09-01

    This study examines how student practice of scientific argumentation using socioscientific bioethics issues affects both teacher expectations of students’ general performance and student confidence in their own work. When teachers use bioethical issues in the classroom students can gain not only biology content knowledge but also important decision-making skills. Learning bioethics through scientific argumentation gives students opportunities to express their ideas, formulate educated opinions and value others’ viewpoints. Research has shown that science teachers’ expectations of student success and knowledge directly influence student achievement and confidence levels. Our study analyzes pre-course and post-course surveys completed by students enrolled in a university level bioethics course ( n = 111) and by faculty in the College of Biology and Agriculture faculty ( n = 34) based on their perceptions of student confidence. Additionally, student data were collected from classroom observations and interviews. Data analysis showed a disconnect between faculty and students perceptions of confidence for both knowledge and the use of science argumentation. Student reports of their confidence levels regarding various bioethical issues were higher than faculty reports. A further disconnect showed up between students’ preferred learning styles and the general faculty’s common teaching methods; students learned more by practicing scientific argumentation than listening to traditional lectures. Students who completed a bioethics course that included practice in scientific argumentation, significantly increased their confidence levels. This study suggests that professors’ expectations and teaching styles influence student confidence levels in both knowledge and scientific argumentation.

  18. Experiences with 'on-line' diagnostic instrumentation in nuclear power plants

    International Nuclear Information System (INIS)

    Gopal, R.; Ciaramitaro, W.; Smith, J.R.

    1981-01-01

    Over the past several years, Westinghouse has developed a coordinated system of on-line diagnostic instrumentation for the acquisition and analysis of data for diagnostics and incipient failure detection of critical plant equipment and systems. Primary motivation for this work is to improve Nuclear Steam Supply System (NSSS) availability and maintainability through the detection of malfunctions at their inception. These systems include: 1) Acoustic leak monitoring for detection and location of leaks in the primary system pressure boundary and other piping systems in PWR's; 2) Metal impact monitoring for detection of loose debris in the reactor vessel and steam generators; 3) Nuclear noise monitoring for monitoring core barrel vibration. Summarized in this paper are some of the features of the systems and inplant experience. (author)

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

    Science.gov (United States)

    Arana, E

    2015-01-01

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

  20. Family Health Histories and Their Impact on Retirement Confidence.

    Science.gov (United States)

    Zick, Cathleen D; Mayer, Robert N; Smith, Ken R

    2015-08-01

    Retirement confidence is a key social barometer. In this article, we examine how personal and parental health histories relate to working-age adults' feelings of optimism or pessimism about their overall retirement prospects. This study links survey data on retirement planning with information on respondents' own health histories and those of their parents. The multivariate models control for the respondents' socio-demographic and economic characteristics along with past retirement planning activities when estimating the relationships between family health histories and retirement confidence. Retirement confidence is inversely related to parental history of cancer and cardiovascular disease but not to personal health history. In contrast, retirement confidence is positively associated with both parents being deceased. As members of the public become increasingly aware of how genetics and other family factors affect intergenerational transmission of chronic diseases, it is likely that the link between family health histories and retirement confidence will intensify. © The Author(s) 2015.

  1. Multivoxel neurofeedback selectively modulates confidence without changing perceptual performance

    Science.gov (United States)

    Cortese, Aurelio; Amano, Kaoru; Koizumi, Ai; Kawato, Mitsuo; Lau, Hakwan

    2016-01-01

    A central controversy in metacognition studies concerns whether subjective confidence directly reflects the reliability of perceptual or cognitive processes, as suggested by normative models based on the assumption that neural computations are generally optimal. This view enjoys popularity in the computational and animal literatures, but it has also been suggested that confidence may depend on a late-stage estimation dissociable from perceptual processes. Yet, at least in humans, experimental tools have lacked the power to resolve these issues convincingly. Here, we overcome this difficulty by using the recently developed method of decoded neurofeedback (DecNef) to systematically manipulate multivoxel correlates of confidence in a frontoparietal network. Here we report that bi-directional changes in confidence do not affect perceptual accuracy. Further psychophysical analyses rule out accounts based on simple shifts in reporting strategy. Our results provide clear neuroscientific evidence for the systematic dissociation between confidence and perceptual performance, and thereby challenge current theoretical thinking. PMID:27976739

  2. Cooperative Monitoring Center Occasional Paper/13: Cooperative monitoring for confidence building: A case study of the Sino-Indian border areas

    Energy Technology Data Exchange (ETDEWEB)

    SIDHU,WAHEGURU PAL SINGH; YUAN,JING-DONG; BIRINGER,KENT L.

    1999-08-01

    This occasional paper identifies applicable cooperative monitoring techniques and develops models for possible application in the context of the border between China and India. The 1993 and 1996 Sino-Indian agreements on maintaining peace and tranquility along the Line of Actual Control (LAC) and establishing certain confidence building measures (CBMs), including force reductions and limitation on military exercises along their common border, are used to examine the application of technically based cooperative monitoring in both strengthening the existing terms of the agreements and also enhancing trust. The paper also aims to further the understanding of how and under what conditions technology-based tools can assist in implementing existing agreements on arms control and confidence building. The authors explore how cooperative monitoring techniques can facilitate effective implementation of arms control agreements and CBMS between states and contribute to greater security and stability in bilateral, regional, and global contexts.

  3. Confidence Measurement in the Light of Signal Detection Theory

    Directory of Open Access Journals (Sweden)

    Sébastien eMassoni

    2014-12-01

    Full Text Available We compare three alternative methods for eliciting retrospective confidence in the context of a simple perceptual task: the Simple Confidence Rating (a direct report on a numerical scale, the Quadratic Scoring Rule (a post-wagering procedure and the Matching Probability (a generalization of the no-loss gambling method. We systematically compare the results obtained with these three rules to the theoretical confidence levels that can be inferred from performance in the perceptual task using Signal Detection Theory. We find that the Matching Probability provides better results in that respect. We conclude that Matching Probability is particularly well suited for studies of confidence that use Signal Detection Theory as a theoretical framework.

  4. Molecular diagnostics clinical utility strategy: a six-part framework.

    Science.gov (United States)

    Frueh, Felix W; Quinn, Bruce

    2014-09-01

    The clinical utility of a molecular test rises proportional to a favorable regulatory risk/benefit assessment, and clinical utility is the driver of payer coverage decisions. Although a great deal has been written about clinical utility, debates still center on its 'definition.' We argue that the definition (an impact on clinical outcomes) is self-evident, and improved communications should focus on sequential steps in building and proving an adequate level of confidence for the diagnostic test's clinical value proposition. We propose a six-part framework to facilitate communications between test developers and health technology evaluators, relevant to both regulatory and payer decisions.

  5. Self-confidence, overconfidence and prenatal testosterone exposure : Evidence from the lab

    NARCIS (Netherlands)

    Dalton, Patricio S.; Ghosal, Sayantan

    2018-01-01

    This paper examines whether foetal testosterone exposure predicts the extent of confidence and over-confidence in own absolute ability in adulthood. To study this question, we elicited incentive-compatible measures of confidence and over-confidence in the lab and correlate them with measures of

  6. Yield of diagnostic tests for celiac disease in individuals with symptoms suggestive of irritable bowel syndrome: systematic review and meta-analysis.

    Science.gov (United States)

    Ford, Alexander C; Chey, William D; Talley, Nicholas J; Malhotra, Ashish; Spiegel, Brennan M R; Moayyedi, Paul

    2009-04-13

    Individuals with irritable bowel syndrome (IBS) report abdominal pain, bloating, and diarrhea, symptoms similar to those in celiac disease. Studies suggest that the prevalence of celiac disease is increased in individuals with IBS; however, evidence is conflicting, and current guidelines do not always recommend screening for celiac disease in these individuals. We conducted a systematic review and meta-analysis to estimate prevalence of celiac disease in unselected adults who met diagnostic criteria for IBS. MEDLINE (1950 to May 31, 2008) and EMBASE (1980 to May 31, 2008) were searched. Case series and case-control studies that used serologic tests for celiac disease were eligible for inclusion. Prevalence of positive serologic indications of celiac disease and biopsy-proved celiac disease were extracted and pooled for all studies and were compared between cases and controls using an odds ratio and 95% confidence interval. Fourteen studies were identified comprising 4204 individuals, of whom 2278 (54%) met diagnostic criteria for IBS. Pooled prevalence of positive IgA-class antigliadin antibodies, either positive endomysial antibodies or tissue transglutaminase, and biopsy-proved celiac disease were 4.0% (95% confidence interval, 1.7-7.2), 1.63% (0.7-3.0), and 4.1% (1.9-7.0), respectively. Pooled odds ratios (95% confidence intervals) for positive IgA-class antigliadin antibodies, either positive endomysial antibodies or tissue transglutaminase, and biopsy-proved celiac disease in cases meeting diagnostic criteria for IBS compared with controls without IBS were 3.40 (1.62-7.13), 2.94 (1.36-6.35), and 4.34 (1.78-10.6). Prevalence of biopsy-proved celiac disease in cases meeting diagnostic criteria for IBS was more than 4-fold that in controls without IBS.

  7. 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...

  8. The confidence-accuracy relationship for eyewitness identification decisions: Effects of exposure duration, retention interval, and divided attention.

    Science.gov (United States)

    Palmer, Matthew A; Brewer, Neil; Weber, Nathan; Nagesh, Ambika

    2013-03-01

    Prior research points to a meaningful confidence-accuracy (CA) relationship for positive identification decisions. However, there are theoretical grounds for expecting that different aspects of the CA relationship (calibration, resolution, and over/underconfidence) might be undermined in some circumstances. This research investigated whether the CA relationship for eyewitness identification decisions is affected by three, forensically relevant variables: exposure duration, retention interval, and divided attention at encoding. In Study 1 (N = 986), a field experiment, we examined the effects of exposure duration (5 s vs. 90 s) and retention interval (immediate testing vs. a 1-week delay) on the CA relationship. In Study 2 (N = 502), we examined the effects of attention during encoding on the CA relationship by reanalyzing data from a laboratory experiment in which participants viewed a stimulus video under full or divided attention conditions and then attempted to identify two targets from separate lineups. Across both studies, all three manipulations affected identification accuracy. The central analyses concerned the CA relation for positive identification decisions. For the manipulations of exposure duration and retention interval, overconfidence was greater in the more difficult conditions (shorter exposure; delayed testing) than the easier conditions. Only the exposure duration manipulation influenced resolution (which was better for 5 s than 90 s), and only the retention interval manipulation affected calibration (which was better for immediate testing than delayed testing). In all experimental conditions, accuracy and diagnosticity increased with confidence, particularly at the upper end of the confidence scale. Implications for theory and forensic settings are discussed.

  9. Robust misinterpretation of confidence intervals

    NARCIS (Netherlands)

    Hoekstra, Rink; Morey, Richard; Rouder, Jeffrey N.; Wagenmakers, Eric-Jan

    2014-01-01

    Null hypothesis significance testing (NHST) is undoubtedly the most common inferential technique used to justify claims in the social sciences. However, even staunch defenders of NHST agree that its outcomes are often misinterpreted. Confidence intervals (CIs) have frequently been proposed as a more

  10. Stability in the metamemory realism of eyewitness confidence judgments.

    Science.gov (United States)

    Buratti, Sandra; Allwood, Carl Martin; Johansson, Marcus

    2014-02-01

    The stability of eyewitness confidence judgments over time in regard to their reported memory and accuracy of these judgments is of interest in forensic contexts because witnesses are often interviewed many times. The present study investigated the stability of the confidence judgments of memory reports of a witnessed event and of the accuracy of these judgments over three occasions, each separated by 1 week. Three age groups were studied: younger children (8-9 years), older children (10-11 years), and adults (19-31 years). A total of 93 participants viewed a short film clip and were asked to answer directed two-alternative forced-choice questions about the film clip and to confidence judge each answer. Different questions about details in the film clip were used on each of the three test occasions. Confidence as such did not exhibit stability over time on an individual basis. However, the difference between confidence and proportion correct did exhibit stability across time, in terms of both over/underconfidence and calibration. With respect to age, the adults and older children exhibited more stability than the younger children for calibration. Furthermore, some support for instability was found with respect to the difference between the average confidence level for correct and incorrect answers (slope). Unexpectedly, however, the younger children's slope was found to be more stable than the adults. Compared to the previous research, the present study's use of more advanced statistical methods provides a more nuanced understanding of the stability of confidence judgments in the eyewitness reports of children and adults.

  11. Nurses' training and confidence on deep venous catheterization.

    Science.gov (United States)

    Liachopoulou, A P; Synodinou-Kamilou, E E; Deligiannidi, P G; Giannakopoulou, M; Birbas, K N

    2008-01-01

    The rough estimation of the education and the self-confidence of nurses, both students and professionals, regarding deep venous catheterization in adult patients, the evaluation of the change in self-confidence of one team of students who were trained with a simulator on deep venous catheterization and the correlation of their self-confidence with their performance recorded by the simulator. Seventy-six nurses and one hundred twenty-four undergraduate students participated in the study. Fourty-four University students took part in a two-day educational seminar and were trained on subclavian and femoral vein paracentesis with a simulator and an anatomical model. Three questionnaires were filled in by the participants: one from nurses, one from students of Technological institutions, while the University students filled in the previous questionnaire before their attendance of the seminar, and another questionnaire after having attended it. Impressive results in improving the participants' self-confidence were recorded. However, the weak correlation of their self-confidence with the score automatically provided by the simulator after each user's training obligates us to be particularly cautious about the ability of the users to repeat the action successfully in a clinical environment. Educational courses and simulators are useful educational tools that are likely to shorten but in no case can efface the early phase of the learning curve in clinical setting, substituting the clinical training of inexperienced users.

  12. Can confidence indicators forecast the probability of expansion in Croatia?

    Directory of Open Access Journals (Sweden)

    Mirjana Čižmešija

    2016-04-01

    Full Text Available The aim of this paper is to investigate how reliable are confidence indicators in forecasting the probability of expansion. We consider three Croatian Business Survey indicators: the Industrial Confidence Indicator (ICI, the Construction Confidence Indicator (BCI and the Retail Trade Confidence Indicator (RTCI. The quarterly data, used in the research, covered the periods from 1999/Q1 to 2014/Q1. Empirical analysis consists of two parts. The non-parametric Bry-Boschan algorithm is used for distinguishing periods of expansion from the period of recession in the Croatian economy. Then, various nonlinear probit models were estimated. The models differ with respect to the regressors (confidence indicators and the time lags. The positive signs of estimated parameters suggest that the probability of expansion increases with an increase in Confidence Indicators. Based on the obtained results, the conclusion is that ICI is the most powerful predictor of the probability of expansion in Croatia.

  13. 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.

  14. Factors influencing diagnostic yield of CT-guided percutaneous core needle biopsy for bone lesions

    International Nuclear Information System (INIS)

    Li, Y.; Du, Y.; Luo, T.Y.; Yang, H.F.; Yu, J.H.; Xu, X.X.; Zheng, H.J.; Li, B.

    2014-01-01

    Aim: To evaluate the factors influencing diagnostic yield of computed tomography (CT)-guided percutaneous core needle biopsy (CNB) for bone lesions. Materials and methods: Between September 2005 and July 2011, 162 consecutive CT-guided CNB procedures were performed in 155 patients. The variables analysed were age, sex, lesion location, lesion type, lesion size, specimen size, biopsy needle gauge, and individual radiologist. The factors influencing diagnostic yield of CT-guided percutaneous CNB for bone lesions were determined by multivariate analysis of variables. Results: The diagnostic yield was 81.5%. Diagnostic yield was 89.9% for lytic bone lesions and 48.5% for sclerotic bone lesions (p < 0.001), and 89.2% for lesions ≥3 cm and 73.4% for lesions <3 cm (p = 0.010). The significant factors influencing diagnostic yield of CT-guided percutaneous CNB for bone lesions were lesion type [p < 0.001; odds ratio (OR) for a lytic lesion was approximately 12 times higher than that for a sclerotic lesion; 95% confidence interval (CI): 4.22–34.01], and lesion size (p = 0.012; OR for a lesion size ≥3 cm was about five-times higher than that for a lesion size <3 cm; 95% CI: 1.42–16.71). Conclusion: Lesion type and lesion size are determining factors in diagnostic yield. The higher diagnostic yield is correlated with lytic lesion and lesion size ≥3 cm

  15. Modeling Confidence and Response Time in Recognition Memory

    Science.gov (United States)

    Ratcliff, Roger; Starns, Jeffrey J.

    2009-01-01

    A new model for confidence judgments in recognition memory is presented. In the model, the match between a single test item and memory produces a distribution of evidence, with better matches corresponding to distributions with higher means. On this match dimension, confidence criteria are placed, and the areas between the criteria under the…

  16. The diagnostic value of diffusion-weighted magnetic resonance imaging in soft tissue abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Unal, Ozkan; Koparan, Halil Ibrahim [Yuezuencue Yil University, Department of Radiology, Van (Turkey); Avcu, Serhat, E-mail: serhatavcu@hotmail.com [Yuezuencue Yil University, Department of Radiology, Van (Turkey); Kalender, Ali Murat [Yuezuencue Yil University, Department of Orthopaedics, General Surgery, Van (Turkey); Kisli, Erol [Yuezuencue Yil University, Department of General Surgery, Van (Turkey)

    2011-03-15

    Purpose: To study the diagnostic value of diffusion-weighted imaging (DWI) in soft tissue abscesses. Materials and methods: Fifty patients were included in this study who were thought to have soft tissue abscess or cystic lesion as a result of clinical and radiological examinations. Localisations of the lesions were: 1 periorbital, 3 breast, 14 intraabdominal, and 32 intramuscular lesions. After other radiological examinations, DWI was performed. The signal intensity values of the lesions were evaluated qualitatively according to the hyperintensity on b-1000 DWI, using 1.5 T MR system. All of the lesions were aspirated after DWI, and detection of pus in the aspiration material was accepted as gold standard for the diagnosis of abscess. Results: In 38 of the 50 patients, hyperintensity was obtained on diffusion-weighted images. False-positive results were maintained in 2 of these patients, and true-positive results were maintained in 36 of them. In 11 of the 50 patients, hypointensity was visualised on diffusion-weighted images. False-negative results were maintained in 3 of these patients, and true-negative results were maintained in 8 of them. An abscess which was seen on post-contrast conventional MRI could not be seen on DWI, and this was regarded as false-negative. Conclusion: The sensitivity and specificity of diffusion-weighted images for detecting soft tissue abscesses were found to be 92% and 80%, respectively. DWI has a high diagnostic value in soft tissue abscesses, and is an important imaging modality that may be used for the differentiation of cysts and abscesses.

  17. The diagnostic value of diffusion-weighted magnetic resonance imaging in soft tissue abscesses

    International Nuclear Information System (INIS)

    Unal, Ozkan; Koparan, Halil Ibrahim; Avcu, Serhat; Kalender, Ali Murat; Kisli, Erol

    2011-01-01

    Purpose: To study the diagnostic value of diffusion-weighted imaging (DWI) in soft tissue abscesses. Materials and methods: Fifty patients were included in this study who were thought to have soft tissue abscess or cystic lesion as a result of clinical and radiological examinations. Localisations of the lesions were: 1 periorbital, 3 breast, 14 intraabdominal, and 32 intramuscular lesions. After other radiological examinations, DWI was performed. The signal intensity values of the lesions were evaluated qualitatively according to the hyperintensity on b-1000 DWI, using 1.5 T MR system. All of the lesions were aspirated after DWI, and detection of pus in the aspiration material was accepted as gold standard for the diagnosis of abscess. Results: In 38 of the 50 patients, hyperintensity was obtained on diffusion-weighted images. False-positive results were maintained in 2 of these patients, and true-positive results were maintained in 36 of them. In 11 of the 50 patients, hypointensity was visualised on diffusion-weighted images. False-negative results were maintained in 3 of these patients, and true-negative results were maintained in 8 of them. An abscess which was seen on post-contrast conventional MRI could not be seen on DWI, and this was regarded as false-negative. Conclusion: The sensitivity and specificity of diffusion-weighted images for detecting soft tissue abscesses were found to be 92% and 80%, respectively. DWI has a high diagnostic value in soft tissue abscesses, and is an important imaging modality that may be used for the differentiation of cysts and abscesses.

  18. Contrasting Academic Behavioural Confidence in Mexican and European Psychology Students

    Science.gov (United States)

    Ochoa, Alma Rosa Aguila; Sander, Paul

    2012-01-01

    Introduction: Research with the Academic Behavioural Confidence scale using European students has shown that students have high levels of confidence in their academic abilities. It is generally accepted that people in more collectivist cultures have more realistic confidence levels in contrast to the overconfidence seen in individualistic European…

  19. Market Confidence Predicts Stock Price: Beyond Supply and Demand.

    Directory of Open Access Journals (Sweden)

    Xiao-Qian Sun

    Full Text Available Stock price prediction is an important and challenging problem in stock market analysis. Existing prediction methods either exploit autocorrelation of stock price and its correlation with the supply and demand of stock, or explore predictive indictors exogenous to stock market. In this paper, using transaction record of stocks with identifier of traders, we introduce an index to characterize market confidence, i.e., the ratio of the number of traders who is active in two successive trading days to the number of active traders in a certain trading day. Strong Granger causality is found between the index of market confidence and stock price. We further predict stock price by incorporating the index of market confidence into a neural network based on time series of stock price. Experimental results on 50 stocks in two Chinese Stock Exchanges demonstrate that the accuracy of stock price prediction is significantly improved by the inclusion of the market confidence index. This study sheds light on using cross-day trading behavior to characterize market confidence and to predict stock price.

  20. Market Confidence Predicts Stock Price: Beyond Supply and Demand.

    Science.gov (United States)

    Sun, Xiao-Qian; Shen, Hua-Wei; Cheng, Xue-Qi; Zhang, Yuqing

    2016-01-01

    Stock price prediction is an important and challenging problem in stock market analysis. Existing prediction methods either exploit autocorrelation of stock price and its correlation with the supply and demand of stock, or explore predictive indictors exogenous to stock market. In this paper, using transaction record of stocks with identifier of traders, we introduce an index to characterize market confidence, i.e., the ratio of the number of traders who is active in two successive trading days to the number of active traders in a certain trading day. Strong Granger causality is found between the index of market confidence and stock price. We further predict stock price by incorporating the index of market confidence into a neural network based on time series of stock price. Experimental results on 50 stocks in two Chinese Stock Exchanges demonstrate that the accuracy of stock price prediction is significantly improved by the inclusion of the market confidence index. This study sheds light on using cross-day trading behavior to characterize market confidence and to predict stock price.

  1. Confidence in leadership among the newly qualified.

    Science.gov (United States)

    Bayliss-Pratt, Lisa; Morley, Mary; Bagley, Liz; Alderson, Steven

    2013-10-23

    The Francis report highlighted the importance of strong leadership from health professionals but it is unclear how prepared those who are newly qualified feel to take on a leadership role. We aimed to assess the confidence of newly qualified health professionals working in the West Midlands in the different competencies of the NHS Leadership Framework. Most respondents felt confident in their abilities to demonstrate personal qualities and work with others, but less so at managing or improving services or setting direction.

  2. Biased but in Doubt: Conflict and Decision Confidence

    Science.gov (United States)

    De Neys, Wim; Cromheeke, Sofie; Osman, Magda

    2011-01-01

    Human reasoning is often biased by intuitive heuristics. A central question is whether the bias results from a failure to detect that the intuitions conflict with traditional normative considerations or from a failure to discard the tempting intuitions. The present study addressed this unresolved debate by using people's decision confidence as a nonverbal index of conflict detection. Participants were asked to indicate how confident they were after solving classic base-rate (Experiment 1) and conjunction fallacy (Experiment 2) problems in which a cued intuitive response could be inconsistent or consistent with the traditional correct response. Results indicated that reasoners showed a clear confidence decrease when they gave an intuitive response that conflicted with the normative response. Contrary to popular belief, this establishes that people seem to acknowledge that their intuitive answers are not fully warranted. Experiment 3 established that younger reasoners did not yet show the confidence decrease, which points to the role of improved bias awareness in our reasoning development. Implications for the long standing debate on human rationality are discussed. PMID:21283574

  3. "Depressive Realism" assessed via Confidence in Decision-making.

    Science.gov (United States)

    Hancock, J A

    1996-08-01

    There are two currently influential views regarding the link between cognitive distortions and depression. The first states that depressed individuals perceive the world and themselves with a strong negative bias or distortion, and that mentally healthy individuals perceive the word with relative accuracy. The second ''depressive realism'' camp argues that healthy individuals are positively biased and the depressed are relatively unbiased and hence, more realistic. In the present investigation, subjects suffering from major depression, subjects recovered from major depression, and a group of healthy controls were examined with regard to their confidence in answering each of 99 general knowledge questions. Confidence ratings were analysed separately according to correct or incorrect responses. There were no significant differences in performance (i.e. accuracy of answer between the three groups). When answering correctly, depressed subjects were significantly less confident than healthy control subjects. On answering incorrectly, none of the three groups were significantly different in their confidence ratings. These findings support the cognitive distortion view of depression and provide no evidence of ''depressive realism''.

  4. Challenge for reconstruction of public confidence

    International Nuclear Information System (INIS)

    Matsuura, S.

    2001-01-01

    Past incidents and scandals that have had a large influence on damaging public confidence in nuclear energy safety are presented. Radiation leak on nuclear-powered ship 'Mutsu' (1974), the T.M.I. incident in 1979, Chernobyl accident (1986), the sodium leak at the Monju reactor (1995), fire and explosion at a low level waste asphalt solidification facility (1997), J.C.O. incident (Tokai- MURA, 1999), are so many examples that have created feelings of distrust and anxiety in society. In order to restore public confidence there is no other course but to be prepared for difficulty and work honestly to our fullest ability, with all steps made openly and accountably. (N.C.)

  5. Graduating general surgery resident operative confidence: perspective from a national survey.

    Science.gov (United States)

    Fonseca, Annabelle L; Reddy, Vikram; Longo, Walter E; Gusberg, Richard J

    2014-08-01

    General surgical training has changed significantly over the last decade with work hour restrictions, increasing subspecialization, the expanding use of minimally invasive techniques, and nonoperative management for solid organ trauma. Given these changes, this study was undertaken to assess the confidence of graduating general surgery residents in performing open surgical operations and to determine factors associated with increased confidence. A survey was developed and sent to general surgery residents nationally. We queried them regarding demographics and program characteristics, asked them to rate their confidence (rated 1-5 on a Likert scale) in performing open surgical procedures and compared those who indicated confidence with those who did not. We received 653 responses from the fifth year (postgraduate year 5) surgical residents: 69% male, 68% from university programs, and 51% from programs affiliated with a Veterans Affairs hospital; 22% from small programs, 34% from medium programs, and 44% from large programs. Anticipated postresidency operative confidence was 72%. More than 25% of residents reported a lack of confidence in performing eight of the 13 operations they were queried about. Training at a university program, a large program, dedicated research years, future fellowship plans, and training at a program that performed a large percentage of operations laparoscopically was associated with decreased confidence in performing a number of open surgical procedures. Increased surgical volume was associated with increased operative confidence. Confidence in performing open surgery also varied regionally. Graduating surgical residents indicated a significant lack of confidence in performing a variety of open surgical procedures. This decreased confidence was associated with age, operative volume as well as type, and location of training program. Analyzing and addressing this confidence deficit merits further study. Copyright © 2014 Elsevier Inc. All

  6. A genetic programming approach for Burkholderia Pseudomallei diagnostic pattern discovery

    Science.gov (United States)

    Yang, Zheng Rong; Lertmemongkolchai, Ganjana; Tan, Gladys; Felgner, Philip L.; Titball, Richard

    2009-01-01

    Motivation: Finding diagnostic patterns for fighting diseases like Burkholderia pseudomallei using biomarkers involves two key issues. First, exhausting all subsets of testable biomarkers (antigens in this context) to find a best one is computationally infeasible. Therefore, a proper optimization approach like evolutionary computation should be investigated. Second, a properly selected function of the antigens as the diagnostic pattern which is commonly unknown is a key to the diagnostic accuracy and the diagnostic effectiveness in clinical use. Results: A conversion function is proposed to convert serum tests of antigens on patients to binary values based on which Boolean functions as the diagnostic patterns are developed. A genetic programming approach is designed for optimizing the diagnostic patterns in terms of their accuracy and effectiveness. During optimization, it is aimed to maximize the coverage (the rate of positive response to antigens) in the infected patients and minimize the coverage in the non-infected patients while maintaining the fewest number of testable antigens used in the Boolean functions as possible. The final coverage in the infected patients is 96.55% using 17 of 215 (7.4%) antigens with zero coverage in the non-infected patients. Among these 17 antigens, BPSL2697 is the most frequently selected one for the diagnosis of Burkholderia Pseudomallei. The approach has been evaluated using both the cross-validation and the Jack–knife simulation methods with the prediction accuracy as 93% and 92%, respectively. A novel approach is also proposed in this study to evaluate a model with binary data using ROC analysis. Contact: z.r.yang@ex.ac.uk PMID:19561021

  7. Alan Greenspan, the confidence strategy

    Directory of Open Access Journals (Sweden)

    Edwin Le Heron

    2006-12-01

    Full Text Available To evaluate the Greenspan era, we nevertheless need to address three questions: Is his success due to talent or just luck? Does he have a system of monetary policy or is he himself the system? What will be his legacy? Greenspan was certainly lucky, but he was also clairvoyant. Above all, he has developed a profoundly original monetary policy. His confidence strategy is clearly opposed to the credibility strategy developed in central banks and the academic milieu after 1980, but also inflation targeting, which today constitutes the mainstream monetary policy regime. The question of his legacy seems more nuanced. However, Greenspan will remain 'for a considerable period of time' a highly heterodox and original central banker. His political vision, his perception of an uncertain world, his pragmatism and his openness form the structure of a powerful alternative system, the confidence strategy, which will leave its mark on the history of monetary policy.

  8. The Influence of Endogenous and Exogenous Spatial Attention on Decision Confidence.

    Science.gov (United States)

    Kurtz, Phillipp; Shapcott, Katharine A; Kaiser, Jochen; Schmiedt, Joscha T; Schmid, Michael C

    2017-07-25

    Spatial attention allows us to make more accurate decisions about events in our environment. Decision confidence is thought to be intimately linked to the decision making process as confidence ratings are tightly coupled to decision accuracy. While both spatial attention and decision confidence have been subjected to extensive research, surprisingly little is known about the interaction between these two processes. Since attention increases performance it might be expected that confidence would also increase. However, two studies investigating the effects of endogenous attention on decision confidence found contradictory results. Here we investigated the effects of two distinct forms of spatial attention on decision confidence; endogenous attention and exogenous attention. We used an orientation-matching task, comparing the two attention conditions (endogenous and exogenous) to a control condition without directed attention. Participants performed better under both attention conditions than in the control condition. Higher confidence ratings than the control condition were found under endogenous attention but not under exogenous attention. This finding suggests that while attention can increase confidence ratings, it must be voluntarily deployed for this increase to take place. We discuss possible implications of this relative overconfidence found only during endogenous attention with respect to the theoretical background of decision confidence.

  9. Confidence in Numerical Simulations

    International Nuclear Information System (INIS)

    Hemez, Francois M.

    2015-01-01

    This PowerPoint presentation offers a high-level discussion of uncertainty, confidence and credibility in scientific Modeling and Simulation (M&S). It begins by briefly evoking M&S trends in computational physics and engineering. The first thrust of the discussion is to emphasize that the role of M&S in decision-making is either to support reasoning by similarity or to ''forecast,'' that is, make predictions about the future or extrapolate to settings or environments that cannot be tested experimentally. The second thrust is to explain that M&S-aided decision-making is an exercise in uncertainty management. The three broad classes of uncertainty in computational physics and engineering are variability and randomness, numerical uncertainty and model-form uncertainty. The last part of the discussion addresses how scientists ''think.'' This thought process parallels the scientific method where by a hypothesis is formulated, often accompanied by simplifying assumptions, then, physical experiments and numerical simulations are performed to confirm or reject the hypothesis. ''Confidence'' derives, not just from the levels of training and experience of analysts, but also from the rigor with which these assessments are performed, documented and peer-reviewed.

  10. 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.

  11. A simultaneous confidence band for sparse longitudinal regression

    KAUST Repository

    Ma, Shujie; Yang, Lijian; Carroll, Raymond J.

    2012-01-01

    Functional data analysis has received considerable recent attention and a number of successful applications have been reported. In this paper, asymptotically simultaneous confidence bands are obtained for the mean function of the functional regression model, using piecewise constant spline estimation. Simulation experiments corroborate the asymptotic theory. The confidence band procedure is illustrated by analyzing CD4 cell counts of HIV infected patients.

  12. Graphing within-subjects confidence intervals using SPSS and S-Plus.

    Science.gov (United States)

    Wright, Daniel B

    2007-02-01

    Within-subjects confidence intervals are often appropriate to report and to display. Loftus and Masson (1994) have reported methods to calculate these, and their use is becoming common. In the present article, procedures for calculating within-subjects confidence intervals in SPSS and S-Plus are presented (an R version is on the accompanying Web site). The procedure in S-Plus allows the user to report the bias corrected and adjusted bootstrap confidence intervals as well as the standard confidence intervals based on traditional methods. The presented code can be easily altered to fit the individual user's needs.

  13. The Development of Confidence Limits for Fatigue Strength Data

    International Nuclear Information System (INIS)

    SUTHERLAND, HERBERT J.; VEERS, PAUL S.

    1999-01-01

    Over the past several years, extensive databases have been developed for the S-N behavior of various materials used in wind turbine blades, primarily fiberglass composites. These data are typically presented both in their raw form and curve fit to define their average properties. For design, confidence limits must be placed on these descriptions. In particular, most designs call for the 95/95 design values; namely, with a 95% level of confidence, the designer is assured that 95% of the material will meet or exceed the design value. For such material properties as the ultimate strength, the procedures for estimating its value at a particular confidence level is well defined if the measured values follow a normal or a log-normal distribution. Namely, based upon the number of sample points and their standard deviation, a commonly-found table may be used to determine the survival percentage at a particular confidence level with respect to its mean value. The same is true for fatigue data at a constant stress level (the number of cycles to failure N at stress level S(sub 1)). However, when the stress level is allowed to vary, as with a typical S-N fatigue curve, the procedures for determining confidence limits are not as well defined. This paper outlines techniques for determining confidence limits of fatigue data. Different approaches to estimating the 95/95 level are compared. Data from the MSU/DOE and the FACT fatigue databases are used to illustrate typical results

  14. Nurse leader certification preparation: how are confidence levels impacted?

    Science.gov (United States)

    Junger, Stacey; Trinkle, Nicole; Hall, Norma

    2016-09-01

    The aim was to examine the effect of a nurse leader certification preparation course on the confidence levels of the participants. Limited literature is available regarding nurse leader development and certifications. Barriers exist related to lack of confidence, high cost, time and lack of access to a preparation course. Nurse leaders (n = 51) completed a pre- and post-survey addressing confidence levels of participants related to the topics addressed in the nurse leader certification preparation course. There were statistically significant increases in confidence levels related to all course content for the participants. At the time of the study, there were 31.4% of participants intending to sit for the certification examination, and 5 of the 51 participants successfully sat for and passed the examination. A nurse leader certification preparation course increases confidence levels of the participants and removes barriers, thereby increasing the number of certifications obtained. The health-care climate is increasingly complex and nurse leaders need the expertise to navigate the ever-changing health-care environment. Certification in a specialty, such as leadership, serves as an indicator of a high level of competence in the field. © 2016 John Wiley & Sons Ltd.

  15. Remote handling installation of diagnostics in the JET Tokamak

    Energy Technology Data Exchange (ETDEWEB)

    Allan, P., E-mail: Peter.Allan@ccfe.ac.uk [JET-EFDA, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); CCFE, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Loving, A.B. [JET-EFDA, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); CCFE, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Omran, H. [JET-EFDA, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Oxford Technologies Ltd, 7 Nuffield Way, Abingdon OX14 1RJ (United Kingdom); Collins, S.; Thomas, J. [JET-EFDA, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); CCFE, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Parsloe, A.; Merrigan, I. [JET-EFDA, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); British Nuclear Services, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Hassall, I. [JET-EFDA, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Oxford Technologies Ltd, 7 Nuffield Way, Abingdon OX14 1RJ (United Kingdom)

    2011-10-15

    The requirement for an upgrade of the diagnostics for the JET ITER Like Wall (ILW) while maintaining personnel exposure to contamination as low as reasonably practicable or ALARP, has necessitated the development of a bespoke set of diagnostic components. These components, by virtue of their design and location, require a versatile yet comprehensive suite of remote handling tools to undertake their in-vessel installation. The installation of the various diagnostic components is covered in multiple tasks. Each task requires careful assessment and design of tools that can successfully interface with the components and comply with the handling and installation requirements. With remote maintenance a requirement, the looms/conduits were designed to be modular with connections which are electrically connected when the module is fitted or conversely disconnected when removed. The shape of each complex and often bulky component is verified during the design phase, to ensure that it can be delivered and installed to its specified location in the torus. This is done by matching the kinematic capabilities of the remote handling system and the path of the component through the torus by using a state of the art virtual reality system.

  16. Confidence and the stock market: an agent-based approach.

    Science.gov (United States)

    Bertella, Mario A; Pires, Felipe R; Feng, Ling; Stanley, Harry Eugene

    2014-01-01

    Using a behavioral finance approach we study the impact of behavioral bias. We construct an artificial market consisting of fundamentalists and chartists to model the decision-making process of various agents. The agents differ in their strategies for evaluating stock prices, and exhibit differing memory lengths and confidence levels. When we increase the heterogeneity of the strategies used by the agents, in particular the memory lengths, we observe excess volatility and kurtosis, in agreement with real market fluctuations--indicating that agents in real-world financial markets exhibit widely differing memory lengths. We incorporate the behavioral traits of adaptive confidence and observe a positive correlation between average confidence and return rate, indicating that market sentiment is an important driver in price fluctuations. The introduction of market confidence increases price volatility, reflecting the negative effect of irrationality in market behavior.

  17. Tables of Confidence Limits for Proportions

    Science.gov (United States)

    1990-09-01

    0.972 180 49 0.319 0.332 0,357 175 165 0.964 0.969 0.976 ISO 50 0.325 0.338 0.363 175 166 0.969 0.973 0.980 180 51 0.331 0.344 0.368 175 167 0.973 0.977...0.528 180 18 0.135 0 145 0.164 180 19 0.141 0.151 0.171 ISO 80 0.495 0,508 0.534 347 UPPER CONFIDENCE LIMIT FOR PROPORTIONS CONFIDENCE LEVEL...500 409 0.8401 0.8459 0.8565 500 355 0.7364 0.7434 0.7564 500 356 0.7383 0.7453 0.7582 500 410 0.8420 0.8478 0 8583 500 357 0.7402 0.7472 0.7602 500

  18. Confidence bounds of recurrence-based complexity measures

    International Nuclear Information System (INIS)

    Schinkel, Stefan; Marwan, N.; Dimigen, O.; Kurths, J.

    2009-01-01

    In the recent past, recurrence quantification analysis (RQA) has gained an increasing interest in various research areas. The complexity measures the RQA provides have been useful in describing and analysing a broad range of data. It is known to be rather robust to noise and nonstationarities. Yet, one key question in empirical research concerns the confidence bounds of measured data. In the present Letter we suggest a method for estimating the confidence bounds of recurrence-based complexity measures. We study the applicability of the suggested method with model and real-life data.

  19. Confidence building - is science the only approach

    International Nuclear Information System (INIS)

    Bragg, K.

    1990-01-01

    The Atomic Energy Control Board (AECB) has begun to develop some simplified methods to determine if it is possible to provide confidence that dose, risk and environmental criteria can be respected without undue reliance on detailed scientific models. The progress to date will be outlined and the merits of this new approach will be compared to the more complex, traditional approach. Stress will be given to generating confidence in both technical and non-technical communities as well as the need to enhance communication between them. 3 refs., 1 tab

  20. Diagnostic value of chemical shift artifact in distinguishing benign lymphadenopathy

    Energy Technology Data Exchange (ETDEWEB)

    Farshchian, Nazanin, E-mail: farshchian.n@gmail.com [Department of Radiology, Kermanshah University of Medical Sciences, Kermanshah (Iran, Islamic Republic of); Tamari, Saghar; Farshchian, Negin [Department of Radiology, Kermanshah University of Medical Sciences, Kermanshah (Iran, Islamic Republic of); Madani, Hamid [Department of Pathology, Imam-Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah (Iran, Islamic Republic of); Rezaie, Mansour [Department of Biostatistics, Kermanshah University of Medical Sciences, Kermanshah (Iran, Islamic Republic of); Mohammadi-Motlagh, Hamid-Reza, E-mail: mohammadimotlagh@gmail.com [Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah (Iran, Islamic Republic of)

    2011-11-15

    Purpose: Today, distinguishing metastatic lymph nodes from secondary benign inflammatory ones via using non-invasive methods is increasingly favorable. In this study, the diagnostic value of chemical shift artifact (CSA) in magnetic resonance imaging (MRI) was evaluated to distinguish benign lymphadenopathy. Subjects and methods: A prospective intraindividual internal review board-approved study was carried out on 15 men and 15 women having lymphadenopathic lesions in different locations of the body who underwent contrast-enhanced dynamic MR imaging at 1.5 T. Then, the imaging findings were compared with pathology reports, using the statistics analyses. Results: Due to the findings of the CSA existence in MRI, a total of 56.7% of the studied lesions (17 of 30) were identified as benign lesions and the rest were malignant, whereas the pathology reports distinguished twelve malignant and eighteen benign cases. Furthermore, the CSA findings comparing the pathology reports indicated that CSA, with confidence of 79.5%, has a significant diagnostic value to differentiate benign lesions from malignant ones. Conclusion: Our study demonstrated that CSA in MR imaging has a suitable diagnostic potential nearing readiness for clinical trials. Furthermore, CSA seems to be a feasible tool to differentiate benign lymph nodes from malignant ones; however, further studies including larger numbers of patients are required to confirm our results.

  1. Inferring high-confidence human protein-protein interactions

    Directory of Open Access Journals (Sweden)

    Yu Xueping

    2012-05-01

    Full Text Available Abstract Background As numerous experimental factors drive the acquisition, identification, and interpretation of protein-protein interactions (PPIs, aggregated assemblies of human PPI data invariably contain experiment-dependent noise. Ascertaining the reliability of PPIs collected from these diverse studies and scoring them to infer high-confidence networks is a non-trivial task. Moreover, a large number of PPIs share the same number of reported occurrences, making it impossible to distinguish the reliability of these PPIs and rank-order them. For example, for the data analyzed here, we found that the majority (>83% of currently available human PPIs have been reported only once. Results In this work, we proposed an unsupervised statistical approach to score a set of diverse, experimentally identified PPIs from nine primary databases to create subsets of high-confidence human PPI networks. We evaluated this ranking method by comparing it with other methods and assessing their ability to retrieve protein associations from a number of diverse and independent reference sets. These reference sets contain known biological data that are either directly or indirectly linked to interactions between proteins. We quantified the average effect of using ranked protein interaction data to retrieve this information and showed that, when compared to randomly ranked interaction data sets, the proposed method created a larger enrichment (~134% than either ranking based on the hypergeometric test (~109% or occurrence ranking (~46%. Conclusions From our evaluations, it was clear that ranked interactions were always of value because higher-ranked PPIs had a higher likelihood of retrieving high-confidence experimental data. Reducing the noise inherent in aggregated experimental PPIs via our ranking scheme further increased the accuracy and enrichment of PPIs derived from a number of biologically relevant data sets. These results suggest that using our high-confidence

  2. High sensitivity and specificity in proposed clinical diagnostic criteria for anti-N-methyl-D-aspartate receptor encephalitis.

    Science.gov (United States)

    Ho, Alvin C C; Mohammad, Shekeeb S; Pillai, Sekhar C; Tantsis, Esther; Jones, Hannah; Ho, Reena; Lim, Ming; Hacohen, Yael; Vincent, Angela; Dale, Russell C

    2017-12-01

    To determine the validity of the proposed clinical diagnostic criteria for anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis in paediatric patients. The diagnostic criteria for anti-NMDAR encephalitis proposed by Graus et al. (2016) use clinical features and conventional investigations to facilitate early immunotherapy before antibody status is available. The criteria are satisfied if patients develop four out of six symptom groups within 3 months, together with at least one abnormal investigation (electroencephalography/cerebrospinal fluid) and reasonable exclusion of other disorders. We evaluated the validity of the criteria using a retrospective cohort of paediatric patients with encephalitis. Twenty-nine patients with anti-NMDAR encephalitis and 74 comparison children with encephalitis were included. As expected, the percentage of patients with anti-NMDAR encephalitis who fulfilled the clinical criteria increased over time. During the hospital inpatient admission, most patients (26/29, 90%) with anti-NMDAR encephalitis fulfilled the criteria, significantly more than the comparison group (3/74, 4%) (panti-NMDAR encephalitis was 2 weeks from first symptom onset (range 1-6). The sensitivity of the criteria was 90% (95% confidence interval 73-98) and the specificity was 96% (95% confidence interval 89-99). The proposed diagnostic criteria for anti-NMDAR encephalitis have good sensitivity and specificity. Incomplete criteria do not exclude the diagnosis. The proposed clinical diagnostic criteria for anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis by Graus et al. (2016) have high sensitivity and specificity in paediatric patients. The median time of fulfilling the criteria in patients with anti-NMDAR was 2 weeks from first symptom onset. © 2017 Mac Keith Press.

  3. Animal Spirits and Extreme Confidence: No Guts, No Glory?

    NARCIS (Netherlands)

    M.G. Douwens-Zonneveld (Mariska)

    2012-01-01

    textabstractThis study investigates to what extent extreme confidence of either management or security analysts may impact financial or operating performance. We construct a multidimensional degree of company confidence measure from a wide range of corporate decisions. We empirically test this

  4. The appropriateness of XML for diagnostic description

    Energy Technology Data Exchange (ETDEWEB)

    Neto, A. [Associacao Euratom/IST, Centro de Fusao Nuclear, Av. Rovisco Pais, P-1049-001 Lisboa (Portugal)], E-mail: andre.neto@cfn.ist.utl.pt; Lister, J.B. [CRPP-EPFL, Association EURATOM-Confederation Suisse, 1015 Lausanne (Switzerland); Fernandes, H. [Associacao Euratom/IST, Centro de Fusao Nuclear, Av. Rovisco Pais, P-1049-001 Lisboa (Portugal); Yonekawa, I. [JAEA, Japan Atomic Energy Agency Naka (Japan); Varandas, C.A.F. [Associacao Euratom/IST, Centro de Fusao Nuclear, Av. Rovisco Pais, P-1049-001 Lisboa (Portugal)

    2007-10-15

    A standard for the self-description of fusion plasma diagnostics will be required in the near future. The motivation is to maintain and organize the information on all the components of a laboratory experiment, from the hardware to the access security, to save time and money. Since there is no existing standard to organize this kind of information, every EU Association stores and organizes each experiment in different ways. This can lead to severe problems when the particular organization schema is poorly documented. Standardization is the key to solve these problems. From the commercial information on the diagnostic (component supplier; component price) to the hardware description (component specifications; drawings) to the operation of the equipment (finite state machines) through change control (who changed what and when) and internationalization (information at least in English and a local language). This problem will be met on the ITER project, for which a solution is essential. A strong candidate solution is the Extensible Markup Language (XML). In this paper, a review of the current status of XML related technologies will be presented.

  5. The appropriateness of XML for diagnostic description

    International Nuclear Information System (INIS)

    Neto, A.; Lister, J.B.; Fernandes, H.; Yonekawa, I.; Varandas, C.A.F.

    2007-01-01

    A standard for the self-description of fusion plasma diagnostics will be required in the near future. The motivation is to maintain and organize the information on all the components of a laboratory experiment, from the hardware to the access security, to save time and money. Since there is no existing standard to organize this kind of information, every EU Association stores and organizes each experiment in different ways. This can lead to severe problems when the particular organization schema is poorly documented. Standardization is the key to solve these problems. From the commercial information on the diagnostic (component supplier; component price) to the hardware description (component specifications; drawings) to the operation of the equipment (finite state machines) through change control (who changed what and when) and internationalization (information at least in English and a local language). This problem will be met on the ITER project, for which a solution is essential. A strong candidate solution is the Extensible Markup Language (XML). In this paper, a review of the current status of XML related technologies will be presented

  6. A Non-Interfering Beam Radius Diagnostic Suitable For Induction Linacs

    International Nuclear Information System (INIS)

    Nexsen, W E

    2005-01-01

    High current electron induction linacs operate in a parameter regime that allows the use of a diamagnetic loop (DML) to measure the beam magnetic moment. Under certain easily met conditions the beam radius can be derived from the moment measurement. The DML has the advantage over the present methods of measuring beam radius in that it is an electrical measurement with good time resolution that does not interfere with the beam transport. I describe experiments on the LLNL accelerators, ETA-II and FXR that give confidence in the use of a DML as a beam diagnostic

  7. The influence of endogenous and exogenous spatial attention on decision confidence

    OpenAIRE

    Kurtz, Phillipp; Shapcott, Katharine A.; Kaiser , Jochen; Schmiedt, Joscha T.; Schmid, Michael C.

    2017-01-01

    Spatial attention allows us to make more accurate decisions about events in our environment. Decision confidence is thought to be intimately linked to the decision making process as confidence ratings are tightly coupled to decision accuracy. While both spatial attention and decision confidence have been subjected to extensive research, surprisingly little is known about the interaction between these two processes. Since attention increases performance it might be expected that confidence wou...

  8. Vaccination Confidence and Parental Refusal/Delay of Early Childhood Vaccines.

    Directory of Open Access Journals (Sweden)

    Melissa B Gilkey

    Full Text Available To support efforts to address parental hesitancy towards early childhood vaccination, we sought to validate the Vaccination Confidence Scale using data from a large, population-based sample of U.S. parents.We used weighted data from 9,354 parents who completed the 2011 National Immunization Survey. Parents reported on the immunization history of a 19- to 35-month-old child in their households. Healthcare providers then verified children's vaccination status for vaccines including measles, mumps, and rubella (MMR, varicella, and seasonal flu. We used separate multivariable logistic regression models to assess associations between parents' mean scores on the 8-item Vaccination Confidence Scale and vaccine refusal, vaccine delay, and vaccination status.A substantial minority of parents reported a history of vaccine refusal (15% or delay (27%. Vaccination confidence was negatively associated with refusal of any vaccine (odds ratio [OR] = 0.58, 95% confidence interval [CI], 0.54-0.63 as well as refusal of MMR, varicella, and flu vaccines specifically. Negative associations between vaccination confidence and measures of vaccine delay were more moderate, including delay of any vaccine (OR = 0.81, 95% CI, 0.76-0.86. Vaccination confidence was positively associated with having received vaccines, including MMR (OR = 1.53, 95% CI, 1.40-1.68, varicella (OR = 1.54, 95% CI, 1.42-1.66, and flu vaccines (OR = 1.32, 95% CI, 1.23-1.42.Vaccination confidence was consistently associated with early childhood vaccination behavior across multiple vaccine types. Our findings support expanding the application of the Vaccination Confidence Scale to measure vaccination beliefs among parents of young children.

  9. Learning to make collective decisions: the impact of confidence escalation.

    Science.gov (United States)

    Mahmoodi, Ali; Bang, Dan; Ahmadabadi, Majid Nili; Bahrami, Bahador

    2013-01-01

    Little is known about how people learn to take into account others' opinions in joint decisions. To address this question, we combined computational and empirical approaches. Human dyads made individual and joint visual perceptual decision and rated their confidence in those decisions (data previously published). We trained a reinforcement (temporal difference) learning agent to get the participants' confidence level and learn to arrive at a dyadic decision by finding the policy that either maximized the accuracy of the model decisions or maximally conformed to the empirical dyadic decisions. When confidences were shared visually without verbal interaction, RL agents successfully captured social learning. When participants exchanged confidences visually and interacted verbally, no collective benefit was achieved and the model failed to predict the dyadic behaviour. Behaviourally, dyad members' confidence increased progressively and verbal interaction accelerated this escalation. The success of the model in drawing collective benefit from dyad members was inversely related to confidence escalation rate. The findings show an automated learning agent can, in principle, combine individual opinions and achieve collective benefit but the same agent cannot discount the escalation suggesting that one cognitive component of collective decision making in human may involve discounting of overconfidence arising from interactions.

  10. Confidence-Based Learning in Investment Analysis

    Science.gov (United States)

    Serradell-Lopez, Enric; Lara-Navarra, Pablo; Castillo-Merino, David; González-González, Inés

    The aim of this study is to determine the effectiveness of using multiple choice tests in subjects related to the administration and business management. To this end we used a multiple-choice test with specific questions to verify the extent of knowledge gained and the confidence and trust in the answers. The tests were performed in a group of 200 students at the bachelor's degree in Business Administration and Management. The analysis made have been implemented in one subject of the scope of investment analysis and measured the level of knowledge gained and the degree of trust and security in the responses at two different times of the course. The measurements have been taken into account different levels of difficulty in the questions asked and the time spent by students to complete the test. The results confirm that students are generally able to obtain more knowledge along the way and get increases in the degree of trust and confidence in the answers. It is confirmed as the difficulty level of the questions set a priori by the heads of the subjects are related to levels of security and confidence in the answers. It is estimated that the improvement in the skills learned is viewed favourably by businesses and are especially important for job placement of students.

  11. Confidence, Visual Research, and the Aesthetic Function

    Directory of Open Access Journals (Sweden)

    Stan Ruecker

    2007-05-01

    Full Text Available The goal of this article is to identify and describe one of the primary purposes of aesthetic quality in the design of computer interfaces and visualization tools. We suggest that humanists can derive advantages in visual research by acknowledging by their efforts to advance aesthetic quality that a significant function of aesthetics in this context is to inspire the user’s confidence. This confidence typically serves to create a sense of trust in the provider of the interface or tool. In turn, this increased trust may result in an increased willingness to engage with the object, on the basis that it demonstrates an attention to detail that promises to reward increased engagement. In addition to confidence, the aesthetic may also contribute to a heightened degree of satisfaction with having spent time using or investigating the object. In the realm of interface design and visualization research, we propose that these aesthetic functions have implications not only for the quality of interactions, but also for the results of the standard measures of performance and preference.

  12. The Relationship Between Eyewitness Confidence and Identification Accuracy: A New Synthesis.

    Science.gov (United States)

    Wixted, John T; Wells, Gary L

    2017-05-01

    The U.S. legal system increasingly accepts the idea that the confidence expressed by an eyewitness who identified a suspect from a lineup provides little information as to the accuracy of that identification. There was a time when this pessimistic assessment was entirely reasonable because of the questionable eyewitness-identification procedures that police commonly employed. However, after more than 30 years of eyewitness-identification research, our understanding of how to properly conduct a lineup has evolved considerably, and the time seems ripe to ask how eyewitness confidence informs accuracy under more pristine testing conditions (e.g., initial, uncontaminated memory tests using fair lineups, with no lineup administrator influence, and with an immediate confidence statement). Under those conditions, mock-crime studies and police department field studies have consistently shown that, for adults, (a) confidence and accuracy are strongly related and (b) high-confidence suspect identifications are remarkably accurate. However, when certain non-pristine testing conditions prevail (e.g., when unfair lineups are used), the accuracy of even a high-confidence suspect ID is seriously compromised. Unfortunately, some jurisdictions have not yet made reforms that would create pristine testing conditions and, hence, our conclusions about the reliability of high-confidence identifications cannot yet be applied to those jurisdictions. However, understanding the information value of eyewitness confidence under pristine testing conditions can help the criminal justice system to simultaneously achieve both of its main objectives: to exonerate the innocent (by better appreciating that initial, low-confidence suspect identifications are error prone) and to convict the guilty (by better appreciating that initial, high-confidence suspect identifications are surprisingly accurate under proper testing conditions).

  13. Experiential Education Builds Student Self-Confidence in Delivering Medication Therapy Management

    Directory of Open Access Journals (Sweden)

    Wendy M. Parker

    2017-07-01

    Full Text Available To determine the impact of advanced pharmacy practice experiences (APPE on student self-confidence related to medication therapy management (MTM, fourth-year pharmacy students were surveyed pre/post APPE to: identify exposure to MTM learning opportunities, assess knowledge of the MTM core components, and assess self-confidence performing MTM services. An anonymous electronic questionnaire administered pre/post APPE captured demographics, factors predicted to impact student self-confidence (Grade point average (GPA, work experience, exposure to MTM learning opportunities, MTM knowledge and self-confidence conducting MTM using a 5-point Likert scale (1 = Not at all Confident; 5 = Extremely Confident. Sixty-two students (26% response rate responded to the pre-APPE questionnaire and n = 44 (18% to the post-APPE. Over 90% demonstrated MTM knowledge and 68.2% completed MTM learning activities. APPE experiences significantly improved students’ overall self-confidence (pre-APPE = 3.27 (0.85 SD, post-APPE = 4.02 (0.88, p < 0.001. Students engaging in MTM learning opportunities had higher self-confidence post-APPE (4.20 (0.71 vs. those not reporting MTM learning opportunities (3.64 (1.08, p = 0.05. Post-APPE, fewer students reported MTM was patient-centric or anticipated engaging in MTM post-graduation. APPE learning opportunities increased student self-confidence to provide MTM services. However, the reduction in anticipated engagement in MTM post-graduation and reduction in sensing the patient-centric nature of MTM practice, may reveal a gap between practice expectations and reality.

  14. Confidence intervals for distinguishing ordinal and disordinal interactions in multiple regression.

    Science.gov (United States)

    Lee, Sunbok; Lei, Man-Kit; Brody, Gene H

    2015-06-01

    Distinguishing between ordinal and disordinal interaction in multiple regression is useful in testing many interesting theoretical hypotheses. Because the distinction is made based on the location of a crossover point of 2 simple regression lines, confidence intervals of the crossover point can be used to distinguish ordinal and disordinal interactions. This study examined 2 factors that need to be considered in constructing confidence intervals of the crossover point: (a) the assumption about the sampling distribution of the crossover point, and (b) the possibility of abnormally wide confidence intervals for the crossover point. A Monte Carlo simulation study was conducted to compare 6 different methods for constructing confidence intervals of the crossover point in terms of the coverage rate, the proportion of true values that fall to the left or right of the confidence intervals, and the average width of the confidence intervals. The methods include the reparameterization, delta, Fieller, basic bootstrap, percentile bootstrap, and bias-corrected accelerated bootstrap methods. The results of our Monte Carlo simulation study suggest that statistical inference using confidence intervals to distinguish ordinal and disordinal interaction requires sample sizes more than 500 to be able to provide sufficiently narrow confidence intervals to identify the location of the crossover point. (c) 2015 APA, all rights reserved).

  15. Influence of companion diagnostics on efficacy and safety of targeted anti-cancer drugs: systematic review and meta-analyses.

    Science.gov (United States)

    Ocana, Alberto; Ethier, Josee-Lyne; Díez-González, Laura; Corrales-Sánchez, Verónica; Srikanthan, Amirrtha; Gascón-Escribano, María J; Templeton, Arnoud J; Vera-Badillo, Francisco; Seruga, Bostjan; Niraula, Saroj; Pandiella, Atanasio; Amir, Eitan

    2015-11-24

    Companion diagnostics aim to identify patients that will respond to targeted therapies, therefore increasing the clinical efficacy of such drugs. Less is known about their influence on safety and tolerability of targeted anti-cancer agents. Randomized trials evaluating targeted agents for solid tumors approved by the US Food and Drug Administration since year 2000 were assessed. Odds ratios (OR) and and 95% confidence intervals (CI) were computed for treatment-related death, treatment-discontinuation related to toxicity and occurrence of any grade 3/4 adverse events (AEs). The 12 most commonly reported individual AEs were also explored. ORs were pooled in a meta-analysis. Analysis comprised 41 trials evaluating 28 targeted agents. Seventeen trials (41%) utilized companion diagnostics. Compared to control groups, targeted drugs in experimental arms were associated with increased odds of treatment discontinuation, grade 3/4 AEs, and toxic death irrespective of whether they utilized companion diagnostics or not. Compared to drugs without available companion diagnostics, agents with companion diagnostics had a lower magnitude of increased odds of treatment discontinuation (OR = 1.12 vs. 1.65, p diagnostics were greatest for diarrhea (OR = 1.29 vs. 2.43, p diagnostics are associated with improved safety, and tolerability. Differences were most marked for gastrointestinal, cutaneous and neurological toxicity.

  16. Determining the confidence levels of sensor outputs using neural networks

    Energy Technology Data Exchange (ETDEWEB)

    Broten, G S; Wood, H C [Saskatchewan Univ., Saskatoon, SK (Canada). Dept. of Electrical Engineering

    1996-12-31

    This paper describes an approach for determining the confidence level of a sensor output using multi-sensor arrays, sensor fusion and artificial neural networks. The authors have shown in previous work that sensor fusion and artificial neural networks can be used to learn the relationships between the outputs of an array of simulated partially selective sensors and the individual analyte concentrations in a mixture of analyses. Other researchers have shown that an array of partially selective sensors can be used to determine the individual gas concentrations in a gaseous mixture. The research reported in this paper shows that it is possible to extract confidence level information from an array of partially selective sensors using artificial neural networks. The confidence level of a sensor output is defined as a numeric value, ranging from 0% to 100%, that indicates the confidence associated with a output of a given sensor. A three layer back-propagation neural network was trained on a subset of the sensor confidence level space, and was tested for its ability to generalize, where the confidence level space is defined as all possible deviations from the correct sensor output. A learning rate of 0.1 was used and no momentum terms were used in the neural network. This research has shown that an artificial neural network can accurately estimate the confidence level of individual sensors in an array of partially selective sensors. This research has also shown that the neural network`s ability to determine the confidence level is influenced by the complexity of the sensor`s response and that the neural network is able to estimate the confidence levels even if more than one sensor is in error. The fundamentals behind this research could be applied to other configurations besides arrays of partially selective sensors, such as an array of sensors separated spatially. An example of such a configuration could be an array of temperature sensors in a tank that is not in

  17. Determining the confidence levels of sensor outputs using neural networks

    International Nuclear Information System (INIS)

    Broten, G.S.; Wood, H.C.

    1995-01-01

    This paper describes an approach for determining the confidence level of a sensor output using multi-sensor arrays, sensor fusion and artificial neural networks. The authors have shown in previous work that sensor fusion and artificial neural networks can be used to learn the relationships between the outputs of an array of simulated partially selective sensors and the individual analyte concentrations in a mixture of analyses. Other researchers have shown that an array of partially selective sensors can be used to determine the individual gas concentrations in a gaseous mixture. The research reported in this paper shows that it is possible to extract confidence level information from an array of partially selective sensors using artificial neural networks. The confidence level of a sensor output is defined as a numeric value, ranging from 0% to 100%, that indicates the confidence associated with a output of a given sensor. A three layer back-propagation neural network was trained on a subset of the sensor confidence level space, and was tested for its ability to generalize, where the confidence level space is defined as all possible deviations from the correct sensor output. A learning rate of 0.1 was used and no momentum terms were used in the neural network. This research has shown that an artificial neural network can accurately estimate the confidence level of individual sensors in an array of partially selective sensors. This research has also shown that the neural network's ability to determine the confidence level is influenced by the complexity of the sensor's response and that the neural network is able to estimate the confidence levels even if more than one sensor is in error. The fundamentals behind this research could be applied to other configurations besides arrays of partially selective sensors, such as an array of sensors separated spatially. An example of such a configuration could be an array of temperature sensors in a tank that is not in

  18. Exposure criteria for medical diagnostic ultrasound: 1, Criteria based on thermal mechanisms

    International Nuclear Information System (INIS)

    1992-01-01

    A previous report (NCRP, 1983) contains a comprehensive review of biological effects and mechanisms of action of ultrasound and an analysis of their implications for medical ultrasound. This Report presents background material for a scientifically-based approach to safety assessment of ultrasound. It is intended to help the medical community take advantage of new developments, while maintaining the excellent safety record which now exists for diagnostic ultrasound

  19. 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

  20. Diagnostic x-ray equipment compliance and facility survey. Recommended procedures for equipment and facility testing

    International Nuclear Information System (INIS)

    1994-01-01

    The Radiation Protection Bureau has set out guidelines for the testing of diagnostic x-ray equipment and facilities. This guide provides information for the x-ray inspector, test engineer, technologist, medical physicist and any other person responsible for verifying the regulatory compliance or safety of diagnostic x-ray equipment and facilities. Diagnostic x-radiation is an essential part of present day medical practice. The largest contributor of irradiation to the general population comes from diagnostic x-radiation. Although individual irradiations are usually small, there is a concern of possible excess cancer risk when large populations are irradiated. Unnecessary irradiations to patients from radiological procedures can be significantly reduced with little or no decrease in the value of medical diagnostic information. This can be achieved by using well designed x-ray equipment which is installed, used and maintained by trained personnel, and by the adoption of standardized procedures. In general, when patient surface dose is reduced, there is a corresponding decrease in dose to x-ray equipment operators and other health care personnel. 2 tabs., 4 figs

  1. Diagnostic x-ray equipment compliance and facility survey. Recommended procedures for equipment and facility testing

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-12-31

    The Radiation Protection Bureau has set out guidelines for the testing of diagnostic x-ray equipment and facilities. This guide provides information for the x-ray inspector, test engineer, technologist, medical physicist and any other person responsible for verifying the regulatory compliance or safety of diagnostic x-ray equipment and facilities. Diagnostic x-radiation is an essential part of present day medical practice. The largest contributor of irradiation to the general population comes from diagnostic x-radiation. Although individual irradiations are usually small, there is a concern of possible excess cancer risk when large populations are irradiated. Unnecessary irradiations to patients from radiological procedures can be significantly reduced with little or no decrease in the value of medical diagnostic information. This can be achieved by using well designed x-ray equipment which is installed, used and maintained by trained personnel, and by the adoption of standardized procedures. In general, when patient surface dose is reduced, there is a corresponding decrease in dose to x-ray equipment operators and other health care personnel. 2 tabs., 4 figs.

  2. Maintaining Oxygenation Successfully with High Flow Nasal Cannula during Diagnostic Bronchoscopy on a Postoperative Lung Transplant Patient in the Intensive Care

    Directory of Open Access Journals (Sweden)

    Sara Diab

    2014-01-01

    Full Text Available Bronchoscopy is an important diagnostic and therapeutic intervention for a variety of patients displaying pulmonary pathology. The heterogeneity of the patients undergoing bronchoscopy affords a challenge for providing minimal and safe respiratory support during anesthesia. Currently, options are intubation and general anesthesia versus frequently inadequate sedation or local anaesthesia with low flow oxygen through nasal prongs or mouthpiece. The advent of high flow nasal cannula allows the clinician to have a “middle man” that allows high flow oxygen delivery as well as a degree of respiratory support, which in some cases has been noted to be between 3 and 4 cm of continuous positive airway pressure-like effect. There are minimal data analyzing the use of high flow nasal cannula during anesthesia for bronchoscopy. We present a case report of orthotropic lung transplant recipient undergoing diagnostic bronchoscopy whilst being supported with high flow nasal oxygen in the intensive care unit.

  3. Student certainty answering misconception question: study of Three-Tier Multiple-Choice Diagnostic Test in Acid-Base and Solubility Equilibrium

    Science.gov (United States)

    Ardiansah; Masykuri, M.; Rahardjo, S. B.

    2018-04-01

    Students’ concept comprehension in three-tier multiple-choice diagnostic test related to student confidence level. The confidence level related to certainty and student’s self-efficacy. The purpose of this research was to find out students’ certainty in misconception test. This research was quantitative-qualitative research method counting students’ confidence level. The research participants were 484 students that were studying acid-base and equilibrium solubility subject. Data was collected using three-tier multiple-choice (3TMC) with thirty questions and students’ questionnaire. The findings showed that #6 item gives the highest misconception percentage and high student confidence about the counting of ultra-dilute solution’s pH. Other findings were that 1) the student tendency chosen the misconception answer is to increase over item number, 2) student certainty decreased in terms of answering the 3TMC, and 3) student self-efficacy and achievement were related each other in the research. The findings suggest some implications and limitations for further research.

  4. The Sense of Confidence during Probabilistic Learning: A Normative Account.

    Directory of Open Access Journals (Sweden)

    Florent Meyniel

    2015-06-01

    Full Text Available Learning in a stochastic environment consists of estimating a model from a limited amount of noisy data, and is therefore inherently uncertain. However, many classical models reduce the learning process to the updating of parameter estimates and neglect the fact that learning is also frequently accompanied by a variable "feeling of knowing" or confidence. The characteristics and the origin of these subjective confidence estimates thus remain largely unknown. Here we investigate whether, during learning, humans not only infer a model of their environment, but also derive an accurate sense of confidence from their inferences. In our experiment, humans estimated the transition probabilities between two visual or auditory stimuli in a changing environment, and reported their mean estimate and their confidence in this report. To formalize the link between both kinds of estimate and assess their accuracy in comparison to a normative reference, we derive the optimal inference strategy for our task. Our results indicate that subjects accurately track the likelihood that their inferences are correct. Learning and estimating confidence in what has been learned appear to be two intimately related abilities, suggesting that they arise from a single inference process. We show that human performance matches several properties of the optimal probabilistic inference. In particular, subjective confidence is impacted by environmental uncertainty, both at the first level (uncertainty in stimulus occurrence given the inferred stochastic characteristics and at the second level (uncertainty due to unexpected changes in these stochastic characteristics. Confidence also increases appropriately with the number of observations within stable periods. Our results support the idea that humans possess a quantitative sense of confidence in their inferences about abstract non-sensory parameters of the environment. This ability cannot be reduced to simple heuristics, it seems

  5. LitPathExplorer: a confidence-based visual text analytics tool for exploring literature-enriched pathway models.

    Science.gov (United States)

    Soto, Axel J; Zerva, Chrysoula; Batista-Navarro, Riza; Ananiadou, Sophia

    2018-04-15

    Pathway models are valuable resources that help us understand the various mechanisms underpinning complex biological processes. Their curation is typically carried out through manual inspection of published scientific literature to find information relevant to a model, which is a laborious and knowledge-intensive task. Furthermore, models curated manually cannot be easily updated and maintained with new evidence extracted from the literature without automated support. We have developed LitPathExplorer, a visual text analytics tool that integrates advanced text mining, semi-supervised learning and interactive visualization, to facilitate the exploration and analysis of pathway models using statements (i.e. events) extracted automatically from the literature and organized according to levels of confidence. LitPathExplorer supports pathway modellers and curators alike by: (i) extracting events from the literature that corroborate existing models with evidence; (ii) discovering new events which can update models; and (iii) providing a confidence value for each event that is automatically computed based on linguistic features and article metadata. Our evaluation of event extraction showed a precision of 89% and a recall of 71%. Evaluation of our confidence measure, when used for ranking sampled events, showed an average precision ranging between 61 and 73%, which can be improved to 95% when the user is involved in the semi-supervised learning process. Qualitative evaluation using pair analytics based on the feedback of three domain experts confirmed the utility of our tool within the context of pathway model exploration. LitPathExplorer is available at http://nactem.ac.uk/LitPathExplorer_BI/. sophia.ananiadou@manchester.ac.uk. Supplementary data are available at Bioinformatics online.

  6. Brain networks for confidence weighting and hierarchical inference during probabilistic learning.

    Science.gov (United States)

    Meyniel, Florent; Dehaene, Stanislas

    2017-05-09

    Learning is difficult when the world fluctuates randomly and ceaselessly. Classical learning algorithms, such as the delta rule with constant learning rate, are not optimal. Mathematically, the optimal learning rule requires weighting prior knowledge and incoming evidence according to their respective reliabilities. This "confidence weighting" implies the maintenance of an accurate estimate of the reliability of what has been learned. Here, using fMRI and an ideal-observer analysis, we demonstrate that the brain's learning algorithm relies on confidence weighting. While in the fMRI scanner, human adults attempted to learn the transition probabilities underlying an auditory or visual sequence, and reported their confidence in those estimates. They knew that these transition probabilities could change simultaneously at unpredicted moments, and therefore that the learning problem was inherently hierarchical. Subjective confidence reports tightly followed the predictions derived from the ideal observer. In particular, subjects managed to attach distinct levels of confidence to each learned transition probability, as required by Bayes-optimal inference. Distinct brain areas tracked the likelihood of new observations given current predictions, and the confidence in those predictions. Both signals were combined in the right inferior frontal gyrus, where they operated in agreement with the confidence-weighting model. This brain region also presented signatures of a hierarchical process that disentangles distinct sources of uncertainty. Together, our results provide evidence that the sense of confidence is an essential ingredient of probabilistic learning in the human brain, and that the right inferior frontal gyrus hosts a confidence-based statistical learning algorithm for auditory and visual sequences.

  7. Brain networks for confidence weighting and hierarchical inference during probabilistic learning

    Science.gov (United States)

    Meyniel, Florent; Dehaene, Stanislas

    2017-01-01

    Learning is difficult when the world fluctuates randomly and ceaselessly. Classical learning algorithms, such as the delta rule with constant learning rate, are not optimal. Mathematically, the optimal learning rule requires weighting prior knowledge and incoming evidence according to their respective reliabilities. This “confidence weighting” implies the maintenance of an accurate estimate of the reliability of what has been learned. Here, using fMRI and an ideal-observer analysis, we demonstrate that the brain’s learning algorithm relies on confidence weighting. While in the fMRI scanner, human adults attempted to learn the transition probabilities underlying an auditory or visual sequence, and reported their confidence in those estimates. They knew that these transition probabilities could change simultaneously at unpredicted moments, and therefore that the learning problem was inherently hierarchical. Subjective confidence reports tightly followed the predictions derived from the ideal observer. In particular, subjects managed to attach distinct levels of confidence to each learned transition probability, as required by Bayes-optimal inference. Distinct brain areas tracked the likelihood of new observations given current predictions, and the confidence in those predictions. Both signals were combined in the right inferior frontal gyrus, where they operated in agreement with the confidence-weighting model. This brain region also presented signatures of a hierarchical process that disentangles distinct sources of uncertainty. Together, our results provide evidence that the sense of confidence is an essential ingredient of probabilistic learning in the human brain, and that the right inferior frontal gyrus hosts a confidence-based statistical learning algorithm for auditory and visual sequences. PMID:28439014

  8. An MRI-based diagnostic framework for early diagnosis of dyslexia

    International Nuclear Information System (INIS)

    El-Baz, A.; Casanova, M.; Mott, M.; Switala, A.; Gimel'farb, G.

    2008-01-01

    A computer-aided diagnosis (CAD) system for early diagnosis of dyslexia was developed and tested. Dyslexia can severely impair the learning abilities of children so improved diagnostic methods are needed. Neuropathological studies show abnormal anatomy of the cerebral white matter (CWM) in dyslexic brains. We sought to develop an MRI-based macroscopic neuropathological correlate to the minicolumnopathy of dyslexia that relates to cortical connectivity: the gyral window. The brains of dyslexic patients often exhibit decreased gyrifications, so the thickness of gyral CWM for dyslexic subjects is greater than for normal subjects. We developed an MRI-based method for assessment of gyral CWM thickness with automated recognition of abnormal (e.g., dyslexic) brains. In vivo data was collected from 16 right-handed dyslexic men aged 18-40 years, and a group of 14 controls matched for gender, age, educational level, socioeconomic background, handedness and general intelligence. All the subjects were physically healthy and free of history of neurological diseases and head injury. Images were acquired with the same 1.5T MRI scanner (GE, Milwaukee, WI, USA) with voxel resolution 0.9375 x 0.9375 x 1.5 mm using a T1-weighted imaging sequence protocol. The ''ground truth'' diagnosis to evaluate the classification accuracy for each patient was given by the clinicians. The accuracy of diagnosis/classification of both the training and test subjects was evaluated using the Chi-square test at the three confidence levels - 85, 90 and 95% - in order to examine significant differences in the Levy distances. As expected, the 85% confidence level yielded the best results, the system correctly classified 16 out of 16 dyslexic subjects (a 100% accuracy) and 14 out of 14 control subjects (a 100% accuracy). At the 90% confidence level, 16 out of 16 dyslexic subjects were still classified correctly; however, only 13 out of 14 control subjects were correct, bringing the accuracy rate for the

  9. An MRI-based diagnostic framework for early diagnosis of dyslexia

    Energy Technology Data Exchange (ETDEWEB)

    El-Baz, A. [University of Louisville, Bioengineering Department, Louisville, KY (United States); Casanova, M.; Mott, M.; Switala, A. [University of Louisville, Department of Psychiatry and Behavioral Science, Louisville, KY (United States); Gimel' farb, G. [University of Auckland, Computer Science Department, Auckland (New Zealand)

    2008-09-15

    A computer-aided diagnosis (CAD) system for early diagnosis of dyslexia was developed and tested. Dyslexia can severely impair the learning abilities of children so improved diagnostic methods are needed. Neuropathological studies show abnormal anatomy of the cerebral white matter (CWM) in dyslexic brains. We sought to develop an MRI-based macroscopic neuropathological correlate to the minicolumnopathy of dyslexia that relates to cortical connectivity: the gyral window. The brains of dyslexic patients often exhibit decreased gyrifications, so the thickness of gyral CWM for dyslexic subjects is greater than for normal subjects. We developed an MRI-based method for assessment of gyral CWM thickness with automated recognition of abnormal (e.g., dyslexic) brains. In vivo data was collected from 16 right-handed dyslexic men aged 18-40 years, and a group of 14 controls matched for gender, age, educational level, socioeconomic background, handedness and general intelligence. All the subjects were physically healthy and free of history of neurological diseases and head injury. Images were acquired with the same 1.5T MRI scanner (GE, Milwaukee, WI, USA) with voxel resolution 0.9375 x 0.9375 x 1.5 mm using a T1-weighted imaging sequence protocol. The ''ground truth'' diagnosis to evaluate the classification accuracy for each patient was given by the clinicians. The accuracy of diagnosis/classification of both the training and test subjects was evaluated using the Chi-square test at the three confidence levels - 85, 90 and 95% - in order to examine significant differences in the Levy distances. As expected, the 85% confidence level yielded the best results, the system correctly classified 16 out of 16 dyslexic subjects (a 100% accuracy) and 14 out of 14 control subjects (a 100% accuracy). At the 90% confidence level, 16 out of 16 dyslexic subjects were still classified correctly; however, only 13 out of 14 control subjects were correct, bringing the

  10. Beam-beam diagnostics from closed-orbit distortion

    International Nuclear Information System (INIS)

    Furman, M.; Chin, Y.H.; Eden, J.; Kozanecki, W.; Tennyson, J.; Ziemann, V.

    1992-07-01

    We study the applicability of beam-beam deflection techniques as a tuning tool for asymmetric B factories, focusing on PEP-II as an example. Assuming that the closed orbits of the two beams are separated vertically at the interaction point by a local orbit bump that is nominally closed, we calculate the residual beam orbit distortions due to the beam-beam interaction. Difference orbit measurements, performed at points conveniently distant from the interaction point (IP), provide distinct signatures that can be used to maintain the beams in collision and perform detailed optical diagnostics at the IP. A proposal to test this method experimentally at the TRISTAN ring is briefly discussed

  11. Confidence assessment. Site descriptive modelling SDM-Site Forsmark

    International Nuclear Information System (INIS)

    2008-09-01

    The objective of this report is to assess the confidence that can be placed in the Forsmark site descriptive model, based on the information available at the conclusion of the surface-based investigations (SDM-Site Forsmark). In this exploration, an overriding question is whether remaining uncertainties are significant for repository engineering design or long-term safety assessment and could successfully be further reduced by more surface based investigations or more usefully by explorations underground made during construction of the repository. The confidence in the Forsmark site descriptive model, based on the data available at the conclusion of the surface-based site investigations, have been assessed by exploring: Confidence in the site characterisation data base; Key remaining issues and their handling; Handling of alternative models; Consistency between disciplines; and, Main reasons for confidence and lack of confidence in the model. It is generally found that the key aspects of importance for safety assessment and repository engineering of the Forsmark site descriptive model are associated with a high degree of confidence. Because of the robust geological model that describes the site, the overall confidence in Forsmark site descriptive model is judged to be high. While some aspects have lower confidence this lack of confidence is handled by providing wider uncertainty ranges, bounding estimates and/or alternative models. Most, but not all, of the low confidence aspects have little impact on repository engineering design or for long-term safety. Poor precision in the measured data are judged to have limited impact on uncertainties on the site descriptive model, with the exceptions of inaccuracy in determining the position of some boreholes at depth in 3-D space, as well as the poor precision of the orientation of BIPS images in some boreholes, and the poor precision of stress data determined by overcoring at the locations where the pre

  12. Monitoring consumer confidence in food safety: an exploratory study

    NARCIS (Netherlands)

    Jonge, de J.; Frewer, L.J.; Trijp, van J.C.M.; Renes, R.J.; Wit, de W.; Timmers, J.C.M.

    2004-01-01

    Abstract: In response to the potential for negative economic and societal effects resulting from a low level of consumer confidence in food safety, it is important to know how confidence is potentially influenced by external events. The aim of this article is to describe the development of a monitor

  13. Diagnostic imaging of compression neuropathy

    International Nuclear Information System (INIS)

    Weishaupt, D.; Andreisek, G.

    2007-01-01

    Compression-induced neuropathy of peripheral nerves can cause severe pain of the foot and ankle. Early diagnosis is important to institute prompt treatment and to minimize potential injury. Although clinical examination combined with electrophysiological studies remain the cornerstone of the diagnostic work-up, in certain cases, imaging may provide key information with regard to the exact anatomic location of the lesion or aid in narrowing the differential diagnosis. In other patients with peripheral neuropathies of the foot and ankle, imaging may establish the etiology of the condition and provide information crucial for management and/or surgical planning. MR imaging and ultrasound provide direct visualization of the nerve and surrounding abnormalities. Bony abnormalities contributing to nerve compression are best assessed by radiographs and CT. Knowledge of the anatomy, the etiology, typical clinical findings, and imaging features of peripheral neuropathies affecting the peripheral nerves of the foot and ankle will allow for a more confident diagnosis. (orig.) [de

  14. Differentially Private Confidence Intervals for Empirical Risk Minimization

    OpenAIRE

    Wang, Yue; Kifer, Daniel; Lee, Jaewoo

    2018-01-01

    The process of data mining with differential privacy produces results that are affected by two types of noise: sampling noise due to data collection and privacy noise that is designed to prevent the reconstruction of sensitive information. In this paper, we consider the problem of designing confidence intervals for the parameters of a variety of differentially private machine learning models. The algorithms can provide confidence intervals that satisfy differential privacy (as well as the mor...

  15. Expert system for diagnostics and status monitoring of NPP water chemistry condition

    International Nuclear Information System (INIS)

    Shvedova, M.N.; Kritski, V.G.; Zakharova, S.V.; Benediktov, V.B.; Nikolaev, F.V.

    2002-01-01

    Water chemistry condition (WCC) has been the subject of constant study and improvement up to the present day. It is connected with the presence of a direct relationship between the violation of water chemistry regulation on the one hand and components reliability of the circuit's equipment and cost-effectiveness of their operation on the other. It dictates the necessity to apply different optimization methods in the field of monitoring and use of information analytical and diagnostic systems to assess WCC quality, control and support. LI ''VNIPIET'' employees have, for several years, been developing an expert diagnostic system for supporting WCC and status monitoring of RBMK - reactor NPPs [2]. This system has not only conveniently organized the traditional functions of information acquisition and storage, a complete presentation of information in the form of tables, graphs of a dynamical changes of parameters and formation regular reports, diagnostic functions and issuing recommendations on WCC correction, but it also allows the assessment of confidence in the diagnosis made, relying on a wide range of numerical estimates, which were calculated by the use of expert data, and to make a credible prediction of an existing situation development. (authors)

  16. Thought confidence as a determinant of persuasion: the self-validation hypothesis.

    Science.gov (United States)

    Petty, Richard E; Briñol, Pablo; Tormala, Zakary L

    2002-05-01

    Previous research in the domain of attitude change has described 2 primary dimensions of thinking that impact persuasion processes and outcomes: the extent (amount) of thinking and the direction (valence) of issue-relevant thought. The authors examined the possibility that another, more meta-cognitive aspect of thinking is also important-the degree of confidence people have in their own thoughts. Four studies test the notion that thought confidence affects the extent of persuasion. When positive thoughts dominate in response to a message, increasing confidence in those thoughts increases persuasion, but when negative thoughts dominate, increasing confidence decreases persuasion. In addition, using self-reported and manipulated thought confidence in separate studies, the authors provide evidence that the magnitude of the attitude-thought relationship depends on the confidence people have in their thoughts. Finally, the authors also show that these self-validation effects are most likely in situations that foster high amounts of information processing activity.

  17. A diagnostic algorithm to optimize data collection and interpretation of Ripple Maps in atrial tachycardias.

    Science.gov (United States)

    Koa-Wing, Michael; Nakagawa, Hiroshi; Luther, Vishal; Jamil-Copley, Shahnaz; Linton, Nick; Sandler, Belinda; Qureshi, Norman; Peters, Nicholas S; Davies, D Wyn; Francis, Darrel P; Jackman, Warren; Kanagaratnam, Prapa

    2015-11-15

    Ripple Mapping (RM) is designed to overcome the limitations of existing isochronal 3D mapping systems by representing the intracardiac electrogram as a dynamic bar on a surface bipolar voltage map that changes in height according to the electrogram voltage-time relationship, relative to a fiduciary point. We tested the hypothesis that standard approaches to atrial tachycardia CARTO™ activation maps were inadequate for RM creation and interpretation. From the results, we aimed to develop an algorithm to optimize RMs for future prospective testing on a clinical RM platform. CARTO-XP™ activation maps from atrial tachycardia ablations were reviewed by two blinded assessors on an off-line RM workstation. Ripple Maps were graded according to a diagnostic confidence scale (Grade I - high confidence with clear pattern of activation through to Grade IV - non-diagnostic). The RM-based diagnoses were corroborated against the clinical diagnoses. 43 RMs from 14 patients were classified as Grade I (5 [11.5%]); Grade II (17 [39.5%]); Grade III (9 [21%]) and Grade IV (12 [28%]). Causes of low gradings/errors included the following: insufficient chamber point density; window-of-interestRipple Maps in atrial tachycardias. This algorithm requires prospective testing on a real-time clinical platform. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. True and False Memories, Parietal Cortex, and Confidence Judgments

    Science.gov (United States)

    Urgolites, Zhisen J.; Smith, Christine N.; Squire, Larry R.

    2015-01-01

    Recent studies have asked whether activity in the medial temporal lobe (MTL) and the neocortex can distinguish true memory from false memory. A frequent complication has been that the confidence associated with correct memory judgments (true memory) is typically higher than the confidence associated with incorrect memory judgments (false memory).…

  19. Tree-structured vector quantization of CT chest scans: Image quality and diagnostic accuracy

    International Nuclear Information System (INIS)

    Cosman, P.C.; Tseng, C.; Gray, R.M.; Olshen, R.A.; Moses, L.E.; Davidson, H.C.; Bergin, C.J.; Riskin, E.A.

    1993-01-01

    The quality of lossy compressed images is often characterized by signal-to-noise ratios, informal tests of subjective quality, or receiver operating characteristic (ROC) curves that include subjective appraisals of the value of an image for a particular application. The authors believe that for medical applications, lossy compressed images should be judged by a more natural and fundamental aspect of relative image quality: their use in making accurate diagnoses. They apply a lossy compression algorithm to medical images, and quantify the quality of the images by the diagnostic performance of radiologists, as well as by traditional signal-to-noise ratios and subjective ratings. The study is unlike previous studies of the effects of lossy compression in that they consider non-binary detection tasks, simulate actual diagnostic practice instead of using paired tests or confidence rankings, use statistical methods that are more appropriate for non-binary clinical data than are the popular ROC curves, and use low-complexity predictive tree-structured vector quantization for compression rather than DCT-based transform codes combined with entropy coding. Their diagnostic tasks are the identification of nodules (tumors) in the lungs and lymphadenopathy in the mediastinum from computerized tomography (CT) chest scans. For the image modality, compression algorithm, and diagnostic tasks they consider, the original 12 bit per pixel (bpp) CT image can be compressed to between 1 bpp and 2 bpp with no significant changes in diagnostic accuracy

  20. Electron density diagnostics in the 10-100 A interval for a solar flare

    Science.gov (United States)

    Brown, W. A.; Bruner, M. E.; Acton, L. W.; Mason, H. E.

    1986-01-01

    Electron density measurements from spectral-line diagnostics are reported for a solar flare on July 13, 1982, 1627 UT. The spectrogram, covering the 10-95 A interval, contained usable lines of helium-like ions C V, N VI, O VII, and Ne IX which are formed over the temperature interval 0.7-3.5 x 10 to the 6th K. In addition, spectral-line ratios of Si IX, Fe XIV, and Ca XV were compared with new theoretical estimates of their electron density sensitivity to obtain additional electron density diagnostics. An electron density of 3 x 10 to the 10th/cu cm was obtained. The comparison of these results from helium-like and other ions gives confidence in the utility of these tools for solar coronal analysis and will lead to a fuller understanding of the phenomena observed in this flare.

  1. Competition and confidence

    International Nuclear Information System (INIS)

    Borloo, J.L.

    2007-01-01

    After a presentation of the new situation of the energy sector with the opening of European energy markets to competition, the author recalls the role of the French government in the organisation and operation of this market: reliable information and protection of consumers, security of supplies with reasonable gas prices, sound relations and partnerships with producing and transit countries. France agrees with the diagnostic of the European Commission about the necessity to improve the operation of the domestic energy markets but differs with the projects of the Commission on the means to be implemented to ensure transparency, non-discrimination, and efficiency in the operation of these markets. (J.S.)

  2. Experimental article – Reducing effective dose to a paediatric phantom by using different combinations of kVp, mAs and additional filtration whilst maintaining image quality

    NARCIS (Netherlands)

    Elsbeth Huizinga; Ana Pereira; Wouter Schaake; Charlotte Bloomfield; Heidi Knight; Emilie Crausaz; Hanne Hustveit; Ruurd Visser; Vanja Harsaker; Diane Chabloz; Filipa Boavida

    2015-01-01

    Purpose: To determine whether using different combinations of kVp and mAs with additional filtration can reduce the effective dose to a paediatric phantom whilst maintaining diagnostic image quality. Methods: 27 images of a paediatric AP pelvis phantom were acquired with different kVp, mAs

  3. Building and strengthening confidence and security in Asia

    International Nuclear Information System (INIS)

    Corden, P.S.

    1992-01-01

    This paper presents a few thoughts on the question of building and strengthening confidence and security in Asia, in particular in the area centred on the Korean peninsula. This question includes the process of establishing and implementing confidence- and security-building measures, some of which might involve States other than North and South Korea. The development of CSBMs has now been well established in Europe, and there are encouraging signs that such measures are taking hold in other areas of the world, including in Korea. Consequently there is a fairly rich mine of information, precedent and experience from which to draw in focusing on the particular subject at hand. In these remarks the concept of confidence- and security-building is briefly addressed and measures are examined that have proven useful in other circumstances and review some possibilities that appear of interest in the present context

  4. The integrated model of sport confidence: a canonical correlation and mediational analysis.

    Science.gov (United States)

    Koehn, Stefan; Pearce, Alan J; Morris, Tony

    2013-12-01

    The main purpose of the study was to examine crucial parts of Vealey's (2001) integrated framework hypothesizing that sport confidence is a mediating variable between sources of sport confidence (including achievement, self-regulation, and social climate) and athletes' affect in competition. The sample consisted of 386 athletes, who completed the Sources of Sport Confidence Questionnaire, Trait Sport Confidence Inventory, and Dispositional Flow Scale-2. Canonical correlation analysis revealed a confidence-achievement dimension underlying flow. Bias-corrected bootstrap confidence intervals in AMOS 20.0 were used in examining mediation effects between source domains and dispositional flow. Results showed that sport confidence partially mediated the relationship between achievement and self-regulation domains and flow, whereas no significant mediation was found for social climate. On a subscale level, full mediation models emerged for achievement and flow dimensions of challenge-skills balance, clear goals, and concentration on the task at hand.

  5. Confidence in Assessment of Lumbar Spondylolysis Using Three-Dimensional Volumetric T2-Weighted MRI Compared With Limited Field of View, Decreased-Dose CT.

    Science.gov (United States)

    Delavan, Joshua Adam; Stence, Nicholas V; Mirsky, David M; Gralla, Jane; Fadell, Michael F

    2016-07-01

    Limited z-axis-coverage computed tomography (CT) to evaluate for pediatric lumbar spondylolysis, altering the technique such that the dose to the patient is comparable or lower than radiographs, is currently used at our institution. The objective of the study was to determine whether volumetric 3-dimensional fast spin echo magnetic resonance imaging (3D MRI) can provide equal or greater diagnostic accuracy compared with limited CT in the diagnosis of pediatric lumbar spondylolysis without ionizing radiation. Volumetric 3D MRI can provide equal or greater diagnostic accuracy compared with low-dose CT for pediatric lumbar spondylolysis without ionizing radiation. Clinical review. Level 2. Three pediatric neuroradiologists evaluated 2-dimensional (2D) MRI, 2D + 3D MRI, and limited CT examinations in 42 pediatric patients who obtained imaging for low back pain and suspected spondylolysis. As there is no gold standard for the diagnosis of spondylolysis besides surgery, interobserver agreement and degree of confidence were compared to determine which modality is preferable. Decreased-dose CT provided a greater level of agreement than 2D MRI and 2D + 3D MRI. The kappa for rater agreement with 2D MRI, 2D + 3D MRI, and CT was 0.19, 0.32, and 1.0, respectively. All raters agreed in 31%, 40%, and 100% of cases with 2D MRI, 2D + 3D MRI, and CT. Lack of confidence was significantly lower with CT (0%) than with 2D MRI (30%) and 2D + 3D MRI (25%). For diagnosing spondylolysis, radiologist agreement and confidence trended toward improvement with the addition of a volumetric 3D MRI sequence to standard 2D MRI sequences compared with 2D MRI alone; however, agreement and confidence remain significantly greater using decreased-dose CT when compared with either MRI acquisition. Decreased-dose CT of the lumbar spine remains the optimal examination to confirm a high suspicion of spondylolysis, with dose essentially equivalent to radiographs. If clinical symptoms are not classic for

  6. The Effects of Fatigue From Overnight Shifts on Radiology Search Patterns and Diagnostic Performance.

    Science.gov (United States)

    Hanna, Tarek N; Zygmont, Matthew E; Peterson, Ryan; Theriot, David; Shekhani, Haris; Johnson, Jamlik-Omari; Krupinski, Elizabeth A

    2018-01-20

    The aim of this study was to assess the effect of overnight shifts (ONS) on radiologist fatigue, visual search pattern, and diagnostic performance. This experimental study was approved by the institutional review board. Twelve radiologists (five faculty members and seven residents) each completed two sessions: one during a normal workday ("not fatigued") and another in the morning after an ONS ("fatigued"). Each radiologist completed the Swedish Occupational Fatigue Inventory. During each session, radiologists viewed 20 bone radiographs consisting of normal and abnormal findings. Viewing time, diagnostic confidence, and eye-tracking data were recorded. Swedish Occupational Fatigue Inventory results demonstrated worsening in all five variables (lack of energy, physical exertion, physical discomfort, lack of motivation, and sleepiness) after ONS (P radiologists were more fatigued with worse diagnostic performance, a 45% increase in view time per case, a 60% increase in total gaze fixations, and a 34% increase in time to fixate on the fracture. The effects of fatigue were more pronounced in residents. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  7. SOCIAL MEDIA – VITAL INSTRUMENT IN GAINING CONSUMERS CONFIDENCE

    Directory of Open Access Journals (Sweden)

    Mirela-Cristina VOICU

    2016-06-01

    Full Text Available Given that, currently, the consumer has become more demanding and organizations face some of the greatest challenges due to the economic climate of recent years, the need to build and cultivate strong relationships has become vital not only for the company's success but also for its survival. And solid relationships are built over time through confidence. Trust is one of the most important elements in the process of purchasing and consumer loyalty; it is difficult to obtain but easy to lose. Companies that are enjoying a high degree of confidence benefit from best quotations for their shares, higher profits and a better retention of the best employees. The effects of the lack of confidence are obvious (unsatisfied consumers, lost sales and very expensive for the company. In this context, through the following paper we seek to bring more understanding on how a company can gain the confidence of consumers given that the forms of communication that consumers prefer and that are gaining momentum currently, are taking place online, especially in the social media.

  8. Workshop on confidence limits. Proceedings

    International Nuclear Information System (INIS)

    James, F.; Lyons, L.; Perrin, Y.

    2000-01-01

    The First Workshop on Confidence Limits was held at CERN on 17-18 January 2000. It was devoted to the problem of setting confidence limits in difficult cases: number of observed events is small or zero, background is larger than signal, background not well known, and measurements near a physical boundary. Among the many examples in high-energy physics are searches for the Higgs, searches for neutrino oscillations, B s mixing, SUSY, compositeness, neutrino masses, and dark matter. Several different methods are on the market: the CL s methods used by the LEP Higgs searches; Bayesian methods; Feldman-Cousins and modifications thereof; empirical and combined methods. The Workshop generated considerable interest, and attendance was finally limited by the seating capacity of the CERN Council Chamber where all the sessions took place. These proceedings contain all the papers presented, as well as the full text of the discussions after each paper and of course the last session which was a discussion session. The list of participants and the 'required reading', which was expected to be part of the prior knowledge of all participants, are also included. (orig.)

  9. Constructability and maintainability

    International Nuclear Information System (INIS)

    Hart, R.S.

    1985-01-01

    A set of principles for minimizing the construction schedule was established at the outset of the CANDU 300 programme. Consideration of these principles and other factors led to the development of the unique CANDU 300 station layout. The paper discusses the CANDU 300 station layout and construction methods. In summary, the station layout provides 360 deg. construction access to all buildings, separation of nuclear and non-nuclear systems, precise and minimal physical interfaces between buildings, accommodation of many contractors and construction activities without interference, and maximum flexibility in terms of constructional, financial and supply arrangements. The CANDU 300 further employs modularization, shop fabrication and advanced instrumentation (multiplexers, remote processors, data highways) to minimize construction time. Many of the CANDU 300 features that enhance constructability also contribute to maintainability. These include the 360 deg. access to all principal buildings, the uncluttered and spacious building layouts, the simplification of systems and the high level of modularization. The CANDU 300 has also been designed to facilitate the replacement of all key components, thereby offering an essentially unlimited station life. A prime example is a reduction in the fuel channel inlet end-fitting diameter such that the fuel channels can be shop assembled and easily replaced after the initial 40 years of operation, without an extended unit outage. Maintainability within the reactor building has been given particular attention in the CANDU 300 design; key features of other CANDU reactors (the ability to replace a heat transport system pump motor at power, for example) have been incorporated, while accessibility and maintainability of all systems and components have been enhanced. These and other aspects of maintainability are discussed. (author)

  10. Evidence-based diagnostics: adult septic arthritis.

    Science.gov (United States)

    Carpenter, Christopher R; Schuur, Jeremiah D; Everett, Worth W; Pines, Jesse M

    2011-08-01

    Acutely swollen or painful joints are common complaints in the emergency department (ED). Septic arthritis in adults is a challenging diagnosis, but prompt differentiation of a bacterial etiology is crucial to minimize morbidity and mortality. The objective was to perform a systematic review describing the diagnostic characteristics of history, physical examination, and bedside laboratory tests for nongonococcal septic arthritis. A secondary objective was to quantify test and treatment thresholds using derived estimates of sensitivity and specificity, as well as best-evidence diagnostic and treatment risks and anticipated benefits from appropriate therapy. Two electronic search engines (PUBMED and EMBASE) were used in conjunction with a selected bibliography and scientific abstract hand search. Inclusion criteria included adult trials of patients presenting with monoarticular complaints if they reported sufficient detail to reconstruct partial or complete 2 × 2 contingency tables for experimental diagnostic test characteristics using an acceptable criterion standard. Evidence was rated by two investigators using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS). When more than one similarly designed trial existed for a diagnostic test, meta-analysis was conducted using a random effects model. Interval likelihood ratios (LRs) were computed when possible. To illustrate one method to quantify theoretical points in the probability of disease whereby clinicians might cease testing altogether and either withhold treatment (test threshold) or initiate definitive therapy in lieu of further diagnostics (treatment threshold), an interactive spreadsheet was designed and sample calculations were provided based on research estimates of diagnostic accuracy, diagnostic risk, and therapeutic risk/benefits. The prevalence of nongonococcal septic arthritis in ED patients with a single acutely painful joint is approximately 27% (95% confidence interval [CI] = 17

  11. Diagnostic accuracy of slit skin smears in leprosy

    International Nuclear Information System (INIS)

    Naveed, T.; Shaikh, Z.

    2015-01-01

    To determine the diagnostic accuracy of slit skin smears in clinically suspected patients of leprosy using histopathology as gold standard. Study Design: Validation study Place and Duration of Study: Study was carried out at Rawalpindi Leprosy Hospital, Dermatology Department Military Hospital (MH) and Armed Forces Institute of Pathology (AFIP), Rawalpindi from 18th August 2012 to 18 Feb 2013. Methods: Appropriate technical and ethical approval for the study and patient consent were obtained. All suspected patients of leprosy of any age and either gender having typical hypo-aesthetic or anesthetic, erythematous or hypo-pigmented scaly skin lesions on any part of body were included in this study. All patients who have already received treatment for leprosy, patients with pure neural leprosy, patient not giving their consent for skin biopsy and patients with lepra reactions were excluded from this study. Forty eight patients fulfilling the inclusion criteria were included in the study. Sample size had been calculated by using WHO sample size calculator taking confidence level 95%, absolute precision required 14% and anticipated population proportion 40%. Non-probability consecutive sampling technique was used to collect sample. Results: The results of the study revealed that out of 48 clinically suspected patients of leprosy skin biopsy confirmed the diagnosis in 34 patients (70.8%) and the slit skin smear had diagnostic accuracy of 68.75% with sensitivity 55.8% and specificity and positive predictive value of 100%. Conclusion: Study suggested that although slit skin smears are rapid and inexpensive method of diagnosis but their diagnostic accuracy is low. (author)

  12. Confidence bounds and hypothesis tests for normal distribution coefficients of variation

    Science.gov (United States)

    Steve P. Verrill; Richard A. Johnson

    2007-01-01

    For normally distributed populations, we obtain confidence bounds on a ratio of two coefficients of variation, provide a test for the equality of k coefficients of variation, and provide confidence bounds on a coefficient of variation shared by k populations. To develop these confidence bounds and test, we first establish that estimators based on Newton steps from n-...

  13. Design of a magnetic field alignment diagnostic for the MFTF-B magnet system

    International Nuclear Information System (INIS)

    Deadrick, F.J.; House, P.A.; Frye, R.W.

    1985-01-01

    Magnet alignment in tandem mirror fusion machines plays a crucial role in achieving and maintaining plasma confinement. Various visual alignment tools have been described by Post et al. to align the Tara magnet system. We have designed and installed a remotely operated magnetic field alignment (MFA) diagnostic system as a part of the Mirror Fusion Test Facility (MFTF-B). It measures critical magnetic field alignment parameters of the MFTF-B coil set while under full-field operating conditions. The MFA diagnostic employs a pair of low-energy, electron beam guns on a remotely positionable probe to trace and map selected magnetic field lines. An array of precision electrical detector paddles locates the position of the electron beam, and thus the magnetic field line, at several critical points. The measurements provide a means to compute proper compensating currents to correct for mechanical misalignments of the magnets with auxiliary trim coils if necessary. This paper describes both the mechanical and electrical design of the MFA diagnostic hardware

  14. Experimental article – Reducing effective dose to a paediatric phantom by using different combinations of kVp, mAs and additional filtration whilst maintaining image quality

    NARCIS (Netherlands)

    Huizinga, Elsbeth; Schaake, Wouter; Visser, Ruurd; Bloomfield, Charlotte; Boavida, Filipa; Chabloz, Diane; Crausaz, Emilie; Hustveit, Hanne; Knight, Heidi; Pereira, Anna; Harsaker, Vanja

    2015-01-01

    Purpose: To determine whether using different combinations of kVp and mAs with additional filtration can reduce the effective dose to a paediatric phantom whilst maintaining diagnostic image quality. Methods: 27 images of a paediatric AP pelvis phantom were acquired with different kVp, mAs and

  15. Perceptual learning effect on decision and confidence thresholds.

    Science.gov (United States)

    Solovey, Guillermo; Shalom, Diego; Pérez-Schuster, Verónica; Sigman, Mariano

    2016-10-01

    Practice can enhance of perceptual sensitivity, a well-known phenomenon called perceptual learning. However, the effect of practice on subjective perception has received little attention. We approach this problem from a visual psychophysics and computational modeling perspective. In a sequence of visual search experiments, subjects significantly increased the ability to detect a "trained target". Before and after training, subjects performed two psychophysical protocols that parametrically vary the visibility of the "trained target": an attentional blink and a visual masking task. We found that confidence increased after learning only in the attentional blink task. Despite large differences in some observables and task settings, we identify common mechanisms for decision-making and confidence. Specifically, our behavioral results and computational model suggest that perceptual ability is independent of processing time, indicating that changes in early cortical representations are effective, and learning changes decision criteria to convey choice and confidence. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Gene expression-based molecular diagnostic system for malignant gliomas is superior to histological diagnosis.

    Science.gov (United States)

    Shirahata, Mitsuaki; Iwao-Koizumi, Kyoko; Saito, Sakae; Ueno, Noriko; Oda, Masashi; Hashimoto, Nobuo; Takahashi, Jun A; Kato, Kikuya

    2007-12-15

    Current morphology-based glioma classification methods do not adequately reflect the complex biology of gliomas, thus limiting their prognostic ability. In this study, we focused on anaplastic oligodendroglioma and glioblastoma, which typically follow distinct clinical courses. Our goal was to construct a clinically useful molecular diagnostic system based on gene expression profiling. The expression of 3,456 genes in 32 patients, 12 and 20 of whom had prognostically distinct anaplastic oligodendroglioma and glioblastoma, respectively, was measured by PCR array. Next to unsupervised methods, we did supervised analysis using a weighted voting algorithm to construct a diagnostic system discriminating anaplastic oligodendroglioma from glioblastoma. The diagnostic accuracy of this system was evaluated by leave-one-out cross-validation. The clinical utility was tested on a microarray-based data set of 50 malignant gliomas from a previous study. Unsupervised analysis showed divergent global gene expression patterns between the two tumor classes. A supervised binary classification model showed 100% (95% confidence interval, 89.4-100%) diagnostic accuracy by leave-one-out cross-validation using 168 diagnostic genes. Applied to a gene expression data set from a previous study, our model correlated better with outcome than histologic diagnosis, and also displayed 96.6% (28 of 29) consistency with the molecular classification scheme used for these histologically controversial gliomas in the original article. Furthermore, we observed that histologically diagnosed glioblastoma samples that shared anaplastic oligodendroglioma molecular characteristics tended to be associated with longer survival. Our molecular diagnostic system showed reproducible clinical utility and prognostic ability superior to traditional histopathologic diagnosis for malignant glioma.

  17. Summary of the activities of the ISAM Confidence Building Working Group

    International Nuclear Information System (INIS)

    Dolinar, G.M.; Batandjieva, B.

    2002-01-01

    During the early stages of the ISAM project confidence building was a relatively new topic in the radioactive waste disposal literature, but it was beginning to receive some attention. Although almost all safety assessment activities are intended to provide a level of confidence in the results of the assessment, considering the activities from the viewpoint of how they contributed to the decision making of various 'audiences' was relatively new. The ISAM project included the Confidence Building Working Group (CBWG) to examine the topic of Confidence Building and this paper provides a summary of the working group findings. (author)

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

    Directory of Open Access Journals (Sweden)

    Chang Mo Moon

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

  19. Kangaroo Care Education Effects on Nurses' Knowledge and Skills Confidence.

    Science.gov (United States)

    Almutairi, Wedad Matar; Ludington-Hoe, Susan M

    2016-11-01

    Less than 20% of the 996 NICUs in the United States routinely practice kangaroo care, due in part to the inadequate knowledge and skills confidence of nurses. Continuing education improves knowledge and skills acquisition, but the effects of a kangaroo care certification course on nurses' knowledge and skills confidence are unknown. A pretest-posttest quasi-experiment was conducted. The Kangaroo Care Knowledge and Skills Confidence Tool was administered to 68 RNs at a 2.5-day course about kangaroo care evidence and skills. Measures of central tendency, dispersion, and paired t tests were conducted on 57 questionnaires. The nurses' characteristics were varied. The mean posttest Knowledge score (M = 88.54, SD = 6.13) was significantly higher than the pretest score (M = 78.7, SD = 8.30), t [54] = -9.1, p = .000), as was the posttest Skills Confidence score (pretest M = 32.06, SD = 3.49; posttest M = 26.80, SD = 5.22), t [53] = -8.459, p = .000). The nurses' knowledge and skills confidence of kangaroo care improved following continuing education, suggesting a need for continuing education in this area. J Contin Educ Nurs. 2016;47(11):518-524. Copyright 2016, SLACK Incorporated.

  20. Confidence intervals for experiments with background and small numbers of events

    International Nuclear Information System (INIS)

    Bruechle, W.

    2003-01-01

    Methods to find a confidence interval for Poisson distributed variables are illuminated, especially for the case of poor statistics. The application of 'central' and 'highest probability density' confidence intervals is compared for the case of low count-rates. A method to determine realistic estimates of the confidence intervals for Poisson distributed variables affected with background, and their ratios, is given. (orig.)

  1. Confidence intervals for experiments with background and small numbers of events

    International Nuclear Information System (INIS)

    Bruechle, W.

    2002-07-01

    Methods to find a confidence interval for Poisson distributed variables are illuminated, especially for the case of poor statistics. The application of 'central' and 'highest probability density' confidence intervals is compared for the case of low count-rates. A method to determine realistic estimates of the confidence intervals for Poisson distributed variables affected with background, and their ratios, is given. (orig.)

  2. The classification and diagnostic criteria of the erythrocytoses (polycythaemias)

    Science.gov (United States)

    Messinezy, M; Pearson, T C

    1999-10-01

    The term 'erythrocytosis' has advantages over 'polycythaemia' to describe patients with a raised haematocrit (PCV) and deserves to be more widely used. Measurement of red cell mass (RCM) and its relation to that expected for an individual's height and weight permits initial subdivision of erythrocytosis into absolute (increased RCM) or apparent normal RCM. Absolute erythrocytosis may be primary (intrinsically abnormal marrow erythropoiesis) or secondary (increased erythropoietin drive in response to pathological events outside the bone marrow). Both primary and secondary erythrocytosis may be either congenital or acquired. Idiopathic erythrocytosis is a third, probably heterogenous, group within the absolute erythrocytoses. Familial abnormalities of the erythropoietin receptor underlie the primary congenital subgroup. Polycythaemia vera (PV), the clonal myeloproliferative disorder, is so far, the only primary acquired disorder. Newer diagnostic investigations such as serum erythropoietin estimation, improved karyotypic analysis, in vitro culture of erythroid colonies and estimation of spleen size before splenomegaly is palpable, have permitted some modification of the traditional diagnostic criteria of polycythaemia vera. This may allow more confident diagnosis and, together with improved testing for causes of secondary erythrocytosis, may reduce the number of patients so far unsatisfactorily consigned to the idiopathic erythrocytosis group.

  3. EAST-AIA deployment under vacuum: Calibration of laser diagnostic system using computer vision

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Yang, E-mail: yangyang@ipp.ac.cn [Institute of Plasma Physics, Chinese Academy of Sciences, 350 Shushanhu Rd, Hefei, Anhui (China); Song, Yuntao; Cheng, Yong; Feng, Hansheng; Wu, Zhenwei; Li, Yingying; Sun, Yongjun; Zheng, Lei [Institute of Plasma Physics, Chinese Academy of Sciences, 350 Shushanhu Rd, Hefei, Anhui (China); Bruno, Vincent; Eric, Villedieu [CEA-IRFM, F-13108 Saint-Paul-Lez-Durance (France)

    2016-11-15

    Highlights: • The first deployment of the EAST articulated inspection arm robot under vacuum is presented. • A computer vision based approach to measure the laser spot displacement is proposed. • An experiment on the real EAST tokamak is performed to validate the proposed measure approach, and the results shows that the measurement accuracy satisfies the requirement. - Abstract: For the operation of EAST tokamak, it is crucial to ensure that all the diagnostic systems are in the good condition in order to reflect the plasma status properly. However, most of the diagnostic systems are mounted inside the tokamak vacuum vessel, which makes them extremely difficult to maintain under high vacuum condition during the tokamak operation. Thanks to a system called EAST articulated inspection arm robot (EAST-AIA), the examination of these in-vessel diagnostic systems can be performed by an embedded camera carried by the robot. In this paper, a computer vision algorithm has been developed to calibrate a laser diagnostic system with the help of a monocular camera at the robot end. In order to estimate the displacement of the laser diagnostic system with respect to the vacuum vessel, several visual markers were attached to the inner wall. This experiment was conducted both on the EAST vacuum vessel mock-up and the real EAST tokamak under vacuum condition. As a result, the accuracy of the displacement measurement was within 3 mm under the current camera resolution, which satisfied the laser diagnostic system calibration.

  4. Maintaining Healthy Skin -- Part 2

    Science.gov (United States)

    ... and SCI • Depression and SCI • Taking Care of Pressure Sores • Maintaining Healthy Skin (Part I) • Maintaining Healthy Skin ( ... For information on establishing skin tolerance, see our “Pressure Sores” pamphlet.) Pressure releases in a wheelchair can be ...

  5. The effect of terrorism on public confidence : an exploratory study.

    Energy Technology Data Exchange (ETDEWEB)

    Berry, M. S.; Baldwin, T. E.; Samsa, M. E.; Ramaprasad, A.; Decision and Information Sciences

    2008-10-31

    A primary goal of terrorism is to instill a sense of fear and vulnerability in a population and to erode confidence in government and law enforcement agencies to protect citizens against future attacks. In recognition of its importance, the Department of Homeland Security includes public confidence as one of the metrics it uses to assess the consequences of terrorist attacks. Hence, several factors--including a detailed understanding of the variations in public confidence among individuals, by type of terrorist event, and as a function of time--are critical to developing this metric. In this exploratory study, a questionnaire was designed, tested, and administered to small groups of individuals to measure public confidence in the ability of federal, state, and local governments and their public safety agencies to prevent acts of terrorism. Data were collected from the groups before and after they watched mock television news broadcasts portraying a smallpox attack, a series of suicide bomber attacks, a refinery bombing, and cyber intrusions on financial institutions that resulted in identity theft and financial losses. Our findings include the following: (a) the subjects can be classified into at least three distinct groups on the basis of their baseline outlook--optimistic, pessimistic, and unaffected; (b) the subjects make discriminations in their interpretations of an event on the basis of the nature of a terrorist attack, the time horizon, and its impact; (c) the recovery of confidence after a terrorist event has an incubation period and typically does not return to its initial level in the long-term; (d) the patterns of recovery of confidence differ between the optimists and the pessimists; and (e) individuals are able to associate a monetary value with a loss or gain in confidence, and the value associated with a loss is greater than the value associated with a gain. These findings illustrate the importance the public places in their confidence in government

  6. Integrated Safeguards Information System for Japan (ISIS-J) - Strengthening SSAC for Enhancing Confidence in Compliance with Safeguards Obligations -

    International Nuclear Information System (INIS)

    Iso, S.; Nishiyama, N.; Kumakura, S.; Takizawa, K.; Yoshida, H.; Kobayashi, I.; Kikuchi, M.; Kimura, N.; Matsubara, T.; Yatsu, S.

    2010-01-01

    IAEA has stated the importance of enhancing cooperation with SSAC. Therefore, Japan has developed the Integrated Safeguards Information System for enhancing confidence in compliance with the national obligation under the safeguards agreement and the additional protocol. Japan already established the National System including national inspections with NDA and DA verification functions and evaluation of data obtained from national inspections and has maintained the National System of safeguards as a SSAC in accordance with the safeguards agreement. Nuclear Material Control Center (NMCC) is engaged in national safeguards activities as designated organization of national inspectorate and information treatment including safeguards data analysis. Recently, purpose of IAEA's safeguards activities may shift to detection of proliferation based on plausible proliferation paths from detection of diversion by certain material accountancy measures. Major safeguards activities of IAEA have changed from quantitative aspects to qualitative them. As supplements for declining the quantitative measures such as the activities based on the safeguards criteria the IAEA would expect the SSAC functions for maintaining the activities of quantitative manners. Japan believes that the State's responsibility for enhancing cooperation between the National System and the IAEA must assure the confidence level of correctness and completeness of the State declarations with accurate and precise accountability as findings from SSAC. Japan has started the development of the strengthened and autonomous national system namely the Integrated safeguards Information System for Japan (ISIS-J) in order to fulfil our responsibility. Japan would seek to improve quality of information including nuclear material accounting data as well as expanded declaration relevant to nuclear activities in Japan, and to increase abilities for explaining safeguards relevant events in Japan. The enhanced findings could include

  7. Pre-examination factors affecting molecular diagnostic test results and interpretation: A case-based approach.

    Science.gov (United States)

    Payne, Deborah A; Baluchova, Katarina; Peoc'h, Katell H; van Schaik, Ron H N; Chan, K C Allen; Maekawa, Masato; Mamotte, Cyril; Russomando, Graciela; Rousseau, François; Ahmad-Nejad, Parviz

    2017-04-01

    Multiple organizations produce guidance documents that provide opportunities to harmonize quality practices for diagnostic testing. The International Organization for Standardization ISO 15189 standard addresses requirements for quality in management and technical aspects of the clinical laboratory. One technical aspect addresses the complexities of the pre-examination phase prior to diagnostic testing. The Committee for Molecular Diagnostics of the International Federation for Clinical Chemistry and Laboratory Medicine (also known as, IFCC C-MD) conducted a survey of international molecular laboratories and determined ISO 15189 to be the most referenced guidance document. In this review, the IFCC C-MD provides case-based examples illustrating the value of select pre-examination processes as these processes relate to molecular diagnostic testing. Case-based examples in infectious disease, oncology, inherited disease and pharmacogenomics address the utility of: 1) providing information to patients and users, 2) designing requisition forms, 3) obtaining informed consent and 4) maintaining sample integrity prior to testing. The pre-examination phase requires extensive and consistent communication between the laboratory, the healthcare provider and the end user. The clinical vignettes presented in this paper illustrate the value of applying select ISO 15189 recommendations for general laboratory to the more specialized area of Molecular Diagnostics. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Diagnostic indicators for peptic ulcer perforation at a tertiary care hospital in Thailand

    Directory of Open Access Journals (Sweden)

    Suriya C

    2011-12-01

    Full Text Available Chutikarn Suriya1, Nongyao Kasatpibal2, Wipada Kunaviktikul2, Toranee Kayee31Clinical Epidemiology, Faculty of Medicine, Chiang Mai University, 2Faculty of Nursing, Chiang Mai University, 3Department of Surgery, Nakornping Hospital, Chiang Mai, ThailandIntroduction: Limited data currently exists regarding the diagnostic indicators of peptic ulcer perforation for early detection among patients in Thailand. Delayed diagnosis and treatment for an ulcer can be life-threatening, resulting in shock or death.Objective: To determine the diagnostic indicators of peptic ulcer perforation.Material and methods: A cohort study was conducted in a tertiary care hospital in Thailand from 2005 to 2009. Peptic ulcer patients aged 15 years and over admitted to the surgical department were included. The diagnostic indicators used criteria of the patients' final diagnoses and operations, coded according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, which included patient profiles, gender, age, coexisting illnesses, personal habits, signs and symptoms, laboratory investigations, radiological finding, and treatment role. Exponential risk regression analyses to obtain relative risk (RR estimates for diagnostic indicators were analyzed using Stata® statistical software package, version 11 (StataCorp LP, College Station, TX.Results: The study included 1290 patients. Of these, 57% reported perforated peptic ulcer. Multivariate analysis showed five diagnostic indicators: signs and symptoms including intense abdominal pain (RR = 1.53, 95% confidence interval [CI] 1.14–2.06, tenderness (RR = 1.94, 95% CI 1.17–3.21, and guarding (RR = 1.52, 95% CI 1.05–2.20; X-ray with free air (RR = 2.80, 95% CI 2.08–3.77; and referral from other hospitals (RR = 1.37, 95% CI 1.03–1.82.Conclusion: Five diagnostic indicators for peptic ulcer perforation monitoring were suggested from this study. Improving diagnostic

  9. Changes in hospitalization rate and mortality after acute myocardial infarction in Denmark after diagnostic criteria and methods changed

    DEFF Research Database (Denmark)

    Abildstrøm, Steen Zabell; Rasmussen, Søren; Madsen, Mette

    2004-01-01

    AIMS: To analyse the effect of the change in diagnostic criteria for acute myocardial infarction (AMI) and the use of troponin as a diagnostic marker on the hospitalization rate and mortality of hospitalized AMI patients from 1994 to 2001. METHODS AND RESULTS: Patients (> or =30 years) admitted...... for their first AMI were identified using the National Patient Registry in Denmark. We registered when each hospital introduced troponin as a diagnostic marker. The reported hospitalization rate decreased until 1998 and then increased substantially from 1999 to 2001 from 3472 to 4163 per million inhabitants (19.......9%) for men and from 1648 to 2020 per million inhabitants (22.6%) for women. Troponin use was associated with a significant 14% increase in hospitalization rate in this period [rate ratio 1.14, 95% confidence interval (CI) 1.11-1.18]. The effect of troponin was greatest among patients 70 years and older (rate...

  10. 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

  11. Dry Eye Disease: Concordance Between the Diagnostic Tests in African Eyes.

    Science.gov (United States)

    Onwubiko, Stella N; Eze, Boniface I; Udeh, Nnenma N; Onwasigwe, Ernest N; Umeh, Rich E

    2016-11-01

    To assess the concordance between the diagnostic tests for dry eye disease (DED) in a Nigerian hospital population. The study was a hospital-based cross-sectional survey of adults (≥18 years) presenting at the eye clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu; September-December, 2011. Participants' socio-demographic data were collected. Each subject was assessed for DED using the "Ocular Surface Disease Index" (OSDI) questionnaire, tear-film breakup time (TBUT), and Schirmer test. The intertest concordance was assessed using kappa statistic, correlation, and regression coefficients. The participants (n=402; men: 193) were aged 50.1±19.1 standard deviation years (range: 18-94 years). Dry eye disease was diagnosed in 203 by TBUT, 170 by Schirmer test, and 295 by OSDI; the concordance between the tests were OSDI versus TBUT (Kappa, κ=-0.194); OSDI versus Schirmer (κ=-0.276); and TBUT versus Schirmer (κ=0.082). Ocular Surface Disease Index was inversely correlated with Schirmer test (Spearman ρ=-0.231, P<0.001) and TBUT (ρ=-0.237, P<0.001). In the linear regression model, OSDI was poorly predicted by TBUT (β=-0.09; 95% confidence interval (CI): -0.26 to -0.03, P=0.14) and Schirmer test (β=-0.35, 95% CI: -0.53 to -0.18, P=0.18). At UNTH, there is poor agreement, and almost equal correlation, between the subjective and objective tests for DED. Therefore, the selection of diagnostic test for DED should be informed by cost-effectiveness and diagnostic resource availability, not diagnostic efficiency or utility.

  12. Vacuum system design and tritium inventory for the charge exchange diagnostic on the Tokamak Fusion Test Reactor

    International Nuclear Information System (INIS)

    Medley, S.S.

    1986-01-01

    The application of charge exchange analyzers for the measurement of ion temperature in fusion plasma experiments requires a direct connection between the diagnostic and plasma-discharge vacuum chambers. Differential pumping of the gas load from the diagnostic stripping cell operated at > or approx. = 10 -3 Torr is required to maintain the analyzer chamber at a pressure of -6 Torr. The migration of gases between the diagnostic and plasma vacuum chambers must be minimized. In particular, introduction of the analyzer stripping cell gas into the plasma chamber having a base pressure of -8 Torr must be suppressed. The charge exchange diagnostic for the Tokamak Fusion Test Reactor (TFTR) is comprised of two analyzer systems designed to contain a total of 18 independent mass/energy analyzers and one diagnostic neutral beam rated at 80 keV, 15 A. The associated arrays of multiple, interconnected vacuum systems were analyzed using the Vacuum System Transient Simulator (Vsts) computer program which models the transient transport of multigas species through complex networks of ducts, valves, traps, vacuum pumps, and other related vacuum system components. In addition to providing improved design performance at reduced costs, the analysis yields estimates for the exchange of tritium from the torus to the diagnostic components and of the diagnostic working gases to the torus

  13. Evaluation of reduced-dose CT for acute non-traumatic abdominal pain: evaluation of diagnostic accuracy in comparison to standard-dose CT.

    Science.gov (United States)

    Othman, Ahmed E; Bongers, Malte Niklas; Zinsser, Dominik; Schabel, Christoph; Wichmann, Julian L; Arshid, Rami; Notohamiprodjo, Mike; Nikolaou, Konstantin; Bamberg, Fabian

    2018-01-01

    Background Patients with acute non-traumatic abdominal pain often undergo abdominal computed tomography (CT). However, abdominal CT is associated with high radiation exposure. Purpose To evaluate diagnostic performance of a reduced-dose 100 kVp CT protocol with advanced modeled iterative reconstruction as compared to a linearly blended 120 kVp protocol for assessment of acute, non-traumatic abdominal pain. Material and Methods Two radiologists assessed 100 kVp and linearly blended 120 kVp series of 112 consecutive patients with acute non-traumatic pain (onset diagnostic confidence. Both 100 kVp and linearly blended 120 kVp series were quantitatively evaluated regarding radiation dose and image noise. Comparative statistics and diagnostic accuracy was calculated using receiver operating curve (ROC) statistics, with final clinical diagnosis/clinical follow-up as reference standard. Results Image quality was high for both series without detectable significant differences ( P = 0.157). Image noise and artifacts were rated low for both series but significantly higher for 100 kVp ( P ≤ 0.021). Diagnostic accuracy was high for both series (120 kVp: area under the curve [AUC] = 0.950, sensitivity = 0.958, specificity = 0.941; 100 kVp: AUC ≥ 0.910, sensitivity ≥ 0.937, specificity = 0.882; P ≥ 0.516) with almost perfect inter-rater agreement (Kappa = 0.939). Diagnostic confidence was high for both dose levels without significant differences (100 kVp 5, range 4-5; 120 kVp 5, range 3-5; P = 0.134). The 100 kVp series yielded 26.1% lower radiation dose compared with the 120 kVp series (5.72 ± 2.23 mSv versus 7.75 ± 3.02 mSv, P diagnostic accuracy for the assessment of acute non-traumatic abdominal pain.

  14. An Exact Confidence Region in Multivariate Calibration

    OpenAIRE

    Mathew, Thomas; Kasala, Subramanyam

    1994-01-01

    In the multivariate calibration problem using a multivariate linear model, an exact confidence region is constructed. It is shown that the region is always nonempty and is invariant under nonsingular transformations.

  15. A Poisson process approximation for generalized K-5 confidence regions

    Science.gov (United States)

    Arsham, H.; Miller, D. R.

    1982-01-01

    One-sided confidence regions for continuous cumulative distribution functions are constructed using empirical cumulative distribution functions and the generalized Kolmogorov-Smirnov distance. The band width of such regions becomes narrower in the right or left tail of the distribution. To avoid tedious computation of confidence levels and critical values, an approximation based on the Poisson process is introduced. This aproximation provides a conservative confidence region; moreover, the approximation error decreases monotonically to 0 as sample size increases. Critical values necessary for implementation are given. Applications are made to the areas of risk analysis, investment modeling, reliability assessment, and analysis of fault tolerant systems.

  16. The meaning of diagnostic test results: A spreadsheet for swift data analysis

    International Nuclear Information System (INIS)

    MacEneaney, Peter M.; Malone, Dermot E.

    2000-01-01

    AIMS: To design a spreadsheet program to: (a) analyse rapidly diagnostic test result data produced in local research or reported in the literature; (b) correct reported predictive values for disease prevalence in any population; (c) estimate the post-test probability of disease in individual patients. MATERIALS AND METHODS: Microsoft Excel TM was used. Section A: a contingency (2 x 2) table was incorporated into the spreadsheet. Formulae for standard calculations [sample size, disease prevalence, sensitivity and specificity with 95% confidence intervals, predictive values and likelihood ratios (LRs)] were linked to this table. The results change automatically when the data in the true or false negative and positive cells are changed. Section B: this estimates predictive values in any population, compensating for altered disease prevalence. Sections C-F: Bayes' theorem was incorporated to generate individual post-test probabilities. The spreadsheet generates 95% confidence intervals, LRs and a table and graph of conditional probabilities once the sensitivity and specificity of the test are entered. The latter shows the expected post-test probability of disease for any pre-test probability when a test of known sensitivity and specificity is positive or negative. RESULTS: This spreadsheet can be used on desktop and palmtop computers. The MS Excel TM version can be downloaded via the Internet from the URL ftp://radiography.com/pub/Rad-data99.xls CONCLUSION: A spreadsheet is useful for contingency table data analysis and assessment of the clinical meaning of diagnostic test results. MacEneaney, P.M., Malone, D.E. (2000)

  17. Institutional Confidence in the United States: Attitudes of Secular Americans

    Directory of Open Access Journals (Sweden)

    Isabella Kasselstrand

    2017-04-01

    Full Text Available The First Amendment to the United States’ Constitution addresses freedom of religion and the separation of church and state. However, the historical influence of religion in laws, policies, and political representation have left secular individuals feeling excluded. At the same time, levels of confidence in social and political institutions in the United States are at an all-time low. This begs the question: Is there a relationship between secularity and confidence in various social and political institutions (e.g. the armed forces, churches, major companies, government, police, and political parties? This question is examined using data on the United States from the World Values Survey from 1995–2011. While controlling for a range of key demographics, the findings show a negative relationship between secularity and institutional confidence. More specifically, atheists and nonreligious individuals are less likely than those who are religious to have confidence in all six institutions. Based on previous literature and the empirical evidence presented in this study, we argue that overall lower levels of institutional confidence among secular Americans is an outcome of the exclusion of such individuals from American social life. Thus, it highlights the importance of addressing the stereotypes and prejudice that this minority group faces.

  18. 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.)

  19. Decisions to withhold diagnostic investigations in nursing home patients with a clinical suspicion of venous thromboembolism.

    Directory of Open Access Journals (Sweden)

    Henrike J Schouten

    Full Text Available This study aimed to gather insights in physicians' considerations for decisions to either refer for- or to withhold additional diagnostic investigations in nursing home patients with a suspicion of venous thromboembolism.Our study was nested in an observational study on diagnostic strategies for suspected venous thromboembolism in nursing home patients. Patient characteristics, bleeding-complications and mortality were related to the decision to withhold investigations. For a better understanding of the physicians' decisions, 21 individual face-to-face in-depth interviews were performed and analysed using the grounded theory approach.Referal for additional diagnostic investigations was forgone in 126/322 (39.1% patients with an indication for diagnostic work-up. 'Blind' anticoagulant treatment was initiated in 95 (75.4% of these patients. The 3 month mortality rates were higher for patients in whom investigations were withheld than in the referred patients, irrespective of anticoagulant treatment (odds ratio 2.45; 95% confidence interval 1.40 to 4.29 but when adjusted for the probability of being referred (i.e. the propensity score, there was no relation of non-diagnosis decisions to mortality (odds ratio 1.75; 0.98 to 3.11. In their decisions to forgo diagnostic investigations, physicians incorporated the estimated relative impact of the potential disease; the potential net-benefits of diagnostic investigations and whether performing investigations agreed with established management goals in advance care planning.Referral for additional diagnostic investigations is withheld in almost 40% of Dutch nursing home patients with suspected venous thromboembolism and an indication for diagnostic work-up. We propose that, given the complexity of these decisions and the uncertainty regarding their indirect effects on patient outcome, more attention should be focused on the decision to either use or withhold additional diagnostic tests.

  20. Teachers and Counselors: Building Math Confidence in Schools

    Directory of Open Access Journals (Sweden)

    Joseph M. Furner

    2017-08-01

    Full Text Available Mathematics teachers need to take on the role of counselors in addressing the math anxious in today's math classrooms. This paper looks at the impact math anxiety has on the future of young adults in our high-tech society. Teachers and professional school counselors are encouraged to work together to prevent and reduce math anxiety. It is important that all students feel confident in their ability to do mathematics in an age that relies so heavily on problem solving, technology, science, and mathematics. It really is a school's obligation to see that their students value and feel confident in their ability to do math, because ultimately a child's life: all decisions they will make and careers choices may be determined based on their disposition toward mathematics. This paper raises some interesting questions and provides some strategies (See Appendix A for teachers and counselors for addressing the issue of math anxiety while discussing the importance of developing mathematically confident young people for a high-tech world of STEM.

  1. Building public confidence in the world's nuclear industry

    International Nuclear Information System (INIS)

    Duncan, C.D.

    1996-01-01

    Public confidence in the nuclear industry requires two things, which are trust and understanding. Trust is an emotional response based upon an instinctive reaction. Understanding, on the other hand, is an intellectual response based upon facts. To gain public confidence, both of these levels must be communicated and proactive strategies must be implemented to do this. To achieve this objective will require confidence and courage in communication programs. Each company operating in the nuclear sector must be proactive in building its individual reputation and must not retreat from controversy. Similarly, each industry body must continue the Herculean task of building understanding. The nuclear industry has powerful arguments. ICI, BP or Ford did not achieve their licences to operate by keeping their heads down, they achieved their current market positions by building a positive corporate reputation within their respective industrial contexts over many decades. In order to achieve a similar position for the nuclear industry and the companies, their examples must be followed. If it is continued to 'keep the heads down' in the trenches, public opinion will surely bury within it. (G.K.)

  2. Two sides of the same coin: Monetary incentives concurrently improve and bias confidence judgments.

    Science.gov (United States)

    Lebreton, Maël; Langdon, Shari; Slieker, Matthijs J; Nooitgedacht, Jip S; Goudriaan, Anna E; Denys, Damiaan; van Holst, Ruth J; Luigjes, Judy

    2018-05-01

    Decisions are accompanied by a feeling of confidence, that is, a belief about the decision being correct. Confidence accuracy is critical, notably in high-stakes situations such as medical or financial decision-making. We investigated how incentive motivation influences confidence accuracy by combining a perceptual task with a confidence incentivization mechanism. By varying the magnitude and valence (gains or losses) of monetary incentives, we orthogonalized their motivational and affective components. Corroborating theories of rational decision-making and motivation, our results first reveal that the motivational value of incentives improves aspects of confidence accuracy. However, in line with a value-confidence interaction hypothesis, we further show that the affective value of incentives concurrently biases confidence reports, thus degrading confidence accuracy. Finally, we demonstrate that the motivational and affective effects of incentives differentially affect how confidence builds on perceptual evidence. Together, these findings may provide new hints about confidence miscalibration in healthy or pathological contexts.

  3. Two sides of the same coin: Monetary incentives concurrently improve and bias confidence judgments

    Science.gov (United States)

    Lebreton, Maël; Slieker, Matthijs J.; Nooitgedacht, Jip S.; van Holst, Ruth J.; Luigjes, Judy

    2018-01-01

    Decisions are accompanied by a feeling of confidence, that is, a belief about the decision being correct. Confidence accuracy is critical, notably in high-stakes situations such as medical or financial decision-making. We investigated how incentive motivation influences confidence accuracy by combining a perceptual task with a confidence incentivization mechanism. By varying the magnitude and valence (gains or losses) of monetary incentives, we orthogonalized their motivational and affective components. Corroborating theories of rational decision-making and motivation, our results first reveal that the motivational value of incentives improves aspects of confidence accuracy. However, in line with a value-confidence interaction hypothesis, we further show that the affective value of incentives concurrently biases confidence reports, thus degrading confidence accuracy. Finally, we demonstrate that the motivational and affective effects of incentives differentially affect how confidence builds on perceptual evidence. Together, these findings may provide new hints about confidence miscalibration in healthy or pathological contexts. PMID:29854944

  4. Growing confidence, building skills | IDRC - International ...

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

    In 2012 Rashid explored the influence of think tanks on policy in Bangladesh, as well as their relationships with international donors and media. In 2014, he explored two-way student exchanges between Canadian and ... his IDRC experience “gave me the confidence to conduct high quality research in social sciences.”.

  5. Relating faults in diagnostic reasoning with diagnostic errors and patient harm.

    NARCIS (Netherlands)

    Zwaan, L.; Thijs, A.; Wagner, C.; Wal, G. van der; Timmermans, D.R.M.

    2012-01-01

    Purpose: The relationship between faults in diagnostic reasoning, diagnostic errors, and patient harm has hardly been studied. This study examined suboptimal cognitive acts (SCAs; i.e., faults in diagnostic reasoning), related them to the occurrence of diagnostic errors and patient harm, and studied

  6. A scale for consumer confidence in the safety of food

    NARCIS (Netherlands)

    Jonge, de J.; Trijp, van J.C.M.; Lans, van der I.A.; Renes, R.J.; Frewer, L.J.

    2008-01-01

    The aim of this study was to develop and validate a scale to measure general consumer confidence in the safety of food. Results from exploratory and confirmatory analyses indicate that general consumer confidence in the safety of food consists of two distinct dimensions, optimism and pessimism,

  7. Confidence Scoring of Speaking Performance: How Does Fuzziness become Exact?

    Science.gov (United States)

    Jin, Tan; Mak, Barley; Zhou, Pei

    2012-01-01

    The fuzziness of assessing second language speaking performance raises two difficulties in scoring speaking performance: "indistinction between adjacent levels" and "overlap between scales". To address these two problems, this article proposes a new approach, "confidence scoring", to deal with such fuzziness, leading to "confidence" scores between…

  8. Variance misperception explains illusions of confidence in simple perceptual decisions

    NARCIS (Netherlands)

    Zylberberg, Ariel; Roelfsema, Pieter R.; Sigman, Mariano

    2014-01-01

    Confidence in a perceptual decision is a judgment about the quality of the sensory evidence. The quality of the evidence depends not only on its strength ('signal') but critically on its reliability ('noise'), but the separate contribution of these quantities to the formation of confidence judgments

  9. Internet gaming disorder: Inadequate diagnostic criteria wrapped in a constraining conceptual model.

    Science.gov (United States)

    Starcevic, Vladan

    2017-06-01

    Background and aims The paper "Chaos and confusion in DSM-5 diagnosis of Internet Gaming Disorder: Issues, concerns, and recommendations for clarity in the field" by Kuss, Griffiths, and Pontes (in press) critically examines the DSM-5 diagnostic criteria for Internet gaming disorder (IGD) and addresses the issue of whether IGD should be reconceptualized as gaming disorder, regardless of whether video games are played online or offline. This commentary provides additional critical perspectives on the concept of IGD. Methods The focus of this commentary is on the addiction model on which the concept of IGD is based, the nature of the DSM-5 criteria for IGD, and the inclusion of withdrawal symptoms and tolerance as the diagnostic criteria for IGD. Results The addiction framework on which the DSM-5 concept of IGD is based is not without problems and represents only one of multiple theoretical approaches to problematic gaming. The polythetic, non-hierarchical DSM-5 diagnostic criteria for IGD make the concept of IGD unacceptably heterogeneous. There is no support for maintaining withdrawal symptoms and tolerance as the diagnostic criteria for IGD without their substantial revision. Conclusions The addiction model of IGD is constraining and does not contribute to a better understanding of the various patterns of problematic gaming. The corresponding diagnostic criteria need a thorough overhaul, which should be based on a model of problematic gaming that can accommodate its disparate aspects.

  10. Diagnostic accuracy of contemporary multidetector computed tomography (MDCT) for the detection of lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Notohamiprodjo, S.; Stahl, R.; Braunagel, M.; Kazmierczak, P.M.; Thierfelder, K.M.; Treitl, K.M.; Wirth, S. [University Hospital of Munich, LMU Munich, Institute for Clinical Radiology, Munich (Germany); Notohamiprodjo, M. [University Hospital Tuebingen, Eberhard Karls University Tuebingen, Diagnostic and Interventional Radiology, Tuebingen (Germany)

    2017-08-15

    To evaluate the diagnostic accuracy of multidetector CT (MDCT) for detection of lumbar disc herniation with MRI as standard of reference. Patients with low back pain underwent indicated MDCT (128-row MDCT, helical pitch), 60 patients with iterative reconstruction (IR) and 67 patients with filtered back projection (FBP). Lumbar spine MRI (1.5 T) was performed within 1 month. Signal-to-noise ratios (SNR) of cerebrospinal fluid (CSF), annulus fibrosus (AF) and the spinal cord (SC) were determined for all modalities. Two readers independently rated image quality (IQ), diagnostic confidence and accuracy in the diagnosis of lumbar disc herniation using MRI as standard of reference. Inter-reader correlation was assessed with weighted κ. Sensitivity, specificity, precision and accuracy of MDCT for disc protrusion were 98.8%, 96.5%, 97.1%, 97.8% (disc level), 97.7%, 92.9%, 98.6%, 96.9% (patient level). SNR of IR was significantly higher than FBP. IQ was significantly better in IR owing to visually reduced noise and improved delineation of the discs. κ (>0.90) was excellent for both algorithms. MDCT of the lumbar spine yields high diagnostic accuracy for detection of lumbar disc herniation. IR improves image quality so that the provided diagnostic accuracy is principally equivalent to MRI. (orig.)

  11. THE USE OF SKIT TECHNIQUE TO INCREASE STUDENTS’ SELF-CONFIDENCE IN SPEAKING

    Directory of Open Access Journals (Sweden)

    Dini Deswarni

    2017-12-01

    The study aimed to know the use of Skit Technique to increase students’ self-confidence in speaking English. Speaking is one of important skills in English. Self-Confidence is really need to speak in English. Someone needs self-confidence to express their idea and their feelings in a foreign language especially in English. Not all of the people have good self-confidence in using English to express or to share their idea and their opinion. The aim of this study is to know whether the Skit Technique can increase self- confidence in speaking English. In other words Skit Technique can help to increase self-confidence in speaking English. The design of this research is experiment. The population of the research is 46 students at the eight grade students of MTs Darul Ihsan Duri. The sample technique is random sampling. From the data, it can be seen that Ttable < Tvalue (2.101 < 12.466. It means Ha is accepted and Skit Technique done in experiment class.

  12. A diagnostic scoring system for myxedema coma.

    Science.gov (United States)

    Popoveniuc, Geanina; Chandra, Tanu; Sud, Anchal; Sharma, Meeta; Blackman, Marc R; Burman, Kenneth D; Mete, Mihriye; Desale, Sameer; Wartofsky, Leonard

    2014-08-01

    To develop diagnostic criteria for myxedema coma (MC), a decompensated state of extreme hypothyroidism with a high mortality rate if untreated, in order to facilitate its early recognition and treatment. The frequencies of characteristics associated with MC were assessed retrospectively in patients from our institutions in order to derive a semiquantitative diagnostic point scale that was further applied on selected patients whose data were retrieved from the literature. Logistic regression analysis was used to test the predictive power of the score. Receiver operating characteristic (ROC) curve analysis was performed to test the discriminative power of the score. Of the 21 patients examined, 7 were reclassified as not having MC (non-MC), and they were used as controls. The scoring system included a composite of alterations of thermoregulatory, central nervous, cardiovascular, gastrointestinal, and metabolic systems, and presence or absence of a precipitating event. All 14 of our MC patients had a score of ≥60, whereas 6 of 7 non-MC patients had scores of 25 to 50. A total of 16 of 22 MC patients whose data were retrieved from the literature had a score ≥60, and 6 of 22 of these patients scored between 45 and 55. The odds ratio per each score unit increase as a continuum was 1.09 (95% confidence interval [CI], 1.01 to 1.16; P = .019); a score of 60 identified coma, with an odds ratio of 1.22. The area under the ROC curve was 0.88 (95% CI, 0.65 to 1.00), and the score of 60 had 100% sensitivity and 85.71% specificity. A score ≥60 in the proposed scoring system is potentially diagnostic for MC, whereas scores between 45 and 59 could classify patients at risk for MC.

  13. Using an R Shiny to Enhance the Learning Experience of Confidence Intervals

    Science.gov (United States)

    Williams, Immanuel James; Williams, Kelley Kim

    2018-01-01

    Many students find understanding confidence intervals difficult, especially because of the amalgamation of concepts such as confidence levels, standard error, point estimates and sample sizes. An R Shiny application was created to assist the learning process of confidence intervals using graphics and data from the US National Basketball…

  14. Exploring miRNA based approaches in cancer diagnostics and therapeutics.

    Science.gov (United States)

    Mishra, Shivangi; Yadav, Tanuja; Rani, Vibha

    2016-02-01

    MicroRNAs (miRNAs), a highly conserved class of tissue specific, small non-protein coding RNAs maintain cell homeostasis by negative gene regulation. Proper controlling of miRNA expression is required for a balanced physiological environment, as these small molecules influence almost every genetic pathway from cell cycle checkpoint, cell proliferation to apoptosis, with a wide range of target genes. Deregulation in miRNAs expression correlates with various cancers by acting as tumor suppressors and oncogenes. Although promising therapies exist to control tumor development and progression, there is a lack of efficient diagnostic and therapeutic approaches for delineating various types of cancer. The molecularly different tumors can be differentiated by specific miRNA profiling as their phenotypic signatures, which can hence be exploited to surmount the diagnostic and therapeutic challenges. Present review discusses the involvement of miRNAs in oncogenesis with the analysis of patented research available on miRNAs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Development and Evaluation of a Confidence-Weighting Computerized Adaptive Testing

    Science.gov (United States)

    Yen, Yung-Chin; Ho, Rong-Guey; Chen, Li-Ju; Chou, Kun-Yi; Chen, Yan-Lin

    2010-01-01

    The purpose of this study was to examine whether the efficiency, precision, and validity of computerized adaptive testing (CAT) could be improved by assessing confidence differences in knowledge that examinees possessed. We proposed a novel polytomous CAT model called the confidence-weighting computerized adaptive testing (CWCAT), which combined a…

  16. Confident Communication: Speaking Tips for Educators.

    Science.gov (United States)

    Parker, Douglas A.

    This resource book seeks to provide the building blocks needed for public speaking while eliminating the fear factor. The book explains how educators can perfect their oratorical capabilities as well as enjoy the security, confidence, and support needed to create and deliver dynamic speeches. Following an Introduction: A Message for Teachers,…

  17. Confidence intervals for correlations when data are not normal.

    Science.gov (United States)

    Bishara, Anthony J; Hittner, James B

    2017-02-01

    With nonnormal data, the typical confidence interval of the correlation (Fisher z') may be inaccurate. The literature has been unclear as to which of several alternative methods should be used instead, and how extreme a violation of normality is needed to justify an alternative. Through Monte Carlo simulation, 11 confidence interval methods were compared, including Fisher z', two Spearman rank-order methods, the Box-Cox transformation, rank-based inverse normal (RIN) transformation, and various bootstrap methods. Nonnormality often distorted the Fisher z' confidence interval-for example, leading to a 95 % confidence interval that had actual coverage as low as 68 %. Increasing the sample size sometimes worsened this problem. Inaccurate Fisher z' intervals could be predicted by a sample kurtosis of at least 2, an absolute sample skewness of at least 1, or significant violations of normality hypothesis tests. Only the Spearman rank-order and RIN transformation methods were universally robust to nonnormality. Among the bootstrap methods, an observed imposed bootstrap came closest to accurate coverage, though it often resulted in an overly long interval. The results suggest that sample nonnormality can justify avoidance of the Fisher z' interval in favor of a more robust alternative. R code for the relevant methods is provided in supplementary materials.

  18. Post-mortem whole-body magnetic resonance imaging of human fetuses: a comparison of 3-T vs. 1.5-T MR imaging with classical autopsy

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Xin; Bevilacqua, Elisa; Cos Sanchez, Teresa; Jani, Jacques C. [University Hospital Brugmann, Universite Libre de Bruxelles, Department of Obstetrics and Gynecology, Fetal Medicine Unit, Brussels (Belgium); Cannie, Mieke M. [University Hospital Brugmann, Universite Libre de Bruxelles, Department of Radiology, Brussels (Belgium); Vrije Universiteit Brussel, Department of Radiology, UZ Brussel, Brussels (Belgium); Arthurs, Owen J.; Sebire, Neil J. [Great Ormond Street Hospital for Children NHS Foundation Trust, London (United Kingdom); UCL Institute of Child Health, London (United Kingdom); Segers, Valerie; Fourneau, Catherine [University Hospital Brugmann, Universite Libre de Bruxelles, Department of Fetopathology, Brussels (Belgium)

    2017-08-15

    To prospectively compare diagnostic accuracy of fetal post-mortem whole-body MRI at 3-T vs. 1.5-T. Between 2012 and 2015, post-mortem MRI at 1.5-T and 3-T was performed in fetuses after miscarriage/stillbirth or termination. Clinical MRI diagnoses were assessed using a confidence diagnostic score and compared with classical autopsy to derive a diagnostic error score. The relation of diagnostic error for each organ group with gestational age was calculated and 1.5-T with 3-T was compared with accuracy analysis. 135 fetuses at 12-41 weeks underwent post-mortem MRI (followed by conventional autopsy in 92 fetuses). For all organ groups except the brain, and for both modalities, the diagnostic error decreased with gestation (P < 0.0001). 3-T MRI diagnostic error was significantly lower than that of 1.5-T for all anatomic structures and organ groups, except the orbits and brain. This difference was maintained for fetuses <20 weeks gestation. Moreover, 3-T was associated with fewer non-diagnostic scans and greater concordance with classical autopsy than 1.5-T MRI, especially for the thorax, heart and abdomen in fetuses <20 weeks. Post-mortem fetal 3-T MRI improves confidence scores and overall accuracy compared with 1.5-T, mainly for the thorax, heart and abdomen of fetuses <20 weeks of gestation. (orig.)

  19. The introduction, deployment and impact of assistant practitioners in diagnostic radiography in Scotland

    International Nuclear Information System (INIS)

    Price, R.; Miller, L.; Hicks, B.; Higgs, A.

    2015-01-01

    This article describes the outcomes of an evaluation of the impact of introducing Assistant Practitioners (AP) roles into imaging departments in 13 of the 14 NHS Boards in Scotland. Between 2006 and 2009 some 34 individuals were trained as APs in diagnostic radiography with 33 subsequently taking up AP posts. In 2010 NHS Education for Scotland commissioned an evaluation of the impact brought about through introduction of the diagnostic imaging AP role in imaging departments. The research found that a minority of the managers had considered the workforce implications of introducing the new roles or the supervisory arrangements that would be required. In some sites implementation of the roles had resulted in the release of radiographers for additional training and higher level activities, but in others financial constraints had limited such initiatives. Managers believed that APs had helped maintain or improve service capacity and quality. - Highlights: • Minority of managers consider implications of new roles or supervisory arrangements. • Assistant practitioners (APs) help maintain or improve service capacity and quality. • Financial constraints limit training and initiatives. • APs can allow staff release for training and work in specialist modalities. • Data collection key in measuring financial effectiveness, capacity and impact

  20. First tests of diagnostic mirrors in a tokamak divertor: An overview of experiments in DIII-D

    International Nuclear Information System (INIS)

    Litnovsky, A.; Rudakov, D.L.; De Temmerman, G.; Wienhold, P.; Philipps, V.; Samm, U.; McLean, A.G.; West, W.P.; Wong, C.P.C.; Brooks, N.H.; Watkins, J.G.; Wampler, W.R.; Stangeby, P.C.; Boedo, J.A.; Moyer, R.A.; Allen, S.L.; Fenstermacher, M.E.; Groth, M.; Lasnier, C.J.; Boivin, R.L.

    2008-01-01

    Mirrors will be used in ITER in all optical diagnostic systems observing the plasma radiation in the ultraviolet, visible and infrared ranges. Diagnostic mirrors in ITER will suffer from electromagnetic radiation, energetic particles and neutron irradiation. Erosion due to impact of fast neutrals from plasma and deposition of plasma impurities may significantly degrade optical and polarization characteristics of mirrors influencing the overall performance of the respective diagnostics. Therefore, maintaining the best possible performance of mirrors is of the crucial importance for the ITER optical diagnostics. Mirrors in ITER divertor are expected to suffer from deposition of impurities. The dedicated experiment in a tokamak divertor was needed to address this issue. Investigations with molybdenum diagnostic mirrors were made in DIII-D divertor. Mirror samples were exposed at different temperatures in the private flux region to a series of ELMy H-mode discharges with partially detached divertor plasmas. An increase of temperature of mirrors during the exposure generally led to the mitigation of carbon deposition, primarily due to temperature-enhanced chemical erosion of carbon layers by D atoms. Finally, for the mirrors exposed at the temperature of ∼160 o C neither carbon deposition nor degradation of optical properties was detected

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

    Science.gov (United States)

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

    2014-01-01

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

  2. Confidence bounds for normal and lognormal distribution coefficients of variation

    Science.gov (United States)

    Steve Verrill

    2003-01-01

    This paper compares the so-called exact approach for obtaining confidence intervals on normal distribution coefficients of variation to approximate methods. Approximate approaches were found to perform less well than the exact approach for large coefficients of variation and small sample sizes. Web-based computer programs are described for calculating confidence...

  3. Experienced physicians benefit from analyzing initial diagnostic hypotheses

    Directory of Open Access Journals (Sweden)

    Adam Bass

    2013-03-01

    Full Text Available Background: Most incorrect diagnoses involve at least one cognitive error, of which premature closure is the most prevalent. While metacognitive strategies can mitigate premature closure in inexperienced learners, these are rarely studied in experienced physicians. Our objective here was to evaluate the effect of analytic information processing on diagnostic performance of nephrologists and nephrology residents. Methods: We asked nine nephrologists and six nephrology residents at the University of Calgary and Glasgow University to diagnose ten nephrology cases. We provided presenting features along with contextual information, after which we asked for an initial diagnosis. We then primed participants to use either hypothetico-deductive reasoning or scheme-inductive reasoning to analyze the remaining case data and generate a final diagnosis. Results: After analyzing initial hypotheses, both nephrologists and residents improved the accuracy of final diagnoses (31.1% vs. 65.6%, p < 0.001, and 40.0% vs. 70.0%, p < 0.001, respectively. We found a significant interaction between experience and analytic processing strategy (p = 0.002: nephrology residents had significantly increased odds of diagnostic success when using scheme-inductive reasoning (odds ratio [95% confidence interval] 5.69 [1.59, 20.33], p = 0.007, whereas the performance of experienced nephrologists did not differ between strategies (odds ratio 0.57 [0.23, 1.39], p = 0.2. Discussion: Experienced nephrologists and nephrology residents can improve their performance by analyzing initial diagnostic hypotheses. The explanation of the interaction between experience and the effect of different reasoning strategies is unclear, but may relate to preferences in reasoning strategy, or the changes in knowledge structure with experience.

  4. The application of deep confidence network in the problem of image recognition

    Directory of Open Access Journals (Sweden)

    Chumachenko О.І.

    2016-12-01

    Full Text Available In order to study the concept of deep learning, in particular the substitution of multilayer perceptron on the corresponding network of deep confidence, computer simulations of the learning process to test voters was carried out. Multi-layer perceptron has been replaced by a network of deep confidence, consisting of successive limited Boltzmann machines. After training of a network of deep confidence algorithm of layer-wise training it was found that the use of networks of deep confidence greatly improves the accuracy of multilayer perceptron training by method of reverse distribution errors.

  5. The accuracy of meta-metacognitive judgments: regulating the realism of confidence.

    Science.gov (United States)

    Buratti, Sandra; Allwood, Carl Martin

    2012-08-01

    Can people improve the realism of their confidence judgments about the correctness of their episodic memory reports by deselecting the least realistic judgments? An assumption of Koriat and Goldsmith's (Psychol Rev 103:490-517, 1996) model is that confidence judgments regulate the reporting of memory reports. We tested whether this assumption generalizes to the regulation of the realism (accuracy) of confidence judgments. In two experiments, 270 adults in separate conditions answered 50 recognition and recall questions about the contents of a just-seen video. After each answer, they made confidence judgments about the answer's correctness. In Experiment 1, the participants in the recognition conditions significantly increased their absolute bias when they excluded 15 questions. In Experiment 2, the participants in the recall condition significantly improved their calibration. The results indicate that recall, more than recognition, offers valid cues for participants to increase the realism of their report. However, the effects were small with only weak support for the conclusion that people have some ability to regulate the realism in their confidence judgments.

  6. Emotor control: computations underlying bodily resource allocation, emotions, and confidence.

    Science.gov (United States)

    Kepecs, Adam; Mensh, Brett D

    2015-12-01

    Emotional processes are central to behavior, yet their deeply subjective nature has been a challenge for neuroscientific study as well as for psychiatric diagnosis. Here we explore the relationships between subjective feelings and their underlying brain circuits from a computational perspective. We apply recent insights from systems neuroscience-approaching subjective behavior as the result of mental computations instantiated in the brain-to the study of emotions. We develop the hypothesis that emotions are the product of neural computations whose motor role is to reallocate bodily resources mostly gated by smooth muscles. This "emotor" control system is analagous to the more familiar motor control computations that coordinate skeletal muscle movements. To illustrate this framework, we review recent research on "confidence." Although familiar as a feeling, confidence is also an objective statistical quantity: an estimate of the probability that a hypothesis is correct. This model-based approach helped reveal the neural basis of decision confidence in mammals and provides a bridge to the subjective feeling of confidence in humans. These results have important implications for psychiatry, since disorders of confidence computations appear to contribute to a number of psychopathologies. More broadly, this computational approach to emotions resonates with the emerging view that psychiatric nosology may be best parameterized in terms of disorders of the cognitive computations underlying complex behavior.

  7. Engineering challenges and solutions for the ITER magnetic diagnostics flux loops

    International Nuclear Information System (INIS)

    Clough, M.; Casal, N.; Suarez Diaz, A.; Vayakis, G.; Walsh, M.

    2014-01-01

    The Magnetic Diagnostics Flux Loops (MDFL) are a key diagnostic for the ITER tokamak, providing important information about the shape of the plasma boundary, instabilities and magnetic error fields. In total, 237 flux loops will be installed on ITER, on the inside and outside walls of the Vacuum Vessel, and will range in area from 1 m 2 to 250 m 2 . This paper describes the detailed engineering design of the MDFL, explaining the solutions developed to maintain measurement accuracy within their difficult operating environment and other requirements: ultra-high vacuum conditions, strong magnetic fields, high gamma and neutron radiation doses, challenging installation, very high reliability and no maintenance during the 20 year machine lifetime. In addition, the paper discusses testing work undertaken to validate the design and outlines the remaining tasks to be performed. The views and opinions expressed herein do not necessarily reflect those of the ITER Organization. (authors)

  8. Proposals for new standardized general diagnostic criteria for the secondary headaches

    DEFF Research Database (Denmark)

    Olesen, J; Steiner, T; Bousser, M-G

    2009-01-01

    headache and chronic migraine. These changes made apparent a further need for broader revisions to the standard formulation of diagnostic criteria for the secondary headaches. Currently, the fourth criterion makes impossible the definitive diagnosis of a secondary headache until the underlying cause has...... propose maintaining a standard approach to the secondary headaches using a set of four criteria A, B, C and D, but we construct these so that the requirement for resolution or successful treatment is removed. The proposal for general diagnostic criteria for the secondary headaches will be entered...... classification are then foreseen for the next 10 years. Until the printing of ICHD-IIR, the printed ICHD-II criteria remain in place for all other purposes. We issue a plea to the headache community to use and study these proposed general criteria for the secondary headaches in order to provide more evidence...

  9. Principles of validation of diagnostic assays for infectious diseases

    International Nuclear Information System (INIS)

    Jacobson, R.H.

    1998-01-01

    Assay validation requires a series of inter-related processes. Assay validation is an experimental process: reagents and protocols are optimized by experimentation to detect the analyte with accuracy and precision. Assay validation is a relative process: its diagnostic sensitivity and diagnostic specificity are calculated relative to test results obtained from reference animal populations of known infection/exposure status. Assay validation is a conditional process: classification of animals in the target population as infected or uninfected is conditional upon how well the reference animal population used to validate the assay represents the target population; accurate predictions of the infection status of animals from test results (PV+ and PV-) are conditional upon the estimated prevalence of disease/infection in the target population. Assay validation is an incremental process: confidence in the validity of an assay increases over time when use confirms that it is robust as demonstrated by accurate and precise results; the assay may also achieve increasing levels of validity as it is upgraded and extended by adding reference populations of known infection status. Assay validation is a continuous process: the assay remains valid only insofar as it continues to provide accurate and precise results as proven through statistical verification. Therefore, the work required for validation of diagnostic assays for infectious diseases does not end with a time-limited series of experiments based on a few reference samples rather, to assure valid test results from an assay requires constant vigilance and maintenance of the assay, along with reassessment of its performance characteristics for each unique population of animals to which it is applied. (author)

  10. How Is Gender Self-Confidence Related to Subjective Well-Being?

    Science.gov (United States)

    Hoffman, Rose Marie

    2006-01-01

    This study of ethnically diverse participants explored the relationship of gender self-confidence to subjective well-being. The 2 components of gender self-confidence (gender self-definition and gender self-acceptance) were assessed using the Hoffman Gender Scale (R. M. Hoffman, 1996; R. M. Hoffman, L. D. Borders, & J. A. Hattie, 2000). The…

  11. The Metamemory Approach to Confidence: A Test Using Semantic Memory

    Science.gov (United States)

    Brewer, William F.; Sampaio, Cristina

    2012-01-01

    The metamemory approach to memory confidence was extended and elaborated to deal with semantic memory tasks. The metamemory approach assumes that memory confidence is based on the products and processes of a completed memory task, as well as metamemory beliefs that individuals have about how their memory products and processes relate to memory…

  12. To protect and serve: Restoring public confidence in the SAPS ...

    African Journals Online (AJOL)

    Persistent incidents of brutality, criminal behaviour and abuse of authority by members of South Africa's police agencies have serious implications for public trust and confidence in the police. A decline in trust and confidence in the police is inevitably harmful to the ability of the government to reduce crime and improve public ...

  13. Government policy, research and stakeholder confidence - Current Trends in Canada

    International Nuclear Information System (INIS)

    Letourneau, Carmel

    2006-01-01

    uncertainties; - Assure adequate human capacity to manage the program throughout its existence to maintain competence and credibility; - Enhance scientific understanding to improve confidence in predictions and to evaluate potential program improvements; - Confirm performance or identify anomalies during and after program operations and thereby increase confidence; - Clearly demonstrate to citizens an ongoing capability to manage the enterprise and to respond to their concerns and desires; - Be able to enact mid-course corrections in response to new information or societal decisions by adapting to new designs, new regional, national or international institutional changes, or new international standards; - Be able to adapt to new capabilities developed externally to the program that show promise of improving program success. Ms. Letourneau addressed the role of the public and private sector in conducting research on RWM in Canada. The Government of Canada has clearly indicated that the responsibility for providing sound scientific data for proposed practices rests with the proponent who is taking action associated with the risk of potential serious harm. Where it is less clear that the proponent should shoulder the entire responsibility for research programs, the Government step in and assist the proponent or the general industry in question. The relationship between research and Government policy focuses on the public good and always aspires to public confidence. It cannot focus only on ideas and technologies with commercial potential. Its top priority must retain the public interest of present and future generations of Canadians. The Government is interested in supporting research which responds to public priorities of the day. The presentation reviewed the functional objectives of government research, and noted that increasingly, the setting of research priorities now involves more intensive and extensive public consultations. It was noted that allocation of responsibility

  14. AECL's reliability and maintainability program

    International Nuclear Information System (INIS)

    Wolfe, W.A.; Nieuwhof, G.W.E.

    1976-05-01

    AECL's reliability and maintainability program for nuclear generating stations is described. How the various resources of the company are organized to design and construct stations that operate reliably and safely is shown. Reliability and maintainability includes not only special mathematically oriented techniques, but also the technical skills and organizational abilities of the company. (author)

  15. Tourette and tic disorders in ICD-11: standing at the diagnostic crossroads.

    Science.gov (United States)

    Woods, Douglas W; Thomsen, Per H

    2014-01-01

    This article reflects discussion by the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders. After reviewing the historical classification of tic disorders, this article discusses their placement in ICD-11. Existing problems with diagnostic labels and criteria, appropriate placement of the tic disorders category within the ICD-11 system, and pragmatic factors affecting classification are reviewed. The article ends with recommendations to (a) maintain consistency with the DSM-5 diagnostic labels for tic disorders, (b) add a minimum duration guideline for a provisional tic disorder diagnosis, (c) remove the multiple motor tic guideline for the diagnosis of Tourette disorder, and (d) co-parent the tic disorder diagnoses in the disorders of the nervous system and the mental and behavioral disorders categories, with secondary co-parenting in the obsessive-compulsive and related disorders and neurodevelopmental disorders sections.

  16. Bootstrap-based confidence estimation in PCA and multivariate statistical process control

    DEFF Research Database (Denmark)

    Babamoradi, Hamid

    be used to detect outliers in the data since the outliers can distort the bootstrap estimates. Bootstrap-based confidence limits were suggested as alternative to the asymptotic limits for control charts and contribution plots in MSPC (Paper II). The results showed that in case of the Q-statistic......Traditional/Asymptotic confidence estimation has limited applicability since it needs statistical theories to estimate the confidences, which are not available for all indicators/parameters. Furthermore, in case the theories are available for a specific indicator/parameter, the theories are based....... The goal was to improve process monitoring by improving the quality of MSPC charts and contribution plots. Bootstrapping algorithm to build confidence limits was illustrated in a case study format (Paper I). The main steps in the algorithm were discussed where a set of sensible choices (plus...

  17. Does nutritional intervention maintain its prognostic benefit in the long term for malnourished patients hospitalised for heart failure?

    Science.gov (United States)

    Bonilla-Palomas, J L; Gámez-López, A L; Castillo-Domínguez, J C; Moreno-Conde, M; López-Ibáñez, M C; Anguita-Sánchez, M

    2018-03-01

    To assess the long-term effect of nutritional intervention on malnourished, hospitalised patients with heart failure (HF). A total of 120 malnourished patients hospitalized for HF were randomised to undergo (or not) an individual nutritional intervention for 6 months. The primary event was the combination of all-cause death and readmission for HF. We performed an intent-to-treat analysis and assessed the effect of the intervention at 24 months. The combined event occurred in 47.5% of the intervention group and in 73.8% of the control group (hazard ratio: 0.45; 95% confidence interval: 0.28-0.72; P=.001). Thirty-nine percent of the intervention group and 59% of the control group died (hazard ratio: 0.53; 95% confidence interval: 0.31-0.89; P=.017). A nutritional intervention for malnourished patients hospitalised for HF maintains its prognostic benefit in the long-term follow-up. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  18. Confidence Sharing in the Vocational Counselling Interview: Emergence and Repercussions

    Science.gov (United States)

    Olry-Louis, Isabelle; Bremond, Capucine; Pouliot, Manon

    2012-01-01

    Confidence sharing is an asymmetrical dialogic episode to which both parties consent, in which one reveals something personal to the other who participates in the emergence and unfolding of the confidence. We describe how this is achieved at a discursive level within vocational counselling interviews. Based on a corpus of 64 interviews, we analyse…

  19. Diagnostic nerve ultrasonography

    International Nuclear Information System (INIS)

    Baeumer, T.; Grimm, A.; Schelle, T.

    2017-01-01

    For the diagnostics of nerve lesions an imaging method is necessary to visualize peripheral nerves and their surrounding structures for an etiological classification. Clinical neurological and electrophysiological investigations provide functional information about nerve lesions. The information provided by a standard magnetic resonance imaging (MRI) examination is inadequate for peripheral nerve diagnostics; however, MRI neurography is suitable but on the other hand a resource and time-consuming method. Using ultrasonography for peripheral nerve diagnostics. With ultrasonography reliable diagnostics of entrapment neuropathies and traumatic nerve lesions are possible. The use of ultrasonography for neuropathies shows that a differentiation between different forms is possible. Nerve ultrasonography is an established diagnostic tool. In addition to the clinical examination and clinical electrophysiology, structural information can be obtained, which results in a clear improvement in the diagnostics. Ultrasonography has become an integral part of the diagnostic work-up of peripheral nerve lesions in neurophysiological departments. Nerve ultrasonography is recommended for the diagnostic work-up of peripheral nerve lesions in addition to clinical and electrophysiological investigations. It should be used in the clinical work-up of entrapment neuropathies, traumatic nerve lesions and spacy-occupying lesions of nerves. (orig.) [de

  20. Confidence Intervals from Realizations of Simulated Nuclear Data

    Energy Technology Data Exchange (ETDEWEB)

    Younes, W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Ratkiewicz, A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Ressler, J. J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-09-28

    Various statistical techniques are discussed that can be used to assign a level of confidence in the prediction of models that depend on input data with known uncertainties and correlations. The particular techniques reviewed in this paper are: 1) random realizations of the input data using Monte-Carlo methods, 2) the construction of confidence intervals to assess the reliability of model predictions, and 3) resampling techniques to impose statistical constraints on the input data based on additional information. These techniques are illustrated with a calculation of the keff value, based on the 235U(n, f) and 239Pu (n, f) cross sections.

  1. Exploring Self - Confidence Level of High School Students Doing Sport

    Directory of Open Access Journals (Sweden)

    Nurullah Emir Ekinci

    2014-10-01

    Full Text Available The aim of this study was to investigate self-confidence levels of high school students, who do sport, in the extent of their gender, sport branch (individual/team sports and aim for participating in sport (professional/amateur. 185 active high school students from Kutahya voluntarily participated for the study. In the study as data gathering tool self-confidence scale was used. In the evaluation of the data as a hypothesis test Mann Whitney U non parametric test was used. As a result self-confidence levels of participants showed significant differences according to their gender and sport branch but there was no significant difference according to aim for participating in sport.

  2. 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.

  3. Does Consumer Confidence Forecast Household Saving and Borrowing Behavior? Evidence for Poland.

    Science.gov (United States)

    Kłopocka, Aneta Maria

    2017-01-01

    Consumer confidence plays an important role in households' decision-making processes. This study investigates the effects of consumer confidence on household saving and borrowing behavior that are unsatisfactorily considered in previous discussions. The questions of interest are first, whether indexes of consumer confidence have any predictive power on their own for future household saving and borrowing rates, and second, whether they contain information about future household saving and borrowing rates aside from the information contained in other available indicators. In addition to aggregate confidence indicators, their components are used to provide more precise information. Overall, the multiple linear regression analysis (OLS technique) of Polish time-series data gives positive answers to both questions. This finding supports the recommendation of combining the strengths of objective indicators (such as economic fundamentals) and subjective indicators (such as consumer confidence) to improve household financial behavior forecasts.

  4. Tune-Based Halo Diagnostics

    International Nuclear Information System (INIS)

    Cameron, Peter

    2003-01-01

    Tune-based halo diagnostics can be divided into two categories -- diagnostics for halo prevention, and diagnostics for halo measurement. Diagnostics for halo prevention are standard fare in accumulators, synchrotrons, and storage rings, and again can be divided into two categories -- diagnostics to measure the tune distribution (primarily to avoid resonances), and diagnostics to identify instabilities (which will not be discussed here). These diagnostic systems include kicked (coherent) tune measurement, phase-locked loop (PLL) tune measurement, Schottky tune measurement, beam transfer function (BTF) measurements, and measurement of transverse quadrupole mode envelope oscillations. We refer briefly to tune diagnostics used at RHIC and intended for the SNS, and then present experimental results. Tune-based diagnostics for halo measurement (as opposed to prevention) are considerably more difficult. We present one brief example of tune-based halo measurement

  5. Coping under pressure: Strategies for maintaining confidence amongst South African soccer coaches

    Directory of Open Access Journals (Sweden)

    Jhalukpreya Surujlal

    2011-02-01

    Sport afrigting kan ’n baie vervullende en bevredigende beroepskeuse wees, maar as gevolg van die eise en verwagtinge van verskeie omgewings faktore, kan dit ook as ’n spanningsvolle beroep ervaar word. Afrigters moet verskeie rolle vertolk (o.a. opvoeder, motiveerder, sielkundige, adviseerder, afrigter, bestuurder en administrateur wat deel uitmaak van die komplekse en buitengewone eise wat op hulle geplaas word. Sokker afrigters beleef ’n aantal uitdagings, konflik situasies, frustrasies en spanning waarvan die impak of waarde daarvan selde gemeet kan word. Afrigting as ’n konsep word beskryf of gedefinieer as ’n potensieel onveilige en/of wisselvallige beroep waar die meerderheid afrigters spanning ervaar, konflik beleef, media druk moet verwerk en ’n geweldige inbreuk op hul persoonlike en familielewe ervaar. Hierdie studie ondersoek Suid-Afrikaanse sokker afrigters se persepsies aangaande die meganismes wat hulle gebruik om die potensiële spanning van hul beroep te bestuur. Die studie is gebaseer op ’n nie-eksperimentele ontwerp met ’n kwantitatiewe benadering van Suid-Afrikaanse sokker afrigters om spanning te evalueer en te bestuur. Een honderd en twaalf sokker afrigters wat op provinsiale vlak of hoër afgerig het, het vraelyste ingevul aangaande spanning en spanning hanteringstegnieke wat in hul afrigtingsberoepe gebruik is. Beskrywende data analise is met behulp van ’n statistiese pakket in Sosiale Wetenskap (SPSS-weergawe 16 gedoen. Die oorsake van spanning asook die hanteringstegnieke wat deur die afrigters gebruik is, is geevalueer. Die resultate het bevind dat daar drie duidelike oorsake van spanning was, naamlik ’n tekort aan hulpbronne, die akkumulasie van geskeduleerde wedstryde asook wedstryde waarvan die uitslag krities is. Die drie laagste oorsake van spanning was onder andere politieke inmenging, fisiese aanranding deur spelers en die vervanging van spelers. Die afrigters het ’n verskeidenheid van spannings hanteringstegnieke gebruik, maar die resultate toon dat 5.68%, 5.14% en 89.78% van die eksperimentele groep oneffektiewe spannings-, emosionele- en probleem bestuurstegnieke geïmplementeer het. Akademiese en praktiese implikasies van die navorsingsresultate word bespreek.

  6. Improvement of Roller Bearing Diagnosis with Unlabeled Data Using Cut Edge Weight Confidence Based Tritraining

    Directory of Open Access Journals (Sweden)

    Wei-Li Qin

    2016-01-01

    Full Text Available Roller bearings are one of the most commonly used components in rotational machines. The fault diagnosis of roller bearings thus plays an important role in ensuring the safe functioning of the mechanical systems. However, in most cases of bearing fault diagnosis, there are limited number of labeled data to achieve a proper fault diagnosis. Therefore, exploiting unlabeled data plus few labeled data, this paper proposed a roller bearing fault diagnosis method based on tritraining to improve roller bearing diagnosis performance. To overcome the noise brought by wrong labeling into the classifiers training process, the cut edge weight confidence is introduced into the diagnosis framework. Besides a small trick called suspect principle is adopted to avoid overfitting problem. The proposed method is validated in two independent roller bearing fault experiment vibrational signals that both include three types of faults: inner-ring fault, outer-ring fault, and rolling element fault. The results demonstrate the desirable diagnostic performance improvement by the proposed method in the extreme situation where there is only limited number of labeled data.

  7. Confidence Intervals: From tests of statistical significance to confidence intervals, range hypotheses and substantial effects

    Directory of Open Access Journals (Sweden)

    Dominic Beaulieu-Prévost

    2006-03-01

    Full Text Available For the last 50 years of research in quantitative social sciences, the empirical evaluation of scientific hypotheses has been based on the rejection or not of the null hypothesis. However, more than 300 articles demonstrated that this method was problematic. In summary, null hypothesis testing (NHT is unfalsifiable, its results depend directly on sample size and the null hypothesis is both improbable and not plausible. Consequently, alternatives to NHT such as confidence intervals (CI and measures of effect size are starting to be used in scientific publications. The purpose of this article is, first, to provide the conceptual tools necessary to implement an approach based on confidence intervals, and second, to briefly demonstrate why such an approach is an interesting alternative to an approach based on NHT. As demonstrated in the article, the proposed CI approach avoids most problems related to a NHT approach and can often improve the scientific and contextual relevance of the statistical interpretations by testing range hypotheses instead of a point hypothesis and by defining the minimal value of a substantial effect. The main advantage of such a CI approach is that it replaces the notion of statistical power by an easily interpretable three-value logic (probable presence of a substantial effect, probable absence of a substantial effect and probabilistic undetermination. The demonstration includes a complete example.

  8. A systematic review of the diagnostic performance of orthopedic physical examination tests of the hip.

    Science.gov (United States)

    Rahman, Labib Ataur; Adie, Sam; Naylor, Justine Maree; Mittal, Rajat; So, Sarah; Harris, Ian Andrew

    2013-08-30

    Previous reviews of the diagnostic performances of physical tests of the hip in orthopedics have drawn limited conclusions because of the low to moderate quality of primary studies published in the literature. This systematic review aims to build on these reviews by assessing a broad range of hip pathologies, and employing a more selective approach to the inclusion of studies in order to accurately gauge diagnostic performance for the purposes of making recommendations for clinical practice and future research. It specifically identifies tests which demonstrate strong and moderate diagnostic performance. A systematic search of Medline, Embase, Embase Classic and CINAHL was conducted to identify studies of hip tests. Our selection criteria included an analysis of internal and external validity. We reported diagnostic performance in terms of sensitivity, specificity, predictive values and likelihood ratios. Likelihood ratios were used to identify tests with strong and moderate diagnostic utility. Only a small proportion of tests reported in the literature have been assessed in methodologically valid primary studies. 16 studies were included in our review, producing 56 independent test-pathology combinations. Two tests demonstrated strong clinical utility, the patellar-pubic percussion test for excluding radiologically occult hip fractures (negative LR 0.05, 95% Confidence Interval [CI] 0.03-0.08) and the hip abduction sign for diagnosing sarcoglycanopathies in patients with known muscular dystrophies (positive LR 34.29, 95% CI 10.97-122.30). Fifteen tests demonstrated moderate diagnostic utility for diagnosing and/or excluding hip fractures, symptomatic osteoarthritis and loosening of components post-total hip arthroplasty. We have identified a number of tests demonstrating strong and moderate diagnostic performance. These findings must be viewed with caution as there are concerns over the methodological quality of the primary studies from which we have extracted our

  9. Impact of lossy compression on diagnostic accuracy of radiographs for periapical lesions

    Science.gov (United States)

    Eraso, Francisco E.; Analoui, Mostafa; Watson, Andrew B.; Rebeschini, Regina

    2002-01-01

    OBJECTIVES: The purpose of this study was to evaluate the lossy Joint Photographic Experts Group compression for endodontic pretreatment digital radiographs. STUDY DESIGN: Fifty clinical charge-coupled device-based, digital radiographs depicting periapical areas were selected. Each image was compressed at 2, 4, 8, 16, 32, 48, and 64 compression ratios. One root per image was marked for examination. Images were randomized and viewed by four clinical observers under standardized viewing conditions. Each observer read the image set three times, with at least two weeks between each reading. Three pre-selected sites per image (mesial, distal, apical) were scored on a five-scale score confidence scale. A panel of three examiners scored the uncompressed images, with a consensus score for each site. The consensus score was used as the baseline for assessing the impact of lossy compression on the diagnostic values of images. The mean absolute error between consensus and observer scores was computed for each observer, site, and reading session. RESULTS: Balanced one-way analysis of variance for all observers indicated that for compression ratios 48 and 64, there was significant difference between mean absolute error of uncompressed and compressed images (P <.05). After converting the five-scale score to two-level diagnostic values, the diagnostic accuracy was strongly correlated (R (2) = 0.91) with the compression ratio. CONCLUSION: The results of this study suggest that high compression ratios can have a severe impact on the diagnostic quality of the digital radiographs for detection of periapical lesions.

  10. Intellectual property considerations for molecular diagnostic development with emphasis on companion diagnostics.

    Science.gov (United States)

    Glorikian, Harry; Warburg, Richard Jeremy; Moore, Kelly; Malinowski, Jennifer

    2018-02-01

    The development of molecular diagnostics is a complex endeavor, with multiple regulatory pathways to consider and numerous approaches to development and commercialization. Companion diagnostics, devices which are "essential for the safe and effective use of a corresponding drug or diagnostic product" (see U.S. Food & Drug Administration, In Vitro Diagnostics - Companion Diagnostics, U.S. Dept. of Health & Human Services(2016), available at https://www.fda.gov/medicaldevices/productsandmedicalprocedures/invitrodiagnostics/ucm407297.htm ) and complementary diagnostics, which are more broadly associated with a class of drug, are becoming increasingly important as integral components of the implementation of precision medicine. Areas covered: The following article will highlight the intellectual property ('IP') considerations pertinent to molecular diagnostics development with special emphasis on companion diagnostics. Expert opinion/commentary Summary: For all molecular diagnostics, intellectual property (IP) concerns are of paramount concern, whether the device will be marketed only in the United States or abroad. Taking steps to protect IP at each stage of product development is critical to optimize profitability of a diagnostic product. Also the legal framework around IP protection of diagnostic technologies has been changing over the previous few years and can be expected to continue to change in the foreseeable near future, thus, a comprehensive IP strategy should take into account the fact that changes in the law can be expected.

  11. Changing job seekers' image perceptions during recruitment visits: the moderating role of belief confidence.

    Science.gov (United States)

    Slaughter, Jerel E; Cable, Daniel M; Turban, Daniel B

    2014-11-01

    The purpose of this study was to understand how an important construct in social psychology-confidence in one's beliefs-could both (a) influence the effectiveness of organizations' recruiting processes and (b) be changed during recruitment. Using a sample of recruits to a branch of the United States military, the authors studied belief confidence before and after recruits' formal visits to the organization's recruiting stations. Personal sources of information had a stronger influence on recruits' belief confidence than impersonal sources. Moreover, recruits' confidence in their initial beliefs affected how perceptions of the recruiter changed their employer images. Among participants with low-initial confidence, the relation between recruitment experiences and employer images was positive and linear across the whole range of recruitment experiences. Among recruits with high-initial confidence, however, the recruitment experience-image relationship was curvilinear, such that recruitment experiences were related to images only at more positive recruitment experiences. The relationship between recruitment experiences and changes in belief confidence was also curvilinear, such that only more positive recruitment experiences led to changes in confidence. These results indicate not only that belief confidence influences the effectiveness of recruiting efforts but also that recruiting efforts can influence belief confidence. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  12. A Comparative Study of Self-Confidence from the Perspectives of Quran, Ahadith and Psychology

    Directory of Open Access Journals (Sweden)

    Sayyed Ali Mostajaboldavati

    2017-03-01

    Full Text Available Background and Objectives: Self-confidence, referring to relying on and exploiting individual abilities and talents for realizing spiritual and material prosperity, not only contradicts but is in agreement with and a prerequisite for faith in God. Practically, the greater faith in God one has, the more potent self-confidence he /she possess. Investigating the subject of self-confidence from the perspectives of Quran, Ahadith and psychology, this study explores the meaning of self (soul in self-confidence and its levels, the prerequisites for development and enhancement of self-confidence, the association of self-concept and self-esteem with self-confidence, and the approaches to develop and enhance positive self-concept as well as to boost self-confidence. Methods: The data of this descriptive review article were gathered from library and digital references. Results: Although it appears that self-confidence contradicts Islamic teachings, it can be clearly understood that this teaching subject is confirmed and emphasized in Islamic teachings by discovery of its true meaning. Conclusion: If having self-confidence is meant to rely on and exploiting individual abilities and talents to reach material and spiritual prosperity, it not only does not contradict but is in agreement with and a prerequisite for faith in God. Self in self- confidence indeed means human as a combination of the body and the spirit which is fully consistent with indices of self-confidence. According to psychologists, improving self-esteem and positive self-concept affects self-confidence directly. From perspective of religion, paying attention to venerability and God-given dignity of human, recognizing the superb purpose in life, etc. are approaches to develop and enhance positive self-concept and self-esteem, and to boost self-confidence.

  13. Leadership by Confidence in Teams

    OpenAIRE

    Kobayashi, Hajime; Suehiro, Hideo

    2008-01-01

    We study endogenous signaling by analyzing a team production problem with endogenous timing. Each agent of the team is privately endowed with some level of confidence about team productivity. Each of them must then commit a level of effort in one of two periods. At the end of each period, each agent observes his partner' s move in this period. Both agents are rewarded by a team output determined by team productivity and total invested effort. Each agent must personally incur the cost of effor...

  14. 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.

  15. Maintaining positive

    OpenAIRE

    Gheorghe Gh. IONESCU; Adina Letitia NEGRUSA

    2004-01-01

    Maintaining positive work-force relationships includes in effective labor-management relations and making appropriate responses to current employee issues. Among the major current employee issues are protection from arbitrary dismissal, drug and alcohol abuse, privacy rights and family maters and they impact work. In our paper we discus two problems: first, the meanings of industrial democracy; second, the three principal operational concepts of industrial democracy (1) industrial democracy t...

  16. Quality control test solutions for diagnostic radiology, nuclear medicine and health physics with PTW equipment

    International Nuclear Information System (INIS)

    Froescher, Olga

    2007-01-01

    Complete test of publication follows. In 1922 PTW-Freiburg was founded to produce and market a revolutionary new electromechanical component for measuring very small electrical charges. Today PTW is the specialist and one of the global market leaders for manufacturing and supplying high-quality products in diagnostic radiology, nuclear medicine, radiation therapy and health physics. The quality control of X-ray images is influenced by a number of parameters. To maintain a consistent performance of X-ray installations, quality checks have to be conducted regularly. PTW offers a variety of diagnostic test tools for different X-ray devices, and therefore to reduce patient exposure and costs for X-ray departments. PTW's 'Code of Practice' defines in an easy and compact way how to perform quality control measurements on different diagnostic X-ray installations. The necessary equipment for measuring main parameters as well as acceptable limits are mentioned accordingly. The 'Code of Practice' bases on actual standards.

  17. Confidence bounds and hypothesis tests for normal distribution coefficients of variation

    Science.gov (United States)

    Steve Verrill; Richard A. Johnson

    2007-01-01

    For normally distributed populations, we obtain confidence bounds on a ratio of two coefficients of variation, provide a test for the equality of k coefficients of variation, and provide confidence bounds on a coefficient of variation shared by k populations.

  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. 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

  20. Transparency as an element of public confidence

    International Nuclear Information System (INIS)

    Kim, H.K.

    2007-01-01

    In the modern society, there is increasing demands for greater transparency. It has been discussed with respect to corruption or ethics issues in social science. The need for greater openness and transparency in nuclear regulation is widely recognised as public expectations on regulator grow. It is also related to the digital and information technology that enables disclosures of every activity and information of individual and organisation, characterised by numerous 'small brothers'. Transparency has become a key word in this ubiquitous era. Transparency in regulatory activities needs to be understood in following contexts. First, transparency is one of elements to build public confidence in regulator and eventually to achieve regulatory goal of providing the public with satisfaction at nuclear safety. Transparent bases of competence, independence, ethics and integrity of working process of regulatory body would enhance public confidence. Second, activities transmitting information on nuclear safety and preparedness to be accessed are different types of transparency. Communication is an active method of transparency. With increasing use of web-sites, 'digital transparency' is also discussed as passive one. Transparency in regulatory process may be more important than that of contents. Simply providing more information is of little value and specific information may need to be protected for security reason. Third, transparency should be discussed in international, national and organizational perspectives. It has been demanded through international instruments. for each country, transparency is demanded by residents, public, NGOs, media and other stakeholders. Employees also demand more transparency in operating and regulatory organisations. Whistle-blower may appear unless they are satisfied. Fourth, pursuing transparency may cause undue social cost or adverse effects. Over-transparency may decrease public confidence and the process for transparency may also hinder

  1. 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.

  2. 78 FR 57538 - Proposed Waste Confidence Rule and Draft Generic Environmental Impact Statement

    Science.gov (United States)

    2013-09-19

    ..., Chief, Communication, Planning, and Rulemaking Branch Waste Confidence Directorate, Office of Nuclear...-2012-0246] RIN 3150-AJ20 Proposed Waste Confidence Rule and Draft Generic Environmental Impact... disposal (proposed Waste Confidence rule). In addition, the NRC will receive public comment on its...

  3. Diagnostic accuracy of magnetic resonance, computed tomography and contrast enhanced ultrasound in radiological multimodality assessment of peribiliary liver metastases.

    Directory of Open Access Journals (Sweden)

    Vincenza Granata

    Full Text Available We compared diagnostic performance of Magnetic Resonance (MR, Computed Tomography (CT and Ultrasound (US with (CEUS and without contrast medium to identify peribiliary metastasis.We identified 35 subjects with histological proven peribiliary metastases who underwent CEUS, CT and MR study. Four radiologists evaluated the presence of peribiliary lesions, using a 4-point confidence scale. Echogenicity, density and T1-Weigthed (T1-W, T2-W and Diffusion Weighted Imaging (DWI signal intensity as well as the enhancement pattern during contrast studies on CEUS, CT and MR so as hepatobiliary-phase on MRI was assessed.All lesions were detected by MR. CT detected 8 lesions, while US/CEUS detected one lesion. According to the site of the lesion, respect to the bile duct and hepatic parenchyma: 19 (54.3% were periductal, 15 (42.8% were intra-periductal and 1 (2.8% was periductal-intrahepatic. According to the confidence scale MRI had the best diagnostic performance to assess the lesion. CT obtained lower diagnostic performance. There was no significant difference in MR signal intensity and contrast enhancement among all metastases (p>0.05. There was no significant difference in CT density and contrast enhancement among all metastases (p>0.05.MRI is the method of choice for biliary tract tumors but it does not allow a correct differential diagnosis among different histological types of metastasis. The presence of biliary tree dilatation without hepatic lesions on CT and US/CEUS study may be an indirect sign of peribiliary metastases and for this reason the patient should be evaluated by MRI.

  4. Investigating the psychological resilience, self-confidence and problem-solving skills of midwife candidates.

    Science.gov (United States)

    Ertekin Pinar, Sukran; Yildirim, Gulay; Sayin, Neslihan

    2018-05-01

    The high level of psychological resilience, self-confidence and problem solving skills of midwife candidates play an important role in increasing the quality of health care and in fulfilling their responsibilities towards patients. This study was conducted to investigate the psychological resilience, self-confidence and problem-solving skills of midwife candidates. It is a convenience descriptive quantitative study. Students who study at Health Sciences Faculty in Turkey's Central Anatolia Region. Midwife candidates (N = 270). In collection of data, the Personal Information Form, Psychological Resilience Scale for Adults (PRSA), Self-Confidence Scale (SCS), and Problem Solving Inventory (PSI) were used. There was a negatively moderate-level significant relationship between the Problem Solving Inventory scores and the Psychological Resilience Scale for Adults scores (r = -0.619; p = 0.000), and between Self-Confidence Scale scores (r = -0.524; p = 0.000). There was a positively moderate-level significant relationship between the Psychological Resilience Scale for Adults scores and the Self-Confidence Scale scores (r = 0.583; p = 0.000). There was a statistically significant difference (p Problem Solving Inventory and the Psychological Resilience Scale for Adults scores according to getting support in a difficult situation. As psychological resilience and self-confidence levels increase, problem-solving skills increase; additionally, as self-confidence increases, psychological resilience increases too. Psychological resilience, self-confidence, and problem-solving skills of midwife candidates in their first-year of studies are higher than those who are in their fourth year. Self-confidence and psychological resilience of midwife candidates aged between 17 and 21, self-confidence and problem solving skills of residents of city centers, psychological resilience of those who perceive their monthly income as sufficient are high

  5. Experienced physicians benefit from analyzing initial diagnostic hypotheses

    Science.gov (United States)

    Bass, Adam; Geddes, Colin; Wright, Bruce; Coderre, Sylvain; Rikers, Remy; McLaughlin, Kevin

    2013-01-01

    Background Most incorrect diagnoses involve at least one cognitive error, of which premature closure is the most prevalent. While metacognitive strategies can mitigate premature closure in inexperienced learners, these are rarely studied in experienced physicians. Our objective here was to evaluate the effect of analytic information processing on diagnostic performance of nephrologists and nephrology residents. Methods We asked nine nephrologists and six nephrology residents at the University of Calgary and Glasgow University to diagnose ten nephrology cases. We provided presenting features along with contextual information, after which we asked for an initial diagnosis. We then primed participants to use either hypothetico-deductive reasoning or scheme-inductive reasoning to analyze the remaining case data and generate a final diagnosis. Results After analyzing initial hypotheses, both nephrologists and residents improved the accuracy of final diagnoses (31.1% vs. 65.6%, p inductive reasoning (odds ratio [95% confidence interval] 5.69 [1.59, 20.33], p = 0.07), whereas the performance of experienced nephrologists did not differ between strategies (odds ratio 0.57 [0.23, 1.39], p = 0.20). Discussion Experienced nephrologists and nephrology residents can improve their performance by analyzing initial diagnostic hypotheses. The explanation of the interaction between experience and the effect of different reasoning strategies is unclear, but may relate to preferences in reasoning strategy, or the changes in knowledge structure with experience. PMID:26451203

  6. Veterinary Molecular Diagnostics

    NARCIS (Netherlands)

    Roest, H.I.J.; Engelsma, M.Y.; Weesendorp, E.; Bossers, A.; Elbers, A.R.W.

    2017-01-01

    In veterinary molecular diagnostics, samples originating from animals are tested. Developments in the farm animals sector and in our societal attitude towards pet animals have resulted in an increased demand for fast and reliable diagnostic techniques. Molecular diagnostics perfectly matches this

  7. Diagnosing Anomalous Network Performance with Confidence

    Energy Technology Data Exchange (ETDEWEB)

    Settlemyer, Bradley W [ORNL; Hodson, Stephen W [ORNL; Kuehn, Jeffery A [ORNL; Poole, Stephen W [ORNL

    2011-04-01

    Variability in network performance is a major obstacle in effectively analyzing the throughput of modern high performance computer systems. High performance interconnec- tion networks offer excellent best-case network latencies; how- ever, highly parallel applications running on parallel machines typically require consistently high levels of performance to adequately leverage the massive amounts of available computing power. Performance analysts have usually quantified network performance using traditional summary statistics that assume the observational data is sampled from a normal distribution. In our examinations of network performance, we have found this method of analysis often provides too little data to under- stand anomalous network performance. Our tool, Confidence, instead uses an empirically derived probability distribution to characterize network performance. In this paper we describe several instances where the Confidence toolkit allowed us to understand and diagnose network performance anomalies that we could not adequately explore with the simple summary statis- tics provided by traditional measurement tools. In particular, we examine a multi-modal performance scenario encountered with an Infiniband interconnection network and we explore the performance repeatability on the custom Cray SeaStar2 interconnection network after a set of software and driver updates.

  8. The Stockholm-3 (STHLM3) Model can Improve Prostate Cancer Diagnostics in Men Aged 50-69 yr Compared with Current Prostate Cancer Testing.

    Science.gov (United States)

    Eklund, Martin; Nordström, Tobias; Aly, Markus; Adolfsson, Jan; Wiklund, Peter; Brandberg, Yvonne; Thompson, James; Wiklund, Fredrik; Lindberg, Johan; Presti, Joseph C; StLezin, Mark; Clements, Mark; Egevad, Lars; Grönberg, Henrik

    2016-11-23

    Prostate cancer screening is associated with low specificity, unnecessary biopsies, and overdiagnosis. We have previously shown that the Stockholm-3 model (S3M) can reduce biopsies compared with using prostate-specific antigen (PSA) ≥3ng/ml as an indication for biopsy. Urologists in today's current prostate cancer testing (CPT) have access to numerous variables in addition to PSA (eg, age, ethnicity, family history, free PSA, PSA velocity, digital rectal examination, and prostate volume) to support biopsy decisions. We estimated the number of prostate cancers diagnosed and prostate biopsies performed if S3M replaced CPT in Stockholm, Sweden, by comparing biopsy results in 56 282 men who underwent PSA testing according to CPT in Stockholm in 2011 with the 47 688 men enrolled in the STHLM3 validation cohort 2012-2015. With the same sensitivity as CPT to diagnose Gleason score ≥7 prostate cancer, S3M was estimated to reduce the number of men biopsied by 53% (95% confidence interval [CI]: 41-65%), avoid 76% (95% CI: 67-81%) of negative biopsies, and reduce Gleason score 6 cancers by 23% (95% CI: 6-40%). S3M has the potential to improve prostate cancer diagnostics by better selecting men with high risk of GS ≥7 prostate cancer. We modeled the effect the Stockholm-3 model would have on prostate cancer diagnostics if it replaced current clinical practice. We found that Stockholm-3 model may substantially reduce the number of biopsies, while maintaining the same sensitivity to diagnose clinically significant prostate cancer. Copyright © 2016. Published by Elsevier B.V.

  9. Distribution of the product confidence limits for the indirect effect: Program PRODCLIN

    Science.gov (United States)

    MacKinnon, David P.; Fritz, Matthew S.; Williams, Jason; Lockwood, Chondra M.

    2010-01-01

    This article describes a program, PRODCLIN (distribution of the PRODuct Confidence Limits for INdirect effects), written for SAS, SPSS, and R, that computes confidence limits for the product of two normal random variables. The program is important because it can be used to obtain more accurate confidence limits for the indirect effect, as demonstrated in several recent articles (MacKinnon, Lockwood, & Williams, 2004; Pituch, Whittaker, & Stapleton, 2005). Tests of the significance of and confidence limits for indirect effects based on the distribution of the product method have more accurate Type I error rates and more power than other, more commonly used tests. Values for the two paths involved in the indirect effect and their standard errors are entered in the PRODCLIN program, and distribution of the product confidence limits are computed. Several examples are used to illustrate the PRODCLIN program. The PRODCLIN programs in rich text format may be downloaded from www.psychonomic.org/archive. PMID:17958149

  10. Building confidence: an exploration of nurses undertaking a postgraduate biological science course.

    Science.gov (United States)

    Van Wissen, Kim; McBride-Henry, Karen

    2010-01-01

    This study aimed to explore the impact of studying biological science at a postgraduate level and how this impacted on nursing practice. The term biological sciences in this research encompasses elements of physiology, genetics, biochemistry and pathophysiology. A qualitative research study was designed, that involved the dissemination of a pre- and post-course semi-structured questionnaire for a biological science course, as part of a Master of Nursing programme at a New Zealand University, thus exploring the impact of undertaking a postgraduate biological sciences course. The responses were analysed into themes, based on interpretive concepts. The primary themes revealed improvement in confidence as: confidence in communication, confidence in linking nursing theoretical knowledge to practice and confidence in clinical nursing knowledge. This study highlights the need to privilege clinically-derived nursing knowledge, and that confidence in this nursing knowledge and clinical practice can be instilled through employing the model of theory-guided practice.

  11. Continuous Opinion Dynamics Under Bounded Confidence:. a Survey

    Science.gov (United States)

    Lorenz, Jan

    Models of continuous opinion dynamics under bounded confidence have been presented independently by Krause and Hegselmann and by Deffuant et al. in 2000. They have raised a fair amount of attention in the communities of social simulation, sociophysics and complexity science. The researchers working on it come from disciplines such as physics, mathematics, computer science, social psychology and philosophy. In these models agents hold continuous opinions which they can gradually adjust if they hear the opinions of others. The idea of bounded confidence is that agents only interact if they are close in opinion to each other. Usually, the models are analyzed with agent-based simulations in a Monte Carlo style, but they can also be reformulated on the agent's density in the opinion space in a master equation style. The contribution of this survey is fourfold. First, it will present the agent-based and density-based modeling frameworks including the cases of multidimensional opinions and heterogeneous bounds of confidence. Second, it will give the bifurcation diagrams of cluster configuration in the homogeneous model with uniformly distributed initial opinions. Third, it will review the several extensions and the evolving phenomena which have been studied so far, and fourth it will state some open questions.

  12. Additional diagnostic value of systolic dysfunction induced by dipyridamole stress cardiac magnetic resonance used in detecting coronary artery disease.

    Science.gov (United States)

    Husser, Oliver; Bodí, Vicente; Sanchís, Juan; Mainar, Luis; Núñez, Julio; López-Lereu, María P; Monmeneu, José V; Ruiz, Vicente; Rumiz, Eva; Moratal, David; Chorro, Francisco J; Llácer, Angel

    2009-04-01

    Dipyridamole stress perfusion cardiovascular magnetic resonance (CMR) is used to detect coronary artery disease (CAD). However, few data are available on the diagnostic value of the systolic dysfunction induced by dipyridamole. This study investigated whether the induction of systolic dysfunction supplements the diagnostic information provided by perfusion imaging in the detection of CAD. Overall, 166 patients underwent dipyridamole CMR and quantitative coronary angiography, with CAD being defined as a stenosis > or =70%. Systolic dysfunction at rest, systolic dysfunction with dipyridamole, induced systolic dysfunction, and stress first-pass perfussion deficit (PD) and delayed enhancement were quantified. In the multivariate analysis, PD (hazard ratio [HR]=1.6; 95% confidence interval [CI], 1.33-1.91;Pstatistic for predicting CAD (0.81 vs. 0.87; P=.02). Combining induced systolic dysfunction with perfusion imaging increases the diagnostic accuracy of detecting CAD and enables patients with severe ischemia and a high probability of CAD to be identified.

  13. Plasma Diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Zaveryaev, V [Kurchatov Institute, Moscow (Russian Federation); others, and

    2012-09-15

    The success in achieving peaceful fusion power depends on the ability to control a high temperature plasma, which is an object with unique properties, possibly the most complicated object created by humans. Over years of fusion research a new branch of science has been created, namely plasma diagnostics, which involves knowledge of almost all fields of physics, from electromagnetism to nuclear physics, and up-to-date progress in engineering and technology (materials, electronics, mathematical methods of data treatment). Historically, work on controlled fusion started with pulsed systems and accordingly the methods of plasma parameter measurement were first developed for short lived and dense plasmas. Magnetically confined hot plasmas require the creation of special experimental techniques for diagnostics. The diagnostic set is the most scientifically intensive part of a plasma device. During many years of research operation some scientific tasks have been solved while new ones arose. New tasks often require significant changes in the diagnostic system, which is thus a very flexible part of plasma machines. Diagnostic systems are designed to solve several tasks. As an example here are the diagnostic tasks for the International Thermonuclear Experimental Reactor - ITER: (1) Measurements for machine protection and basic control; (2) Measurements for advanced control; (3) Additional measurements for performance evaluation and physics. Every new plasma machine is a further step along the path to the main goal - controlled fusion - and nobody knows in advance what new phenomena will be met on the way. So in the planning of diagnostic construction we should keep in mind further system upgrading to meet possible new scientific and technical challenges. (author)

  14. Lower Confidence Bounds for the Probabilities of Correct Selection

    Directory of Open Access Journals (Sweden)

    Radhey S. Singh

    2011-01-01

    Full Text Available We extend the results of Gupta and Liang (1998, derived for location parameters, to obtain lower confidence bounds for the probability of correctly selecting the t best populations (PCSt simultaneously for all t=1,…,k−1 for the general scale parameter models, where k is the number of populations involved in the selection problem. The application of the results to the exponential and normal probability models is discussed. The implementation of the simultaneous lower confidence bounds for PCSt is illustrated through real-life datasets.

  15. Metacognitive Confidence Increases with, but Does Not Determine, Visual Perceptual Learning.

    Science.gov (United States)

    Zizlsperger, Leopold; Kümmel, Florian; Haarmeier, Thomas

    2016-01-01

    While perceptual learning increases objective sensitivity, the effects on the constant interaction of the process of perception and its metacognitive evaluation have been rarely investigated. Visual perception has been described as a process of probabilistic inference featuring metacognitive evaluations of choice certainty. For visual motion perception in healthy, naive human subjects here we show that perceptual sensitivity and confidence in it increased with training. The metacognitive sensitivity-estimated from certainty ratings by a bias-free signal detection theoretic approach-in contrast, did not. Concomitant 3Hz transcranial alternating current stimulation (tACS) was applied in compliance with previous findings on effective high-low cross-frequency coupling subserving signal detection. While perceptual accuracy and confidence in it improved with training, there were no statistically significant tACS effects. Neither metacognitive sensitivity in distinguishing between their own correct and incorrect stimulus classifications, nor decision confidence itself determined the subjects' visual perceptual learning. Improvements of objective performance and the metacognitive confidence in it were rather determined by the perceptual sensitivity at the outset of the experiment. Post-decision certainty in visual perceptual learning was neither independent of objective performance, nor requisite for changes in sensitivity, but rather covaried with objective performance. The exact functional role of metacognitive confidence in human visual perception has yet to be determined.

  16. Hilar branching anatomy of living adult liver donors: comparison of T2-MR cholangiography and contrast enhanced T1-MR cholangiography in terms of diagnostic utility

    International Nuclear Information System (INIS)

    Lim, Joon Seok; Kim, Myeong Jin; Kim, Kyung Sik; Kim, Joo Hee; Oh, Young Taik; Kim, Jin Yong; Yoo, Hyung Sik; Lee, Jong Tae; Kim, Ki Whang

    2004-01-01

    To compare T2-weighted MR cholangiography (T2-MRC) and contrast-enhanced T1-weighted MRC (enhanced T1-MRC) in the assessment of biliary anatomy in donor candidates for living related liver transplantation (LRLT). Thirty-three potential donors underwent MR examination for preoperative evaluation. Using the single-shot half-Fourier RARE sequence, T2-weighted single-section and coronal images were obtained, and enhanced T1-MRC was performed, using 3D GRE sequences after the administration of mangafodifir trisodium. To assess the hilar ductal branching pattern and determine diagnostic confidence, two reviewers first evaluated the unpaired T2-MRC and enhanced T1-MRC images, and then paired T2-MRC and enhanced T1-MRC images together. In particular, in 12 cases in which direct cholangiographys were performed, the feasibility of single duct-to-duct anastomosis was assessed using the unpaired and the paired sets sequentially. The reviewers, confidence tended to be higher for enhanced T1-MRC than T2-MRC, but the difference was not statistically significant. For both reviewers, confidence was significantly higher for the paired set than for T2- or enhanced T1-MRC alone (p<0.001). The types of biliary anatomy determined in the paired set matched the consensus reading in 33 (100%) and 30 cases(91%) assessed by reviewer 1 and 2, respectively. The separate interpretation of T2- and enhanced T1-MRC findings matched the consensus interpretation in 30 (91%) and 28 cases (85%), respectively, assessed by reviewer 1, and 26 (79%) and 28 cases (85%), respectively, assessed by reviewer 2. The possibility of single anastomosis was accurately predicted in 91.6% of cases in T2-MRC, and 100% at enhanced T1-MRC and the combined set. In the evaluation of the biliary anatomy of potential donors for LRLT, the combined use of T2-MRC and enhanced T1-MRC may improve diagnostic confidence and decrease the occurrence of a non diagnostic or equivocal interpretation at T2-MRC alone

  17. Tourette and tic disorders in ICD-11: standing at the diagnostic crossroads

    Directory of Open Access Journals (Sweden)

    Douglas W. Woods

    2014-01-01

    Full Text Available This article reflects discussion by the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders. After reviewing the historical classification of tic disorders, this article discusses their placement in ICD-11. Existing problems with diagnostic labels and criteria, appropriate placement of the tic disorders category within the ICD-11 system, and pragmatic factors affecting classification are reviewed. The article ends with recommendations to (a maintain consistency with the DSM-5 diagnostic labels for tic disorders, (b add a minimum duration guideline for a provisional tic disorder diagnosis, (c remove the multiple motor tic guideline for the diagnosis of Tourette disorder, and (d co-parent the tic disorder diagnoses in the disorders of the nervous system and the mental and behavioral disorders categories, with secondary co-parenting in the obsessive-compulsive and related disorders and neurodevelopmental disorders sections.

  18. Confidence-building measures in the Asia-Pacific region

    International Nuclear Information System (INIS)

    Qin Huasun

    1991-01-01

    The regional confidence-building, security and disarmament issues in the Asia-Pacific region, and in particular, support to non-proliferation regime and establishing nuclear-weapon-free zones are reviewed

  19. Integrated control and diagnostic system architectures for future installations

    International Nuclear Information System (INIS)

    Wood, R.; March-Leuba, J.

    2000-01-01

    Nuclear reactors of the 21st century will employ increasing levels of automation and fault tolerance to increase availability, reduce accident risk, and lower operating costs. Key developments in control algorithms, fault diagnostics, fault tolerance, and distributed communications are needed to implement the fully automated plant. It will be equally challenging to integrate developments in separate information and control fields into a cohesive system, which collectively achieves the overall goals of improved safety, reliability, maintainability, and cost-effectiveness. Under the Nuclear Energy Research Initiative (NERI), the US Department of Energy is sponsoring a project to address some of the technical issues involved in meeting the long-range goal of 21st century reactor control systems. This project involves researchers from Oak Ridge National Laboratory, the University of Tennessee, and North Carolina State University. The research tasks under this project focus on some of the first-level breakthroughs in control design, diagnostic techniques, and information system design that will provide a path to enable the design process to be automated in the future. This paper describes the conceptual development of an integrated nuclear plant control and information system architecture, which incorporates automated control system development that can be traced to a set of technical requirements. The expectation is that an integrated plant architecture with optimal control and efficient use of diagnostic information can reduce the potential for operational errors and minimize challenges to the plant safety systems

  20. Guide to Operating and Maintaining EnergySmart Schools

    Energy Technology Data Exchange (ETDEWEB)

    None

    2010-01-01

    Through a commitment to high performance, school districts are discovering that smart energy choices can create lasting benefits for students, communities, and the environment. For example, an energy efficient school district with 4,000 students can save as much as $160,000 a year in energy costs. Over 10 years, those savings can reach $1.6 million, translating into the ability to hire more teachers, purchase more textbooks and computers, or invest in additional high performance facilities. Beyond these bottomline benefits, schools can better foster student health, decrease absenteeism, and serve as centers of community life. The U.S. Department of Energy's EnergySmart Schools Program promotes a 30 percent improvement in existing school energy use. It also encourages the building of new schools that exceed code (ASHRAE 90.11999) by 50 percent or more. The program provides resources like this Guide to Operating and Maintaining EnergySmart Schools to assist school decisionmakers in planning, financing, operating, and maintaining energy efficient, high performance schools. It also offers education and training for building industry professionals. Operations and maintenance refer to all scheduled and unscheduled actions for preventing equipment failure or decline with the goal of increasing efficiency, reliability, and safety. A preventative maintenance program is the organized and planned performance of maintenance activities in order to prevent system or production problems or failures from occurring. In contrast, deferred maintenance or reactive maintenance (also called diagnostic or corrective maintenance) is conducted to address an existing problem. This guide is a primary resource for developing and implementing a districtor schoolwide operations and maintenance (O&M) program that focuses on energy efficiency. The EnergySmart Schools Solutions companion CD contains additional supporting information for design, renovation, and retrofit projects. The objective

  1. Empowerment as Interactions that Generate Self-Confidence

    DEFF Research Database (Denmark)

    Poder, Poul

    2010-01-01

    to address this gap in understanding by theorizing how confidence and other positive emotions contribute to personal agency, which is an essential aspect of the empowerment process.                       It is generally understood that confidence – meaning faith in oneself as opposed to conceit or arrogance...... by particular social interactions that promote recognition and access to relevant resources for action. Drawing on emotion-focused sociological theory about agency and emotional energy, and Fredrickson’s ‘build and broaden’ theory of positive emotions, I argue that the focus on consciousness and intentionality...... as the defining features of human agency has led us to downplay the fact that agency is primarily an emotional phenomenon. As such, it is also dynamic and situational, since it is highly dependent on interactions that engender emotional energy and positive emotions that fuel and widen agency. As an example...

  2. 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.

  3. Introduction of cryobiopsies in the diagnostics of interstitial lung diseases - experiences in a referral center

    DEFF Research Database (Denmark)

    Kronborg-White, Sissel; Folkersen, Birgitte; Rasmussen, Torben Riis

    2017-01-01

    Introduction: Transbronchial cryobiopsies (cTBB) has emerged as a new method for obtaining lung tissue biopsies in the diagnosis of interstitial lung diseases (ILDs). Until now, it has been used in a few highly specialized interventional centers and has shown promising results in obtaining a defi...... bleeding occurred during the procedure and was easily controlled by a Fogarty catheter balloon and in some cases tranexamic acid. Conclusion: Performing cTBB in the diagnostics of ILDs is a safe and feasible procedure. cTBB resulted in a confident diagnosis in 74% of cases....

  4. Diagnostic value of [18F] FDG-PET and PET/CT in urinary bladder cancer: a meta-analysis.

    Science.gov (United States)

    Zhang, Huojun; Xing, Wei; Kang, Qinqin; Chen, Chao; Wang, Linhui; Lu, Jianping

    2015-05-01

    An early diagnosis of urinary bladder cancer is crucial for early treatment and management. The objective of this systematic review was to assess the overall diagnostic accuracy of 18 F FDG-PET and PET/CT in urinary bladder cancer with meta-analysis. The PubMed and CNKI databases were searched for the eligible studies published up to June 01, 2014. The sensitivity, specificity, and other measures of accuracy of 18 F FDG-PET and PET/CT in the diagnosis of urinary bladder cancer were pooled along with 95 % confidence intervals (CI). Summary receiver operating characteristic (ROC) curves were used to summarize overall test performance. Ten studies met our inclusion criteria. The summary estimates for 18 F FDG-PET and PET/CT in the diagnosis of urinary bladder cancer in meta-analysis were as follows: a pooled sensitivity, 0.82 (95 % confidence interval [CI], 0.75 to 0.88); a pooled specificity, 0.92 (95 % CI, 0.87 to 0.95); positive likelihood ratio, 6.80 (95 % CI, 4.31 to 10.74); negative likelihood ratio, 0.27 (95 % CI, 0.19 to 0.36); and diagnostic odds ratio, 25.18 (95 % CI, 17.58 to 70.4). The results indicate that 18 F FDG-PET and PET/CT are relatively high sensitive and specific for the diagnosis of urinary bladder cancer.

  5. Developing and maintaining nuclear competencies

    International Nuclear Information System (INIS)

    Gobert, C.

    2004-01-01

    The paper discusses the following aspects on the nuclear knowledge management: assimilation of knowledge management, recognition of the nuclear specificity, attracting young talents. Another feature which, possibly, differentiates nuclear from other high-tech industries is that time constraints in some nuclear development may very well exceed the duration of a generation of professionals. That means, not only maintaining scientific and technical knowledge, which, as a minimum, leads to maintain: a rigorous supervision of human resources in quality and quantity; anticipatory planning of human resources, with a special focus on succession planning concerning expertise positions; a steady and continuous effort in training and retraining programs. Maintaining the safety culture is also one of the major managerial duties. Taking full account of the nuclear specificity in knowledge maintenance and development in the AREVA group, requests a multifunctional approach, which combines efforts of Research and Innovation, and Human Resources departments, plus the group Nuclear inspectorate. It is acknowledged that the industry, basically, would readily rely on the capabilities of the academic world and research centers in ensuring that training and education in nuclear science and technologies are attuned to the evolving needs of the industry, in maintaining the proper educational programs and in fostering fruitful cooperations between them

  6. The confidence of speech-language pathology students regarding communicating with people with aphasia

    Science.gov (United States)

    2013-01-01

    Background Aphasia is an acquired language disorder that can present a significant barrier to patient involvement in healthcare decisions. Speech-language pathologists (SLPs) are viewed as experts in the field of communication. However, many SLP students do not receive practical training in techniques to communicate with people with aphasia (PWA) until they encounter PWA during clinical education placements. Methods This study investigated the confidence and knowledge of SLP students in communicating with PWA prior to clinical placements using a customised questionnaire. Confidence in communicating with people with aphasia was assessed using a 100-point visual analogue scale. Linear, and logistic, regressions were used to examine the association between confidence and age, as well as confidence and course type (graduate-entry masters or undergraduate), respectively. Knowledge of strategies to assist communication with PWA was examined by asking respondents to list specific strategies that could assist communication with PWA. Results SLP students were not confident with the prospect of communicating with PWA; reporting a median 29-points (inter-quartile range 17–47) on the visual analogue confidence scale. Only, four (8.2%) of respondents rated their confidence greater than 55 (out of 100). Regression analyses indicated no relationship existed between confidence and students‘ age (p = 0.31, r-squared = 0.02), or confidence and course type (p = 0.22, pseudo r-squared = 0.03). Students displayed limited knowledge about communication strategies. Thematic analysis of strategies revealed four overarching themes; Physical, Verbal Communication, Visual Information and Environmental Changes. While most students identified potential use of resources (such as images and written information), fewer students identified strategies to alter their verbal communication (such as reduced speech rate). Conclusions SLP students who had received aphasia related

  7. The confidence of speech-language pathology students regarding communicating with people with aphasia.

    Science.gov (United States)

    Finch, Emma; Fleming, Jennifer; Brown, Kyla; Lethlean, Jennifer; Cameron, Ashley; McPhail, Steven M

    2013-06-27

    Aphasia is an acquired language disorder that can present a significant barrier to patient involvement in healthcare decisions. Speech-language pathologists (SLPs) are viewed as experts in the field of communication. However, many SLP students do not receive practical training in techniques to communicate with people with aphasia (PWA) until they encounter PWA during clinical education placements. This study investigated the confidence and knowledge of SLP students in communicating with PWA prior to clinical placements using a customised questionnaire. Confidence in communicating with people with aphasia was assessed using a 100-point visual analogue scale. Linear, and logistic, regressions were used to examine the association between confidence and age, as well as confidence and course type (graduate-entry masters or undergraduate), respectively. Knowledge of strategies to assist communication with PWA was examined by asking respondents to list specific strategies that could assist communication with PWA. SLP students were not confident with the prospect of communicating with PWA; reporting a median 29-points (inter-quartile range 17-47) on the visual analogue confidence scale. Only, four (8.2%) of respondents rated their confidence greater than 55 (out of 100). Regression analyses indicated no relationship existed between confidence and students' age (p = 0.31, r-squared = 0.02), or confidence and course type (p = 0.22, pseudo r-squared = 0.03). Students displayed limited knowledge about communication strategies. Thematic analysis of strategies revealed four overarching themes; Physical, Verbal Communication, Visual Information and Environmental Changes. While most students identified potential use of resources (such as images and written information), fewer students identified strategies to alter their verbal communication (such as reduced speech rate). SLP students who had received aphasia related theoretical coursework, but not commenced clinical placements

  8. Hitting emissions targets with (statistical) confidence in multi-instrument Emissions Trading Schemes

    International Nuclear Information System (INIS)

    Shipworth, David

    2003-12-01

    A means of assessing, monitoring and controlling aggregate emissions from multi-instrument Emissions Trading Schemes is proposed. The approach allows contributions from different instruments with different forms of emissions targets to be integrated. Where Emissions Trading Schemes are helping to meet specific national targets, the approach allows the entry requirements of new participants to be calculated and set at a level that will achieve these targets. The approach is multi-levelled, and may be extended downwards to support pooling of participants within instruments, or upwards to embed Emissions Trading Schemes within a wider suite of policies and measures with hard and soft targets. Aggregate emissions from each instrument are treated stochastically. Emissions from the scheme as a whole are then the joint probability distribution formed by integrating the emissions from its instruments. Because a Bayesian approach is adopted, qualitative and semi-qualitative data from expert opinion can be used where quantitative data is not currently available, or is incomplete. This approach helps government retain sufficient control over emissions trading scheme targets to allow them to meet their emissions reduction obligations, while minimising the need for retrospectively adjusting existing participants' conditions of entry. This maintains participant confidence, while providing the necessary policy levers for good governance

  9. The relationship between fundamental movement skill proficiency and physical self-confidence among adolescents.

    Science.gov (United States)

    McGrane, Bronagh; Belton, Sarahjane; Powell, Danielle; Issartel, Johann

    2017-09-01

    This study aims to assess fundamental movement skill (FMS) proficiency, physical self-confidence levels, and the relationship between these variables and gender differences among adolescents. Three hundred and ninety five adolescents aged 13.78 years (SD = ±1.2) from 20 schools were involved in this study. The Test of Gross Motor Development-2nd Edition (TGMD), TGMD-2 and Victorian Skills Manual were used to assess 15 FMS. Participants' physical self-confidence was also assessed using a valid skill-specific scale. A significant correlation was observed between FMS proficiency and physical self-confidence for females only (r = 0.305, P < 0.001). Males rated themselves as having significantly higher physical self-confidence levels than females (P = 0.001). Males scored significantly higher than females in FMS proficiency (P < 0.05), and the lowest physical self-confidence group were significantly less proficient at FMS than the medium (P < 0.001) and high physical self-confidence groups (P < 0.05). This information not only highlights those in need of assistance to develop their FMS but will also facilitate in the development of an intervention which aims to improve physical self-confidence and FMS proficiency.

  10. Diagnostic utility of Montreal Cognitive Assessment in the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders: major and mild neurocognitive disorders.

    Science.gov (United States)

    Liew, Tau Ming; Feng, Lei; Gao, Qi; Ng, Tze Pin; Yap, Philip

    2015-02-01

    The Montreal Cognitive Assessment (MOCA) is a screening tool for mild cognitive impairment (MCI) and dementia. The new criteria for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) mild neurocognitive disorder (NCD) define participants with cognitive decline but no dementia, and major NCD (dementia). We explored the usefulness of MOCA to detect major and mild NCD. Cross-sectional test research. Tertiary hospital memory clinic and community-based Singapore Longitudinal Aging Study (SLAS). Participants with questionable dementia (clinical dementia rating, CDR = 0.5) and early dementia (CDR ≤1) over a period of 1 year were identified from the memory clinic registry. The patient records were reviewed and the diagnostic labels of major and mild NCD were applied accordingly. Healthy controls (HC) (CDR = 0, Mini-Mental State Examination >26) were recruited from the on-going SLAS. Major and mild NCD were diagnosed based on medical history, clinical examination, basic and instrumental activities of daily living, locally validated bedside cognitive tests (Mini-Mental State Examination, Frontal Assessment Battery, and Clock Drawing Test), relevant laboratory investigations and standardized neuropsychological assessment. Two hundred fifty-one participants were included (41 mild NCD, 64 major NCD, 146 HC). On receiver operating characteristic curve analysis, the diagnostic performance by area under the curve (AUC) for MOCA was 0.99 [95% confidence interval (CI) 0.98-1.0] for major NCD and 0.77 (95% CI 0.67-0.86) for mild NCD. For diagnosis of mild NCD, MOCA performed better in those with lower education (primary and below) (AUC 0.90) compared with those with secondary education and beyond (AUC 0.66). MOCA has high diagnostic utility for major NCD but its usefulness in detecting mild NCD is more modest. Possible reasons include greater heterogeneity in participants with mild NCD and how "quantified clinical assessment" in the DSM-5 mild NCD criteria

  11. Coefficient Omega Bootstrap Confidence Intervals: Nonnormal Distributions

    Science.gov (United States)

    Padilla, Miguel A.; Divers, Jasmin

    2013-01-01

    The performance of the normal theory bootstrap (NTB), the percentile bootstrap (PB), and the bias-corrected and accelerated (BCa) bootstrap confidence intervals (CIs) for coefficient omega was assessed through a Monte Carlo simulation under conditions not previously investigated. Of particular interests were nonnormal Likert-type and binary items.…

  12. A National Survey of Music Education Majors' Confidence in Teaching Improvisation

    Science.gov (United States)

    Bernhard, H. Christian, II.; Stringham, David A.

    2016-01-01

    The purpose of the study was to investigate undergraduate music education majors' confidence in teaching improvisation, according to the NAfME (1994) K-12 Achievement Standards. Specific research questions were: 1) How confident are music education majors in implementing the 11 improvisation achievement standards for grades K-12? 2) How confident…

  13. Sympathetically maintained pain presenting first as temporomandibular disorder, then as parotid dysfunction.

    Science.gov (United States)

    Giri, Subha; Nixdorf, Donald

    2007-03-01

    Complex regional pain syndrome (CRPS) is a chronic condition characterized by intense pain, swelling, redness, hypersensitivity and additional sudomotor effects. In all 13 cases of CRPS in the head and neck region reported in the literature, nerve injury was identified as the etiology for pain initiation. In this article, we present the case of a 30-year-old female patient with sympathetically maintained pain without apparent nerve injury. Her main symptoms--left-side preauricular pain and inability to open her mouth wide--mimicked temporomandibular joint arthralgia and myofascial pain of the masticatory muscles. Later, symptoms of intermittent preauricular pain and swelling developed, along with hyposalivation, which mimicked parotitis. After an extensive diagnostic process, no definitive underlying pathology could be identified and a diagnosis of neuropathic pain with a prominent sympathetic component was made. Two years after the onset of symptoms and initiation of care, treatment with repeated stellate ganglion blocks and enteral clonidine pharmacotherapy provided adequate pain relief.

  14. Confidence Limits for the Indirect Effect: Distribution of the Product and Resampling Methods

    Science.gov (United States)

    MacKinnon, David P.; Lockwood, Chondra M.; Williams, Jason

    2010-01-01

    The most commonly used method to test an indirect effect is to divide the estimate of the indirect effect by its standard error and compare the resulting z statistic with a critical value from the standard normal distribution. Confidence limits for the indirect effect are also typically based on critical values from the standard normal distribution. This article uses a simulation study to demonstrate that confidence limits are imbalanced because the distribution of the indirect effect is normal only in special cases. Two alternatives for improving the performance of confidence limits for the indirect effect are evaluated: (a) a method based on the distribution of the product of two normal random variables, and (b) resampling methods. In Study 1, confidence limits based on the distribution of the product are more accurate than methods based on an assumed normal distribution but confidence limits are still imbalanced. Study 2 demonstrates that more accurate confidence limits are obtained using resampling methods, with the bias-corrected bootstrap the best method overall. PMID:20157642

  15. Diagnostic outcome following routine genetics clinic referral for the assessment of global developmental delay.

    LENUS (Irish Health Repository)

    Shahdadpuri, R

    2012-02-01

    The aim of this study was to ascertain the diagnostic yield following a routine genetics clinic referral for the assessment of global developmental delay. Detailed retrospective review of 119 complete consecutive case notes of patients referred to one single clinical geneticist over a 14 month time period was undertaken (n = 119; 54 males, 65 females). The age at initial review ranged from 2 months to 37 years 3 months (mean 8 y 3 mo [SD 7 y 10 mo]). We made a diagnosis in 36\\/119 (30%); 21\\/36 were new diagnoses and 15\\/36 were confirmations of diagnoses. We removed a wrong diagnostic label in 8\\/119 (7%). In 3\\/8 we were able to achieve a diagnosis but in 5\\/8 no alternative diagnosis was reached. We had a better diagnostic rate where the patients were dysmorphic (odds ratio [OR] 1.825; 95% confidence interval [CI] 1.065 to 3.128, p = 0.044). In the majority, the diagnosis was made by clinical examination only. Molecular diagnosis was reached in seven cases. Five cases were confirmed by cytogenetic analysis. Brain magnetic resonance imaging (MRI) revealed a diagnosis in three cases. This study confirms the importance of a clinical genetics assessment in the investigation of global developmental delay.

  16. The diagnostic value of the Clarke sign in assessing chondromalacia patella.

    Science.gov (United States)

    Doberstein, Scott T; Romeyn, Richard L; Reineke, David M

    2008-01-01

    Various techniques have been described for assessing conditions that cause pain at the patellofemoral (PF) joint. The Clarke sign is one such test, but the diagnostic value of this test in assessing chondromalacia patella is unknown. To (1) investigate the diagnostic value of the Clarke sign in assessing the presence of chondromalacia patella using arthroscopic examination of the PF joint as the "gold standard," and (2) provide a historical perspective of the Clarke sign as a clinical diagnostic test. Validation study. All patients of one of the investigators who had knee pain or injuries unrelated to the patellofemoral joint and were scheduled for arthroscopic surgery were recruited for this study. A total of 106 otherwise healthy individuals with no history of patellofemoral pain or dysfunction volunteered. The Clarke sign was performed on the surgical knee by a single investigator in the clinic before surgery. A positive test was indicated by the presence of pain sufficient to prevent the patient from maintaining a quadriceps muscle contraction against manual resistance for longer than 2 seconds. The preoperative result was compared with visual evidence of chondromalacia patella during arthroscopy. Sensitivity was 0.39, specificity was 0.67, likelihood ratio for a positive test was 1.18, likelihood ratio for a negative test was 0.91, positive predictive value was 0.25, and negative predictive value was 0.80. Diagnostic validity values for the use of the Clarke sign in assessing chondromalacia patella were unsatisfactory, supporting suggestions that it has poor diagnostic value as a clinical examination technique. Additionally, an extensive search of the available literature for the Clarke sign reveals multiple problems with the test, causing significant confusion for clinicians. Therefore, the use of the Clarke sign as a routine part of a knee examination is not beneficial, and its use should be discontinued.

  17. Globalization of consumer confidence

    Directory of Open Access Journals (Sweden)

    Çelik Sadullah

    2017-01-01

    Full Text Available The globalization of world economies and the importance of nowcasting analysis have been at the core of the recent literature. Nevertheless, these two strands of research are hardly coupled. This study aims to fill this gap through examining the globalization of the consumer confidence index (CCI by applying conventional and unconventional econometric methods. The US CCI is used as the benchmark in tests of comovement among the CCIs of several developing and developed countries, with the data sets divided into three sub-periods: global liquidity abundance, the Great Recession, and postcrisis. The existence and/or degree of globalization of the CCIs vary according to the period, whereas globalization in the form of coherence and similar paths is observed only during the Great Recession and, surprisingly, stronger in developing/emerging countries.

  18. Pediatrics Residents' Confidence and Performance Following a Longitudinal Quality Improvement Curriculum.

    Science.gov (United States)

    Courtlandt, Cheryl; Noonan, Laura; Koricke, Maureen Walsh; Zeskind, Philip Sanford; Mabus, Sarah; Feld, Leonard

    2016-02-01

    Quality improvement (QI) training is an integral part of residents' education. Understanding the educational value of a QI curriculum facilitates understanding of its impact. The purpose of this study was to evaluate the effects of a longitudinal QI curriculum on pediatrics residents' confidence and competence in the acquisition and application of QI knowledge and skills. Three successive cohorts of pediatrics residents (N = 36) participated in a longitudinal curriculum designed to increase resident confidence in QI knowledge and skills. Key components were a succession of progressive experiential projects, QI coaching, and resident team membership culminating in leadership of the project. Residents completed precurricular and postcurricular surveys and demonstrated QI competence by performance on the pediatric QI assessment scenario. Residents participating in the Center for Advancing Pediatric Excellence QI curriculum showed significant increases in pre-post measures of confidence in QI knowledge and skills. Coaching and team leadership were ranked by resident participants as having the most educational value among curriculum components. A pediatric QI assessment scenario, which correlated with resident-perceived confidence in acquisition of QI skills but not QI knowledge, is a tool available to test pediatrics residents' QI knowledge. A 3-year longitudinal, multimodal, experiential QI curriculum increased pediatrics residents' confidence in QI knowledge and skills, was feasible with faculty support, and was well-accepted by residents.

  19. Estimation and interpretation of keff confidence intervals in MCNP

    International Nuclear Information System (INIS)

    Urbatsch, T.J.

    1995-11-01

    MCNP's criticality methodology and some basic statistics are reviewed. Confidence intervals are discussed, as well as how to build them and their importance in the presentation of a Monte Carlo result. The combination of MCNP's three k eff estimators is shown, theoretically and empirically, by statistical studies and examples, to be the best k eff estimator. The method of combining estimators is based on a solid theoretical foundation, namely, the Gauss-Markov Theorem in regard to the least squares method. The confidence intervals of the combined estimator are also shown to have correct coverage rates for the examples considered

  20. Confidence limits for small numbers of events in astrophysical data

    Science.gov (United States)

    Gehrels, N.

    1986-01-01

    The calculation of limits for small numbers of astronomical counts is based on standard equations derived from Poisson and binomial statistics; although the equations are straightforward, their direct use is cumbersome and involves both table-interpolations and several mathematical operations. Convenient tables and approximate formulae are here presented for confidence limits which are based on such Poisson and binomial statistics. The limits in the tables are given for all confidence levels commonly used in astrophysics.

  1. Learning style and confidence: an empirical investigation of Japanese employees

    OpenAIRE

    Yoshitaka Yamazaki

    2012-01-01

    This study aims to examine how learning styles relate to employees' confidence through a view of Kolb's experiential learning theory. For this aim, an empirical investigation was conducted using the sample of 201 Japanese employees who work for a Japanese multinational corporation. Results illustrated that the learning style group of acting orientation described a significantly higher level of job confidence than that of reflecting orientation, whereas the two groups of feeling and thinking o...

  2. Evaluating Measures of Optimism and Sport Confidence

    Science.gov (United States)

    Fogarty, Gerard J.; Perera, Harsha N.; Furst, Andrea J.; Thomas, Patrick R.

    2016-01-01

    The psychometric properties of the Life Orientation Test-Revised (LOT-R), the Sport Confidence Inventory (SCI), and the Carolina SCI (CSCI) were examined in a study involving 260 athletes. The study aimed to test the dimensional structure, convergent and divergent validity, and invariance over competition level of scores generated by these…

  3. Current Developments in Measuring Academic Behavioural Confidence

    Science.gov (United States)

    Sander, Paul

    2009-01-01

    Using published findings and by further analyses of existing data, the structure, validity and utility of the Academic Behavioural Confidence scale (ABC) is critically considered. Validity is primarily assessed through the scale's relationship with other existing scales as well as by looking for predicted differences. The utility of the ABC scale…

  4. Companion diagnostics

    DEFF Research Database (Denmark)

    Jørgensen, Jan Trøst; Hersom, Maria

    2016-01-01

    of disease mechanisms, things are slowly changing. Within the last few years, we have seen an increasing number of predictive biomarker assays being developed to guide the use of targeted cancer drugs. This type of assay is called companion diagnostics and is developed in parallel to the drug using the drug-diagnostic...... co-development model. The development of companion diagnostics is a relatively new discipline and in this review, different aspects will be discussed including clinical and regulatory issues. Furthermore, examples of drugs, such as the ALK and PD-1/PD-L1 inhibitors, that have been approved recently....... Despite having discussed personalized medicine for more than a decade, we still see that most drug prescriptions for severe chronic diseases are largely based on 'trial and error' and not on solid biomarker data. However, with the advance of molecular diagnostics and a subsequent increased understanding...

  5. A pilot study using laser-based technique for non-invasive diagnostics of hypertensive conditions in mice

    Science.gov (United States)

    Litvinova, Karina S.; Ahmad, Shakil; Wang, Keqing; Rafailov, Ilya E.; Sokolovski, Sergei G.; Zhang, Lin; Rafailov, Edik U.; Ahmed, Asif

    2016-02-01

    Endothelial dysfunction is directly linked to preeclampsia, a maternal hypertensive condition that is life threating for both the mother and the baby. Epidemiological studies show that women with a history of pre-eclampsia have an elevated risk for cardiovascular disease. Here we report a new non-invasive diagnostic test for preeclampsia in mice that allows us to non-invasively assess the condition of the animals during the experiment and treatment in established models of preeclampsia. A laser-based multifunctional diagnostics system (LAKK-M) was chosen to carry out non-invasive analysis of multiple parameters. The device was used to simultaneously record the microcirculatory blood flow and oxygen saturation, as well as fluorescence levels of endogenous fluorophores. Preliminary experiments were conducted on adenoviral (Ad-)- mediated overexpression of sFlt-1 (Ad-sFlt-1) to mimic preeclampsialike symptoms in mice. The recorded data displayed the ability of the LAKK-M diagnostics device to detect significant differences in perfusion measurements between the control and Ad-sFlt-1 treatment. Preliminary results provide a potential avenue to employ these diagnostics technology to monitor and aid in maintaining control of live animal conditions throughout the experiment and treatment.

  6. Understanding Confidence Intervals With Visual Representations

    OpenAIRE

    Navruz, Bilgin; Delen, Erhan

    2014-01-01

    In the present paper, we showed how confidence intervals (CIs) are valuable and useful in research studies when they are used in the correct form with correct interpretations. The sixth edition of the APA (2010) Publication Manual strongly recommended reporting CIs in research studies, and it was described as “the best reporting strategy” (p. 34). Misconceptions and correct interpretations of CIs were presented from several textbooks. In addition, limitations of the null hypothesis statistica...

  7. Status of the CNESM diagnostic for SPIDER

    International Nuclear Information System (INIS)

    Muraro, A.; Croci, G.; Albani, G.; Cazzaniga, C.; Claps, G.; Cavenago, M.; Grosso, G.; Palma, M. Dalla; Fincato, M.; Murtas, F.; Pasqualotto, R.; Cippo, E. Perelli; Rebai, M.; Tollin, M.; Tardocchi, M.; Gorini, G.

    2015-01-01

    Highlights: • We have finished the design of the detector box of the CNESM diagnostic for SPIDER. • We have constructed the GEM detector of the CNESM detector for SPIDER. • We have tested the detector under fast neutron irradiation. - Abstract: The ITER neutral beam test facility under construction in Padova will host two experimental devices: SPIDER, a 100 kV negative H/D RF source, and MITICA, a full scale, 1 MeV deuterium beam injector. A detection system called close-contact neutron emission surface mapping (CNESM) is under development with the aim to resolve the horizontal beam intensity profile in MITICA and one of the eight beamlet groups in SPIDER, with a spatial resolution of 1.5 and 2.5 cm respectively. This is achieved by the evaluation of the map of the neutron emission due to interaction of the deuterium beam with the deuterons implanted in the beam dump surface. CNESM uses nGEM detectors, i.e. GEM detectors equipped with a cathode that also serves as neutron–proton converter foil. The diagnostic will be placed right behind the SPIDER and MITICA beam dump, i.e. in an UHV environment, but the nGEM detectors need to operate at atmospheric pressure: in order to maintain the detector at atmospheric pressure, a vacuum sealed box, that will be mounted inside the vacuum, has been designed. The box design was driven by the need to minimize the neutron attenuation and the distance between the beam dump surface and the detector active area. This paper presents the status of the CNESM diagnostic describing the design of the detector, the design of the sealed box and reporting the results obtained with the first full-size prototype under fast neutron irradiation.

  8. Space maintainers in dentistry: past to present.

    Science.gov (United States)

    Setia, Vikas; Pandit, Inder Kumar; Srivastava, Nikhil; Gugnani, Neeraj; Sekhon, Harveen Kaur

    2013-10-01

    Early orthodontic interventions are often initiated in the developing dentition to promote favourable developmental changes. Interceptive orthodontic can eliminate or reduce the severity of a developing malocclusion, the complexity of orthodontic treatment, overall treatment time and cost. The safest way to prevent future malocclusions from tooth loss is to place a space maintainer that is effective and durable. An appropriate use of space maintainer is advocated to hold the space until the eruption of permanent teeth. This case report describes the various changing trends in use of space maintainers: conventional band and loop, prefabricated band with custom made loop and glass fibre reinforced composite resins as space maintainers.

  9. Beyond Diagnostic Accuracy: The Clinical Utility of Diagnostic Tests

    NARCIS (Netherlands)

    Bossuyt, Patrick M. M.; Reitsma, Johannes B.; Linnet, Kristian; Moons, Karel G. M.

    2012-01-01

    Like any other medical technology or intervention, diagnostic tests should be thoroughly evaluated before their introduction into daily practice. Increasingly, decision makers, physicians, and other users of diagnostic tests request more than simple measures of a test's analytical or technical

  10. Confidence Testing for Knowledge-Based Global Communities

    Science.gov (United States)

    Jack, Brady Michael; Liu, Chia-Ju; Chiu, Houn-Lin; Shymansky, James A.

    2009-01-01

    This proposal advocates the position that the use of confidence wagering (CW) during testing can predict the accuracy of a student's test answer selection during between-subject assessments. Data revealed female students were more favorable to taking risks when making CW and less inclined toward risk aversion than their male counterparts. Student…

  11. Electronic Health Record-Driven Workflow for Diagnostic Radiologists.

    Science.gov (United States)

    Geeslin, Matthew G; Gaskin, Cree M

    2016-01-01

    In most settings, radiologists maintain a high-throughput practice in which efficiency is crucial. The conversion from film-based to digital study interpretation and data storage launched the era of PACS-driven workflow, leading to significant gains in speed. The advent of electronic health records improved radiologists' access to patient data; however, many still find this aspect of workflow to be relatively cumbersome. Nevertheless, the ability to guide a diagnostic interpretation with clinical information, beyond that provided in the examination indication, can add significantly to the specificity of a radiologist's interpretation. Responsibilities of the radiologist include, but are not limited to, protocoling examinations, interpreting studies, chart review, peer review, writing notes, placing orders, and communicating with referring providers. Most of the aforementioned activities are not PACS-centric and require a login to one or more additional applications. Consolidation of these tasks for completion through a single interface can simplify workflow, save time, and potentially reduce the incidence of errors. Here, the authors describe diagnostic radiology workflow that leverages the electronic health record to significantly add to a radiologist's ability to be part of the health care team, provide relevant interpretations, and improve efficiency and quality. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  12. Planning an Availability Demonstration Test with Consideration of Confidence Level

    Directory of Open Access Journals (Sweden)

    Frank Müller

    2017-08-01

    Full Text Available The full service life of a technical product or system is usually not completed after an initial failure. With appropriate measures, the system can be returned to a functional state. Availability is an important parameter for evaluating such repairable systems: Failure and repair behaviors are required to determine this availability. These data are usually given as mean value distributions with a certain confidence level. Consequently, the availability value also needs to be expressed with a confidence level. This paper first highlights the bootstrap Monte Carlo simulation (BMCS for availability demonstration and inference with confidence intervals based on limited failure and repair data. The BMCS enables point-, steady-state and average availability to be determined with a confidence level based on the pure samples or mean value distributions in combination with the corresponding sample size of failure and repair behavior. Furthermore, the method enables individual sample sizes to be used. A sample calculation of a system with Weibull-distributed failure behavior and a sample of repair times is presented. Based on the BMCS, an extended, new procedure is introduced: the “inverse bootstrap Monte Carlo simulation” (IBMCS to be used for availability demonstration tests with consideration of confidence levels. The IBMCS provides a test plan comprising the required number of failures and repair actions that must be observed to demonstrate a certain availability value. The concept can be applied to each type of availability and can also be applied to the pure samples or distribution functions of failure and repair behavior. It does not require special types of distribution. In other words, for example, a Weibull, a lognormal or an exponential distribution can all be considered as distribution functions of failure and repair behavior. After presenting the IBMCS, a sample calculation will be carried out and the potential of the BMCS and the IBMCS

  13. Evaluating online diagnostic decision support tools for the clinical setting.

    Science.gov (United States)

    Pryor, Marie; White, David; Potter, Bronwyn; Traill, Roger

    2012-01-01

    Clinical decision support tools available at the point of care are an effective adjunct to support clinicians to make clinical decisions and improve patient outcomes. We developed a methodology and applied it to evaluate commercially available online clinical diagnostic decision support (DDS) tools for use at the point of care. We identified 11 commercially available DDS tools and assessed these against an evaluation instrument that included 6 categories; general information, content, quality control, search, clinical results and other features. We developed diagnostically challenging clinical case scenarios based on real patient experience that were commonly missed by junior medical staff. The evaluation was divided into 2 phases; an initial evaluation of all identified and accessible DDS tools conducted by the Clinical Information Access Portal (CIAP) team and a second phase that further assessed the top 3 tools identified in the initial evaluation phase. An evaluation panel consisting of senior and junior medical clinicians from NSW Health conducted the second phase. Of the eleven tools that were assessed against the evaluation instrument only 4 tools completely met the DDS definition that was adopted for this evaluation and were able to produce a differential diagnosis. From the initial phase of the evaluation 4 DDS tools scored 70% or more (maximum score 96%) for the content category, 8 tools scored 65% or more (maximum 100%) for the quality control category, 5 tools scored 65% or more (maximum 94%) for the search category, and 4 tools score 70% or more (maximum 81%) for the clinical results category. The second phase of the evaluation was focused on assessing diagnostic accuracy for the top 3 tools identified in the initial phase. Best Practice ranked highest overall against the 6 clinical case scenarios used. Overall the differentiating factor between the top 3 DDS tools was determined by diagnostic accuracy ranking, ease of use and the confidence and

  14. Dose modulated retrospective ECG-gated versus non-gated 64-row CT angiography of the aorta at the same radiation dose: Comparison of motion artifacts, diagnostic confidence and signal-to-noise-ratios

    International Nuclear Information System (INIS)

    Schernthaner, Ruediger E.; Stadler, Alfred; Beitzke, Dietrich; Homolka, Peter; Weber, Michael; Lammer, Johannes; Czerny, Martin; Loewe, Christian

    2012-01-01

    Purpose: To compare ECG-gated and non-gated CT angiography of the aorta at the same radiation dose, with regard to motion artifacts (MA), diagnostic confidence (DC) and signal-to-noise-ratios (SNRs). Materials and methods: Sixty consecutive patients prospectively randomized into two groups underwent 64-row CT angiography, with or without dose-modulated ECG-gating, of the entire aorta, due to several pathologies of the ascending aorta. MA and DC were both assessed using a four-point scale. SNRs were calculated by dividing the mean enhancement by the standard deviation. The dose-length-product (DLP) of each examination was recorded and the effective dose was estimated. Results: Dose-modulated ECG-gating showed statistically significant advantages over non-gated CT angiography, with regard to MA (p < 0.001) and DC (p < 0.001), at the aortic valve, at the origin of the coronary arteries, and at the dissection membrane, with a significant correlation (p < 0.001) between MA and DC. At the aortic wall, however, ECG-gated CT angiography showed statistically significant fewer MA (p < 0.001), but not a statistically significant higher DC (p = 0.137) compared to non-gated CT angiography. At the supra-aortic vessels and the descending aorta, the ECG-triggering showed no statistically significant differences with regard to MA (p = 0.861 and 0.526, respectively) and DC (p = 1.88 and 0.728, respectively). The effective dose of ECG-gated CT angiography (23.24 mSv; range, 18.43–25.94 mSv) did not differ significantly (p = 0.051) from that of non-gated CT angiography (24.28 mSv; range, 19.37–29.27 mSv). Conclusion: ECG-gated CT angiography of the entire aorta reduces MA and results in a higher DC with the same SNR, compared to non-gated CT angiography at the same radiation dose.

  15. Confidence-based learning CME: overcoming barriers in irritable bowel syndrome with constipation.

    Science.gov (United States)

    Cash, Brooks; Mitchner, Natasha A; Ravyn, Dana

    2011-01-01

    Performance of health care professionals depends on both medical knowledge and the certainty with which they possess it. Conventional continuing medical education interventions assess the correctness of learners' responses but do not determine the degree of confidence with which they hold incorrect information. This study describes the use of confidence-based learning (CBL) in an activity designed to enhance learners' knowledge, confidence in their knowledge, and clinical competence with regard to constipation-predominant IBS (IBS-C), a frequently underdiagnosed and misdiagnosed condition. The online CBL activity included multiple-choice questions in 2 modules: Burden of Care (BOC; 28 questions) and Patient Scenarios (PS; 9 case-based questions). After formative assessment, targeted feedback was provided, and the learner focused on material with demonstrated knowledge and/or confidence gaps. The process was repeated until 85% of questions were answered correctly and confidently (ie, mastery was attained). Of 275 participants (24% internal medicine, 13% gastroenterology, 32% family medicine, and 31% other), 249 and 167 completed the BOC and PS modules, respectively. Among all participants, 61.8% and 98.2% achieved mastery in the BOC and PS modules, respectively. Baseline mastery levels between specialties were significantly different in the BOC module (p = 0.002); no significant differences were evident between specialties in final mastery levels. Approximately one-third of learners were confident and wrong in topics of epidemiology, defining IBS and constipation, and treatments in the first iteration. No significant difference was observed between specialties for the PS module in either the first or last iterations. Learners achieved mastery in topics pertaining to IBS-C regardless of baseline knowledge or specialty. These data indicate that CME activities employing CBL can be used to address knowledge and confidence gaps. Copyright © 2010 The Alliance for

  16. Maintainability effectiveness evaluations and enhancement

    International Nuclear Information System (INIS)

    Seminara, J.L.

    1985-01-01

    In the mid-seventies EPRI initiated a research project to review the human factors aspects of nuclear power plant control rooms. In the course of investigating operator-control room interfaces in five operational control rooms, it became evident that many plant outages had either been caused or prolonged by human factors problems associated with maintenance activities. Consequently, as one of several follow-on projects, EPRI sponsored a review of nine power plants (five nuclear and four fossil) to examine the human factors aspects of plant maintainability. This survey revealed a wide variety of generic human factors problems that could negatively impact the effectiveness of plant maintenance personnel. It was clear that plant maintainability features deserved no less attention to human factors concerns than the operational features of the control room. This paper describes subsequent EPRI-initiated efforts to assist the utilities in conducting self-reviews of maintainability effectiveness and effect needed enhancements

  17. Re-thinking accountability: trust versus confidence in medical practice.

    Science.gov (United States)

    Checkland, K; Marshall, M; Harrison, S

    2004-04-01

    In seeking to prevent a reoccurrence of scandals such as that involving cardiac surgery in Bristol, the UK government has adopted a model of regulation that uses rules and surveillance as a way of both improving the quality of care delivered and increasing confidence in healthcare institutions. However, this approach may actually act to reduce confidence and trust while also reducing the moral motivation of practitioners. Accountability in health care is discussed, and it is suggested that openness about the difficult dilemmas that arise when practitioners have a duty to be accountable to more than one audience may be an alternative means of restoring trust. A greater emphasis on the sharing of information between individual health professionals and their patients would increase trust and would allow patients to hold their doctors to account for the quality of care they receive. Concentrating more on developing trust by the sharing of information and less on the futile search for complete confidence in systems and rules may improve the quality of care delivered while also nurturing the moral motivation of professionals upon which the delivery of high quality health care depends.

  18. Post choice information integration as a causal determinant of confidence: Novel data and a computational account.

    Science.gov (United States)

    Moran, Rani; Teodorescu, Andrei R; Usher, Marius

    2015-05-01

    Confidence judgments are pivotal in the performance of daily tasks and in many domains of scientific research including the behavioral sciences, psychology and neuroscience. Positive resolution i.e., the positive correlation between choice-correctness and choice-confidence is a critical property of confidence judgments, which justifies their ubiquity. In the current paper, we study the mechanism underlying confidence judgments and their resolution by investigating the source of the inputs for the confidence-calculation. We focus on the intriguing debate between two families of confidence theories. According to single stage theories, confidence is based on the same information that underlies the decision (or on some other aspect of the decision process), whereas according to dual stage theories, confidence is affected by novel information that is collected after the decision was made. In three experiments, we support the case for dual stage theories by showing that post-choice perceptual availability manipulations exert a causal effect on confidence-resolution in the decision followed by confidence paradigm. These finding establish the role of RT2, the duration of the post-choice information-integration stage, as a prime dependent variable that theories of confidence should account for. We then present a novel list of robust empirical patterns ('hurdles') involving RT2 to guide further theorizing about confidence judgments. Finally, we present a unified computational dual stage model for choice, confidence and their latencies namely, the collapsing confidence boundary model (CCB). According to CCB, a diffusion-process choice is followed by a second evidence-integration stage towards a stochastic collapsing confidence boundary. Despite its simplicity, CCB clears the entire list of hurdles. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. The P Value Problem in Otolaryngology: Shifting to Effect Sizes and Confidence Intervals.

    Science.gov (United States)

    Vila, Peter M; Townsend, Melanie Elizabeth; Bhatt, Neel K; Kao, W Katherine; Sinha, Parul; Neely, J Gail

    2017-06-01

    There is a lack of reporting effect sizes and confidence intervals in the current biomedical literature. The objective of this article is to present a discussion of the recent paradigm shift encouraging the use of reporting effect sizes and confidence intervals. Although P values help to inform us about whether an effect exists due to chance, effect sizes inform us about the magnitude of the effect (clinical significance), and confidence intervals inform us about the range of plausible estimates for the general population mean (precision). Reporting effect sizes and confidence intervals is a necessary addition to the biomedical literature, and these concepts are reviewed in this article.

  20. Expanding Horizons--Into the Future with Confidence!

    Science.gov (United States)

    Volk, Valerie

    2006-01-01

    Gifted students often show a deep interest in and profound concern for the complex issues of society. Given the leadership potential of these students and their likely responsibility for solving future social problems, they need to develop this awareness and also a sense of confidence in dealing with future issues. The Future Problem Solving…