WorldWideScience

Sample records for modeling suspected potential

  1. A Risk Prediction Model for In-hospital Mortality in Patients with Suspected Myocarditis.

    Science.gov (United States)

    Xu, Duo; Zhao, Ruo-Chi; Gao, Wen-Hui; Cui, Han-Bin

    2017-04-05

    Myocarditis is an inflammatory disease of the myocardium that may lead to cardiac death in some patients. However, little is known about the predictors of in-hospital mortality in patients with suspected myocarditis. Thus, the aim of this study was to identify the independent risk factors for in-hospital mortality in patients with suspected myocarditis by establishing a risk prediction model. A retrospective study was performed to analyze the clinical medical records of 403 consecutive patients with suspected myocarditis who were admitted to Ningbo First Hospital between January 2003 and December 2013. A total of 238 males (59%) and 165 females (41%) were enrolled in this study. We divided the above patients into two subgroups (survival and nonsurvival), according to their clinical in-hospital outcomes. To maximize the effectiveness of the prediction model, we first identified the potential risk factors for in-hospital mortality among patients with suspected myocarditis, based on data pertaining to previously established risk factors and basic patient characteristics. We subsequently established a regression model for predicting in-hospital mortality using univariate and multivariate logistic regression analyses. Finally, we identified the independent risk factors for in-hospital mortality using our risk prediction model. The following prediction model for in-hospital mortality in patients with suspected myocarditis, including creatinine clearance rate (Ccr), age, ventricular tachycardia (VT), New York Heart Association (NYHA) classification, gender and cardiac troponin T (cTnT), was established in the study: P = ea/(1 + ea) (where e is the exponential function, P is the probability of in-hospital death, and a = -7.34 + 2.99 × [Ccr model demonstrated that a Ccr prediction model for in-hospital mortality in patients with suspected myocarditis. In addition, sufficient life support during the early stage of the disease might improve the prognoses of patients with

  2. Amnioinfusion for potential or suspected umbilical cord compression in labour.

    Science.gov (United States)

    Hofmeyr, G Justus; Lawrie, Theresa A

    2012-01-18

    Amnioinfusion aims to prevent or relieve umbilical cord compression during labour by infusing a solution into the uterine cavity. To assess the effects of amnioinfusion for potential or suspected umbilical cord compression on maternal and perinatal outcome . We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2011). Randomised trials of amnioinfusion compared with no amnioinfusion in women with babies at risk of umbilical cord compression in labour. The original review had one author only (Justus Hofmeyr (GJH)). For this update, two authors (GJH and T Lawrie) assessed 13 additional trial reports for eligibility and quality. We extracted data and checked for accuracy. We have included 19 studies, with all but two studies having fewer than 200 participants. Transcervical amnioinfusion for potential or suspected umbilical cord compression was associated with the following reductions: caesarean section overall (13 trials, 1493 participants; average risk ratio (RR) 0.62, 95% confidence interval (CI) 0.46 to 0.83); fetal heart rate (FHR) decelerations (seven trials, 1006 participants; average RR 0.53, 95% CI 0.38 to 0.74); Apgar score less than seven at five minutes (12 trials, 1804 participants; average RR 0.47, 95% CI 0.30 to 0.72); meconium below the vocal cords (three trials, 674 participants, RR 0.53, 95% CI 0.31 to 0.92); postpartum endometritis (six trials, 767 participants; RR 0.45, 95% CI 0.25 to 0.81) and maternal hospital stay greater than three days (four trials, 1051 participants; average RR 0.45, 95% CI 0.25 to 0.78). Transabdominal amnioinfusion showed similar trends, though numbers studied were small.Mean cord umbilical artery pH was higher in the amnioinfusion group (seven trials, 855 participants; average mean difference 0.03, 95% CI 0.00 to 0.06) and there was a trend toward fewer neonates with a low cord arterial pH (less than 7.2 or as defined by trial authors) in the amnioinfusion group (eight trials, 972

  3. PATIENTS WITH SUSPECTED METAL IMPLANT ALLERGY: POTENTIAL CLINICAL PICTURES AND ALLERGOLOGICAL DIAGNOSTIC APPROACH (REVIEW

    Directory of Open Access Journals (Sweden)

    P. Thomas

    2014-01-01

    Full Text Available The focus of this review are allergic complications following insertion of metallic orthopedic implants. Such potential allergic reactions encompass eczema, impaired wound and fracture healing, infection-mimicking reactions, effusions, pain and loosening. Nickel, cobalt and chromium seem to be the predominant eliciting allergens. Allergy might be considered prior to planned orthopaedic surgery or in patients with complications following arthroplasty We recommend, that differential diagnoses - in particular infection -should always be excluded in cooperation with surgery collegues. The clinical work up of a patient suspected of suffering from metal implant allergy should include a combined evaluation of medical history, clinical findings, patch testing and histology In vitro testing, namely the lymphocyte transformation test (LTT, can indicate metal sensitization, but needs careful interpretation.

  4. Comparison of clinically suspected injuries with injuries detected at whole-body CT in suspected multi-trauma victims

    International Nuclear Information System (INIS)

    Shannon, L.; Peachey, T.; Skipper, N.; Adiotomre, E.; Chopra, A.; Marappan, B.; Kotnis, N.

    2015-01-01

    Aim: To assess the accuracy of the trauma team leader's clinical suspicion of injury in patients who have undergone whole-body computed tomography (WBCT) for suspected polytrauma, and to assess the frequency of unsuspected injuries and specific patterns of injury at WBCT. Materials and methods: Requests for patients who underwent WBCT for suspected polytrauma from April 2011 to March 2014 were reviewed and each body area that was clinically suspected to be injured was recorded. Body areas were divided into the following groups based on anatomical regions covered in each segment of the WBCT examination: head (including facial bones); neck (including cervical spine); chest (including thoracic spine); and abdomen/pelvis (including lumbar spine). The formal radiology report for each study was reviewed and injuries found at CT were grouped into the same body areas. For each patient, the number of clinically suspected injured areas was compared to the number of confirmed injured areas at WBCT. Results: Five hundred and eighty-eight patients were included in the study. Thirty-two percent (186/588) had a normal scan. Ninety-three percent (546/588) had fewer injured body areas at WBCT than suspected. Four percent (27/588) had the equivalent number of injured areas at WBCT as suspected. Three percent (15/588) had more injured areas at WBCT than suspected. Fifty percent (263/527) with clinically suspected chest injuries were confirmed to have chest injuries at WBCT. This was lower for other areas: abdomen/pelvis 31% (165/535); head 29% (155/533); neck 13% (66/513). Four percent of (24/588) patients had unsuspected injuries found at WBCT. Seventy-five percent (18/24) of unsuspected injuries were considered as serious, where failure to treat would have the potential for significant morbidity. Most of these patients had severe injuries to other body areas that were correctly suspected. Of the 165 with abdominal/pelvic region injuries, there were associated injuries in the

  5. Multivariable prediction model for suspected giant cell arteritis: development and validation

    Directory of Open Access Journals (Sweden)

    Ing EB

    2017-11-01

    Full Text Available Edsel B Ing,1 Gabriela Lahaie Luna,2 Andrew Toren,3 Royce Ing,4 John J Chen,5 Nitika Arora,6 Nurhan Torun,7 Otana A Jakpor,8 J Alexander Fraser,9 Felix J Tyndel,10 Arun NE Sundaram,10 Xinyang Liu,11 Cindy TY Lam,1 Vivek Patel,12 Ezekiel Weis,13 David Jordan,14 Steven Gilberg,14 Christian Pagnoux,15 Martin ten Hove21Department of Ophthalmology and Vision Sciences, University of Toronto Medical School, Toronto, 2Department of Ophthalmology, Queen’s University, Kingston, ON, 3Department of Ophthalmology, University of Laval, Quebec, QC, 4Toronto Eyelid, Strabismus and Orbit Surgery Clinic, Toronto, ON, Canada; 5Mayo Clinic, Department of Ophthalmology and Neurology, 6Mayo Clinic, Department of Ophthalmology, Rochester, MN, 7Department of Surgery, Division of Ophthalmology, Harvard Medical School, Boston, MA, 8Harvard Medical School, Boston, MA, USA; 9Department of Clinical Neurological Sciences and Ophthalmology, Western University, London, 10Department of Medicine, University of Toronto Medical School, Toronto, ON, Canada; 11Department of Medicine, Fudan University Shanghai Medical College, Shanghai, People’s Republic of China; 12Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; 13Departments of Ophthalmology, Universities of Alberta and Calgary, Edmonton and Calgary, AB, 14Department of Ophthalmology, University of Ottawa, Ottawa, ON, 15Vasculitis Clinic, Mount Sinai Hospital, Toronto, ON, CanadaPurpose: To develop and validate a diagnostic prediction model for patients with suspected giant cell arteritis (GCA.Methods: A retrospective review of records of consecutive adult patients undergoing temporal artery biopsy (TABx for suspected GCA was conducted at seven university centers. The pathologic diagnosis was considered the final diagnosis. The predictor variables were age, gender, new onset headache, clinical temporal artery abnormality, jaw claudication, ischemic vision loss (VL, diplopia

  6. Police officers' perceptions and experiences with mentally disordered suspects.

    Science.gov (United States)

    Oxburgh, Laura; Gabbert, Fiona; Milne, Rebecca; Cherryman, Julie

    Despite mentally disordered suspects being over-represented within the criminal justice system, there is a dearth of published literature that examines police officers' perceptions when interviewing this vulnerable group. This is concerning given that police officers are increasingly the first point of contact with these individuals. Using a Grounded Theory approach, this study examined 35 police officers' perceptions and experiences when interviewing mentally disordered suspects. Current safeguards, such as Appropriate Adults, and their experiences of any training they received were also explored. A specially designed questionnaire was developed and distributed across six police forces in England and Wales. Nine conceptual categories emerged from the data that highlighted how police officers' level of experience impacted upon their perceptions when dealing with this cohort. As a consequence, a new model grounded within Schema Theory has emerged termed Police Experience Transitional Model. Implications include the treatment and outcome of mentally disordered suspects being heavily dependent on whom they encounter within the criminal justice system. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Guidelines for identifying suspect/counterfeit material

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    These guidelines are intended to assist users of products in identifying: substandard, misrepresented, or fraudulently marked items. The guidelines provide information about such topics as: precautions, inspection and testing, dispositioning identified items, installed inspection and reporting suspect/counterfeit materials. These guidelines apply to users who are developing procurement documents, product acceptance/verification methods, company procedures, work instructions, etc. The intent of these SM guidelines in relation to the Quality Assurance Program Description (QAPD) and implementing company Management Control Procedures is not to substitute or replace existing requirements, as defined in either the QAPD or company implementing instructions (Management Control Procedures). Instead, the guidelines are intended to provide a consolidated source of information addressing the issue of Suspect/Counterfeit materials. These guidelines provide an extensive suspect component listing and suspect indications listing. Users can quickly check their suspect items against the list of manufacturers products (i.e., type, LD. number, and nameplate information) by consulting either of these listings.

  8. Extra-appendiceal findings in pediatric abdominal CT for suspected appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Halverson, Mark; Delgado, Jorge; Mahboubi, Soroosh [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2014-07-15

    Much has been written regarding the incidence, types, importance and management of abdominal CT incidental findings in adults, but there is a paucity of literature on incidental findings in children. We sought to determine the prevalence and characteristics of extra-appendiceal and incidental findings in pediatric abdominal CT performed for suspected appendicitis. A retrospective review was performed of abdominal CT for suspected appendicitis in a pediatric emergency department from July 2010 to June 2012. Extra-appendiceal findings were recorded. Any subsequent imaging was noted. Extra-appendiceal findings were divided into incidental findings of doubtful clinical significance, alternative diagnostic findings potentially providing a diagnosis other than appendicitis explaining the symptoms, and incidental findings that were abnormalities requiring clinical correlation and sometimes requiring further evaluation but not likely related to the patient symptoms. One hundred sixty-five children had abdominal CT for suspected appendicitis. Seventy-seven extra-appendiceal findings were found in 57 (34.5%) patients. Most findings (64 of 77) were discovered in children who did not have appendicitis. Forty-one of these findings (53%) could potentially help explain the patient's symptoms, while 30 of the findings (39%) were abnormalities that were unlikely to be related to the symptoms but required clinical correlation and sometimes further work-up. Six of the findings (8%) had doubtful or no clinical significance. Extra-appendiceal findings are common in children who undergo abdominal CT in the setting of suspected appendicitis. A significant percentage of these patients have findings that help explain their symptoms. Knowledge of the types and prevalence of these findings may help radiologists in the planning and interpretation of CT examinations in this patient population. (orig.)

  9. Spatial epidemiology of suspected clinical leptospirosis in Sri Lanka.

    Science.gov (United States)

    Robertson, C; Nelson, T A; Stephen, C

    2012-04-01

    Leptospirosis is one of the most widespread zoonoses in the world. A large outbreak of suspected human leptospirosis began in Sri Lanka during 2008. This study investigated spatial variables associated with suspected leptospirosis risk during endemic and outbreak periods. Data were obtained for monthly numbers of reported cases of suspected clinical leptospirosis for 2005-2009 for all of Sri Lanka. Space-time scan statistics were combined with regression modelling to test associations during endemic and outbreak periods. The cross-correlation function was used to test association between rainfall and leptospirosis at four locations. During the endemic period (2005-2007), leptospirosis risk was positively associated with shorter average distance to rivers and with higher percentage of agriculture made up of farms <0·20 hectares. Temporal correlation analysis of suspected leptospirosis cases and rainfall revealed a 2-month lag in rainfall-case association during the baseline period. Outbreak locations in 2008 were characterized by shorter distance to rivers and higher population density. The analysis suggests the possibility of household transmission in densely populated semi-urban villages as a defining characteristic of the outbreak. The role of rainfall in the outbreak remains to be investigated, although analysis here suggests a more complex relationship than simple correlation.

  10. Cortical capillary dysfunction in patients suspected of Alzheimer’s disease

    DEFF Research Database (Denmark)

    Eskildsen, Simon Fristed; Gyldensted, Louise; Nagenthiraja, Kartheeban

    Vascular risk factors are suspected to play a role in the etiology of Alzheimer’s disease. Recently, a model that relates capillary dysfunction to the development of AD was proposed[1]. The model predicts that capillary dysfunction in form of increased capillary transit time heterogeneity (CTH...

  11. International Suspect Screening: NORMAN Suspect Exchange meets the US EPA CompTox Chemistry Dashboard (ICCE 2017 Oslo)

    Science.gov (United States)

    Members of the European NORMAN Network of Environmental Laboratories (www.norman-network.com) have many substance lists, including targets, suspects, surfactants, perfluorinated substances and regulated, partially confidential data sets of complex mixtures. The NORMAN Suspect Lis...

  12. Spooky Suspects

    Science.gov (United States)

    Pacifici, Lara

    2011-01-01

    This activity presents an option for covering biology content while engaging students in an investigation that highlights the spirit of Halloween. Students are engaged in the story line and have fun trying to solve the mystery kidnapping by using science skills to examine the evidence and eliminate some ghoulish suspects. (Contains 1 figure.)

  13. Lineup composition, suspect position, and the sequential lineup advantage.

    Science.gov (United States)

    Carlson, Curt A; Gronlund, Scott D; Clark, Steven E

    2008-06-01

    N. M. Steblay, J. Dysart, S. Fulero, and R. C. L. Lindsay (2001) argued that sequential lineups reduce the likelihood of mistaken eyewitness identification. Experiment 1 replicated the design of R. C. L. Lindsay and G. L. Wells (1985), the first study to show the sequential lineup advantage. However, the innocent suspect was chosen at a lower rate in the simultaneous lineup, and no sequential lineup advantage was found. This led the authors to hypothesize that protection from a sequential lineup might emerge only when an innocent suspect stands out from the other lineup members. In Experiment 2, participants viewed a simultaneous or sequential lineup with either the guilty suspect or 1 of 3 innocent suspects. Lineup fairness was varied to influence the degree to which a suspect stood out. A sequential lineup advantage was found only for the unfair lineups. Additional analyses of suspect position in the sequential lineups showed an increase in the diagnosticity of suspect identifications as the suspect was placed later in the sequential lineup. These results suggest that the sequential lineup advantage is dependent on lineup composition and suspect position. (c) 2008 APA, all rights reserved

  14. Consideration of impact of atmospheric intrusion in subsurface sampling for investigation of suspected underground nuclear explosions

    International Nuclear Information System (INIS)

    Lowrey, J.D.; Bowyer, T.W.; Haas, D.A.; Hayes, J.C.; Biegalski, S.R.

    2016-01-01

    Radioactive noble gases radioxenon and radioargon constitute the primary smoking gun of an underground nuclear explosion. The aim of subsurface sampling of soil gas as part of an on-site inspection (OSI) is to search for evidence of a suspected underground nuclear event. It has been hypothesized that atmospheric gas can disturb soil gas concentrations and therefore potentially add to problems in civilian source discrimination verifying treaty compliance under the comprehensive nuclear-test ban treaty. This work describes a study of intrusion of atmospheric air into the subsurface and its potential impact on an OSI using results of simulations from the underground transport of environmental xenon (UTEX) model. (author)

  15. Oxidation of suspected N-nitrosodimethylamine (NDMA) precursors by ferrate (VI): kinetics and effect on the NDMA formation potential of natural waters.

    Science.gov (United States)

    Lee, Changha; Lee, Yunho; Schmidt, Carsten; Yoon, Jeyong; Von Gunten, Urs

    2008-01-01

    The potential of ferrate (Fe(VI)) oxidation to remove N-nitrosodimethylamine (NDMA) precursors during water treatment was assessed. Apparent second-order rate constants (k(app)) for the reactions of NDMA and its suspected precursors (dimethylamine (DMA) and 7 tertiary amines with DMA functional group) with Fe(VI) were determined in the range of pH 6-12. Four model NDMA precursors (dimethyldithiocarbamate, dimethylaminobenzene, 3-(dimethylaminomethyl)indole and 4-dimethylaminoantipyrine) showed high reactivity toward Fe(VI) with k(app) values at pH 7 between 2.6 x 10(2) and 3.2 x 10(5)M(-1)s(-1). The other NDMA precursors (DMA, trimethylamine, dimethylethanolamine, dimethylformamide) and NDMA had k(app) values ranging from 0.55 to 9.1M(-1)s(-1) at pH 7. In the second part of the study, the NDMA formation potentials (NDMA-FP) of the model NDMA precursors and natural waters were measured with and without pre-oxidation by Fe(VI). For most of the NDMA precursors with the exception of DMA, a significant reduction of the NDMA-FP (>95%) was observed after complete transformation of the NDMA precursor. This result was supported by low yields of DMA from the Fe(VI) oxidation of tertiary amine NDMA precursors. Pre-oxidation of several natural waters (rivers Rhine, Neckar and Pfinz) with a high dose of Fe(VI) (0.38 mM = 21 mg L(-1) as Fe) led to removals of the NDMA-FP of 46-84%. This indicates that the NDMA precursors in these waters have a low reactivity toward Fe(VI) because it has been shown that for fast-reacting NDMA precursors Fe(VI) doses of 20 microM (1.1 mg L(-1) as Fe) are sufficient to completely oxidize the precursors.

  16. Seasonal variation among tuberculosis suspects in four countries

    DEFF Research Database (Denmark)

    Mabaera, Biggie; Naranbat, Nymadawa; Katamba, Achilles

    2009-01-01

    The objective of the study was to analyze monthly trends across a calendar year in tuberculosis suspects and sputum smear-positive cases based on nationally representative samples of tuberculosis laboratory registers from Moldova, Mongolia, Uganda and Zimbabwe. Out of the 47 140 suspects registered...... in the tuberculosis laboratory registers, 13.4% (6312) were cases. The proportion varied from country to country, Moldova having the lowest (9%) and Uganda the highest (21%). From the monthly proportion of suspects and cases among total suspects and cases, seasonal variations were most marked in Mongolia which, among...... attendance to diagnostic laboratory services, evidenced by the contrasting findings of Mongolia (extreme continental northern climate) compared to Uganda (equatorial climate). A combination of external and possibly endogenous factors seems to determine whether tuberculosis suspects and cases present...

  17. Selecting foils for identification lineups: matching suspects or descriptions?

    Science.gov (United States)

    Tunnicliff, J L; Clark, S E

    2000-04-01

    Two experiments directly compare two methods of selecting foils for identification lineups. The suspect-matched method selects foils based on their match to the suspect, whereas the description-matched method selects foils based on their match to the witness's description of the perpetrator. Theoretical analyses and previous results predict an advantage for description-matched lineups both in terms of correctly identifying the perpetrator and minimizing false identification of innocent suspects. The advantage for description-matched lineups should be particularly pronounced if the foils selected in suspect-matched lineups are too similar to the suspect. In Experiment 1, the lineups were created by trained police officers, and in Experiment 2, the lineups were constructed by undergraduate college students. The results of both experiments showed higher suspect-to-foil similarity for suspect-matched lineups than for description-matched lineups. However, neither experiment showed a difference in correct or false identification rates. Both experiments did, however, show that there may be an advantage for suspect-matched lineups in terms of no-pick and rejection responses. From these results, the endorsement of one method over the other seems premature.

  18. A proposed new imaging pathway for patients with suspected lung cancer

    International Nuclear Information System (INIS)

    Macpherson, R.; Benamore, R.; Panakis, N.; Sayeed, R.; Breen, D.; Bradley, K.; Carter, R.; Baldwin, D.; Craig, J.; Gleeson, F.

    2012-01-01

    Aims: PET-CT scans are routinely performed in patients with lung cancer after investigation by chest x-ray (CXR) and CT scan, when these have demonstrated potentially curable disease. If the majority of patients with lung cancer potentially suitable for curative treatment could be identified earlier in the diagnostic pathway on the basis of CXR findings they could be referred for PET-CT imaging without a prior CT scan. We investigated the clinical and financial implications of adopting such a strategy. Materials and methods: The details of 1187 patients referred with suspected lung cancer between July 2006 and August 2009 were analysed. The initial CXR and subsequent imaging of patients fit for curative treatment (Performance Status 0/1, FEV1 > 1.0) were reviewed (n = 251). The clinical and financial implications of referring patients for first line PET-CT if deemed potentially curable based on CXR findings were assessed. Results: 107 of 1187 patients had potentially curable lung cancer on PS, lung function, CT and PET-CT. 96 of these 107 patients (90%) were correctly identified on CXR. 149 patients overall were diagnosed as potentially curable on CXR. Referring suitable patients for an immediate PET-CT scan resulted in a reduction in the time to complete staging investigations. Conclusions: Early PET-CT scanning for patients with suspected lung cancer, potentially suitable for curative therapy could result in more efficient staging with little additional cost.

  19. A proposed new imaging pathway for patients with suspected lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Macpherson, R.; Benamore, R. [Department of Radiology, Churchill Hospital, Oxford (United Kingdom); Panakis, N. [Department of Clinical Oncology, Churchill Hospital, Oxford (United Kingdom); Sayeed, R. [Department of Cardiothoracic Surgery, John Radcliffe Hospital, Oxford (United Kingdom); Breen, D. [Department of Respiratory Medicine, Churchill Hospital, Oxford (United Kingdom); Bradley, K.; Carter, R. [Department of Radiology, Churchill Hospital, Oxford (United Kingdom); Baldwin, D. [Department of Respiratory Medicine, Nottingham City Hospital, Nottingham (United Kingdom); Craig, J. [York Health Economics Consortium Ltd, University of York, York (United Kingdom); Gleeson, F., E-mail: fergus.gleeson@nds.ox.ac.uk [Department of Radiology, Churchill Hospital, Oxford (United Kingdom)

    2012-06-15

    Aims: PET-CT scans are routinely performed in patients with lung cancer after investigation by chest x-ray (CXR) and CT scan, when these have demonstrated potentially curable disease. If the majority of patients with lung cancer potentially suitable for curative treatment could be identified earlier in the diagnostic pathway on the basis of CXR findings they could be referred for PET-CT imaging without a prior CT scan. We investigated the clinical and financial implications of adopting such a strategy. Materials and methods: The details of 1187 patients referred with suspected lung cancer between July 2006 and August 2009 were analysed. The initial CXR and subsequent imaging of patients fit for curative treatment (Performance Status 0/1, FEV1 > 1.0) were reviewed (n = 251). The clinical and financial implications of referring patients for first line PET-CT if deemed potentially curable based on CXR findings were assessed. Results: 107 of 1187 patients had potentially curable lung cancer on PS, lung function, CT and PET-CT. 96 of these 107 patients (90%) were correctly identified on CXR. 149 patients overall were diagnosed as potentially curable on CXR. Referring suitable patients for an immediate PET-CT scan resulted in a reduction in the time to complete staging investigations. Conclusions: Early PET-CT scanning for patients with suspected lung cancer, potentially suitable for curative therapy could result in more efficient staging with little additional cost.

  20. Interviewing strategically to elicit admissions from guilty suspects.

    Science.gov (United States)

    Tekin, Serra; Granhag, Pär Anders; Strömwall, Leif; Giolla, Erik Mac; Vrij, Aldert; Hartwig, Maria

    2015-06-01

    In this article we introduce a novel interviewing tactic to elicit admissions from guilty suspects. By influencing the suspects' perception of the amount of evidence the interviewer holds against them, we aimed to shift the suspects' counterinterrogation strategies from less to more forthcoming. The proposed tactic (SUE-Confrontation) is a development of the Strategic Use of Evidence (SUE) framework and aims to affect the suspects' perception by confronting them with statement-evidence inconsistencies. Participants (N = 90) were asked to perform several mock criminal tasks before being interviewed using 1 of 3 interview techniques: (a) SUE-Confrontation, (b) Early Disclosure of Evidence, or (c) No Disclosure of Evidence. As predicted, the SUE-Confrontation interview generated more statement-evidence inconsistencies from suspects than the Early Disclosure interview. Importantly, suspects in the SUE-Confrontation condition (vs. Early and No disclosure conditions) admitted more self-incriminating information and also perceived the interviewer to have had more information about the critical phase of the crime (the phase where the interviewer lacked evidence). The findings show the adaptability of the SUE-technique and how it may be used as a tool for eliciting admissions. (c) 2015 APA, all rights reserved).

  1. Book Review: Placing the Suspect behind the Keyboard: Using Digital Forensics and Investigative Techniques to Identify Cybercrime Suspects

    Directory of Open Access Journals (Sweden)

    Thomas Nash

    2013-06-01

    Full Text Available Shavers, B. (2013. Placing the Suspect behind the Keyboard: Using Digital Forensics and Investigative Techniques to Identify Cybercrime Suspects. Waltham, MA: Elsevier, 290 pages, ISBN-978-1-59749-985-9, US$51.56. Includes bibliographical references and index.Reviewed by Detective Corporal Thomas Nash (tnash@bpdvt.org, Burlington Vermont Police Department, Internet Crime against Children Task Force. Adjunct Instructor, Champlain College, Burlington VT.In this must read for any aspiring novice cybercrime investigator as well as the seasoned professional computer guru alike, Brett Shaver takes the reader into the ever changing and dynamic world of Cybercrime investigation.  Shaver, an experienced criminal investigator, lays out the details and intricacies of a computer related crime investigation in a clear and concise manner in his new easy to read publication, Placing the Suspect behind the Keyboard. Using Digital Forensics and Investigative techniques to Identify Cybercrime Suspects. Shaver takes the reader from start to finish through each step of the investigative process in well organized and easy to follow sections, with real case file examples to reach the ultimate goal of any investigation: identifying the suspect and proving their guilt in the crime. Do not be fooled by the title. This excellent, easily accessible reference is beneficial to both criminal as well as civil investigations and should be in every investigator’s library regardless of their respective criminal or civil investigative responsibilities.(see PDF for full review

  2. Optimizing imaging in suspected appendicitis (OPTIMAP-study: A multicenter diagnostic accuracy study of MRI in patients with suspected acute appendicitis. Study Protocol

    Directory of Open Access Journals (Sweden)

    Bossuyt Patrick MM

    2010-10-01

    Full Text Available Abstract Background In patients with clinically suspected appendicitis, imaging is needed to substantiate the clinical diagnosis. Imaging accuracy of ultrasonography (US is suboptimal, while the most accurate technique (CT is associated with cancer related deaths through exposure to ionizing radiation. MRI is a potential replacement, without associated ionizing radiation and no need for contrast medium administration. If MRI is proven to be sufficiently accurate, it could be introduced in the diagnostic pathway of patients with suspected appendicitis, increasing diagnostic accuracy and improving clinical outcomes, without the risk of radiation induced cancer or iodinated contrast medium-related drawbacks. The multicenter OPTIMAP study was designed to estimate the diagnostic accuracy of MRI in patients with suspected acute appendicitis in the general population. Methods/Design Eligible for this study are consecutive patients presenting with clinically suspected appendicitis at the emergency department in six centers. All patients will undergo imaging according to the Dutch guideline for acute appendicitis: initial ultrasonography in all and subsequent CT whenever US does not confirm acute appendicitis. Then MRI is performed in all patients, but the results are not used for patient management. A final diagnosis assigned by an expert panel, based on all available information including 3-months follow-up, except MRI findings, is used as the reference standard in estimating accuracy. We will calculate the sensitivity, specificity, predictive values and inter-observer agreement of MRI, and aim to include 230 patients. Patient acceptance and total imaging costs will also be evaluated. Discussion If MRI is found to be sufficiently accurate, it could replace CT in some or all patients. This will limit or obviate the ionizing radiation exposure associated risk of cancer induction and contrast medium induced nephropathy with CT, preventing the burden and

  3. A cost-effectiveness analysis of "test" versus "treat" patients hospitalized with suspected influenza in Hong Kong.

    Directory of Open Access Journals (Sweden)

    Joyce H S You

    Full Text Available BACKGROUND: Seasonal and 2009 H1N1 influenza viruses may cause severe diseases and result in excess hospitalization and mortality in the older and younger adults, respectively. Early antiviral treatment may improve clinical outcomes. We examined potential outcomes and costs of test-guided versus empirical treatment in patients hospitalized for suspected influenza in Hong Kong. METHODS: We designed a decision tree to simulate potential outcomes of four management strategies in adults hospitalized for severe respiratory infection suspected of influenza: "immunofluorescence-assay" (IFA or "polymerase-chain-reaction" (PCR-guided oseltamivir treatment, "empirical treatment plus PCR" and "empirical treatment alone". Model inputs were derived from literature. The average prevalence (11% of influenza in 2010-2011 (58% being 2009 H1N1 among cases of respiratory infections was used in the base-case analysis. Primary outcome simulated was cost per quality-adjusted life-year (QALY expected (ICER from the Hong Kong healthcare providers' perspective. RESULTS: In base-case analysis, "empirical treatment alone" was shown to be the most cost-effective strategy and dominated the other three options. Sensitivity analyses showed that "PCR-guided treatment" would dominate "empirical treatment alone" when the daily cost of oseltamivir exceeded USD18, or when influenza prevalence was <2.5% and the predominant circulating viruses were not 2009 H1N1. Using USD50,000 as the threshold of willingness-to-pay, "empirical treatment alone" and "PCR-guided treatment" were cost-effective 97% and 3% of time, respectively, in 10,000 Monte-Carlo simulations. CONCLUSIONS: During influenza epidemics, empirical antiviral treatment appears to be a cost-effective strategy in managing patients hospitalized with severe respiratory infection suspected of influenza, from the perspective of healthcare providers in Hong Kong.

  4. 48 CFR 403.303 - Reporting suspected antitrust violations.

    Science.gov (United States)

    2010-10-01

    ... Antitrust Violations 403.303 Reporting suspected antitrust violations. Contracting officers shall report the circumstances of suspected violations of antitrust laws to the Office of Inspector General in accordance with... antitrust violations. 403.303 Section 403.303 Federal Acquisition Regulations System DEPARTMENT OF...

  5. Believable Suspect Agents: Response and Interpersonal Style Selection for an Artificial Suspect

    NARCIS (Netherlands)

    Bruijnes, Merijn

    2016-01-01

    The social skills necessary to properly and successfully conduct a police interrogation can and need to be trained. In the thesis I will describe the steps I took towards a virtual character that can play the role of a suspect in a police interrogation training. Students of the police academy will

  6. Independent oversight review of the Department of Energy Quality Assurance Program for suspect/counterfeit parts. Revision 1

    International Nuclear Information System (INIS)

    1996-05-01

    To address the potential threat that suspect/counterfeit parts could pose to DOE workers and the public, the Office of the Deputy Assistant Secretary for Oversight initiated a number of activities beginning in mid-1995. Oversight placed increased emphasis on the field's quality assurance-suspect/counterfeit parts programs during safety management evaluations, in keeping with the Office of Environment, Safety and Health (EH) oversight responsibilities, which include oversight of the Department's quality assurance (QA) programs. In addition, Oversight reviewed relevant policy documents and occurrence reports to determine the nature and magnitude of the problem within the Department. The results of that review, contained in an Office of Oversight report, Independent Oversight Analysis of Suspect/Counterfeit Parts Within the Department of Energy (November 1995), indicate a lack of consistency and comprehensiveness in the Department's QA-suspect/counterfeit parts program. A detailed analysis of the causes and impacts of the problem was recommended. In response, this review was initiated to determine the effectiveness of the Department's QA program for suspect/counterfeit parts. This study goes beyond merely assessing and reporting the status of the program, however. It is the authors intention to highlight the complex issues associated with suspect/counterfeit parts in the Department today and to present approaches that DOE managers might consider to address these issues

  7. Independent oversight review of the Department of Energy Quality Assurance Program for suspect/counterfeit parts. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-05-01

    To address the potential threat that suspect/counterfeit parts could pose to DOE workers and the public, the Office of the Deputy Assistant Secretary for Oversight initiated a number of activities beginning in mid-1995. Oversight placed increased emphasis on the field`s quality assurance-suspect/counterfeit parts programs during safety management evaluations, in keeping with the Office of Environment, Safety and Health (EH) oversight responsibilities, which include oversight of the Department`s quality assurance (QA) programs. In addition, Oversight reviewed relevant policy documents and occurrence reports to determine the nature and magnitude of the problem within the Department. The results of that review, contained in an Office of Oversight report, Independent Oversight Analysis of Suspect/Counterfeit Parts Within the Department of Energy (November 1995), indicate a lack of consistency and comprehensiveness in the Department`s QA-suspect/counterfeit parts program. A detailed analysis of the causes and impacts of the problem was recommended. In response, this review was initiated to determine the effectiveness of the Department`s QA program for suspect/counterfeit parts. This study goes beyond merely assessing and reporting the status of the program, however. It is the authors intention to highlight the complex issues associated with suspect/counterfeit parts in the Department today and to present approaches that DOE managers might consider to address these issues.

  8. Vascular factors in suspected normal pressure hydrocephalus

    Science.gov (United States)

    Agerskov, Simon; Rabiei, Katrin; Marlow, Thomas; Jensen, Christer; Guo, Xinxin; Kern, Silke; Wikkelsø, Carsten; Skoog, Ingmar

    2016-01-01

    Objective: We examined clinical and imaging findings of suspected idiopathic normal pressure hydrocephalus (iNPH) in relation to vascular risk factors and white matter lesions (WMLs), using a nested case-control design in a representative, population-based sample. Methods: From a population-based sample, 1,235 persons aged 70 years or older were examined with CT of the brain between 1986 and 2000. We identified 55 persons with hydrocephalic ventricular enlargement, i.e., radiologic findings consistent with iNPH. Among these, 26 had clinical signs that fulfilled international guideline criteria for probable iNPH. These cases were labeled suspected iNPH. Each case was matched to 5 controls from the same sample, based on age, sex, and study cohort. Data on risk factors were obtained from clinical examinations and the Swedish Hospital Discharge Register. History of hypertension, diabetes mellitus (DM), smoking, overweight, history of coronary artery disease, stroke/TIA, and WMLs on CT were examined. Risk factors associated with iNPH with a p value <0.1 in χ2 tests were included in conditional logistic regression models. Results: In the regression analyses, suspected iNPH was related to moderate to severe WMLs (odds ratio [OR] 5.2; 95% confidence interval [CI]: 1.5–17.6), while hydrocephalic ventricular enlargement was related to hypertension (OR 2.7; 95% CI: 1.1–6.8), moderate to severe WMLs (OR 6.5; 95% CI: 2.1–20.3), and DM (OR 4.3; 95% CI: 1.1–16.3). Conclusions: Hypertension, WMLs, and DM were related to clinical and imaging features of iNPH, suggesting that vascular mechanisms are involved in the pathophysiology. These findings might have implications for understanding disease mechanisms in iNPH and possibly prevention. PMID:26773072

  9. 48 CFR 1403.303 - Reporting suspected antitrust violations.

    Science.gov (United States)

    2010-10-01

    ... Antitrust Violations 1403.303 Reporting suspected antitrust violations. (a) Reports on suspected violations of antitrust laws as required by FAR 3.303 shall be prepared by the CO, reviewed by the SOL, and... antitrust violations. 1403.303 Section 1403.303 Federal Acquisition Regulations System DEPARTMENT OF THE...

  10. Exome Sequencing in Suspected Monogenic Dyslipidemias

    Science.gov (United States)

    Stitziel, Nathan O.; Peloso, Gina M.; Abifadel, Marianne; Cefalu, Angelo B.; Fouchier, Sigrid; Motazacker, M. Mahdi; Tada, Hayato; Larach, Daniel B.; Awan, Zuhier; Haller, Jorge F.; Pullinger, Clive R.; Varret, Mathilde; Rabès, Jean-Pierre; Noto, Davide; Tarugi, Patrizia; Kawashiri, Masa-aki; Nohara, Atsushi; Yamagishi, Masakazu; Risman, Marjorie; Deo, Rahul; Ruel, Isabelle; Shendure, Jay; Nickerson, Deborah A.; Wilson, James G.; Rich, Stephen S.; Gupta, Namrata; Farlow, Deborah N.; Neale, Benjamin M.; Daly, Mark J.; Kane, John P.; Freeman, Mason W.; Genest, Jacques; Rader, Daniel J.; Mabuchi, Hiroshi; Kastelein, John J.P.; Hovingh, G. Kees; Averna, Maurizio R.; Gabriel, Stacey; Boileau, Catherine; Kathiresan, Sekar

    2015-01-01

    Background Exome sequencing is a promising tool for gene mapping in Mendelian disorders. We utilized this technique in an attempt to identify novel genes underlying monogenic dyslipidemias. Methods and Results We performed exome sequencing on 213 selected family members from 41 kindreds with suspected Mendelian inheritance of extreme levels of low-density lipoprotein (LDL) cholesterol (after candidate gene sequencing excluded known genetic causes for high LDL cholesterol families) or high-density lipoprotein (HDL) cholesterol. We used standard analytic approaches to identify candidate variants and also assigned a polygenic score to each individual in order to account for their burden of common genetic variants known to influence lipid levels. In nine families, we identified likely pathogenic variants in known lipid genes (ABCA1, APOB, APOE, LDLR, LIPA, and PCSK9); however, we were unable to identify obvious genetic etiologies in the remaining 32 families despite follow-up analyses. We identified three factors that limited novel gene discovery: (1) imperfect sequencing coverage across the exome hid potentially causal variants; (2) large numbers of shared rare alleles within families obfuscated causal variant identification; and (3) individuals from 15% of families carried a significant burden of common lipid-related alleles, suggesting complex inheritance can masquerade as monogenic disease. Conclusions We identified the genetic basis of disease in nine of 41 families; however, none of these represented novel gene discoveries. Our results highlight the promise and limitations of exome sequencing as a discovery technique in suspected monogenic dyslipidemias. Considering the confounders identified may inform the design of future exome sequencing studies. PMID:25632026

  11. Optimisation of the digital radiographic imaging of suspected non-accidental injury

    Science.gov (United States)

    Offiah, Amaka

    of differences in quality of film-screen and digital images. There is much variability in the quality and number of radiographs performed as part of skeletal surveys in the UK for suspected NAI. The Leeds test objects are either not sensitive enough (TO. 10) or perhaps over sensitive (TO. 16) for the purposes of this project. Furthermore, the minimum spatial resolution required for digital imaging in NAI has not been established. Therefore the objective interpretation of phantom studies is difficult. There is scope for reduction of radiation dose to children with no effect on image quality. Diagnostic accuracy (fracture detection) in suspected NAI is generally low, and is not affected by image display modality. Conclusions: The CEC quality criteria are not applicable to the assessment of clinical image quality. A national protocol for skeletal surveys in NAI is required. Dedicated training, close supervision, collaboration and consistent exposure of radiologists to cases of NAI should improve diagnostic accuracy. The potential exists for dose reduction when performing skeletal surveys in children and infants with suspected NAI. Future studies should address this issue.

  12. Control of Suspect/Counterfeit and Defective Items

    Energy Technology Data Exchange (ETDEWEB)

    Sheriff, Marnelle L.

    2013-09-03

    This procedure implements portions of the requirements of MSC-MP-599, Quality Assurance Program Description. It establishes the Mission Support Alliance (MSA) practices for minimizing the introduction of and identifying, documenting, dispositioning, reporting, controlling, and disposing of suspect/counterfeit and defective items (S/CIs). employees whose work scope relates to Safety Systems (i.e., Safety Class [SC] or Safety Significant [SS] items), non-safety systems and other applications (i.e., General Service [GS]) where engineering has determined that their use could result in a potential safety hazard. MSA implements an effective Quality Assurance (QA) Program providing a comprehensive network of controls and verification providing defense-in-depth by preventing the introduction of S/CIs through the design, procurement, construction, operation, maintenance, and modification of processes. This procedure focuses on those safety systems, and other systems, including critical load paths of lifting equipment, where the introduction of S/CIs would have the greatest potential for creating unsafe conditions.

  13. One-step radiolabelled biotin scintigraphy in patients with suspected vertebral infections

    International Nuclear Information System (INIS)

    Lazzeri, E.; Erba, P.; Chinol, M.; Tascini, C.; Menichetti, F.; Paganelli, G.; Mariani, G.

    2003-01-01

    Full text: Biotin (B), or vitamin H, belonging to the B-complex group is utilized by bacteria for acid synthesis by acetyl-CoA carboxylase. We evaluated the diagnostic potential per se of radiolabeled biotin without avidin pre-targeting, in patients with suspected vertebral bacterial infections. We evaluated 31 patients for suspected spine infection. All patients were selected on clinical ground, blood chemistry findings, back pain and fever. Patients were injected i.v. with 500 μg of DTPA-conjugated Biotin labelled with 111In (110-130 MBq); planar and SPECT scans were recorded starting 90 min post-injection. All patients underwent MR, or CT and some patients were imaged with either 99mTc-HMPAO-WBC and/or 67Ga-citrate. Diagnostic-quality imaging was obtained at 90 min and 4 hr after 111In-DTPA-Biotin injection. We observed only 2 false-negative results, while 24 studies were true-positive (4 performed during follow-up) and 10 true-negative (1 during follow-up) (91% sensitivity, 100% specificity). Either MR, CT or 99mTc-HMPAO-WBC had high proportions of either false-negative, false-positive or equivocal results (sensitivity/specificity around 50%). These preliminary results outline the high diagnostic potential of one-step 111In-DTPA-Biotin scintigraphy without avidin pre-targeting) in patients with suspected vertebral infection. The high true-positive and true-negative rate suggests that this system displays some specificity for bacterial infections. The high diagnostic accuracy of 111In-Biotin scintigraphy seems to be independent from antibiotic therapy, thus making this method very helpful relative to other imaging modalities in the clinical decision on starting proper therapy and for monitoring the efficacy of treatment. (author)

  14. Suspects in criminal investigations of rape

    Directory of Open Access Journals (Sweden)

    Marinković Darko

    2014-01-01

    Full Text Available Investigations of sexual assaults mostly focus on victims and their credibility, which may cause lack of firm evidence in relation to suspects. Given the fact that the criminal offence of rape is characterised by a high incidence of false reports and accusations, frequently indicating specific persons as the perpetrators, certain caution is necessary in the investigation in order to avoid false accusations and/or convictions. As regards the personality of the rapist and motives for committing a forcible sexual act, certain types or rather certain categories of perpetrators can be distinguished, although it should be noted that a large number of rapists do not belong to one category only, but rather combine characteristics of several different types. During a criminal investigation it is of vital importance to differentiate between a rape as a surprise attack and a rape as abuse of trust, as they are compatible with the nature of the suspect's defence. The suspect shall be subjected to a forensic examination in the course of the investigation in order to find traces which prove vaginal, anal or oral penetration, coerced sexual intercourse and identity of the rapist. While conducting an interrogation of a suspected rapist, a crime investigating officer shall use either factual or emotional approach to his interviewee, depending on his psychological and motivational characteristics. In this regard, the factual approach is believed to be more efficient with anger rapists and sadistic rapists, whereas the compassionate approach gives good results with the gentlemen-rapists and partly with the power asserting rapists.

  15. The clinical course of patients with suspected pulmonary embolism

    NARCIS (Netherlands)

    van Beek, E. J.; Kuijer, P. M.; Büller, H. R.; Brandjes, D. P.; Bossuyt, P. M.; ten Cate, J. W.

    1997-01-01

    BACKGROUND: The outcome of patients with suspected pulmonary embolism is known to a limited extent only. OBJECTIVE: To address this limited knowledge in a cohort in whom pulmonary embolism was proved or ruled out. METHODS: Consecutive patients with clinically suspected pulmonary embolism underwent

  16. Unfair Lineups Make Witnesses More Likely to Confuse Innocent and Guilty Suspects.

    Science.gov (United States)

    Colloff, Melissa F; Wade, Kimberley A; Strange, Deryn

    2016-09-01

    Eyewitness-identification studies have focused on the idea that unfair lineups (i.e., ones in which the police suspect stands out) make witnesses more willing to identify the police suspect. We examined whether unfair lineups also influence subjects' ability to distinguish between innocent and guilty suspects and their ability to judge the accuracy of their identification. In a single experiment (N = 8,925), we compared three fair-lineup techniques used by the police with unfair lineups in which we did nothing to prevent distinctive suspects from standing out. Compared with the fair lineups, doing nothing not only increased subjects' willingness to identify the suspect but also markedly impaired subjects' ability to distinguish between innocent and guilty suspects. Accuracy was also reduced at every level of confidence. These results advance theory on witnesses' identification performance and have important practical implications for how police should construct lineups when suspects have distinctive features. © The Author(s) 2016.

  17. The use of psychoactive prescription drugs among DUI suspects.

    Science.gov (United States)

    Karjalainen, Karoliina; Haukka, Jari; Lintonen, Tomi; Joukamaa, Matti; Lillsunde, Pirjo

    2015-10-01

    The study seeks to increase understanding of the use of psychoactive prescription drugs among persons suspected of driving under the influence (DUI). We studied whether the use of prescribed psychoactive medication was associated with DUI, and examined the difference in the use of prescription drugs between DUI recidivists and those arrested only once. In this register-based study, persons suspected of DUI (n=29470) were drawn from the Register of DUI suspects, and an age- and gender-matched reference population (n=30043) was drawn from the Finnish general population. Data on prescription drug use was obtained by linkage to the National Prescription Register. The associations of DUI arrest and use of psychoactive prescription drugs in different DUI groups (findings for alcohol only, prescription drugs, prescription drugs and alcohol, illicit drugs) were estimated by using mixed-effect logistic regression. The use of psychoactive prescription drugs and DUI appeared to be strongly associated, with DUI suspects significantly more likely to use psychoactive prescription drugs compared to the reference population. Gender differences existed, with the use of benzodiazepines being more common among female DUI suspects. Moreover, DUI recidivists were more likely to use psychoactive prescription drugs compared to those arrested only once. In addition to alcohol and/or illicit drug use, a significant proportion of DUI suspects were using psychoactive prescription drugs. When prescribing psychoactive medication, especially benzodiazepines, physicians are challenged to screen for possible substance use problems and also to monitor for patients' alcohol or illicit drug use while being medicated. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Cortical capillary dysfunction in patients suspected of Alzheimer’s disease

    DEFF Research Database (Denmark)

    Eskildsen, Simon Fristed; Gyldensted, Louise; Nagenthiraja, Kartheeban

    ) leads to inefficient oxygen extraction and eventually to tissue hypoxia. In this study we investigated regional cerebral blood flow (CBF) and CTH in cortical gray matter of AD patients and controls using dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) and surface based statistics.......Vascular risk factors are suspected to play a role in the etiology of Alzheimer’s disease. Recently, a model that relates capillary dysfunction to the development of AD was proposed[1]. The model predicts that capillary dysfunction in form of increased capillary transit time heterogeneity (CTH...

  19. Comparison of 18F-FDG PET/MRI and MRI alone for whole-body staging and potential impact on therapeutic management of women with suspected recurrent pelvic cancer: a follow-up study.

    Science.gov (United States)

    Sawicki, Lino M; Kirchner, Julian; Grueneisen, Johannes; Ruhlmann, Verena; Aktas, Bahriye; Schaarschmidt, Benedikt M; Forsting, Michael; Herrmann, Ken; Antoch, Gerald; Umutlu, Lale

    2018-04-01

    To evaluate the diagnostic performance of 18 F-FDG PET/MRI for whole-body staging and potential changes in therapeutic management of women with suspected recurrent pelvic cancer in comparison with MRI alone. Seventy-one consecutive women (54 ± 13 years, range: 25-80 years) with suspected recurrence of cervical (32), ovarian (26), endometrial (7), vulvar (4), and vaginal (2) cancer underwent PET/MRI including a diagnostic contrast-enhanced MRI protocol. PET/MRI and MRI datasets were separately evaluated regarding lesion count, localization, categorization (benign/malignant), and diagnostic confidence (3-point scale; 1-3) by two physicians. The reference standard was based on histopathology results and follow-up imaging. Diagnostic accuracy and proportions of malignant and benign lesions rated correctly were retrospectively compared using McNemar's chi 2 test. Differences in diagnostic confidence were assessed by Wilcoxon test. Fifty-five patients showed cancer recurrence. PET/MRI correctly identified more patients with cancer recurrence than MRI alone (100% vs. 83.6%, p PET/MRI, MRI alone missed 4/15 patients with pelvic recurrence and miscategorized 8/40 patients with distant metastases as having local recurrence only. Based on the reference standard, 241 lesions were detected in the study cohort (181 malignant, 60 benign). While PET/MRI provided correct identification of 181/181 (100%) malignant lesions, MRI alone correctly identified 135/181 (74.6%) malignant lesions, which was significantly less compared to PET/MRI (p PET/MRI offered superior diagnostic accuracy (99.2% vs. 79.3%, p PET/MRI demonstrates excellent diagnostic performance and outperforms MRI alone for whole-body staging of women with suspected recurrent pelvic cancer, indicating potential changes in therapy management based on evaluation of local recurrence and distant metastatic spread.

  20. The comparative capacity of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and MMPI-2 Restructured Form (MMPI-2-RF) validity scales to detect suspected malingering in a disability claimant sample.

    Science.gov (United States)

    Chmielewski, Michael; Zhu, Jiani; Burchett, Danielle; Bury, Alison S; Bagby, R Michael

    2017-02-01

    The current study expands on past research examining the comparative capacity of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher et al., 2001) and MMPI-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008/2011) overreporting validity scales to detect suspected malingering, as assessed by the Miller Forensic Assessment of Symptoms Test (M-FAST; Miller, 2001), in a sample of public insurance disability claimants (N = 742) who were considered to have potential incentives to malinger. Results provide support for the capacity of both the MMPI-2 and the MMPI-2-RF overreporting validity scales to predict suspected malingering of psychopathology. The MMPI-2-RF overreporting validity scales proved to be modestly better predictors of suspected psychopathology malingering-compared with the MMPI-2 overreporting scales-in dimensional predictive models and categorical classification accuracy analyses. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. Spatial distance regulates sex-specific feelings to suspected sexual and emotional infidelity.

    Science.gov (United States)

    Schützwohl, Achim; Morjaria, Sheena; Alvis, Shahin

    2011-09-15

    The present study investigates the hitherto neglected influence of the spatial distance between the jealous person, the partner, and a potential rival as a proximate contextual factor regulating emotion intensity. The study tested four predictions. (1) The jealousy mechanism responds with mild negative feelings at most as long as the partner is close to the jealous person. (2) The negative feelings increase when the partner is far from the jealous person but the rival is close. (3) The most uncomfortable feelings result when the partner and the rival are close together and both far from the jealous person. (4) Based on the evolutionary psychological considerations, men report stronger negative feelings than women when suspecting sexual infidelity. Conversely, women report stronger negative feelings than men when suspecting emotional infidelity. The results confirmed predictions 1 and 4. Reversing predictions 2 and 3, the close rival consistently elicited the most uncomfortable feelings. Implications and limitations of the present study are discussed and suggestions for future research are provided.

  2. Creating fair lineups for suspects with distinctive features.

    Science.gov (United States)

    Zarkadi, Theodora; Wade, Kimberley A; Stewart, Neil

    2009-12-01

    In their descriptions, eyewitnesses often refer to a culprit's distinctive facial features. However, in a police lineup, selecting the only member with the described distinctive feature is unfair to the suspect and provides the police with little further information. For fair and informative lineups, the distinctive feature should be either replicated across foils or concealed on the target. In the present experiments, replication produced more correct identifications in target-present lineups--without increasing the incorrect identification of foils in target-absent lineups--than did concealment. This pattern, and only this pattern, is predicted by the hybrid-similarity model of recognition.

  3. Determination of neuronal antibodies in suspected and definite Creutzfeldt-Jakob disease.

    Science.gov (United States)

    Grau-Rivera, Oriol; Sánchez-Valle, Raquel; Saiz, Albert; Molinuevo, José Luis; Bernabé, Reyes; Munteis, Elvira; Pujadas, Francesc; Salvador, Antoni; Saura, Júlia; Ugarte, Antonio; Titulaer, Maarten; Dalmau, Josep; Graus, Francesc

    2014-01-01

    clinically relevant, number of patients with suspected CJD had potentially treatable disorders associated with NSA-abs. In contrast, none of 49 patients with definite CJD had NSA-abs, including NMDAR-abs, GlyR-abs, LGI1-abs, or CASPR2-abs. These findings suggest that cerebrospinal fluid NSA-abs analysis should be included in the diagnostic workup of patients with rapidly progressive central nervous system syndromes, particularly when they do not fulfill the diagnostic criteria of probable or possible CJD.

  4. Talking heads : interviewing suspects from a cultural perspective

    OpenAIRE

    Beune, K.

    2009-01-01

    Although the literature on the interviewing of suspects has increased over the past decade, research on the use and effectiveness of police strategies and their boundary conditions is very rare. The present dissertation aims to fill this void by identifying behaviors that appeal to and persuade suspects to talk (i.e., influencing behavior), focusing on the effects of such behaviors and their dependency on cultural context (low-context vs. high-context). In doing so, we depart from a theoretic...

  5. Temporal artery biopsy is not required in all cases of suspected giant cell arteritis.

    LENUS (Irish Health Repository)

    Quinn, Edel Marie

    2012-07-01

    Temporal artery biopsy (TAB) is performed during the diagnostic workup for giant cell arteritis (GCA), a vasculitis with the potential to cause irreversible blindness or stroke. However, treatment is often started on clinical grounds, and TAB result frequently does not influence patient management. The aim of this study was to assess the need for TAB in cases of suspected GCA.

  6. 131I-MIBG Scintigraphy in the Evaluation of Suspected Pheochromocytoma

    International Nuclear Information System (INIS)

    Oh, Sei Jung; Yoo, Hyung Sik; Park, Chang Yun; Lee, So Jin

    1992-01-01

    Pheochromocytomas are catecholamine producing tumors of neuroectodermal origin. Diagnosis of pheochromocytoma is significant due to potentially curable hypertension. But they have a significant associated morbidity due to uncontrolled hypertension and mortality since 10% are malignant. From Aug. 1989 to Jul. 1992, 12 patients of our institution had 131 I-MIBG scan during work up of suspected primary or recurrent pheochromocytoma. In our studies conclude that 131 I-MIBG scan is recommended as the initial localizing study of choice (especially for the detection of extraadrenal disease and postoperative recurrence) as a guide for CT and/or MR and specific functional confirmation of their findings.

  7. Histological outcome of duodenal biopsies in patients with clinically suspected celiac disease - a study of 100 cases

    International Nuclear Information System (INIS)

    Sarfraz, T.; Khan, S.A.; Tariq, H.

    2018-01-01

    To see the histological outcome of duodenal biopsies done in patients clinically suspected of celiac disease. Study Design: Prospective descriptive study. Place and Duration of Study: Histopathology Department, Army Medical College Rawalpindi, from 1 Jan 2017 to 30 Jun 2017. Material and Methods: One hundred (100) cases were included in the study. Duodenal biopsies done in patients clinically suspected of celiac disease were included in the study. Inadequate biopsies were excluded from the study. All the normal and abnormal histological features were noted to make the diagnosis. Data was entered and analyzed by using SPSS version 17. Results: Duodenal biopsies of 100 patients, done in clinically suspected cases of celiac disease were analyzed histologically. Out of these 100 cases, 46 cases (46%) showed histological features consistent with celiac disease, while 38 cases (38%) revealed chronic non specific duodenitis, 2 cases (2%) were of giardiasis, while 14 biopsies (14%) were unremarkable with no significant pathology. Conclusion: A significant number of cases clinically suspected of celiac disease may not be showing histological features consistent with celiac disease on duodenal biopsies. Due to the changing presentation of disease, as well as the recognition of a number of potential clinical and histopathological mimics, communication between pathologists and gastroenterologists is essential for appropriate interpretation of duodenal biopsy specimens. (author)

  8. CT coronary angiographic evaluation of suspected anginal chest pain.

    Science.gov (United States)

    Moss, Alastair J; Newby, David E

    2016-02-15

    Non-invasive imaging plays a critical role in the assessment of patients presenting with suspected angina chest pain. However, wide variations in practice across Europe and North America highlight the lack of consensus in selecting the appropriate first-line test for the investigation of coronary artery disease (CAD). CT coronary angiography (CTCA) has a high negative predictive value for excluding the presence of CAD. As such, it serves as a potential 'gatekeeper' to downstream testing by reducing the rate of inappropriate invasive coronary angiography. Two recent large multicentre randomised control trials have provided insights into whether CTCA can be incorporated into chest pain care pathways to improve risk stratification of CAD. They demonstrate that using CTCA enhances diagnostic certainty and improves the targeting of appropriate invasive investigations and therapeutic interventions. Importantly, reductions in cardiac death and non-fatal myocardial infarction appear to be attained through the more appropriate use of preventative therapy and coronary revascularisation when guided by CTCA. With this increasing portfolio of evidence, CTCA should be considered the non-invasive investigation of choice in the evaluation of patients with suspected angina pectoris due to coronary heart disease. NCT01149590, post-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Method for detection of a suspect viral deoxyribonucleic acid in an acellular biological fluid

    Energy Technology Data Exchange (ETDEWEB)

    Berninger, M S

    1982-10-06

    A method for evaluating an acellular biological fluid for the presence of a suspect viral DNA, such as DNA of the Hepatitis-B virus, is described. The acellular biological fluid is treated to immobilize in denatured form the DNAs including the suspect viral DNA on a solid substrate. This substrate is contacted with a solution including radioisotopically-labelled suspect viral denatured DNA to renature the immobilized suspect viral native DNA. The solid substrate is then evaluated for radioisotopically-labelled suspect viral renatured DNA.

  10. Detection of Rabies antigen in brains of suspected Rabid dogs ...

    African Journals Online (AJOL)

    Objective: To detect the presence of rabies antigen in brains of suspected rabid dogs. Materials and Methods: Ninety six (96) brain specimens from suspected rabid dogs were examined for the presence of rabies antigen using Seller's staining technique and enzyme immunoassay. Results: The two techniques were both ...

  11. Method for detection of a suspect viral deoxyribonucleic acid in an acellular biological fluid

    International Nuclear Information System (INIS)

    Berninger, M.S.

    1982-01-01

    A method for evaluating an acellular biological fluid for the presence of a suspect viral DNA, such as DNA of the Hepatitis-B virus, is described. The acellular biological fluid is treated to immobilize in denatured form the DNAs including the suspect viral DNA on a solid substrate. This substrate is contacted with a solution including radioisotopically-labelled suspect viral denatured DNA to renature the immobilized suspect viral native DNA. The solid substrate is then evaluated for radioisotopically-labelled suspect viral renatured DNA. (author)

  12. Spatial Distance Regulates Sex-Specific Feelings to Suspected Sexual and Emotional Infidelity

    Directory of Open Access Journals (Sweden)

    Achim Schützwohl

    2011-07-01

    Full Text Available The present study investigates the hitherto neglected influence of the spatial distance between the jealous person, the partner, and a potential rival as a proximate contextual factor regulating emotion intensity. The study tested four predictions. (1 The jealousy mechanism responds with mild negative feelings at most as long as the partner is close to the jealous person. (2 The negative feelings increase when the partner is far from the jealous person but the rival is close. (3 The most uncomfortable feelings result when the partner and the rival are close together and both far from the jealous person. (4 Based on the evolutionary psychological considerations, men report stronger negative feelings than women when suspecting sexual infidelity. Conversely, women report stronger negative feelings than men when suspecting emotional infidelity. The results confirmed predictions 1 and 4. Reversing predictions 2 and 3, the close rival consistently elicited the most uncomfortable feelings. Implications and limitations of the present study are discussed and suggestions for future research are provided.

  13. Diagnosis of suspected venous thromboembolic disease in pregnancy

    International Nuclear Information System (INIS)

    Scarsbrook, A.F.; Evans, A.L.; Owen, A.R.; Gleeson, F.V.

    2006-01-01

    Venous thromboembolic disease is a leading cause of maternal mortality during pregnancy. Early and accurate radiological diagnosis is essential as anticoagulation is not without risk and clinical diagnosis is unreliable. Although the disorder is potentially treatable, unnecessary treatment should be avoided. Most of the diagnostic imaging techniques involve ionizing radiation which exposes both the mother and fetus to finite radiation risks. There is a relative lack of evidence in the literature to guide clinicians and radiologists on the most appropriate method of assessing this group of patients. This article will review the role of imaging of suspected venous thromboembolic disease in pregnant patients, highlight contentious issues such as radiation risk, intravenous contrast use in pregnancy and discuss the published guidelines, as well as suggesting an appropriate imaging algorithm based on the available evidence

  14. Economic evaluation of a clinical protocol for diagnosing emergency patients with suspected pulmonary embolism

    Directory of Open Access Journals (Sweden)

    Wolfe Rory

    2006-06-01

    Full Text Available Abstract Background The objective of this paper is to estimate the amount of cost-savings to the Australian health care system from implementing an evidence-based clinical protocol for diagnosing emergency patients with suspected pulmonary embolism (PE at the Emergency department of a Victorian public hospital with 50,000 presentations in 2001–2002. Methods A cost-minimisation study used the data collected in a controlled clinical trial of a clinical protocol for diagnosing patients with suspected PE. Thenumber and type of diagnostic tests in a historic cohort of 185 randomly selected patients, who presented to the emergency department with suspectedPE during an eight month period prior to the clinical trial (January 2002 -August 2002 were compared with the number and type of diagnostic tests in745 patients, who presented to the emergency department with suspected PE from November 2002 to August 2003. Current Medicare fees per test were usedas unit costs to calculate the mean aggregated cost of diagnostic investigation per patient in both study groups. A t-test was used to estimate the statistical significance of the difference in the cost of resources used for diagnosing PE in the control and in the intervention group. Results The trial demonstrated that diagnosing PE using an evidence-based clinical protocol was as effective as the existing clinical practice. The clinical protocol offers the advantage of reducing the use of diagnostic imaging, resulting in an average cost savings of at least $59.30 per patient. Conclusion Extrapolating the observed cost-savings of $59.30 per patient to the wholeof Australia could potentially result in annual savings between $3.1 million to $3.7 million.

  15. Using Internet Artifacts to Profile a Child Pornography Suspect

    OpenAIRE

    Marcus K. Rogers; Kathryn C. Seigfried-Spellar

    2014-01-01

    Digital evidence plays a crucial role in child pornography investigations. However, in the following case study, the authors argue that the behavioral analysis or “profiling” of digital evidence can also play a vital role in child pornography investigations. The following case study assessed the Internet Browsing History (Internet Explorer Bookmarks, Mozilla Bookmarks, and Mozilla History) from a suspected child pornography user’s computer. The suspect in this case claimed to be conducting an...

  16. Pseudo potentials and model potentials in atomic collisions

    International Nuclear Information System (INIS)

    Reyes, O.; Jouin, H.; Fuentealba, P.

    1988-01-01

    In this work, it is discussed the main differences between the use of pseudo-potentials and model potentials in collision problems . It is shown the potential energy curves for distinct systems obtained with both kinds of potentials. (A.C.A.S.) [pt

  17. Prime Suspect, Second Row Center

    Science.gov (United States)

    Laird, Ellen A.

    2011-01-01

    His father had been hacked to death in his own bed with an ax the previous November. His mother was similarly brutalized and left for dead with her husband but survived. On the last Monday of that August, after several months and many investigative twists, turns, and fumbles, there sat the son--the prime suspect--in Ellen Laird's literature class,…

  18. Comparison of {sup 18}F-FDG PET/MRI and MRI alone for whole-body staging and potential impact on therapeutic management of women with suspected recurrent pelvic cancer. A follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Sawicki, Lino M.; Kirchner, Julian; Schaarschmidt, Benedikt M.; Antoch, Gerald [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Grueneisen, Johannes; Forsting, Michael; Umutlu, Lale [University Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Ruhlmann, Verena; Herrmann, Ken [University Duisburg-Essen, Medical Faculty, Department of Nuclear Medicine, Essen (Germany); Aktas, Bahriye [University Duisburg-Essen, Medical Faculty, Department of Obstetrics and Gynecology, Essen (Germany)

    2018-04-15

    To evaluate the diagnostic performance of {sup 18}F-FDG PET/MRI for whole-body staging and potential changes in therapeutic management of women with suspected recurrent pelvic cancer in comparison with MRI alone. Seventy-one consecutive women (54 ± 13 years, range: 25-80 years) with suspected recurrence of cervical (32), ovarian (26), endometrial (7), vulvar (4), and vaginal (2) cancer underwent PET/MRI including a diagnostic contrast-enhanced MRI protocol. PET/MRI and MRI datasets were separately evaluated regarding lesion count, localization, categorization (benign/malignant), and diagnostic confidence (3-point scale; 1-3) by two physicians. The reference standard was based on histopathology results and follow-up imaging. Diagnostic accuracy and proportions of malignant and benign lesions rated correctly were retrospectively compared using McNemar's chi{sup 2} test. Differences in diagnostic confidence were assessed by Wilcoxon test. Fifty-five patients showed cancer recurrence. PET/MRI correctly identified more patients with cancer recurrence than MRI alone (100% vs. 83.6%, p < 0.01). In contrast to PET/MRI, MRI alone missed 4/15 patients with pelvic recurrence and miscategorized 8/40 patients with distant metastases as having local recurrence only. Based on the reference standard, 241 lesions were detected in the study cohort (181 malignant, 60 benign). While PET/MRI provided correct identification of 181/181 (100%) malignant lesions, MRI alone correctly identified 135/181 (74.6%) malignant lesions, which was significantly less compared to PET/MRI (p < 0.001). PET/MRI offered superior diagnostic accuracy (99.2% vs. 79.3%, p < 0.001) and diagnostic confidence in the categorization of malignant lesions compared with MRI alone (2.7 ± 0.5 vs. 2.4 ± 0.7, p < 0.001). PET/MRI demonstrates excellent diagnostic performance and outperforms MRI alone for whole-body staging of women with suspected recurrent pelvic cancer, indicating potential changes in therapy

  19. Unfair lineups make witnesses more likely to confuse innocent and guilty suspects

    OpenAIRE

    Colloff, Melissa F.; Wade, Kimberley A.; Strange, D.

    2016-01-01

    Eyewitness-identification studies have focused on the idea that unfair lineups (i.e., ones in which the police suspect stands out) make witnesses more willing to identify the police suspect. We examined whether unfair lineups also influence subjects’ ability to distinguish between innocent and guilty suspects and their ability to judge the accuracy of their identification. In a single experiment (N = 8,925), we compared three fair-lineup techniques used by the police with unfair lineups in wh...

  20. Magnetic resonance angiography in suspected cerebral vasculitis

    International Nuclear Information System (INIS)

    Demaerel, Philippe; De Ruyter, Nele; Wilms, Guido; Maes, Frederik; Velghe, Beatrijs

    2004-01-01

    The purpose of this study was to determine the technical capacity and diagnostic accuracy of 3D time-of-flight magnetic resonance angiography (MRA) in suspected cerebral vasculitis in a retrospective analysis of MRA and digital subtraction angiography (DSA) in 14 young patients with clinical and/or radiological suspicion of cerebral vasculitis. A total of nine arteries were evaluated in each patient. Consensus review of DSA by three observers was the reference standard. The sensitivity for detecting a stenosis varied from 62 to 79% for MRA and from 76 to 94% for DSA, depending on the observer. The specificity for detecting a stenosis varied from 83 to 87% for MRA and from 83 to 97% for DSA. Using the criterion ''more than two stenoses in at least two separate vascular distributions'' to consider the examination as being true positive, the false-positive rates for MRA and DSA were comparable. MRA plays a role as the first angiographical examination in the diagnostic work-up of suspected cerebral vasculitis. When more than two stenoses in at least two separate vascular distributions are depicted on MRA, DSA is not expected to add a significant diagnostic contribution in a patient with suspected cerebral vasculitis. DSA remains necessary when MRA is normal or when less than three stenoses are seen. (orig.)

  1. Magnetic resonance angiography in suspected cerebral vasculitis

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, Philippe; De Ruyter, Nele; Wilms, Guido [Department of Radiology, Universitair Ziekenhuis, KU Leuven, 3000, Leuven (Belgium); Maes, Frederik [Department of Medical Imaging Computing, Universitair Ziekenhuis, KU Leuven, 3000, Leuven (Belgium); Velghe, Beatrijs [Department of Radiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk (Belgium)

    2004-06-01

    The purpose of this study was to determine the technical capacity and diagnostic accuracy of 3D time-of-flight magnetic resonance angiography (MRA) in suspected cerebral vasculitis in a retrospective analysis of MRA and digital subtraction angiography (DSA) in 14 young patients with clinical and/or radiological suspicion of cerebral vasculitis. A total of nine arteries were evaluated in each patient. Consensus review of DSA by three observers was the reference standard. The sensitivity for detecting a stenosis varied from 62 to 79% for MRA and from 76 to 94% for DSA, depending on the observer. The specificity for detecting a stenosis varied from 83 to 87% for MRA and from 83 to 97% for DSA. Using the criterion ''more than two stenoses in at least two separate vascular distributions'' to consider the examination as being true positive, the false-positive rates for MRA and DSA were comparable. MRA plays a role as the first angiographical examination in the diagnostic work-up of suspected cerebral vasculitis. When more than two stenoses in at least two separate vascular distributions are depicted on MRA, DSA is not expected to add a significant diagnostic contribution in a patient with suspected cerebral vasculitis. DSA remains necessary when MRA is normal or when less than three stenoses are seen. (orig.)

  2. Imaging trends in suspected appendicitis-a Canadian perspective.

    Science.gov (United States)

    Tan, Victoria F; Patlas, Michael N; Katz, Douglas S

    2017-06-01

    The purpose of our study was to assess trends in the imaging of suspected appendicitis in adult patients in emergency departments of academic centers in Canada. A questionnaire was sent to all 17 academic centers in Canada to be completed by a radiologist who works in emergency radiology. The questionnaires were sent and collected over a period of 4 months from October 2015 to February 2016. Sixteen centers (94%) responded to the questionnaire. Eleven respondents (73%) use IV contrast-enhanced computed tomography (CT) as the imaging modality of choice for all patients with suspected appendicitis. Thirteen respondents (81%) use ultrasound as the first modality of choice in imaging pregnant patients with suspected appendicitis. Eleven respondents (69%) use ultrasound (US) as the first modality of choice in patients younger than 40 years of age. Ten respondents (67%) use ultrasound as the first imaging modality in female patients younger than 40 years of age. When CT is used, 81% use non-focused CT of the abdomen and pelvis, and 44% of centers use oral contrast. Thirteen centers (81%) have ultrasound available 24 h a day/7 days a week. At 12 centers (75%), ultrasound is performed by ultrasound technologists. Four centers (40%) perform magnetic resonance imaging (MRI) in suspected appendicitis in adult patients at the discretion of the attending radiologist. Eleven centers (69%) have MRI available 24/7. All 16 centers (100%) use unenhanced MRI. Various imaging modalities are available for the work-up of suspected appendicitis. Although there are North American societal guidelines and recommendations regarding the appropriateness of the multiple imaging modalities, significant heterogeneity in the first-line modalities exist, which vary depending on the patient demographics and resource availability. Imaging trends in the use of the first-line modalities should be considered in order to plan for the availability of the imaging examinations and to consider plans for

  3. Glyphosate efficacy on sourgrass biotypes with suspected resistance collected in GR-crop fields

    Directory of Open Access Journals (Sweden)

    Hellen Martins da Silveira

    2017-11-01

    Full Text Available In Brazil, infestations of crop areas with glyphosate-resistant (GR sourgrass (Digitaria insularis (L. Fedde biotypes has risen significantly, increasing crop production costs. Glyphosate efficacy on three biotypes (GO, BA and MT of sourgrass with suspected resistance was evaluated. A susceptible biotype (MG was used as the control. The results confirmed that the MG and GO biotypes were susceptible to glyphosate (control > 90%. The MG biotype exhibited growth reduction and mortality by 50% (GR50 and LD50, respectively with mean glyphosate doses of 243.7 and 431.6 g ae ha-1. The resistance index of the biotypes with suspected resistance ranged from 2.8 to 6.1 in relation to GR50 and between 1.4 to 26.7 in relation to LD50. The glyphosate susceptibility ranking of the sourgrass biotypes was MG < GO < MT < BA. The MT and BA biotypes demonstrated high glyphosate resistance levels, and the GO biotype had a high potential to develop resistance. Farmers should avoid the application of glyphosate overdoses to minimize the selection pressure on weeds.

  4. Nuclear Pedigree Criteria of Suspected HNPCC

    Directory of Open Access Journals (Sweden)

    Kładny Józef

    2003-01-01

    Full Text Available Abstract The criteria for the diagnosis of HNPCC established by the ICG-HNPCC are very restrictive as they do not allow for the diagnosis of a large number of "suspected HNPCC" cases - these are families which do no fulfill the strict diagnostic "Amsterdam criteria", but do present with several pedigree and clinical features characteristic for HNPCC. Several series of families suspected of harboring germline mutations in DNA mismatch repair genes have been studied for germline changes in DNA mismatch repair genes and a mutation rate of somewhere between 8-60% was found. Therefore a subgroup of members of the ICG-HNPCC has been working on pedigree/clinical diagnostic criteria for suspected HNPCC. Materials and methods Part I The study was based on two series of colorectal cancer (CRC cases: 1 HNPCC - this group comprised 190 patients affected by CRC from randomly selected families which fulfilled the Amsterdam II criteria registered in Düsseldorf, Germany (102 cases of CRC, Denmark (18 CRCs, Leiden, Holland (23 CRCs and Szczecin, Poland (47 CRCs. 2 Consecutive CRCs - this group comprised 629 (78.0% of 806 individuals with CRC diagnosed in 1991-1997 in the city of Szczecin (ca. 400,000 of inhabitants, Poland. Nuclear pedigrees in both groups were compared for frequency of occurrence of clinical features, that have been shown to be associated with HNPCC. Part II 52 consecutive CRC cases from Szczecin, matching the criteria recognized in part I as appropriate for diagnosis of cases "suspected of HNPCC" were studied for the occurrence of germline hMSH2/hMLH1 constitutional mutations using "exon by exon" sequencing. Results The combination of features - i.e. the occurrence of an HNPCC associated cancer (CRC or cancer of the endometrium, small bowel or urinary tract in a 1st degree relative of a CRC patient; at least one of the patients being diagnosed under age of 50 - appeared to be strongly associated to HNPCC with an OR - 161. Constitutional

  5. Provider-initiated HIV testing and counselling for TB patients and suspects in Nairobi, Kenya.

    Science.gov (United States)

    Odhiambo, J; Kizito, W; Njoroge, A; Wambua, N; Nganga, L; Mburu, M; Mansoer, J; Marum, L; Phillips, E; Chakaya, J; De Cock, K M

    2008-03-01

    Integrated tuberculosis (TB) and human immunodeficiency virus (HIV) services in a resource-constrained setting. Pilot provider-initiated HIV testing and counselling (PITC) for TB patients and suspects. Through partnerships, resources were mobilised to establish and support services. After community sensitisation and staff training, PITC was introduced to TB patients and then to TB suspects from December 2003 to December 2005. Of 5457 TB suspects who received PITC, 89% underwent HIV testing. Although not statistically significant, TB suspects with TB disease had an HIV prevalence of 61% compared to 63% for those without. Of the 614 suspects who declined HIV testing, 402 (65%) had TB disease. Of 2283 patients referred for cotrimoxazole prophylaxis, 1951 (86%) were enrolled, and of 1727 patients assessed for antiretroviral treatment (ART), 1618 (94%) were eligible and 1441 (83%) started treatment. PITC represents a paradigm shift and is feasible and acceptable to TB patients and TB suspects. Clear directives are nevertheless required to change practice. When offered to TB suspects, PITC identifies large numbers of persons requiring HIV care. Community sensitisation, staff training, multitasking and access to HIV care contributed to a high acceptance of HIV testing. Kenya is using this experience to inform national response and advocate wide PITC implementation in settings faced with the TB-HIV epidemic.

  6. Unexpected MRI findings in clinically suspected Legg-Calve-Perthes disease

    Energy Technology Data Exchange (ETDEWEB)

    Lobert, Philip F.; Dillman, Jonathan R.; Strouse, Peter J.; Hernandez, Ramiro J. [University of Michigan Health System, Department of Radiology, Section of Pediatric Radiology, C.S. Mott Children' s Hospital/F3503, Ann Arbor, MI (United States)

    2011-03-15

    In the setting of clinically suspected Legg-Calve-Perthes (LCP) disease and negative/equivocal radiographs, contrast-enhanced MRI can be performed to confirm the diagnosis. To determine the frequency of unexpected causes of hip pain as identified by MRI in children with clinically suspected LCP disease and negative/equivocal radiographs. All pediatric contrast-enhanced MRI examinations of the pelvis and hips performed between January 2000 and February 2009 to evaluate for possible LCP disease in the setting of negative/equivocal radiographs were identified. MRI examinations performed to evaluate for secondary avascular necrosis were excluded. Imaging reports were retrospectively reviewed for unexpected clinically important causes of hip pain. Thirty-six pediatric patients underwent contrast-enhanced MRI examinations for clinically suspected LCP disease in the setting of negative/equivocal radiographs. Twenty-two (61%) imaging studies were normal, while four (11%) imaging studies demonstrated findings consistent with LCP disease. Ten (28%) imaging studies revealed unexpected clinically important causes of hip pain, including nonspecific unilateral joint effusion and synovitis (n = 7, juvenile chronic arthritis was eventually diagnosed in 3 patients), sacral fracture (n = 1), apophyseal injury (n = 1), and femoral head subluxation (n = 1). MRI frequently reveals unexpected clinically important causes of hip pain in children with suspected LCP disease and negative/equivocal radiographs. (orig.)

  7. Percutaneous cholecystocentesis in cats with suspected hepatobiliary disease.

    Science.gov (United States)

    Byfield, Victoria L; Callahan Clark, Julie E; Turek, Bradley J; Bradley, Charles W; Rondeau, Mark P

    2017-12-01

    Objectives The objective was to evaluate the safety and diagnostic utility of percutaneous ultrasound-guided cholecystocentesis (PUC) in cats with suspected hepatobiliary disease. Methods Medical records of 83 cats with suspected hepatobiliary disease that underwent PUC were retrospectively reviewed. Results At the time of PUC, at least one additional procedure was performed in 79/83 cats, including hepatic aspiration and/or biopsy (n = 75) and splenic aspiration (n = 18). Complications were noted in 14/83 cases, including increased abdominal fluid (n = 11), needle-tip occlusion (n = 1), failed first attempt to penetrate the gall bladder wall (n = 1) and pneumoperitoneum (n = 1). There were no reports of gall bladder rupture, bile peritonitis or hypotension necessitating treatment with vasopressor medication. Blood products were administered to 7/83 (8%) cats. Seventy-two cats (87%) survived to discharge. Of the cats that were euthanized (9/83) or died (2/83), none were reported as a definitive consequence of PUC. Bacteria were identified cytologically in 10/71 samples (14%); all 10 had a positive aerobic bacterial culture. Bile culture was positive in 11/80 samples (14%). Of the cases with a positive bile culture, cytological description of bacteria corresponded to the organism cultured in fewer than 50% of cases. The most common cytologic diagnosis was hepatic lipidosis (49/66). The most common histopathologic diagnosis was cholangitis (10/21). Conclusions and relevance PUC was safe in this group of cats with suspected hepatobiliary disease. Complications were likely associated with ancillary procedures performed at the time of PUC. Bile analysis yielded an abnormal result in nearly one-third of cats with suspected hepatobiliary disease. Complete agreement between bile cytology and culture was lacking. Further evaluation of the correlation between bile cytology and bile culture is warranted.

  8. Should single-phase radionuclide bone imaging be used in suspected osteomyelitis

    International Nuclear Information System (INIS)

    Fihn, S.D.; Larson, E.B.; Nelp, W.B.; Rudd, T.G.; Gerber, F.H.

    1984-01-01

    The records of 69 patients who had 86 delayed, static radionuclide bone images for suspected osteomyelitis were studied to determine the effects of this procedure on diagnosis and treatment. Sensitivity, specificity, and positive predictive value were lower than reported in several other studies. When osteomyelitis was unlikely, imaging was either negative or falsely positive and rarely affected treatment. In 46 cases where osteomyelitis was more likely, imaging potentially changed therapy in 19 but was unhelpful or misleading in 15. Static-phase images with ''definite'' interpretations, particularly when negative, are specific, but ''equivocal'' studies may lead to diagnostic and therapeutic errors. When ostemyelitis is improbable, imaging rarely changes diagnosis or therapy

  9. Handbook for Response to Suspect Radioactive Materials

    International Nuclear Information System (INIS)

    Cliff, William C.; Pappas, Richard A.; Arthur, Richard J.

    2005-01-01

    This document provides response actions to be performed following the initial port, airport, or border crossing discovery of material that is suspected of being radioactive. The purpose of this guide is to provide actions appropriate for handling radioactive material

  10. [Suspected Alzheimer's disease. Selection of outpatients for neuropsychological assessment].

    Science.gov (United States)

    Wolf, S A; Henry, M; Deike, R; Ebert, A D; Wallesch, C-W

    2008-04-01

    Incipient Alzheimer's disease (AD) is frequently suspected by neurologists and psychiatrists, but diagnosis is difficult to establish. The aim of this report was to analyse to what extent suspicion is confirmed by a comprehensive neuropsychological examination intended to distinguish different types of dementia. Descriptive data analysis was used for investigating the differential diagnoses of 47 outpatients with suspected AD referred to a department of neuropsychology by physicians in private practice. Data analysis was based upon the NINCDS-ADRDA diagnostic criteria of AD. Only 38% of the outpatients examined with suspected AD met the NINCDS-ADRDA diagnostic criteria for AD or mixed dementia from a neuropsychological point of view, whereas 22% met criteria for other types of dementia. The remaining patients met criteria for distinct differential diagnoses (23%) or lacked pathological findings in neuropsychological functions (17%). Neuropsychology is an essential part in the differential diagnosis of mild to moderate dementias. It can aid in differential therapeutic considerations concerning the treatment of dementia, for example in selecting appropriate treatments or avoiding expensive but inappropriate ones.

  11. Rational clinical evaluation of suspected acute coronary syndromes: The value of more information.

    Science.gov (United States)

    Hancock, David G; Chuang, Ming-Yu Anthony; Bystrom, Rebecca; Halabi, Amera; Jones, Rachel; Horsfall, Matthew; Cullen, Louise; Parsonage, William A; Chew, Derek P

    2017-12-01

    Many meta-analyses have provided synthesised likelihood ratio data to aid clinical decision-making. However, much less has been published on how to safely combine clinical information in practice. We aimed to explore the benefits and risks of pooling clinical information during the ED assessment of suspected acute coronary syndrome. Clinical information on 1776 patients was collected within a randomised trial conducted across five South Australian EDs between July 2011 and March 2013. Bayes theorem was used to calculate patient-specific post-test probabilities using age- and gender-specific pre-test probabilities and likelihood ratios corresponding to the presence or absence of 18 clinical factors. Model performance was assessed as the presence of adverse cardiac outcomes among patients theoretically discharged at a post-test probability less than 1%. Bayes theorem-based models containing high-sensitivity troponin T (hs-troponin) outperformed models excluding hs-troponin, as well as models utilising TIMI and GRACE scores. In models containing hs-troponin, a plateau in improving discharge safety was observed after the inclusion of four clinical factors. Models with fewer clinical factors better approximated the true event rate, tended to be safer and resulted in a smaller standard deviation in post-test probability estimates. We showed that there is a definable point where additional information becomes uninformative and may actually lead to less certainty. This evidence supports the concept that clinical decision-making in the assessment of suspected acute coronary syndrome should be focused on obtaining the least amount of information that provides the highest benefit for informing the decisions of admission or discharge. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  12. Long-term survival and function after suspected gram-negative sepsis.

    Science.gov (United States)

    Perl, T M; Dvorak, L; Hwang, T; Wenzel, R P

    1995-07-26

    To determine the long-term (> 3 months) survival of septic patients, to develop mathematical models that predict patients likely to survive long-term, and to measure the health and functional status of surviving patients. A large tertiary care university hospital and an associated Veterans Affairs Medical Center. From December 1986 to December 1990, a total of 103 patients with suspected gram-negative sepsis entered a double-blind, placebo-controlled efficacy trial of monoclonal antiendotoxin antibody. Of these, we followed up 100 patients for 7667 patient-months. Beginning in May 1992, we reviewed hospital records and contacted all known survivors. We measured the health status of all surviving patients. The determinants of long-term survival (up to 6 years) were identified through two Cox proportional hazard regression models: one that included patient characteristics identified at the time of sepsis (bedside model) and another that included bedside, infection-related, and treatment characteristics (overall model). Of the 60 patients in the cohort who died at a median interval of 30.5 days after sepsis, 32 died within the first month of the septic episode, seven died within 3 months, and four more died within 6 months. In the bedside multivariate model constructed to predict long-term survival, large hazard ratios (HRs) were associated with severity of underlying illness as classified by McCabe and Jackson criteria (for rapidly fatal disease, HR = 30.4, P respiratory distress syndrome (HR = 2.3; P = .02) predicted patients most likely to die. The Acute Physiology and Chronic Health Evaluation II score was not a significant predictor of outcome when either model included the simpler McCabe and Jackson classification of underlying disease severity. We compared the health status scores with norms for the general population and found that patients with resolved sepsis reported more physical dysfunction (P bedridden), suggesting that the patients' physical function

  13. Prevalence and Correlates of Suspected Nonalcoholic Fatty Liver Disease in Chinese Children

    Directory of Open Access Journals (Sweden)

    Peige Song

    2017-04-01

    Full Text Available Nonalcoholic fatty liver disease (NAFLD has become a serious public health problem worldwide; however, the availability of information on the prevalence of NAFLD in the general pediatric population is still limited. The primary aim of this study was to reveal the prevalence and correlates of suspected NAFLD in Chinese children at the national level. Data from the China Health and Nutrition Surveys (CHNS was used. Weight, height, waist circumference (WC, blood pressure (BP were measured for children aged 7–18 years. Blood samples were collected and analyzed. Children were classified as having suspected NAFLD if common causes of liver disease were excluded, and serum alanine aminotransferase (ALT values were above the established thresholds (>22.1 IU/L for girls and >25.8 IU/L for boys. A percentage of 9.03% (75 out of 831 of Chinese children was found to have suspected NAFLD. Overweight and obesity according to BMI percentiles, abdominal obesity, hyperuricemia (uric acid (UA > 327 μmol/L, and elevated total cholesterol (TC were all detected as the correlates of childhood suspected NAFLD when adjusting for other factors. Our study revealed the prevalence of suspected NAFLD in general Chinese children at the national level for the first time. Our findings indicate that suspected NAFLD in children is associated with increasing childhood morbidities, further studies are needed to better understand the prevalence of childhood NAFLD and its correlates, and large-scale programs should be launched to screen NAFLD in the pediatric population in China.

  14. Suspected Child Maltreatment: Recognize and Respond

    Science.gov (United States)

    Kemple, Kristen Mary; Kim, Hae Kyoung

    2011-01-01

    Early childhood educators spend extensive amounts of time with young children, so they are often the first adults to notice signs that a child may be abused or neglected. All educators are required by law to report suspected maltreatment, and can play an important role in preventing and responding to abuse and neglect of young children. What is…

  15. On the scalar potential models from the isospectral potential class

    Energy Technology Data Exchange (ETDEWEB)

    Lima, V. Gomes [Universidade Federal Rural do Rio de Janeiro, Seropedica, RJ (Brazil). Dept. de Fisica; Santos, V. Silva [Paraiba Univ., Campina Grande, PB (Brazil). Dept. de Engenharia Civil; Rodrigues, R. de Lima [Centro Brasileiro de Pesquisas Fisicas (CBPF), Rio de Janeiro, RJ (Brazil)]. E-mail: rafaelr@cbpf.br

    2001-10-01

    The static field classical configuration in (1+1)-dimensions for new non-linear potential models is investigated from an isospectral potential class and the concept of bosonic zero mode solution. One of the models considered here has a static nontopological configuration with a single vacuum state, whose potential in the stability equation corresponds to broken a supersymmetry. (author)

  16. Timing Errors in Two Children with Suspected Childhood Apraxia of Speech (sCAS) during Speech and Music-Related Tasks

    Science.gov (United States)

    Peter, Beate; Stoel-Gammon, Carol

    2005-01-01

    Impaired speech prosody has been identified as a critical feature of suspected childhood apraxia of speech (sCAS). Lexical stress productions of children with sCAS have been characterized as 'excessive/equal/misplaced'. This investigation examines two potential explanations of this particular deficit, articulatory difficulty and impaired intrinsic…

  17. DNA typing from vaginal smear slides in suspected rape cases

    Directory of Open Access Journals (Sweden)

    Dayse Aparecida da Silva

    Full Text Available In an investigation of suspected rape, proof of sexual assault with penetration is required. In view of this, detailed descriptions of the genitalia, the thighs and pubic region are made within the forensic medical service. In addition, vaginal swabs are taken from the rape victim and some of the biological material collected is then transferred to glass slides. In this report, we describe two rape cases solved using DNA typing from cells recovered from vaginal smear slides. In 1999, two young women informed the Rio de Janeiro Police Department that they had been victims of sexual assaults. A suspect was arrested and the victims identified him as the offender. The suspect maintained that he was innocent. In order to elucidate these crimes, vaginal smear slides were sent to the DNA Diagnostic Laboratory for DNA analysis three months after the crimes, as unique forensic evidence. To get enough epithelial and sperm cells to perform DNA analysis, we used protocols modified from the previously standard protocols used for DNA extraction from biological material fixed on glass slides. The quantity of cells was sufficient to perform human DNA typing using nine short tandem repeat (STR loci. It was 3.3 billion times more probable that it was the examined suspect who had left sperm cells in the victims, rather than any other individual in the population of Rio de Janeiro.

  18. STATUS GIZI DAN STATUS IODIUM PADA BALITA DENGAN SUSPECT DOWN SYNDROME

    Directory of Open Access Journals (Sweden)

    Hastin Dyah K.

    2012-10-01

    Full Text Available Background: Nutritional status is one of the factor that determines the human resources and quality of life. Toddlers are one of vulnerable groups for nutritional problems. One of the nutrition problem in Indonesia is Iodine deficiency disorder. Clinical manifestations are not only endemic goiter and cretins, but also abortion, stillbirth, and congenital abnormalities. Congenital abnormalities are commonly found in areas ofendemic iodine deficiency disorder such as Down Syndrome. Objectives: This study aims to determine the iodine nutrition status of children under jive with Down Syndrome Suspect in endemic areas ofiodine deficiency disorder. Method: This research is descriptive study with cross sectional design. The study was conducted in Magelang district, which is endemic iodine deficiency disorder. Total sample of30 under jive years old with Down Syndrome Suspect. Result: The result showed that the nutritional status of respondents based on the weight/age index was 50% had good nutritional status. According to height/age index as much as 70% are short and very short. Based on weight/height index was 73,3% with normal nutritional status. At least 33% of children with Down Syndrome Suspect accompanied hypothyroidism.  Keywords: Suspect Down Syndrome, Nutritional Status, Iodine Status

  19. Suspecting Neurological Dysfunction From E Mail Messages ...

    African Journals Online (AJOL)

    A non medical person suspected and confirmed neurological dysfunction in an individual, based only on e mail messages sent by the individual. With email communication becoming rampant “peculiar” email messages may raise the suspicion of neurological dysfunction. Organic pathology explaining the abnormal email ...

  20. [Characteristics of communication systems of suspected occupational disease in the Autonomous Communities, Spain].

    Science.gov (United States)

    García Gómez, Montserrat; Urbaneja Arrúe, Félix; García López, Vega; Estaban Buedo, Valentín; Rodríguez Suárez, Valentín; Miralles Martínez-Portillo, Lourdes; González García, Isabel; Egea Garcia, Josefa; Corraliza Infanzon, Emma; Ramírez Salvador, Laura; Briz Blázquez, Santiago; Armengol Rosell, Ricard; Cisnal Gredilla, José María; Correa Rodríguez, Juan Francisco; Coto Fernández, Juan Carlos; Díaz Peral, Mª Rosario; Elvira Espinosa, Mercedes; Fernández Fernández, Iñigo; García-Ramos Alonso, Eduardo; Martínez Arguisuelas, Nieves; Rivas Pérez, Ana Isabel

    2017-03-17

    There are several initiatives to develop systems for the notification of suspected occupational disease (OD) in different autonomous communities. The objective was to describe the status of development and characteristics of these systems implemented by the health authorities. A cross-sectional descriptive study was carried out on the existence of systems for the information and surveillance of suspected OD, their legal framework, responsible institution and availability of information. A specific meeting was held and a survey was designed and sent to all autonomous communities and autonomous cities (AACC). Information was collected on the existence of a regulatory standard, assigned human resources, notifiers, coverage and number of suspected OD received, processed and recognized. 18 of 19 AACC responded. 10 have developed a suspected OD notification system, 3 of them supported by specific autonomic law. The notifiers were physicians of the public health services, physicians of the occupational health services and, in 2 cases, medical inspectors. 7 AACC had specific software to support the system. The OD recognition rate of suspected cases was 53% in the Basque Country; 41% in Castilla-La Mancha; 36% in Murcia; 32.6% in the Valencian Community and 31% in La Rioja. The study has revealed an heterogeneous development of suspected OD reporting systems in Spain. Although the trend is positive, only 55% of the AACC have some type of development and 39% have specific software supporting it. Therefore unequal OD recognition rates have been obtained depending on the territory.

  1. The Lawyer in the Dutch Interrogation Room: Influence on Police and Suspect

    NARCIS (Netherlands)

    W-J. Verhoeven (Willem-Jan); L. Stevens (Lonneke)

    2012-01-01

    textabstractIn many European countries, providing a suspect in custody with legal aid before the first police interrogation is a heavily debated issue. In this paper, we report on an exploratory study on the use of coercion by the police and the use of the right to silence by suspects in 70 Dutch

  2. Theoretical study on optical model potential

    International Nuclear Information System (INIS)

    Lim Hung Gi.

    1984-08-01

    The optical model potential of non-local effect on the rounded edge of the potential is derived. On the basis of this potential the functional form of the optical model potential, the energy dependence and relationship of its parameters, and the dependency of the values of the parameters on energy change are shown in this paper. (author)

  3. Identification of novel micropollutants in wastewater by a combination of suspect and nontarget screening

    International Nuclear Information System (INIS)

    Hug, Christine; Ulrich, Nadin; Schulze, Tobias; Brack, Werner; Krauss, Martin

    2014-01-01

    To detect site-specific, suspected and formerly unknown contaminants in a wastewater treatment plant effluent, we established a screening procedure based on liquid chromatography–high resolution mass spectrometry (LC–HRMS) with stepwise identification schemes. Based on automated substructure searches a list of 2160 suspected site-specific and documented water contaminants was reduced to those amenable to LC–HRMS. After searching chromatograms for exact masses of suspects, presumably false positive detections were stepwise excluded by retention time prediction, the evaluation of isotope patterns, ionization behavior, and HRMS/MS spectra. In nontarget analysis, peaks for identification were selected based on distinctive isotope patterns and intensity. The stepwise identification of nontarget compounds was automated by a plausibility check of molecular formulas using the Seven Golden Rules, an exclusion of compounds with presumably low commercial importance and an automated HRMS/MS evaluation. Six suspected and five nontarget chemicals were identified, of which two have not been previously reported as environmental pollutants. -- Highlights: • A LC–HRMS-based suspect and nontarget screening was applied to wastewater. • Manual data processing to identify candidate structures was accelerated by automated software-based procedure. • Identification was supported by sophisticated analytical methods such as deuterium exchange. • Eleven site-specific and formerly unknown compounds were identified. • We provide a framework to extend analytical procedures from target to suspect and nontarget compounds. -- A screening procedure based on liquid chromatography–high resolution mass spectrometry (LC–HRMS) with a systematic data evaluation was established, which allowed detecting suspected and formerly unknown contaminants in wastewater

  4. Spinal cord magnetic resonance imaging in suspected multiple sclerosis

    International Nuclear Information System (INIS)

    Lycklama a Nijeholt, G.J.; Bergers, E.; Castelijns, J.A.; Barkhof, F.; Uitdehaag, B.M.J.; Polman, C.H.

    2000-01-01

    We examined the value of spinal cord magnetic resonance imaging (MRI) in the diagnostic work-up of multiple sclerosis (MS). Forty patients suspected of having MS were examined within 24 months after the start of symptoms. Disability was assessed, and symptoms were categorized as either brain or spinal cord. Work-up further included cerebrospinal fluid analysis and standard proton-density, T2-, and T1-weighted gadolinium-enhanced brain and spinal cord MRI. Patients were categorized as either clinically definite MS (n = 13), laboratory-supported definite MS (n = 14), or clinically probable MS (n = 4); four patients had clinically probable MS, and in nine MS was suspected. Spinal cord abnormalities were found in 35 of 40 patients (87.5 %), consisting of focal lesions in 31, only diffuse abnormalities in two, and both in two. Asymptomatic spinal cord lesions occurred in six patients. All patients with diffuse spinal cord abnormality had clear spinal cord symptoms and a primary progressive disease course. In clinically definite MS, the inclusion of spinal imaging increased the sensitivity of MRI to 100 %. Seven patients without a definite diagnosis had clinically isolated syndromes involving the spinal cord. Brain MRI was inconclusive, while all had focal spinal cord lesions which explained symptoms and ruled out other causes. Two other patients had atypical brain abnormalities suggesting ischemic/vascular disease. No spinal cord abnormalities were found, and during follow-up MS was ruled out. Spinal cord abnormalities are common in suspected MS, and may occur asymptomatic. Although diagnostic classification is seldom changed, spinal cord imaging increases diagnostic sensitivity of MRI in patients with suspected MS. In addition, patients with primary progressive MS may possibly be earlier diagnosed. Finally, differentiation with atypical lesions may be improved. (orig.)

  5. MRI for clinically suspected pediatric appendicitis: an implemented program

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Michael M.; Gustas, Cristy N.; Choudhary, Arabinda K.; Methratta, Sosamma T.; Hulse, Michael A.; Eggli, Kathleen D.; Boal, Danielle K.B. [Penn State Milton S. Hershey Medical Center, Department of Radiology, Mail Code H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Geeting, Glenn [Penn State Milton S. Hershey Medical Center, Department of Emergency Medicine, Hershey, PA (United States)

    2012-09-15

    Emergent MRI is now a viable alternative to CT for evaluating appendicitis while avoiding the detrimental effects of ionizing radiation. However, primary employment of MRI in the setting of clinically suspected pediatric appendicitis has remained significantly underutilized. To describe our institution's development and the results of a fully implemented clinical program using MRI as the primary imaging evaluation for children with suspected appendicitis. A four-sequence MRI protocol consisting of coronal and axial single-shot turbo spin-echo (SS-TSE) T2, coronal spectral adiabatic inversion recovery (SPAIR), and axial SS-TSE T2 with fat saturation was performed on 208 children, ages 3 to 17 years, with clinically suspected appendicitis. No intravenous or oral contrast material was administered. No sedation was administered. Data collection includes two separate areas: time parameter analysis and MRI diagnostic results. Diagnostic accuracy of MRI for pediatric appendicitis indicated a sensitivity of 97.6% (CI: 87.1-99.9%), specificity 97.0% (CI: 93.2-99.0%), positive predictive value 88.9% (CI: 76.0-96.3%), and negative predictive value 99.4% (CI: 96.6-99.9%). Time parameter analysis indicated clinical feasibility, with time requested to first sequence obtained mean of 78.7 +/- 52.5 min, median 65 min; first-to-last sequence time stamp mean 14.2 +/- 8.8 min, median 12 min; last sequence to report mean 57.4 +/- 35.2 min, median 46 min. Mean age was 11.2 +/- 3.6 years old. Girls represented 57% of patients. MRI is an effective and efficient method of imaging children with clinically suspected appendicitis. Using an expedited four-sequence protocol, sensitivity and specificity are comparable to CT while avoiding the detrimental effects of ionizing radiation. (orig.)

  6. Herbal hepatotoxicity: suspected cases assessed for alternative causes.

    Science.gov (United States)

    Teschke, Rolf; Schulze, Johannes; Schwarzenboeck, Alexander; Eickhoff, Axel; Frenzel, Christian

    2013-09-01

    Alternative explanations are common in suspected drug-induced liver injury (DILI) and account for up to 47.1% of analyzed cases. This raised the question of whether a similar frequency may prevail in cases of assumed herb-induced liver injury (HILI). We searched the Medline database for the following terms: herbs, herbal drugs, herbal dietary supplements, hepatotoxic herbs, herbal hepatotoxicity, and herb-induced liver injury. Additional terms specifically addressed single herbs and herbal products: black cohosh, Greater Celandine, green tea, Herbalife products, Hydroxycut, kava, and Pelargonium sidoides. We retrieved 23 published case series and regulatory assessments related to hepatotoxicity by herbs and herbal dietary supplements with alternative causes. The 23 publications comprised 573 cases of initially suspected HILI; alternative causes were evident in 278/573 cases (48.5%). Among them were hepatitis by various viruses (9.7%), autoimmune diseases (10.4%), nonalcoholic and alcoholic liver diseases (5.4%), liver injury by comedication (DILI and other HILI) (43.9%), and liver involvement in infectious diseases (4.7%). Biliary and pancreatic diseases were frequent alternative diagnoses (11.5%), raising therapeutic problems if specific treatment is withheld; pre-existing liver diseases including cirrhosis (9.7%) were additional confounding variables. Other diagnoses were rare, but possibly relevant for the individual patient. In 573 cases of initially assumed HILI, 48.5% showed alternative causes unrelated to the initially incriminated herb, herbal drug, or herbal dietary supplement, calling for thorough clinical evaluations and appropriate causality assessments in future cases of suspected HILI.

  7. 9 CFR 381.78 - Condemnation of carcasses and parts: separation of poultry suspected of containing biological...

    Science.gov (United States)

    2010-01-01

    ...: separation of poultry suspected of containing biological residues. 381.78 Section 381.78 Animals and Animal... carcasses and parts: separation of poultry suspected of containing biological residues. (a) At the time of... to be not adulterated. (b) When a lot of poultry suspected of containing biological residues is...

  8. Changes in ocular biometry and anterior chamber parameters after pharmacologic mydriasis and peripheral iridotomy in primary angle closure suspects

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Razeghinejad

    2016-07-01

    Conclusions: This study showed no change in the ocular biometric and anterior chamber parameters including iridocorneal angle after PI and/or pharmacologic mydriasis except for increments in anterior chamber volume. This factor has the potential to be used as a numerical proxy for iris position in evaluating and monitoring patients with primary angle closure suspects after PI.

  9. Incidence of clinically suspected venous thromboembolism in British Indian patients.

    Science.gov (United States)

    Siddiqui, B M; Patel, M S; Rudge, S; Best, A; Mangwani, J

    2018-05-01

    Introduction Venous thromboembolism (VTE) remains a major public health issue around the world. Ethnicity is known to alter the incidence of VTE. To our knowledge, there are no reports in the literature investigating the incidence of VTE in British Indians. The aim of this study was to investigate the rates of symptomatic VTE in British Indian patients in the UK. Methods Patients referred to our institution between January 2011 and August 2013 with clinically suspected VTE were eligible for inclusion in the study. Those not of British Indian or Caucasian ethnicity were excluded. A retrospective review of these two cohorts was conducted. Results Overall, 15,529 cases were referred to our institution for suspected VTE. This included 1,498 individuals of British Indian ethnicity. Of these, 182 (12%) had confirmed VTE episodes. A further 13,159 of the patients with suspected VTE were coded as Caucasian, including 2,412 (16%) who had confirmed VTE events. VTE rates were a third lower in British Indians with clinically suspected VTE than in the equivalent Caucasian group. The British Indian cohort presented with VTE at a much earlier age than Caucasians (mean 57.0 vs 68.0 years). Conclusions This study suggests that British Indian patients have a lower incidence of VTE and are more likely to present at an earlier age than Caucasians. There was no significant difference in VTE type (deep vein thrombosis vs pulmonary embolism) among the ethnic groups. Clinicians should be aware of variations within ethnicities but should continue to adhere to existing VTE prevention guidance.

  10. Phenomenological aspects of nonrelativistic potential models

    International Nuclear Information System (INIS)

    Lucha, W.; Schoeberl, F.F.

    1989-01-01

    This review reports on the description of hardrons as bound states of quarks by nonrelativistic potential models. It contains a brief sketch of the way in which information on the form of the inter-quark potential may be gained from quantum chromodynamics, proofs of some general theorems related to the potential-model approach, a discussion of the significance of the treatment of bound states consisting of relativistically-moving constituents by the nonrelativistic Schroedinger formalism, as well as a brief survey of the motivations for the various proposed potential models. Finally, it illustrates the application of the developed theoretical framework at a few selected examples. 60 refs., 8 figs., 17 tabs. (Authors)

  11. CT for suspected appendicitis in children: an analysis of diagnostic errors

    International Nuclear Information System (INIS)

    Taylor, George A.; Callahan, Michael J.; Rodriguez, Diana; Smink, Douglas S.

    2006-01-01

    Mistakes have been made by the use of CT in diagnosing children with suspected appendicitis. Although others have reported the frequency of diagnostic errors, we were unable to find any studies that addressed the specific situations in which diagnostic errors occurred in children with suspected appendicitis. To investigate the frequency and type of diagnostic errors resulting from CT of children with suspected appendicitis when compared to surgical and pathological diagnosis. We reviewed imaging, clinical and pathological data on 1,207 consecutive pediatric patients who underwent CT examination for suspected appendicitis. Imaging findings were categorized as false-positive, false-negative, or indeterminate. Errors were classified as interpretative, technical or unavoidable. Concordance between surgical and pathological findings was also evaluated. The imaging findings of 34 patients (2.8%) were discrepant with the pathological examination or clinical follow-up. The errors in 23 cases were classified as interpretive (68%) and 11 as unavoidable (32%), and no errors were classified as technical. There were 23 false-positive errors (68%), 6 false-negative errors (18%), and 5 indeterminate imaging studies (15%). Isolated CT findings of an enlarged (greater than 6 mm) appendix, fat stranding, thickened bowel or non-visualization of the distal appendix were the most common false-positive CT findings. Of these 34 patients, 22 underwent appendectomy, with 10 (45%) having discordant surgical and pathological findings. (orig.)

  12. The efficiency of sonography in diagnosing volvulus in neonates with suspected intestinal malrotation.

    Science.gov (United States)

    Zhang, Wenhua; Sun, Hongjun; Luo, Fangqiong

    2017-10-01

    This study is to prospectively evaluate the efficiency of sonography for volvulus diagnosis in neonates with clinically suspected intestinal malrotation.A total of 83 patients with suspected intestinal malrotation who underwent detailed abdominal sonography and upper gastrointestinal contrast study were included. Malrotation was characterized by inversion of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) in sonographic examination. The "whirlpool sign" of Color Doppler Sonography was recognized as a characteristic for malrotation with volvulus. The degrees of rotation of the SMV winding around SMA were also detected by sonography. Surgery was performed in patients with sonography diagnosed malrotation.A total of 39 patients were sonographically diagnosed as malrotation which was subsequently confirmed by surgery. The sensitivity and positive predictive value of the sonographic diagnosis were both 100% (39/39). The sensitivity, specificity and accuracy of "whirlpool sign" for the detection of midgut volvulus were 95.2% (20/21), 88.9% (16/18), and 92.3% (36/39), respectively. Greater degrees of rotation (equal or greater than 720°) showed higher risk (odds ratio, 5.0; P volvulus may be used as a potential indicator for intestinal necrosis. In addition, sonography can exclude malrotation and may help the diagnosis of other diseases, such as annular pancreas and duodenal atresia.

  13. Coronary vascular age: An alternate means for predicting stress-induced myocardial ischemia in patients with suspected coronary artery disease.

    Science.gov (United States)

    Nappi, Carmela; Gaudieri, Valeria; Acampa, Wanda; Arumugam, Parthiban; Assante, Roberta; Zampella, Emilia; Mannarino, Teresa; Mainolfi, Ciro Gabriele; Imbriaco, Massimo; Petretta, Mario; Cuocolo, Alberto

    2018-01-22

    Coronary artery calcium (CAC) can be used to estimate vascular age in adults, providing a convenient transformation of CAC from Agatston units into a year's scale. We investigated the role of coronary vascular age in predicting stress-induced myocardial ischemia in subjects with suspected coronary artery disease (CAD). A total of 717 subjects referred to CAC scoring and 82 Rb PET/CT stress-rest myocardial perfusion imaging for suspected CAD were studied. CAC score was measured according to the Agatston method and coronary vascular age by equating estimated CAD risk for chronological age and CAC using the formula 39.1 + 7.25 × ln(CAC + 1). Stress-induced ischemia was present in 105 (15%) patients. Mean chronological age, CAC score, and coronary vascular age were higher (all P age was added to clinical variables. Including vascular age in the model, the global Chi square further increased from 68.77 to 106.38 (P age to clinical data, continuous net reclassification improvement (cNRI) was 0.57, while adding vascular age to clinical data and chronological age cNRI was 0.62. At decision curve analysis, the model including vascular age was associated with the highest net benefit compared to the model including only clinical data, to the model including chronological age and clinical data, and to a strategy considering that all patients had ischemia. The model including vascular age also showed the largest reduction in false-positive rate without missing any ischemic patients. In subjects with suspected CAD, coronary vascular age is strongly associated with stress-induced ischemia. The communication of a given vascular age would have a superior emotive impact improving observance of therapies and healthier lifestyles.

  14. Characterization of waste streams and suspect waste from largest Los Alamos National Laboratory generators

    International Nuclear Information System (INIS)

    Soukup, J.D.; Erpenbeck, G.J.

    1995-01-01

    A detailed waste stream characterization of 4 primary generators of low level waste at LANL was performed to aid in waste minimization efforts. Data was compiled for these four generators from 1988 to the present for analyses. Prior waste minimization efforts have focused on identifying waste stream processes and performing source materials substitutions or reductions where applicable. In this historical survey, the generators surveyed included an accelerator facility, the plutonium facility, a chemistry and metallurgy research facility, and a radiochemistry research facility. Of particular interest in waste minimization efforts was the composition of suspect low level waste in which no radioactivity is detected through initial survey. Ultimately, this waste is disposed of in the LANL low level permitted waste disposal pits (thus filling a scarce and expensive resource with sanitary waste). Detailed analyses of the waste streams from these 4 facilities, have revealed that suspect low level waste comprises approximately 50% of the low level waste by volume and 47% by weight. However, there are significant differences in suspect waste density when one considers the radioactive contamination. For the 2 facilities that deal primarily with beta emitting activation and spallation products (the radiochemistry and accelerator facilities), the suspect waste is much lower density than all low level waste coming from those facilities. For the 2 facilities that perform research on transuranics (the chemistry and metallurgy research and plutonium facilities), suspect waste is higher in density than all the low level waste from those facilities. It is theorized that the low density suspect waste is composed primarily of compactable lab trash, most of which is not contaminated but can be easily surveyed. The high density waste is theorized to be contaminated with alpha emitting radionuclides, and in this case, the suspect waste demonstrates fundamental limits in detection

  15. [Pre-trial psychiatric reports on Antillean suspected offenders in the Netherlands and on the Dutch Antilles].

    Science.gov (United States)

    Vinkers, D J; Heytel, F G M; Matroos, G M; Hermans, K M; Hoek, H W

    2010-01-01

    The registered criminality among Antilleans living in the Netherlands is much higher than among Antilleans living on the Dutch Antilles (113 offences and 11 offences respectively, per year per 1000 persons, pDutch Antilles (n=199) between 2000 and 2006. A careful study was made of pre-trial psychiatric reports on Antillean suspected offenders (referred to as suspects) in the Netherlands and of comparable reports on Antillean suspects on the Dutch Antilles. There was no significant difference in the prevalence of mental disorders among Antillean suspects in the Netherlands (22.3%) and on the Dutch Antilles (20.3%). Abuse of drugs and cannabis was more prevalent on the Dutch Antilles where treatment for addiction is less frequently available than in the Netherlands. Mental retardation was ascertained more often among Antilleans in the Netherlands (22.4%) than among Antilleans on the Dutch Antilles (15.1%). Antillean suspects on the Dutch Antilles were more often found to be fully responsible for their actions than were Antillean suspects in the Netherlands (65.3% versus 19.1%, pDutch Antilles.

  16. Methods for Characterisation of unknown Suspect Radioactive Samples

    International Nuclear Information System (INIS)

    Sahagia, M.; Grigorescu, E.L.; Luca, A.; Razdolescu, A.C.; Ivan, C.

    2001-01-01

    Full text: The paper presents various identification and measurement methods, used for the expertise of a wide variety of suspect radioactive materials, whose circulation was not legally stated. The main types of examined samples were: radioactive sources, illegally trafficked; suspect radioactive materials or radioactively contaminated devices; uranium tablets; fire detectors containing 241 Am sources; osmium samples containing radioactive 185 Os or enriched 187 Os. The types of analyses and determination methods were as follows: the chemical composition was determined by using identification reagents or by neutron activation analysis; the radionuclide composition was determined by using gamma-ray spectrometry; the activity and particle emission rates were determined by using calibrated radiometric equipment; the absorbed dose rate at the wall of all types of containers and samples was determined by using calibrated dose ratemeters. The radiation exposure risk for population, due to these radioactive materials, was evaluated for every case. (author)

  17. Differential diagnosis of Mendelian and mitochondrial disorders in patients with suspected multiple sclerosis

    Science.gov (United States)

    Katz Sand, Ilana B.; Honce, Justin M.; Lublin, Fred D.

    2015-01-01

    Several single gene disorders share clinical and radiologic characteristics with multiple sclerosis and have the potential to be overlooked in the differential diagnostic evaluation of both adult and paediatric patients with multiple sclerosis. This group includes lysosomal storage disorders, various mitochondrial diseases, other neurometabolic disorders, and several other miscellaneous disorders. Recognition of a single-gene disorder as causal for a patient’s ‘multiple sclerosis-like’ phenotype is critically important for accurate direction of patient management, and evokes broader genetic counselling implications for affected families. Here we review single gene disorders that have the potential to mimic multiple sclerosis, provide an overview of clinical and investigational characteristics of each disorder, and present guidelines for when clinicians should suspect an underlying heritable disorder that requires diagnostic confirmation in a patient with a definite or probable diagnosis of multiple sclerosis. PMID:25636970

  18. Optical spectroscopy of known and suspected Herbig-Haro objects

    International Nuclear Information System (INIS)

    Cohen, M.; Fuller, G.A.; California Univ., Berkeley)

    1985-01-01

    Optical spectra of a number of suspected Herbig-Haro objects are presented. From these, the nature of these nebulosities are determined. Several of the nebulae are of very high density, perhaps due to their extreme youth. Extinctions measured toward DG Tau HH and the L1551 IRS 5 optical jet are in each case substantially less than the stellar values. It is suggested that this phenomenon reflects the existence of appreciably thick circumstellar dust disks around these, and two additional, exciting stars. Shock model diagnostics suggest that the emission lines in these Herbig-Haro nebulae arise in modest velocity shocks with sizable preshock densities in several cases. Radial velocities enable lower limits to be placed on the mass loss rates of those stars that have been detected in the radio continuum. 39 references

  19. Suspected placenta accreta and cesarean hysterectomy: observational cohort utilizing an intraoperative decision strategy.

    Science.gov (United States)

    Weiniger, Carolyn F; Kabiri, Doron; Ginosar, Yehuda; Ezra, Yossef; Shachar, BatZion; Lyell, Deirdre J

    2016-03-01

    Planned cesarean hysterectomy (CH) is recommended to minimize morbidity for suspected placenta accreta (PA), yet this ends fertility. We examined CH frequency and post-operative morbidities for suspected PA cases when an intra-operative decision strategy to perform CH was used. Suspected PA cases were pre-operatively identified in one tertiary care center. Women were assessed intra-operatively, prior to uterine incision, for immediate CH or for attempted placental separation. We compared outcomes among women with versus without PA (surgical and/or pathologic diagnosis), and examined outcomes following immediate CH versus attempted placental separation. Our cohort, from 2002 to 2012, comprised 99 women with suspected PA; 54 (54.5%) had PA diagnosed by surgery/pathology, and 45 (45.5%) did not. Among women diagnoses surgically or pathologically with PA, CH was performed for 46/54 (85%); 8 women with suspected PA had successful placental separation. 27 of the 46 CH were performed immediately following uterine wall examination and 19 were performed following attempted placental separation. We received histological confirmation of the clinical placenta accreta diagnosis for 24/46 (52.2%) cases, and in 22/46 (47.8%) cases the histology did not confirm the clinical diagnosis. Surgery duration, packed cell transfusion requirement and postoperative outcomes were similar among women with PA regardless of immediate CH versus attempted placental separation, except for a higher cystotomy rates following attempted placental separation. Emergency deliveries were performed at significantly earlier gestational ages. Among women with suspected PA, an intra-operative CH decision allows some women to avoid CH. Consideration of attempted placental separation did not increase blood transfusion or post-operative complications, but was associated with a higher rate of cystotomy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Autism spectrum disorder symptoms in juvenile suspects of sex offenses.

    Science.gov (United States)

    't Hart-Kerkhoffs, Lisette A; Jansen, Lucres M; Doreleijers, Theo A; Vermeiren, Robert; Minderaa, Ruud B; Hartman, Catharina A

    2009-02-01

    To investigate autism spectrum disorder (ASD) symptoms in juvenile suspects of sex offenses. A group of 175 juvenile suspected sex offenders (all males, mean +/- SD age = 14.9 +/- 1.4 years) was compared with a matched healthy control group (N = 500, mean +/- SD age = 14.0 +/- 1.4 years) and a group of children with DSM-IV-diagnosed ASD (N = 114, mean +/- SD age = 14.2 +/- 1.9 years) with respect to autistic symptoms as measured by means of a standardized questionnaire, the Children's Social Behavior Questionnaire. Furthermore, specific subgroups of sexual offenders, i.e., child molesters, solo peer offenders, and group offenders, were compared with regard to levels of ASD symptoms. The study was conducted from May 2003 to December 2006. Significantly higher levels of ASD symptoms were found in juvenile sex offenders than in healthy controls, while levels were lower than in the ASD group (F = 148.259, p symptoms than group offenders (F = 5.127, p symptoms are higher in juvenile suspects of sex offenses as compared to the healthy population, which argues for considering specific diagnostic assessment in this population, especially in solo offenders and child molesters. Copyright 2009 Physicians Postgraduate Press, Inc.

  1. Placental Growth Factor (PlGF in Women with Suspected Pre-Eclampsia Prior to 35 Weeks' Gestation: A Budget Impact Analysis.

    Directory of Open Access Journals (Sweden)

    Suzy Duckworth

    Full Text Available To model the resource implications of placental growth factor (PlGF testing in women with suspected pre-eclampsia prior to 35 weeks' gestation as part of a management algorithm, compared with current practice.Data on resource use from 132 women with suspected pre-eclampsia prior to 35 weeks' gestation, enrolled in a prospective observational cohort study evaluating PlGF measurement within antenatal assessment units within two UK consultant-led maternity units was extracted by case note review. A decision analytic model was developed using these data to establish the budget impact of managing women with suspected pre-eclampsia for two weeks from the date of PlGF testing, using a clinical management algorithm and reference cost tariffs. The main outcome measures of resource use (numbers of outpatient appointments, ultrasound investigations and hospital admissions were correlated to final diagnosis and used to calculate comparative management regimes.The mean cost saving associated with the PlGF test (in the PlGF plus management arm was £35,087 (95% CI -£33,181 to -£36,992 per 1,000 women. This equated to a saving of £582 (95% CI -552 to -£613 per woman tested. In 94% of iterations, PlGF testing was associated with cost saving compared to current practice.This analysis suggests PlGF used as part of a clinical management algorithm in women presenting with suspected pre-eclampsia prior to 35 weeks' gestation could provide cost savings by reducing unnecessary resource use. Introduction of PlGF testing could be used to direct appropriate resource allocation and overall would be cost saving.

  2. A case suspected for yellow fever vaccine-associated viscerotropic disease in the Netherlands.

    Science.gov (United States)

    van de Pol, Eva M; Gisolf, Elizabeth H; Richter, Clemens

    2014-01-01

    Yellow fever (YF) 17D vaccine is one of the most successful vaccines ever developed. Since 2001, 56 cases of yellow fever vaccine-associated viscerotropic disease (YEL-AVD) have been published in the peer-reviewed literature. Here, we report a new case suspected for YEL-AVD in the Netherlands. Further research is needed to determine the true incidence of YEL-AVD and to clarify host and vaccine-associated factors in the pathogenesis of YEL-AVD. Because of the potential adverse events, healthcare providers should carefully consider vaccination only in people who are truly at risk for YF infection, especially in primary vaccine recipients. © 2014 International Society of Travel Medicine.

  3. Diagnostic work-up and loss of tuberculosis suspects in Jogjakarta, Indonesia.

    Science.gov (United States)

    Ahmad, Riris Andono; Matthys, Francine; Dwihardiani, Bintari; Rintiswati, Ning; de Vlas, Sake J; Mahendradhata, Yodi; van der Stuyft, Patrick

    2012-02-15

    Early and accurate diagnosis of pulmonary tuberculosis (TB) is critical for successful TB control. To assist in the diagnosis of smear-negative pulmonary TB, the World Health Organisation (WHO) recommends the use of a diagnostic algorithm. Our study evaluated the implementation of the national tuberculosis programme's diagnostic algorithm in routine health care settings in Jogjakarta, Indonesia. The diagnostic algorithm is based on the WHO TB diagnostic algorithm, which had already been implemented in the health facilities. We prospectively documented the diagnostic work-up of all new tuberculosis suspects until a diagnosis was reached. We used clinical audit forms to record each step chronologically. Data on the patient's gender, age, symptoms, examinations (types, dates, and results), and final diagnosis were collected. Information was recorded for 754 TB suspects; 43.5% of whom were lost during the diagnostic work-up in health centres, 0% in lung clinics. Among the TB suspects who completed diagnostic work-ups, 51.1% and 100.0% were diagnosed without following the national TB diagnostic algorithm in health centres and lung clinics, respectively. However, the work-up in the health centres and lung clinics generally conformed to international standards for tuberculosis care (ISTC). Diagnostic delays were significantly longer in health centres compared to lung clinics. The high rate of patients lost in health centres needs to be addressed through the implementation of TB suspect tracing and better programme supervision. The national TB algorithm needs to be revised and differentiated according to the level of care.

  4. Analysis of suspected wildlife crimes submitted for forensic examinations in Scotland.

    Science.gov (United States)

    Millins, Caroline; Howie, Fiona; Everitt, Charles; Shand, Michael; Lamm, Catherine

    2014-09-01

    This study describes the occurrence of suspected wildlife crimes submitted for forensic examination in Scotland in 2010. The study aims were to determine which types of crimes were committed, which species were targeted, and the outcome of investigations, in order to assess the contribution of forensic examinations in the prosecution of wildlife crimes. Information on suspected wildlife crimes submitted between January 1 and December 31, 2010 to the SAC Consulting: Veterinary Services Disease Surveillance Centers, Science and Advice for Scottish Agriculture, and to the University of Glasgow, was used. The location of suspected crimes, the species targeted, cause of death, and types of the 188 submitted wildlife crimes were summarized. More information regarding cases involving birds were submitted than cases involving mammals, and included 114 raptors, 14 waterfowl, and 22 "other bird species." Mammal cases (n = 38) included 12 badgers, 8 foxes, 7 deer, 4 hares, and 7 "other mammals." The cause of death was determined in 124 suspected crimes; malicious or accidental trauma was the most likely cause of death in 72, and 33 were poisoned. Forensic evidence supporting criminal activity was found in 53 cases, and poisoning was the most frequent crime recorded. At least five individuals were successfully prosecuted, representing 2.7 % of submissions. It was challenging to track cases from submission through to prosecution and laboratories conducting forensic investigations were often not informed of the outcome of prosecutions or court decisions.

  5. Occurrence of antibodies to Anaplasma phagocytophilum in patients with suspected tick-borne encephalitis

    Directory of Open Access Journals (Sweden)

    Zuzana Kalinová

    2015-09-01

    None of the examined patients with suspected TBE had the disease confirmed. Hoever, as shown by the results, the relative risk of occurrence of anaplasmosis is higher in people examined for some another vector-borne disease (in this case TBE. Therefore, the performance of screening examinations in patients suspected of having any tick-borne disease is very important.

  6. Optimisation of the MR protocol in pregnant women with suspected acute appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ilah; Chung, Yong Eun; An, Chansik; Kim, Honsoul; Lim, Joon Seok; Kim, Myeong-Jin [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Seoul (Korea, Republic of); Lee, Hye Sun [Yonsei University College of Medicine, Department of Research Affairs, Biostatistics Collaboration Unit, Seoul (Korea, Republic of)

    2018-02-15

    To investigate the optimal magnetic resonance (MR) imaging protocol in pregnant women suspected of having acute appendicitis. One hundred and forty-six pregnant women with suspected appendicitis were included. MR images were reviewed by two radiologists in three separate sessions. In session 1, only axial single-shot turbo spin echo (SSH-TSE) T2-weighted images (WI) were included with other routine sequences. In sessions 2 and 3, coronal and sagittal T2WI were sequentially added. The visibility of the appendix and diagnostic confidence of appendicitis were evaluated in each session using a 5-point grading scale. If diseases other than appendicitis were suspected, specific diagnosis with a 5-point confidence scale was recorded. Diagnostic performance for appendicitis and other diseases were evaluated. Twenty-five patients (17.1%) were diagnosed with appendicitis. Among the patients with normal appendix, 28 were diagnosed with other disease. Diagnostic performance including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve values for diagnosing appendicitis and other diseases showed no significant difference among sets for both reviewers (p>0.05). Diagnostic performance of MR in pregnant patients with suspected appendicitis can be preserved with omission of sagittal or both coronal and sagittal SSH-T2WI. (orig.)

  7. Optimisation of the MR protocol in pregnant women with suspected acute appendicitis

    International Nuclear Information System (INIS)

    Shin, Ilah; Chung, Yong Eun; An, Chansik; Kim, Honsoul; Lim, Joon Seok; Kim, Myeong-Jin; Lee, Hye Sun

    2018-01-01

    To investigate the optimal magnetic resonance (MR) imaging protocol in pregnant women suspected of having acute appendicitis. One hundred and forty-six pregnant women with suspected appendicitis were included. MR images were reviewed by two radiologists in three separate sessions. In session 1, only axial single-shot turbo spin echo (SSH-TSE) T2-weighted images (WI) were included with other routine sequences. In sessions 2 and 3, coronal and sagittal T2WI were sequentially added. The visibility of the appendix and diagnostic confidence of appendicitis were evaluated in each session using a 5-point grading scale. If diseases other than appendicitis were suspected, specific diagnosis with a 5-point confidence scale was recorded. Diagnostic performance for appendicitis and other diseases were evaluated. Twenty-five patients (17.1%) were diagnosed with appendicitis. Among the patients with normal appendix, 28 were diagnosed with other disease. Diagnostic performance including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve values for diagnosing appendicitis and other diseases showed no significant difference among sets for both reviewers (p>0.05). Diagnostic performance of MR in pregnant patients with suspected appendicitis can be preserved with omission of sagittal or both coronal and sagittal SSH-T2WI. (orig.)

  8. 48 CFR 903.303 - Reporting suspected antitrust violations.

    Science.gov (United States)

    2010-10-01

    ... as described in FAR 3.301, and antitrust law violations as described in FAR 3.303, evidenced in bids... antitrust violations. 903.303 Section 903.303 Federal Acquisition Regulations System DEPARTMENT OF ENERGY GENERAL IMPROPER BUSINESS PRACTICES AND PERSONAL CONFLICTS OF INTEREST Reports of Suspected Antitrust...

  9. Talking heads : interviewing suspects from a cultural perspective

    NARCIS (Netherlands)

    Beune, K.

    2009-01-01

    Although the literature on the interviewing of suspects has increased over the past decade, research on the use and effectiveness of police strategies and their boundary conditions is very rare. The present dissertation aims to fill this void by identifying behaviors that appeal to and persuade

  10. 48 CFR 3.303 - Reporting suspected antitrust violations.

    Science.gov (United States)

    2010-10-01

    ... suspect. Paragraph (c) below identifies behavior patterns that are often associated with antitrust... offers; (2) A sudden change from competitive bidding to identical bidding; (3) Simultaneous price... turn in sequence as low bidder, or so that certain competitors bid low only on some sizes of contracts...

  11. Deuteron microscopic optical model potential

    International Nuclear Information System (INIS)

    Guo Hairui; Han Yinlu; Shen Qingbiao; Xu Yongli

    2010-01-01

    A deuteron microscopic optical model potential is obtained by the Green function method through nuclear-matter approximation and local-density approximation based on the effective Skyrme interaction. The microscopic optical model potential is used to calculate the deuteron reaction cross sections and the elastic scattering angular distributions for some target nuclei in the mass range 6≤A≤208 with incident deuteron energies up to 200 MeV. The calculated results are compared with the experimental data.

  12. Suspect filler similarity in eyewitness lineups: a literature review and a novel methodology.

    Science.gov (United States)

    Fitzgerald, Ryan J; Oriet, Chris; Price, Heather L

    2015-02-01

    Eyewitness lineups typically contain a suspect (guilty or innocent) and fillers (known innocents). The degree to which fillers should resemble the suspect is a complex issue that has yet to be resolved. Previously, researchers have voiced concern that eyewitnesses would be unable to identify their target from a lineup containing highly similar fillers; however, our literature review suggests highly similar fillers have only rarely been shown to have this effect. To further examine the effect of highly similar fillers on lineup responses, we used morphing software to create fillers of moderately high and very high similarity to the suspect. When the culprit was in the lineup, a higher correct identification rate was observed in moderately high similarity lineups than in very high similarity lineups. When the culprit was absent, similarity did not yield a significant effect on innocent suspect misidentification rates. However, the correct rejection rate in the moderately high similarity lineup was 20% higher than in the very high similarity lineup. When choosing rates were controlled by calculating identification probabilities for only those who made a selection from the lineup, culprit identification rates as well as innocent suspect misidentification rates were significantly higher in the moderately high similarity lineup than in the very high similarity lineup. Thus, very high similarity fillers yielded costs and benefits. Although our research suggests that selecting the most similar fillers available may adversely affect correct identification rates, we recommend additional research using fillers obtained from police databases to corroborate our findings.

  13. Factors associated to referral of tuberculosis suspects by private practitioners to community health centres in Bali Province, Indonesia.

    Science.gov (United States)

    Artawan Eka Putra, I Wayan Gede; Utami, Ni Wayan Arya; Suarjana, I Ketut; Duana, I Made Kerta; Astiti, Cok Istri Darma; Putra, I W; Probandari, Ari; Tiemersma, Edine W; Wahyuni, Chatarina Umbul

    2013-10-28

    The contrast between the low proportion of tuberculosis (TB) suspects referred from private practitioners in Bali province and the high volume of TB suspects seeking care at private practices suggests problems with TB suspect referral from private practitioners to the public health sector. We aimed to identify key factors associated with the referral of TB suspects by private practitioners. We conducted a case-control study conducted in Bali province, Indonesia. The cases were private practitioners who had referred at least one TB suspect to a community health centre between 1 January 2007 and the start of data collection, while the controls were private practitioners who had not referred a single TB suspect in the same time. The following factors were independently associated with referral of TB suspects by private practitioners: having received information about the directly observed treatment short-course (DOTS) strategy (OR 2.0; 95% CI 1.1-3.8), ever having been visited by a district TB program officer (OR 2.1; 95% CI 1.0-4.5), availability of TB suspect referral forms in the practice (OR 2.8; 95% CI 1.5-5.2), and less than 5 km distance between the private practice and the laboratory for smear examination (OR 2.2; 95% CI 1.2-4.0). Education and exposure of private practitioners to the TB program improves referral of TB suspects from private practitioners to the national TB program. We recommend that the TB program provides all private practitioners with information about the DOTS strategy and TB suspect referral forms, and organizes regular visits to private practitioners.

  14. Correlates and Suspected Causes of Obesity in Children

    Science.gov (United States)

    Crothers, Laura M.; Kehle, Thomas J.; Bray, Melissa A.; Theodore, Lea A.

    2009-01-01

    The correlates and suspected causes of the intractable condition obesity are complex and involve environmental and heritable, psychological and physical variables. Overall, the factors associated with and possible causes of it are not clearly understood. Although there exists some ambiguity in the research regarding the degree of happiness in…

  15. Anesthetic management in patients suspected of Creutzfeldt-Jakob disease -A case report-.

    Science.gov (United States)

    In, Chi Bum; Choi, Young Sil; Park, Eun Young; Chang, Dong Jin; Lee, Soo Kyung; Choi, Hyun; Moon, Hyun Soo

    2011-09-01

    Creutzfeldt-Jakob disease (CJD) is a fatal neurodegenerative disorder in which accumulation of the pathogenic prion protein induces neuronal damage and results in distinct pathologic features. This abnormal prion is an infectious protein and resistant to methods of sterilization currently being used. Therefore, management of definite, or suspected CJD patients requires additional precautions. We report our experience of a patient who had undergone brain biopsy for suspected of CJD. The patient was confirmed to have sporadic CJD.

  16. Matrix models with non-even potentials

    International Nuclear Information System (INIS)

    Marzban, C.; Raju Viswanathan, R.

    1990-07-01

    We study examples of hermitian 1-matrix models with even and odd terms present in the potential. A definition of criticality is presented which in these cases leads to multicritical models falling into the same universality classes as those of the purely even potentials. We also show that, in our examples, for polynomial potentials ending in odd powers (unbounded) the coupling constants, in addition to their expected real critical values, also admit critical values which alternate between imaginary/real values in the odd/even terms. We find that, remarkably, the ensuing statistical models are insensitive to the real/imaginary nature of these critical values. This feature may be of relevance in the recently-studied connection between matrix models and the moduli space of Riemann surfaces. (author). 9 refs

  17. A case report of suspected malignant hyperthermia where patient survived the episode.

    Science.gov (United States)

    Iqbal, Asif; Badoo, Shoaib; Naqeeb, Ruqsana

    2017-01-01

    Malignant hyperthermia is rare inherited disorder in our part of the world; there are only few cases reported in literature in India who were suspected of having this condition. The overall incidence of malignant hyperthermia during general anesthesia is estimated to range from 1: 5000 to 1: 50,000-100,000 and mortality rate is estimated to be <5% in the presence of standard care. In India, there is no center where in vitro halothane caffeine contraction test is performed to confirm diagnosis in suspected cases. Second, dantrolene drug of choice for this condition is not freely available in market in India and is stored only in some hospitals in few major cities. Among the cases reported of suspected of malignant hyperthermia in India almost 50% have survived the condition despite nonavailability of dantrolene emphasizing role of early detection and aggressive management in these cases.

  18. A case report of suspected malignant hyperthermia where patient survived the episode

    Directory of Open Access Journals (Sweden)

    Asif Iqbal

    2017-01-01

    Full Text Available Malignant hyperthermia is rare inherited disorder in our part of the world; there are only few cases reported in literature in India who were suspected of having this condition. The overall incidence of malignant hyperthermia during general anesthesia is estimated to range from 1: 5000 to 1: 50,000–100,000 and mortality rate is estimated to be <5% in the presence of standard care. In India, there is no center where in vitro halothane caffeine contraction test is performed to confirm diagnosis in suspected cases. Second, dantrolene drug of choice for this condition is not freely available in market in India and is stored only in some hospitals in few major cities. Among the cases reported of suspected of malignant hyperthermia in India almost 50% have survived the condition despite nonavailability of dantrolene emphasizing role of early detection and aggressive management in these cases.

  19. A parabolic model for dimple potentials

    International Nuclear Information System (INIS)

    Aydin, Melike Cibik; Uncu, Haydar; Deniz, Coskun

    2013-01-01

    We study the truncated parabolic function and demonstrate that it is a representation of the Dirac δ function. We also show that the truncated parabolic function, used as a potential in the Schrödinger equation, has the same bound state spectrum, tunneling and reflection amplitudes as the Dirac δ potential, as the width of the parabola approximates to zero. Dirac δ potential is used to model dimple potentials which are utilized to increase the phase-space density of a Bose–Einstein condensate in a harmonic trap. We show that a harmonic trap with a δ function at the origin is a limiting case of the harmonic trap with a symmetric truncated parabolic potential around the origin. Hence, the truncated parabolic is a better candidate for modeling the dimple potentials. (paper)

  20. Risk Factors and Bacterial Profile of Suspected Neonatal ...

    African Journals Online (AJOL)

    Neonatal septicaemia is a common cause of morbidity and mortality in developing countries and a major health concern. The aim of this study is to evaluate the bacterial profile, antibiotics susceptibility pattern and associated risk factors of suspected septicaemia in neonates in this locality. Five hundred and forty seven ...

  1. Diagnostic work-up and loss of tuberculosis suspects in Jogjakarta, Indonesia

    Directory of Open Access Journals (Sweden)

    Ahmad Riris

    2012-02-01

    Full Text Available Abstract Background Early and accurate diagnosis of pulmonary tuberculosis (TB is critical for successful TB control. To assist in the diagnosis of smear-negative pulmonary TB, the World Health Organisation (WHO recommends the use of a diagnostic algorithm. Our study evaluated the implementation of the national tuberculosis programme's diagnostic algorithm in routine health care settings in Jogjakarta, Indonesia. The diagnostic algorithm is based on the WHO TB diagnostic algorithm, which had already been implemented in the health facilities. Methods We prospectively documented the diagnostic work-up of all new tuberculosis suspects until a diagnosis was reached. We used clinical audit forms to record each step chronologically. Data on the patient's gender, age, symptoms, examinations (types, dates, and results, and final diagnosis were collected. Results Information was recorded for 754 TB suspects; 43.5% of whom were lost during the diagnostic work-up in health centres, 0% in lung clinics. Among the TB suspects who completed diagnostic work-ups, 51.1% and 100.0% were diagnosed without following the national TB diagnostic algorithm in health centres and lung clinics, respectively. However, the work-up in the health centres and lung clinics generally conformed to international standards for tuberculosis care (ISTC. Diagnostic delays were significantly longer in health centres compared to lung clinics. Conclusions The high rate of patients lost in health centres needs to be addressed through the implementation of TB suspect tracing and better programme supervision. The national TB algorithm needs to be revised and differentiated according to the level of care.

  2. Suspected infection in afebrile patients : Are they septic?

    NARCIS (Netherlands)

    Martins, Fernanda de Souza; Guedes, Gisele Giuliane; Santos, Thiago Martins; de Carvalho-Filho, Marco A

    We prospectively evaluated afebrile patients admitted to an emergency department (ED), with suspected infection and only tachycardia or tachypnea.The white blood cell count (WBC) was obtained, and patients were considered septic if leukocyte count was >12,000 μL-1 or <4000 μL-1 or with >10% of band

  3. Pathologically confirmed autoimmune encephalitis in suspected Creutzfeldt-Jakob disease

    NARCIS (Netherlands)

    Maat, P.; de Beukelaar, J.W.; Jansen, C.; Schuur, M.; van Duijn, C.M.; van Coevorden, M.H.; de Graaff, E.; Titulaer, E.; Rozemuller, A.J.M.; Sillevis Smitt, P.

    2015-01-01

    Objective: To determine the clinical features and presence in CSF of antineuronal antibodies in patients with pathologically proven autoimmune encephalitis derived from a cohort of patients with suspected Creutzfeldt-Jakob disease (CJD). Methods: The Dutch Surveillance Centre for Prion Diseases

  4. Producing 'internal suspect bodies': divisive effects of UK counter-terrorism measures on Muslim communities in Leeds and Bradford.

    Science.gov (United States)

    Abbas, Madeline-Sophie

    2018-04-06

    Research on UK government counter-terrorism measures has claimed that Muslims are treated as a 'suspect community'. However, there is limited research exploring the divisive effects that membership of a 'suspect community' has on relations within Muslim communities. Drawing from interviews with British Muslims living in Leeds or Bradford, I address this gap by explicating how co-option of Muslim community members to counter extremism fractures relations within Muslim communities. I reveal how community members internalize fears of state targeting which precipitates internal disciplinary measures. I contribute the category of 'internal suspect body' which is materialized through two intersecting conditions within preventative counter-terrorism: the suspected extremist for Muslims to look out for and suspected informer who might report fellow Muslims. I argue that the suspect community operates through a network of relations by which terrors of counter-terrorism are reproduced within Muslim communities with divisive effects. © London School of Economics and Political Science 2018.

  5. FDG-PET of patients with suspected renal failure. Standardized uptake values in normal tissues

    International Nuclear Information System (INIS)

    Minamimoto, Ryogo; Takahashi, Nobukazu; Inoue, Tomio

    2007-01-01

    This study aims to clarify the effect of renal function on 2-[ 18 F] fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) imaging and determine the clinical significance of renal function in this setting. We compared FDG distribution between normal volunteers and patients with suspected renal failure. Twenty healthy volunteers and 20 patients with suspected renal failure who underwent FDG-PET between November 2002 and May 2005 were selected for this study. We define ''patients with suspected renal failure'' as having a blood serum creatinine level in excess of 1.1 mg/dl. The serum creatinine level was examined once in 2 weeks of the FDG-PET study. Regions of interest were placed over 15 regions for semi-quantitative analysis: the white matter, cortex, both upper lung fields, both middle lung fields, both lower lung fields, mediastinum, myocardium of the left ventricle, the left atrium as a cardiac blood pool, central region of the right lobe of the liver, left kidney, and both femoris muscles. The mean standardized uptake values (SUVs) of brain cortex and white matter were higher in healthy volunteers than in renal patients. The mean SUVs of the mediastinum at the level of the aortic arch and left atrium as a cardiac blood pool were lower in healthy volunteers than in patients with suspected renal failure. These regions differed between healthy volunteers and patients with suspected renal failure (P<0.05). We found decreasing brain accumulation and increasing blood pool accumulation of FDG in patients with high plasma creatinine. Although the difference is small, this phenomenon will not have a huge effect on the assessment of FDG-PET imaging in patients with suspected renal failure. (author)

  6. A suspected case of Addison's disease in cattle.

    Science.gov (United States)

    Lambacher, Bianca; Wittek, Thomas

    2015-09-01

    A 4.75-year old Simmental cow was presented with symptoms of colic and ileus. The clinical signs and blood analysis resulted in the diagnosis of suspected primary hypoadrenocorticism (Addison's disease). Although Addison's disease has been frequently described in other domestic mammals, to our knowledge, this disease has not previously been reported in cattle.

  7. The potential model of coloured quarks

    International Nuclear Information System (INIS)

    Greenberg, O.W.

    1981-01-01

    The success of the additive potential model of colored quarks for the masses, decay rates, and other properties of single mesons and baryons does not imply that this model can yield the observed meson-nucleon and nucleon-nucleon interactions. We give a comprehensive discussion of this issue. In agreement with previous authors, we conclude that, on the contrary, this model predicts inverse-power color-analog van der Waals potentials between separated hadrons which are in substantial contradiction with experimental data. We also discuss pathologies of non-abelian confining potentials, and show that the hamiltonian is unbounded below for an arbitrary number of quarks and antiquarks in a definite color state for all color states, except the singlet, triplet, and antitriplet. (orig.)

  8. The neutron optical model potential

    International Nuclear Information System (INIS)

    Hodgson, P.E.

    1989-01-01

    The present status of optical model calculations of neutron scattering and interactions is reviewed, with special emphasis on more recent developments and the more promising lines of research. The use of dispersion relations to provide an extra constraint on the potential is discussed, together with their application to studies of the Fermi surface anomaly. The application of potential inversion techniques to determine the form of the potential is also considered. (author). 39 refs, figs

  9. Evaluating suspect sites open-quotes to clean or not to clean?close quotes

    International Nuclear Information System (INIS)

    Murray, M.E.; Coleman, R.L.; Tiner, P.F.

    1996-01-01

    Within many large government reservations are many sites that are potentially contaminated from various uses such as experiments, material storage, or material processes. There also exist many smaller areas that, by proximity to contaminated sites, or due to work contracts, are likely to be contaminated. The party responsible for such sites must evaluate if remediation is required, based on current guidelines and future uses. The Departments of Defense and Energy have many sites and properties that are suspected of being contaminated or associated with operations that could cause contamination. In some cases the contaminants may have been adequately cleaned up, then decayed away, biodegraded, or dispersed to a nondetectable level. The decision to remove these sites from any further consideration of remediation or control must be based on historical data, potential contaminants, current analytical data, future uses, and the cost associated with managing the sites. This paper deals with the methodology for evaluating small sites and gives some case studies

  10. A Method for Extracting Suspected Parotid Lesions in CT Images using Feature-based Segmentation and Active Contours based on Stationary Wavelet Transform

    Science.gov (United States)

    Wu, T. Y.; Lin, S. F.

    2013-10-01

    Automatic suspected lesion extraction is an important application in computer-aided diagnosis (CAD). In this paper, we propose a method to automatically extract the suspected parotid regions for clinical evaluation in head and neck CT images. The suspected lesion tissues in low contrast tissue regions can be localized with feature-based segmentation (FBS) based on local texture features, and can be delineated with accuracy by modified active contour models (ACM). At first, stationary wavelet transform (SWT) is introduced. The derived wavelet coefficients are applied to derive the local features for FBS, and to generate enhanced energy maps for ACM computation. Geometric shape features (GSFs) are proposed to analyze each soft tissue region segmented by FBS; the regions with higher similarity GSFs with the lesions are extracted and the information is also applied as the initial conditions for fine delineation computation. Consequently, the suspected lesions can be automatically localized and accurately delineated for aiding clinical diagnosis. The performance of the proposed method is evaluated by comparing with the results outlined by clinical experts. The experiments on 20 pathological CT data sets show that the true-positive (TP) rate on recognizing parotid lesions is about 94%, and the dimension accuracy of delineation results can also approach over 93%.

  11. RETRIEVING SUSPECT TRANSURANIC WASTE FROM THE HANFORD BURIAL GROUNDS PROGRESS PLANS AND CHALLENGES

    International Nuclear Information System (INIS)

    FRENCH, M.S.

    2006-01-01

    This paper describes the scope and status of the program for retrieval of suspect transuranic (TRU) waste stored in the Hanford Site low-level burial grounds. Beginning in 1970 and continuing until the late 1980's, waste suspected of containing significant quantities of transuranic isotopes was placed in ''retrievable'' storage in designated modules in the Hanford burial grounds, with the intent that the waste would be retrieved when a national repository for disposal of such waste became operational. Approximately 15,000 cubic meters of waste, suspected of being TRU, was placed in storage modules in four burial grounds. With the availability of the national repository (the Waste Isolation Pilot Plant), retrieval of the suspect TRU waste is now underway. Retrieval efforts, to date, have been conducted in storage modules that contain waste, which is in general, contact-handled, relatively new (1980's and later), is stacked in neat, engineered configurations, and has a relatively good record of waste characteristics. Even with these optimum conditions, retrieval personnel have had to deal with a large number of structurally degraded containers, radioactive contamination issues, and industrial hazards (including organic vapors). Future retrieval efforts in older, less engineered modules are expected to present additional hazards and difficult challenges

  12. Overcoming Innocents' Naiveté: Pre-interrogation Decision-making Among Innocent Suspects.

    Science.gov (United States)

    Scherr, Kyle C; Alberts, Kimberly M; Franks, Andrew S; Hawkins, Ian

    2016-07-01

    Suspects, especially innocent ones, are highly susceptible to waiving their interrogation rights. This research tested the ability of two strategies to overcome innocent suspects' willingness to waive their rights. One strategy was based on the social influence of scarcity (i.e., not constraining the pre-interrogation time limit). The other strategy focused on disrupting individuals' cognitive fluency during the decision-making process (i.e., violating their induced expectation of offering a waiver). Disrupting innocent individuals' cognitive fluency increased their willingness to invoke their rights and, notably, was not qualified by interactions with any other factors. However, scarcity did not influence individuals' pre-interrogation decision-making. Results also further established the association between innocent individuals' naïve mindset and their willingness to waive their rights - specifically, innocents' willingness to waive their rights increased with the strength of their just world beliefs. The theoretical and applied implications of these findings are discussed. The importance and benefit of reforming pre-interrogation protocols using fair and feasible strategies that would disrupt suspects' cognitive fluency are emphasized. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  13. The 24- hour pattern of intraocular pressure in suspected glaucoma patients

    Directory of Open Access Journals (Sweden)

    Shan-Shan Li

    2018-05-01

    Full Text Available AIM: To analyze the value of 24-hour intraocular pressure(IOPmonitoring in suspected glaucoma patients.METHODS: Totally 48 suspected glaucoma(96 eyeswere selected for 24-hour IOP monitoring by using Accupen tonometer(24-3000and non-contact tonometer(NCT, CT-80Afrom 9:30 to 7:30 next day(once in 2h. During 07:30 to 21:30, patients were measured in sitting position, while during 23:30 to 05:30 in both sitting and supine position.RESULTS: A morning peak of IOP was shown at 7:30 in traditional position by using two measures with 22.05±3.608mmHg of NCT and 19.79±4.147mmHg of Accupen tonometer. The peak IOP in habitual position appeared in 5:30 with 21.64±4.814mmHg. The lowest IOP occurred in both position at 21:30 with 15.73±3.649mmHg. Both positions showed IOP trend of going up at night and then declining in the morning. CONCLUSION: The peak IOP in suspected glaucoma occurs mostly at early morning. Supine IOP of sleeping time is higher than that of sitting position.

  14. Suspected pulmonary tuberculosis in rural South Africa - Sputum ...

    African Journals Online (AJOL)

    Three (125%) of the 24 patients with a discharge diagnosis other than TB (17 pneumonia, 3 old TB, 2 carcinoma of the lung, 1 bronchiectasis) turned out to have TB within the follow-up period; 2 of those had extrapulmonary TB Conclusion, SI produced a positive smear result in 29% of patients with suspected TB who had ...

  15. Respiratory microbes present in the nasopharynx of children hospitalised with suspected pulmonary tuberculosis in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Felix S. Dube

    2016-10-01

    Full Text Available Abstract Background Lower respiratory tract infection in children is increasingly thought to be polymicrobial in origin. Children with symptoms suggestive of pulmonary tuberculosis (PTB may have tuberculosis, other respiratory tract infections or co-infection with Mycobacterium tuberculosis and other pathogens. We aimed to identify the presence of potential respiratory pathogens in nasopharyngeal (NP samples from children with suspected PTB. Method NP samples collected from consecutive children presenting with suspected PTB at Red Cross Children’s Hospital (Cape Town, South Africa were tested by multiplex real-time RT-PCR. Mycobacterial liquid culture and Xpert MTB/RIF was performed on 2 induced sputa obtained from each participant. Children were categorised as definite-TB (culture or qPCR [Xpert MTB/RIF] confirmed, unlikely-TB (improvement of symptoms without TB treatment on follow-up and unconfirmed-TB (all other children. Results Amongst 214 children with a median age of 36 months (interquartile range, [IQR] 19–66 months, 34 (16 % had definite-TB, 86 (40 % had unconfirmed-TB and 94 (44 % were classified as unlikely-TB. Moraxella catarrhalis (64 %, Streptococcus pneumoniae (42 %, Haemophilus influenzae spp (29 % and Staphylococcus aureus (22 % were the most common bacteria detected in NP samples. Other bacteria detected included Mycoplasma pneumoniae (9 %, Bordetella pertussis (7 % and Chlamydophila pneumoniae (4 %. The most common viruses detected included metapneumovirus (19 %, rhinovirus (15 %, influenza virus C (9 %, adenovirus (7 %, cytomegalovirus (7 % and coronavirus O43 (5.6 %. Both bacteria and viruses were detected in 73, 55 and 56 % of the definite, unconfirmed and unlikely-TB groups, respectively. There were no significant differences in the distribution of respiratory microbes between children with and without TB. Using quadratic discriminant analysis, human metapneumovirus, C. pneumoniae, coronavirus 043

  16. Does this adult patient with suspected bacteremia require blood cultures?

    Science.gov (United States)

    Coburn, Bryan; Morris, Andrew M; Tomlinson, George; Detsky, Allan S

    2012-08-01

    Clinicians order blood cultures liberally among patients in whom bacteremia is suspected, though a small proportion of blood cultures yield true-positive results. Ordering blood cultures inappropriately may be both wasteful and harmful. To review the accuracy of easily obtained clinical and laboratory findings to inform the decision to obtain blood cultures in suspected bacteremia. A MEDLINE and EMBASE search (inception to April 2012) yielded 35 studies that met inclusion criteria for evaluating the accuracy of clinical variables for bacteremia in adult immunocompetent patients, representing 4566 bacteremia and 25,946 negative blood culture episodes. Data were extracted to determine the prevalence and likelihood ratios (LRs) of findings for bacteremia. The pretest probability of bacteremia varies depending on the clinical context, from low (eg, cellulitis: 2%) to high (eg, septic shock: 69%). Elevated temperatures alone do not accurately predict bacteremia (for ≥38°C [>100.3°F], LR, 1.9 [95% CI, 1.4-2.4]; for ≥38.5°C [>101.2°F], LR, 1.4 [95% CI, 1.1-2.0]), nor does isolated leukocytosis (LR, cultures should not be ordered for adult patients with isolated fever or leukocytosis without considering the pretest probability. SIRS and the decision rule may be helpful in identifying patients who do not need blood cultures. These conclusions do not apply to immunocompromised patients or when endocarditis is suspected.

  17. Thoracic computed tomography in patients with suspected malignant pleural effusions

    International Nuclear Information System (INIS)

    Traill, Zoee C.; Davies, Robert J.O.; Gleeson, Fergus V.

    2001-01-01

    AIM: To assess the role of contrast-enhanced computed tomography (CT) prospectively in patients with suspected malignant pleural effusions. MATERIALS AND METHODS: Forty consecutive patients referred for the investigation of a suspected malignant pleural effusion had contrast-enhanced thoracic CT, thoracoscopy, thoraco-centesis and pleural biopsy, either percutaneously or at thoracoscopy. Final diagnoses were based on histopathological or cytological analysis (n = 30), autopsy findings (n = 3) or clinical follow-up (n = 7). The pleural surfaces were classified at contrast-enhanced CT as normal or abnormal and, if abnormal, as benign or malignant in appearance using previously established CT criteria for malignant pleural thickening by two observers unaware of the pathological diagnosis. RESULTS: Pleural effusions were malignant in 32 patients and benign in eight patients. Pleural surfaces assessed at CT showed features of malignancy in 27 out of 32 patients with a malignant effusion (sensitivity 84%, specificity 100%). Overall, CT appearances indicated the presence of malignancy in 28 of 32 (87%) patients. All eight patients with benign pleural disease were correctly diagnosed by CT. CONCLUSION: Contrast-enhanced CT is of value in patients with suspected malignant pleural effusions. The previously established criteria for malignant pleural thickening of nodularity, irregularity and pleural thickness >1 cm are reliable in the presence of a pleural effusion. Traill, Z.C. et al. (2001)

  18. Cholescintigraphy and ultrasonography in patients suspected of having acute cholecystitis

    DEFF Research Database (Denmark)

    Lauritsen, K B; Sommer, W; Hahn, L

    1988-01-01

    The diagnostic power of combined cholescintigraphy and ultrasonography was tested in 67 patients suspected of having acute cholecystitis; of these, 42 (63%) had acute cholecystitis. The predictive value of a positive scintigraphy (PVpos) was 95% and that of a negative (PVneg) was 91% (n = 67......). The PVpos and PVneg of ultrasonography were 89% and 75%, respectively (n = 54), and these values did not achieve statistical significance when compared with those for scintigraphy. Inconclusive tests were 10% and 11%, respectively, but in no patient were both scintigraphy and ultrasonography inconclusive...... that in patients suspected of having acute cholecystitis cholescintigraphy should be the first diagnostic procedure performed. If the scintigraphy is positive, additional ultrasonographic detection of gallstones makes the diagnosis almost certain. If one diagnostic modality is inconclusive, the other makes a fair...

  19. The role of bone scintigraphy in the evaluation of the suspected abused child

    International Nuclear Information System (INIS)

    Sty, J.R.; Starshak, R.J.

    1983-01-01

    A comparison was made of the radiographic and scintigraphic skeletal surveys of 261 children who were suspected victims of abuse. Radiography was positive in 105 children and produced false-negative results in 32; scintigraphy was positive in 120 children and produced false-negative results in two. Although radiography has traditionally been used to assess the skeletal injuries of battered children, the authors conclude that scintigraphy should be the screening procedure of choice for children suspected of having been abused

  20. Small-bowel capsule endoscopy in patients with suspected Crohn's disease-diagnostic value and complications.

    Science.gov (United States)

    Figueiredo, Pedro; Almeida, Nuno; Lopes, Sandra; Duque, Gabriela; Freire, Paulo; Lérias, Clotilde; Gouveia, Hermano; Sofia, Carlos

    2010-01-01

    The aim of this work was to assess the value of capsule enteroscopy in the diagnosis of patients with suspected Crohn's Disease (CD). Methods. This was a retrospective study in a single tertiary care centre involving patients undergoing capsule enteroscopy for suspected CD. Patients taking nonsteroidal anti inflammatory drugs during the thirty preceding days or with a follow-up period of less than six months were excluded. Results. Seventy eight patients were included. The endoscopic findings included mucosal breaks in 50%, ulcerated stenosis in 5%, and villous atrophy in 4%. The diagnosis of CD was established in 31 patients. The sensitivity, specificity, positive and negative predictive value of the endoscopic findings were 93%, 80%, 77%, and 94%, respectively. Capsule retention occurred in four patients (5%). The presence of ulcerated stenosis was significantly more frequent in patients with positive inflammatory markers. The diagnostic yield of capsule enteroscopy in patients with negative ileoscopy was 56%, with a diagnostic acuity of 93%. Small bowel capsule endoscopy is a safe and valid technique for assessing patients with suspected CD. Capsule retention is more frequent in patients with positive inflammatory markers. Patients with negative ileoscopy and suspected CD should be submitted to capsule enteroscopy.

  1. One parameter model potential for noble metals

    International Nuclear Information System (INIS)

    Idrees, M.; Khwaja, F.A.; Razmi, M.S.K.

    1981-08-01

    A phenomenological one parameter model potential which includes s-d hybridization and core-core exchange contributions is proposed for noble metals. A number of interesting properties like liquid metal resistivities, band gaps, thermoelectric powers and ion-ion interaction potentials are calculated for Cu, Ag and Au. The results obtained are in better agreement with experiment than the ones predicted by the other model potentials in the literature. (author)

  2. PMS2 Involvement in Patients Suspected of Lynch Syndrome

    NARCIS (Netherlands)

    Niessen, Renee C.; Kleibeuker, Jan H.; Westers, Helga; Jager, Paul O. J.; Rozeveld, Dennie; Bos, Krista K.; Boersma-van Ek, Wytske; Hollema, Harry; Sijmons, Rolf H.; Hofstra, Robert M. W.

    It is well-established that germline mutations in the mismatch repair genes MLH1, MSH2, and MSH6 cause Lynch syndrome. However, mutations in these three genes do not account for all Lynch syndrome (suspected) families. Recently, it was shown that germline mutations in another mismatch repair gene,

  3. Police reports of mock suspect interrogations: A test of accuracy and perception.

    Science.gov (United States)

    Kassin, Saul M; Kukucka, Jeff; Lawson, Victoria Z; DeCarlo, John

    2017-06-01

    A 2-phased experiment assessed the accuracy and completeness of police reports on mock interrogations and their effects on people's perceptions. In Phase 1, 16 experienced officers investigated a mock crime scene, interrogated 2 innocent suspects-1 described by the experimenter as more suspicious than the other-and filed an incident report. All 32 sessions were covertly recorded; the recordings were later used to assess the reports. In Phase 2, 96 lay participants were presented with a brief summary of the case and then either read 1 police report, read 1 verbatim interrogation transcript, or listened to an audiotape of a session. Results showed that (a) Police and suspects diverged in their perceptions of the interrogations; (b) Police committed frequent errors of omission in their reports, understating their use of confrontation, maximization, leniency, and false evidence; and (c) Phase 2 participants who read a police report, compared to those who read a verbatim transcript, perceived the process as less pressure-filled and were more likely to misjudge suspects as guilty. These findings are limited by the brevity and low-stakes nature of the task and by the fact that no significant effects were obtained for our suspicion manipulation, suggesting a need for more research. Limitations notwithstanding, this study adds to a growing empirical literature indicating the need for a requirement that all suspect interrogations be electronically recorded. To provide a more objective and accurate account of what transpired, this study also suggests the benefit of producing verbatim transcripts. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. Investigation of suspected chronic fatigue syndrome/myalgic encephalopathy.

    Science.gov (United States)

    Owe, Jone Furlund; Næss, Halvor; Gjerde, Ivar Otto; Bødtker, Jørn Eilert; Tysnes, Ole-Bjørn

    2016-02-09

    Chronic fatigue is a frequently occurring problem in both the primary and specialist health services. The Department of Neurology at Haukeland University Hospital has established a standard assessment for patients referred with suspected CFS/ME. This study reports diagnoses and findings upon assessment, and considers the benefit of supplementary examinations. Diagnoses and findings from examinations of 365 patients assessed for suspected CFS/ME are retrospectively reported. A total of 48 patients (13.2%) were diagnosed with CFS/ME, while a further 18 patients (4.9%) were diagnosed with post-infectious fatigue. Mental and behavioural disorders were diagnosed in 169 patients (46.3%), and these represented by far the largest group. Serious, but unrecognised somatic illness was discovered in two patients, while changes of uncertain significance were identified by MRI and lumbar puncture in a few patients. Fatigue is a frequently occurring symptom in the population. Thorough somatic and psychiatric investigation is necessary before referral to the specialist health services. Mental disorders and reactions to life crises are common and important differential diagnoses for CFS/ME. Long waiting times in the specialist health services may result in delayed diagnosis for these patients.

  5. Analysis of spontaneous inquiries about suspected adverse drug reactions posted by the general public on the electronic Japanese bulletin board “Yahoo! Japan Chiebukuro”

    Directory of Open Access Journals (Sweden)

    Dobashi A

    2016-04-01

    Full Text Available Akira Dobashi,1 Kaori Kurata,1 Mitsuhiro Okazaki,2,3 Mari Nishizawa4 1Education and Research Institute of Information Science, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, 2Faculty of Health Sciences, Health Innovation and Technology Center, Hokkaido University, Hokkaido, 3Cross Care Field Co., Ltd., 4Yakuju Corporation, Tokyo, Japan Purpose: Spontaneous inquiries about the development of adverse drug reactions (ADRs to medicines can be extracted based on the questions posted by the general public on the electronic Japanese bulletin board “Yahoo! Japan Chiebukuro”. Our aim was to clarify the characteristics related to people’s descriptions of suspected ADRs and determine the reasons for submitting a spontaneous inquiry. Methods: Fifty brand names of medicines used for inquiry extraction were chosen by selecting 35 pharmaceutical products, based on the generic names that had the highest sales in Japan. Questions containing both the brand name of one of these medicines and the term “Fukusayō” (ADR in Japanese that were posted from July 2004 to June 2009 were extracted from the site. Results: Among 1,419 questions extracted, 614 questions had at least one identifiable brand name of a suspected medicine, an ADR description, and the extent to which the ADR appeared to be caused by the suspected medicine(s. Among these 614 questions, 589 described in detail the symptoms/signs that the inquirers themselves or their families had experienced as ADRs. The highest number of questions was found for Paxil (525. Posts asking whether the symptoms being experienced were due to an ADR accounted for the highest number of questions. In most cases, the inquirer suspected that a single medicine led to an ADR and was seeking advice from others taking the same medicine. Conclusion: Our examination of spontaneous inquiries showed that people have sufficient knowledge to adequately report potential ADRs in terms of their symptoms

  6. Association between QRS duration on prehospital ECG and mortality in patients with suspected STEMI

    DEFF Research Database (Denmark)

    Hansen, Rikke; Frydland, Martin; Møller-Helgestad, Ole Kristian

    2017-01-01

    BACKGROUND: QRS duration has previously shown association with mortality in patients with acute myocardial infarction treated with thrombolytics, less is known in patients with suspected ST segment elevation myocardial infarction (STEMI) when assessing QRS duration on prehospital ECG. Thus......, the objective was to investigate the prognostic effect of QRS duration on prehospital ECG and presence of classic left and right bundle branch block (LBBB/RBBB) for all-cause mortality in patients with suspected STEMI. METHOD: In total 2105 consecutive patients (mean age 64±13years, 72% men) with suspected...... STEMI were prospectively included. QRS duration was registered from automated QRS measurement on prehospital ECG and patients were divided according to quartiles of QRS duration (111ms). Primary endpoint was all-cause 30-day mortality. Predictors of all-cause mortality were...

  7. Evaluation of suspected physical abuse in children: a 500-case study

    Directory of Open Access Journals (Sweden)

    Marcos Picini

    Full Text Available ABSTRACT OBJECTIVE: This study evaluated the epidemiological profile of patients with suspected physical abuse, especially regarding the occurrence of fractures, treated in a referral hospital. METHODS: The authors reviewed all reports of suspected abuse against children and adolescents (AACA in this hospital from January 2005 to December 2015. They were assessed and separated by month and year. The characteristics of the victims of physical abuse with occurrence of fractures were studied. The features of the fractures were evaluated in those patients with available radiographs. RESULTS: Of the 3125 notifications, 500 were classified as physical injuries; of these, 63 had fractures. An annual progressive increase in notifications was observed. As for age group, 50 patients (80.6% were up to three years old and 36 (58% up to one year. Most were male (60% and the likely aggressors were mother alone and both parents (27.5% each. In 30 patients with available images, fractures of long bones (femur, tibia, and humerus predominated (71%, as well as a single fracture line (74%, diaphyseal location (73%, and a transverse line (57%. There were two deaths in fracture cases (3%. CONCLUSION: All orthopedists should be alert to suspected AACA in children with trauma below the age of three, even without classic signs of abuse.

  8. Scalar Potential Model progress

    Science.gov (United States)

    Hodge, John

    2007-04-01

    Because observations of galaxies and clusters have been found inconsistent with General Relativity (GR), the focus of effort in developing a Scalar Potential Model (SPM) has been on the examination of galaxies and clusters. The SPM has been found to be consistent with cluster cellular structure, the flow of IGM from spiral galaxies to elliptical galaxies, intergalactic redshift without an expanding universe, discrete redshift, rotation curve (RC) data without dark matter, asymmetric RCs, galaxy central mass, galaxy central velocity dispersion, and the Pioneer Anomaly. In addition, the SPM suggests a model of past expansion, past contraction, and current expansion of the universe. GR corresponds to the SPM in the limit in which a flat and static scalar potential field replaces the Sources and Sinks such as between clusters and on the solar system scale which is small relative to the distance to a Source. The papers may be viewed at http://web.infoave.net/˜scjh/ .

  9. Contribution of co-registered PET/CT for patients with suspected recurrence of colo-rectal cancer

    International Nuclear Information System (INIS)

    Garin, E.; Devillers, A.; Prigent, F.; Girault, S.; Herry, J.Y.; Bourguet, P.; Bouriel, C.; Boudjema, K.; Campion, J.P.; Meunier, B.; Boucher, E.; Raoul, J.L.

    2003-01-01

    Positron emission tomography using 18 F fluorodeoxyglucose (PET) has proved to offer advantages for patients presenting with suspected recurrence of colo-rectal cancer. However; this examination is confronted with two disadvantages: the lack of anatomical reference marks and the presence of physiological uptake that can be difficult to locate. We carried out a retrospective study on 30 patients with suspected recurrence of Colo-rectal cancer in order to evaluate the diagnostic and therapeutic impact of PET/CT fusion images compared with PET alone. PET/CT acquisitions were performed on a prototype Positrace or on a double-detection head gamma camera in coincidence Hawkeye. PET/CT fusion images had a formal diagnostic impact for 6 patients out of 30 (20%), including 5 patients out of 12 (41%) having a suspected pelvic recurrence. In five cases, it allowed us to resolve ambiguities about whether the site of recurrence was located in the bone or the soft tissues. Furthermore, in one case we were able to locate an intra-abdominal uptake focus at the level of the liver. The PET/CT fusion images had a probable diagnostic impact for three additional patients. For two patients, the PET/CT fusion images allowed us to identify an ambiguous uptake focus as being related to physiological renal uptake. For 4 patients out of 30 (13%), the PET/CT fusion images had a clear additional therapeutic impact, including 4/12 (33%) for whom a pelvic recurrence could be suspected. The present study shows that PET/CT fusion images have an important diagnostic and therapeutic impact for patients with suspected recurrence of colorectal cancer; the impact becoming major for the subgroup of patients having a suspected pelvic recurrence. (author)

  10. Interdisciplinary action of nurses to children with suspected sexual abuse

    Directory of Open Access Journals (Sweden)

    Lia Leão Ciuffo

    2014-04-01

    Full Text Available Objective. Understanding the role of nurses as members of interdisciplinary teams in the care of children with suspected sexual abuse. Methodology. This is a qualitative research based on the sociological phenomenology of Alfred Schutz. In 2008 were interviewed eleven nurses who worked in reference institutions for the care of child victims of sexual abuse in Rio de Janeiro. Results. The category called 'Interacting with other professionals in child care' emerged from the analysis of performance of professionals. The intersubjective relations between the nurses and the interdisciplinary team will enable to understand the intent of care from the perspective of social, emotional and psychological needs of children and their families. Conclusion. Interdisciplinarity favored the development of actions based on acceptance, listening and agreements on possible solutions in the care of children with suspected sexual abuse.

  11. MRI for clinically suspected pediatric appendicitis: case interpretation

    International Nuclear Information System (INIS)

    Moore, Michael M.; Brian, James M.; Methratta, Sosamma T.; Hulse, Michael A.; Choudhary, Arabinda K.; Eggli, Kathleen D.; Boal, Danielle K.B.

    2014-01-01

    As utilization of MRI for clinically suspected pediatric appendicitis becomes more common, there will be increased focus on case interpretation. The purpose of this pictorial essay is to share our institution's case interpretation experience. MRI findings of appendicitis include appendicoliths, tip appendicitis, intraluminal fluid-debris level, pitfalls of size measurements, and complications including abscesses. The normal appendix and inguinal appendix are also discussed. (orig.)

  12. MRI for clinically suspected pediatric appendicitis: case interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Michael M.; Brian, James M.; Methratta, Sosamma T.; Hulse, Michael A.; Choudhary, Arabinda K.; Eggli, Kathleen D.; Boal, Danielle K.B. [Penn State Milton S. Hershey Medical Center, Division of Pediatric Radiology, Department of Radiology, Hershey, PA (United States)

    2014-05-15

    As utilization of MRI for clinically suspected pediatric appendicitis becomes more common, there will be increased focus on case interpretation. The purpose of this pictorial essay is to share our institution's case interpretation experience. MRI findings of appendicitis include appendicoliths, tip appendicitis, intraluminal fluid-debris level, pitfalls of size measurements, and complications including abscesses. The normal appendix and inguinal appendix are also discussed. (orig.)

  13. Four-parameter analytical local model potential for atoms

    International Nuclear Information System (INIS)

    Fei, Yu; Jiu-Xun, Sun; Rong-Gang, Tian; Wei, Yang

    2009-01-01

    Analytical local model potential for modeling the interaction in an atom reduces the computational effort in electronic structure calculations significantly. A new four-parameter analytical local model potential is proposed for atoms Li through Lr, and the values of four parameters are shell-independent and obtained by fitting the results of X a method. At the same time, the energy eigenvalues, the radial wave functions and the total energies of electrons are obtained by solving the radial Schrödinger equation with a new form of potential function by Numerov's numerical method. The results show that our new form of potential function is suitable for high, medium and low Z atoms. A comparison among the new potential function and other analytical potential functions shows the greater flexibility and greater accuracy of the present new potential function. (atomic and molecular physics)

  14. 9 CFR 381.74 - Poultry suspected of having biological residues.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Poultry suspected of having biological... OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND CERTIFICATION POULTRY PRODUCTS INSPECTION REGULATIONS Ante Mortem...

  15. Small-Bowel Capsule Endoscopy in Patients with Suspected Crohn's Disease—Diagnostic Value and Complications

    Science.gov (United States)

    Figueiredo, Pedro; Almeida, Nuno; Lopes, Sandra; Duque, Gabriela; Freire, Paulo; Lérias, Clotilde; Gouveia, Hermano; Sofia, Carlos

    2010-01-01

    Background. The aim of this work was to assess the value of capsule enteroscopy in the diagnosis of patients with suspected Crohn's Disease (CD). Methods. This was a retrospective study in a single tertiary care centre involving patients undergoing capsule enteroscopy for suspected CD. Patients taking nonsteroidal anti inflammatory drugs during the thirty preceding days or with a follow-up period of less than six months were excluded. Results. Seventy eight patients were included. The endoscopic findings included mucosal breaks in 50%, ulcerated stenosis in 5%, and villous atrophy in 4%. The diagnosis of CD was established in 31 patients. The sensitivity, specificity, positive and negative predictive value of the endoscopic findings were 93%, 80%, 77%, and 94%, respectively. Capsule retention occurred in four patients (5%). The presence of ulcerated stenosis was significantly more frequent in patients with positive inflammatory markers. The diagnostic yield of capsule enteroscopy in patients with negative ileoscopy was 56%, with a diagnostic acuity of 93%. Conclusions. Small bowel capsule endoscopy is a safe and valid technique for assessing patients with suspected CD. Capsule retention is more frequent in patients with positive inflammatory markers. Patients with negative ileoscopy and suspected CD should be submitted to capsule enteroscopy. PMID:20811612

  16. Small-Bowel Capsule Endoscopy in Patients with Suspected Crohn's Disease—Diagnostic Value and Complications

    Directory of Open Access Journals (Sweden)

    Pedro Figueiredo

    2010-01-01

    Full Text Available Background. The aim of this work was to assess the value of capsule enteroscopy in the diagnosis of patients with suspected Crohn's Disease (CD. Methods. This was a retrospective study in a single tertiary care centre involving patients undergoing capsule enteroscopy for suspected CD. Patients taking nonsteroidal anti inflammatory drugs during the thirty preceding days or with a follow-up period of less than six months were excluded. Results. Seventy eight patients were included. The endoscopic findings included mucosal breaks in 50%, ulcerated stenosis in 5%, and villous atrophy in 4%. The diagnosis of CD was established in 31 patients. The sensitivity, specificity, positive and negative predictive value of the endoscopic findings were 93%, 80%, 77%, and 94%, respectively. Capsule retention occurred in four patients (5%. The presence of ulcerated stenosis was significantly more frequent in patients with positive inflammatory markers. The diagnostic yield of capsule enteroscopy in patients with negative ileoscopy was 56%, with a diagnostic acuity of 93%. Conclusions. Small bowel capsule endoscopy is a safe and valid technique for assessing patients with suspected CD. Capsule retention is more frequent in patients with positive inflammatory markers. Patients with negative ileoscopy and suspected CD should be submitted to capsule enteroscopy.

  17. Drug-induced acute myocardial infarction: identifying 'prime suspects' from electronic healthcare records-based surveillance system.

    Directory of Open Access Journals (Sweden)

    Preciosa M Coloma

    Full Text Available Drug-related adverse events remain an important cause of morbidity and mortality and impose huge burden on healthcare costs. Routinely collected electronic healthcare data give a good snapshot of how drugs are being used in 'real-world' settings.To describe a strategy that identifies potentially drug-induced acute myocardial infarction (AMI from a large international healthcare data network.Post-marketing safety surveillance was conducted in seven population-based healthcare databases in three countries (Denmark, Italy, and the Netherlands using anonymised demographic, clinical, and prescription/dispensing data representing 21,171,291 individuals with 154,474,063 person-years of follow-up in the period 1996-2010. Primary care physicians' medical records and administrative claims containing reimbursements for filled prescriptions, laboratory tests, and hospitalisations were evaluated using a three-tier triage system of detection, filtering, and substantiation that generated a list of drugs potentially associated with AMI. Outcome of interest was statistically significant increased risk of AMI during drug exposure that has not been previously described in current literature and is biologically plausible.Overall, 163 drugs were identified to be associated with increased risk of AMI during preliminary screening. Of these, 124 drugs were eliminated after adjustment for possible bias and confounding. With subsequent application of criteria for novelty and biological plausibility, association with AMI remained for nine drugs ('prime suspects': azithromycin; erythromycin; roxithromycin; metoclopramide; cisapride; domperidone; betamethasone; fluconazole; and megestrol acetate.Although global health status, co-morbidities, and time-invariant factors were adjusted for, residual confounding cannot be ruled out.A strategy to identify potentially drug-induced AMI from electronic healthcare data has been proposed that takes into account not only statistical

  18. Standard Model Effective Potential from Trace Anomalies

    Directory of Open Access Journals (Sweden)

    Renata Jora

    2018-01-01

    Full Text Available By analogy with the low energy QCD effective linear sigma model, we construct a standard model effective potential based entirely on the requirement that the tree level and quantum level trace anomalies must be satisfied. We discuss a particular realization of this potential in connection with the Higgs boson mass and Higgs boson effective couplings to two photons and two gluons. We find that this kind of potential may describe well the known phenomenology of the Higgs boson.

  19. Double-read of skeletal surveys in suspected non-accidental trauma: what we learned

    Energy Technology Data Exchange (ETDEWEB)

    Karmazyn, Boaz; Wanner, Matthew R.; Marine, Megan B. [Indiana University School of Medicine, Department of Radiology and Imaging Sciences, Riley Hospital for Children, Indianapolis, IN (United States); Miller, Elise M.; Jennings, S.G. [Indiana University School of Medicine, Department of Radiology and Imaging Sciences, Indianapolis, IN (United States); Lay, Sara E. [Indiana University School of Medicine, Methodist Hospital, Department of Radiology and Imaging Sciences, Indianapolis, IN (United States); Massey, James M. [The Children' s Hospital at TriStar Centennial, Department of Imaging, Nashville, TN (United States); Ouyang, Fangqian [Indiana University School of Medicine, Department of Biostatistics, Indianapolis, IN (United States); Hibbard, Roberta A. [Indiana University School of Medicine, Department of Pediatrics, Section of Child Protection Programs, Riley Hospital for Children, Indianapolis, IN (United States)

    2017-05-15

    Missing a fracture in a child on skeletal surveys for suspected non-accidental trauma can have devastating results. Double-read has the potential to improve fracture detection. However the yield of double-read is unknown. To determine the advantage of double-read versus single-read of radiographic skeletal surveys for suspected non-accidental trauma. The study was performed in two phases. In the first phase (April 2013 to September 2013), double-read was performed for all skeletal surveys obtained during weekday working hours. Because we had no new double-read findings in studies initially read as negative, we conducted a second phase (January 2014 to March 2014). In the second phase we limited double-reads to skeletal surveys found positive on the first read. At the end of this period, we retrospectively performed double-read for all initially negative skeletal surveys. We excluded follow-up skeletal surveys. The difference in discrepancy (new fracture or false diagnosis of a fracture) ratio between negative and positive skeletal surveys was evaluated using the Fisher exact test, and change in discrepancy ratio between the first and second study phases was evaluated using the stratified Cochran-Mantel-Haenszel test. Overall in the two phases, 178 skeletal surveys were performed in 178 children (67 girls) with mean age of 9 months (range 3 days to 3.7 years). Double-read found 16 discrepancies in 8/178 (4.5%) skeletal surveys. Seven of these studies showed additional fractures (n=15). In one study, an initial read of a skull fracture was read as a variant on the second read. There was a significant (P=0.01) difference between rate of disagreement in negative skeletal surveys (1/104, 1.0%) and positive skeletal surveys (7/74, 9.5%). No significant change in disagreement rate was demonstrated between the two phases of the study (P=0.59). Double-read of skeletal survey for suspected non-accidental trauma found false-negative fractures in a few cases and rarely found

  20. Double-read of skeletal surveys in suspected non-accidental trauma: what we learned

    International Nuclear Information System (INIS)

    Karmazyn, Boaz; Wanner, Matthew R.; Marine, Megan B.; Miller, Elise M.; Jennings, S.G.; Lay, Sara E.; Massey, James M.; Ouyang, Fangqian; Hibbard, Roberta A.

    2017-01-01

    Missing a fracture in a child on skeletal surveys for suspected non-accidental trauma can have devastating results. Double-read has the potential to improve fracture detection. However the yield of double-read is unknown. To determine the advantage of double-read versus single-read of radiographic skeletal surveys for suspected non-accidental trauma. The study was performed in two phases. In the first phase (April 2013 to September 2013), double-read was performed for all skeletal surveys obtained during weekday working hours. Because we had no new double-read findings in studies initially read as negative, we conducted a second phase (January 2014 to March 2014). In the second phase we limited double-reads to skeletal surveys found positive on the first read. At the end of this period, we retrospectively performed double-read for all initially negative skeletal surveys. We excluded follow-up skeletal surveys. The difference in discrepancy (new fracture or false diagnosis of a fracture) ratio between negative and positive skeletal surveys was evaluated using the Fisher exact test, and change in discrepancy ratio between the first and second study phases was evaluated using the stratified Cochran-Mantel-Haenszel test. Overall in the two phases, 178 skeletal surveys were performed in 178 children (67 girls) with mean age of 9 months (range 3 days to 3.7 years). Double-read found 16 discrepancies in 8/178 (4.5%) skeletal surveys. Seven of these studies showed additional fractures (n=15). In one study, an initial read of a skull fracture was read as a variant on the second read. There was a significant (P=0.01) difference between rate of disagreement in negative skeletal surveys (1/104, 1.0%) and positive skeletal surveys (7/74, 9.5%). No significant change in disagreement rate was demonstrated between the two phases of the study (P=0.59). Double-read of skeletal survey for suspected non-accidental trauma found false-negative fractures in a few cases and rarely found

  1. Improving the diagnostic performance of lung scintigraphy in suspected pulmonary embolic disease

    International Nuclear Information System (INIS)

    Gleeson, F.V.; Turner, S.; Scarsbrook, A.F.

    2006-01-01

    Aim: to determine the effectiveness of a new imaging algorithm in the investigation of suspected pulmonary embolism (PE). Materials and methods: A new imaging algorithm for suspected PE was introduced following the installation of a multisection computed tomography (CT) machine at our institution. Before its installation, patients with suspected PE were evaluated with ventilation/perfusion (V/Q) scintigraphy. Subsequently, patients were triaged according to chest radiography (CR) and respiratory history to either lung scintigraphy or CT pulmonary angiography (CTPA). Patients with a normal CR and no history of lung disease were evaluated using perfusion (Q) scintigraphy [ventilation (V) scintigraphy was no longer performed]. Patients with an abnormal CR, asthma or chronic lung disease were evaluated using CTPA. All V/Q images in a continuous 3-year period before the introduction of the new imaging algorithm and all Q images performed in a 3-year period after its introduction were retrospectively reviewed. Imaging reports were categorized into normal, non-diagnostic (low or intermediate probability) or high probability for PE. Patients in the later group who subsequently underwent CTPA, were also reviewed. Results: After the policy change the percentage of normal scintigrams significantly increased (39 to 60%; p < 0.001). There was a non-significant increase in the percentage of high probability scintigrams (15 to 18%; p = 0.716). Overall the diagnostic yield of lung scintigraphy improved significantly (54 to 78%; p < 0.001). Conclusion: the diagnostic performance of lung scintigraphy can be improved by careful triage of patients to either Q scintigraphy or CTPA based on clinical history and CR findings. Q scintigraphy remains a valuable diagnostic test in the investigation of suspected PE in carefully selected patients

  2. The yield of high-detail radiographic skeletal surveys in suspected infant abuse

    International Nuclear Information System (INIS)

    Barber, Ignasi; Perez-Rossello, Jeannette M.; Kleinman, Paul K.; Wilson, Celeste R.

    2015-01-01

    Skeletal surveys are routinely performed in cases of suspected child abuse, but there are limited data regarding the yield of high-detail skeletal surveys in infants. To determine the diagnostic yield of high-detail radiographic skeletal surveys in suspected infant abuse. We reviewed the high-detail American College of Radiology standardized skeletal surveys performed for suspected abuse in 567 infants (median: 4.4 months, SD 3.47; range: 4 days-12 months) at a large urban children's hospital between 2005 and 2013. Skeletal survey images, radiology reports and medical records were reviewed. A skeletal survey was considered positive when it showed at least one unsuspected fracture. In 313 of 567 infants (55%), 1,029 definite fractures were found. Twenty-one percent (119/567) of the patients had a positive skeletal survey with a total of 789 (77%) unsuspected fractures. Long-bone fractures were the most common injuries, present in 145 children (26%). The skull was the site of fracture in 138 infants (24%); rib cage in 77 (14%), clavicle in 24 (4.2%) and uncommon fractures (including spine, scapula, hands and feet and pelvis) were noted in 26 infants (4.6%). Of the 425 infants with neuroimaging, 154 (36%) had intracranial injury. No significant correlation between positive skeletal survey and associated intracranial injury was found. Scapular fractures and complex skull fractures showed a statistically significant correlation with intracranial injury (P = 0.029, P = 0.007, respectively). Previously unsuspected fractures are noted on skeletal surveys in 20% of cases of suspected infant abuse. These data may be helpful in the design and optimization of global skeletal imaging in this vulnerable population. (orig.)

  3. The yield of high-detail radiographic skeletal surveys in suspected infant abuse

    Energy Technology Data Exchange (ETDEWEB)

    Barber, Ignasi [Hospital Vall d' Hebron, Universitat Autonoma de Barcelona, Pediatric Radiology Department, Barcelona (Spain); Perez-Rossello, Jeannette M.; Kleinman, Paul K. [Boston Children' s Hospital, Radiology Department, Boston, MA (United States); Wilson, Celeste R. [Boston Children' s Hospital, Division of General Pediatrics, Boston, MA (United States)

    2014-07-06

    Skeletal surveys are routinely performed in cases of suspected child abuse, but there are limited data regarding the yield of high-detail skeletal surveys in infants. To determine the diagnostic yield of high-detail radiographic skeletal surveys in suspected infant abuse. We reviewed the high-detail American College of Radiology standardized skeletal surveys performed for suspected abuse in 567 infants (median: 4.4 months, SD 3.47; range: 4 days-12 months) at a large urban children's hospital between 2005 and 2013. Skeletal survey images, radiology reports and medical records were reviewed. A skeletal survey was considered positive when it showed at least one unsuspected fracture. In 313 of 567 infants (55%), 1,029 definite fractures were found. Twenty-one percent (119/567) of the patients had a positive skeletal survey with a total of 789 (77%) unsuspected fractures. Long-bone fractures were the most common injuries, present in 145 children (26%). The skull was the site of fracture in 138 infants (24%); rib cage in 77 (14%), clavicle in 24 (4.2%) and uncommon fractures (including spine, scapula, hands and feet and pelvis) were noted in 26 infants (4.6%). Of the 425 infants with neuroimaging, 154 (36%) had intracranial injury. No significant correlation between positive skeletal survey and associated intracranial injury was found. Scapular fractures and complex skull fractures showed a statistically significant correlation with intracranial injury (P = 0.029, P = 0.007, respectively). Previously unsuspected fractures are noted on skeletal surveys in 20% of cases of suspected infant abuse. These data may be helpful in the design and optimization of global skeletal imaging in this vulnerable population. (orig.)

  4. Creating fair lineups for suspects with distinctive features

    OpenAIRE

    Zarkadi, Theodora; Wade, Kimberley A.; Stewart, Neil

    2009-01-01

    In their descriptions, eyewitnesses often refer to a culprit's distinctive facial features. However, in a police lineup, selecting the only member with the described distinctive feature is unfair to the suspect and provides the police with little further information. For fair and informative lineups, the distinctive feature should be either replicated across foils or concealed on the target. In the present experiments, replication produced more correct identifications in target-present lineup...

  5. Managing suspect and counterfeit items in the nuclear industry

    International Nuclear Information System (INIS)

    2000-08-01

    Some manufacturers and suppliers use inferior materials and processes to make substandard supplies whose properties can vary significantly from established standards and specifications. Other suppliers distribute items that they know do not meet the purchase requirements or provide documentation that misrepresent actual conformance to established specifications and standards. These substandard supplies, or suspect/counterfeit items (S/CIs), pose potential threats to the safety of workers, the public and the environment and may also have a detrimental effect on security and operations at nuclear facilities. Nuclear facilities often procure and use commercial-grade items and the quality assurance policies/procedures and procurement methods are not always properly applied to avoid the entry of S/Cls into those facilities. This publication offers practical guidance on how to apply existing quality assurance programmes to effectively prevent the procurement and use of S/Cls. In particular, it provides a practical method of applying the requirements and guidance contained in the IAEA Safety Series 50-C/SG-Q: Code and Safety Guides on Quality Assurance for Safety in Nuclear Power Plants and other Nuclear Installations (1996), to the S/CIs issue

  6. Major trauma from suspected child abuse: a profile of the patient pathway.

    Science.gov (United States)

    Davies, Ffion C; Lecky, Fiona E; Fisher, Ross; Fragoso-Iiguez, Marisol; Coats, Tim J

    2017-09-01

    Networked organised systems of care for patients with major trauma now exist in many countries, designed around the needs of the majority of patients (90% adults). Non-accidental injury is a significant cause of paediatric major trauma and has a different injury and age profile from accidental injury (AI). This paper compares the prehospital and inhospital phases of the patient pathway for children with suspected abuse, with those accidentally injured. The paediatric database of the national trauma registry of England and Wales, Trauma Audit and Research Network, was interrogated from April 2012 (the launch of the major trauma networks) to June 2015, comparing the patient pathway for cases of suspected child abuse (SCA) with AI. In the study population of 7825 children, 7344 (94%) were classified as AI and 481 (6%) as SCA. SCA cases were younger (median 0.4 years vs 7 years for AI), had a higher Injury Severity Score (median 16vs9 for AI), and had nearly three times higher mortality (5.7%vs2.2% for AI). Other differences included presentation to hospital evenly throughout the day and year, arrival by non-ambulance means to hospital (74%) and delayed presentation to hospital from the time of injury (median 8 hours vs 1.8 hours for AI). Despite more severe injuries, these infants were less likely to receive key interventions in a timely manner. Only 20% arrived to a designated paediatric-capable major trauma centre. Secondary transfer to specialist care, if needed, took a median of 21.6 hours from injury(vs 13.8 hours for AI). These data show that children with major trauma that is inflicted rather than accidental follow a different pathway through the trauma system. The current model of major trauma care is not a good fit for the way in which child victims of suspected abuse present to healthcare. To achieve better care, awareness of this patient profile needs to increase, and trauma networks should adjust their conventional responses. © Article author

  7. Exploring the Potential of a Global Emerging Contaminant Early Warning Network through the Use of Retrospective Suspect Screening with High-Resolution Mass Spectrometry.

    Science.gov (United States)

    Alygizakis, Nikiforos A; Samanipour, Saer; Hollender, Juliane; Ibáñez, María; Kaserzon, Sarit; Kokkali, Varvara; van Leerdam, Jan A; Mueller, Jochen F; Pijnappels, Martijn; Reid, Malcolm J; Schymanski, Emma L; Slobodnik, Jaroslav; Thomaidis, Nikolaos S; Thomas, Kevin V

    2018-04-13

    A key challenge in the environmental and exposure sciences is to establish experimental evidence of the role of chemical exposure in human and environmental systems. High resolution and accurate tandem mass spectrometry (HRMS) is increasingly being used for the analysis of environmental samples. One lauded benefit of HRMS is the possibility to retrospectively process data for (previously omitted) compounds that has led to the archiving of HRMS data. Archived HRMS data affords the possibility of exploiting historical data to rapidly and effectively establish the temporal and spatial occurrence of newly identified contaminants through retrospective suspect screening. We propose to establish a global emerging contaminant early warning network to rapidly assess the spatial and temporal distribution of contaminants of emerging concern in environmental samples through performing retrospective analysis on HRMS data. The effectiveness of such a network is demonstrated through a pilot study, where eight reference laboratories with available archived HRMS data retrospectively screened data acquired from aqueous environmental samples collected in 14 countries on 3 different continents. The widespread spatial occurrence of several surfactants (e.g., polyethylene glycols ( PEGs ) and C12AEO-PEGs ), transformation products of selected drugs (e.g., gabapentin-lactam, metoprolol-acid, carbamazepine-10-hydroxy, omeprazole-4-hydroxy-sulfide, and 2-benzothiazole-sulfonic-acid), and industrial chemicals (3-nitrobenzenesulfonate and bisphenol-S) was revealed. Obtaining identifications of increased reliability through retrospective suspect screening is challenging, and recommendations for dealing with issues such as broad chromatographic peaks, data acquisition, and sensitivity are provided.

  8. Risk stratification by the Appendicitis Inflammatory Response score to guide decision-making in patients with suspected appendicitis.

    Science.gov (United States)

    Scott, A J; Mason, S E; Arunakirinathan, M; Reissis, Y; Kinross, J M; Smith, J J

    2015-04-01

    Current management of suspected appendicitis is hampered by the overadmission of patients with non-specific abdominal pain and a significant negative exploration rate. The potential benefits of risk stratification by the Appendicitis Inflammatory Response (AIR) score to guide clinical decision-making were assessed. During this 50-week prospective observational study at one institution, the AIR score was calculated for all patients admitted with suspected appendicitis. Appendicitis was diagnosed by histological examination, and patients were classified as having non-appendicitis pain if histological findings were negative or surgery was not performed. The diagnostic performance of the AIR score and the potential for risk stratification to reduce admissions, optimize imaging and prevent unnecessary explorations were quantified. A total of 464 patients were included, of whom 210 (63·3 per cent) with non-appendicitis pain were correctly classified as low risk. However, 13 low-risk patients had appendicitis. Low-risk patients accounted for 48·1 per cent of admissions (223 of 464), 57 per cent of negative explorations (48 of 84) and 50·7 per cent of imaging requests (149 of 294). An AIR score of 5 or more (intermediate and high risk) had high sensitivity for all severities of appendicitis (90 per cent) and also for advanced appendicitis (98 per cent). An AIR score of 9 or more (high risk) was very specific (97 per cent) for appendicitis, and the majority of patients with appendicitis in the high-risk group (21 of 30, 70 per cent) had perforation or gangrene. Ultrasound imaging could not exclude appendicitis in low-risk patients (negative likelihood ratio (LR) 1·0) but could rule-in the diagnosis in intermediate-risk patients (positive LR 10·2). CT could exclude appendicitis in low-risk patients (negative LR 0·0) and rule-in appendicitis in the intermediate group (positive LR 10·9). Risk stratification of patients with suspected appendicitis by the AIR score could

  9. Usefulness of unenhanced helical CT in patients with suspected ureteral colic

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bong Soo; Nam Kung, Sook; Kim, Heung Cheol; Hwang, Woo Chul; Lee, In Sun; Hwang, Im Kyung; Kim, Ho Chul; Bae, Sang Hoon; Lee, Sang Kon; Lee, Seong Ho [College of Medicine, Hallym Univ., Chunchon (Korea, Republic of)

    2002-07-01

    To determine the usefulness of unenhanced helical CT in patients with suspected renal colic. One hundred and fourteen patients with suspected ureteral colic, referred by physicians, underwent unenhanced helical CT. Two radiologists prospectively interpreted the results, determining the presence or absence of ureter stone and other diseases the arise outside the urinary tract. In cases of ureteral stone, we retrospectively sought secondary signs of hydronephrosis, perinephric fat stranding, thickening of renal fascia, renal enlargement, and the tissue rim sign. Among the 114 patients, 57 were confirmed as having ureter stones. Unenhanced helical CT depicted 57 of 58 stones in 57 patients, producing one false-negative and one false-positive result. Overall, the results showed 98% sensitivity, 95% specificity, 98% positive predictive value, 95% negative predictive value, and 97% accuracy. The frequencies of secondary signs were as follows: hydronephrosis, 95%(54/57); perinephric fat stranding, 81% (46/57); thickening of renal fascia, 77% (44/57); renal enlargement , 65%(37/57); and the tissure rim sign 72%(21/29). In 20 patients, the diagnoses were not related to stone disease and included one false-negative diagnosis of pyonephrosis. Unenhanced helical CT provides information which is valuable in the accurate diagnosis of ureteral stone as well as other diseases that arise outside the urinary tract in patients with suspected renal colic.

  10. The economics of cardiac biomarker testing in suspected myocardial infarction.

    Science.gov (United States)

    Goodacre, Steve; Thokala, Praveen

    2015-03-01

    Suspected myocardial infarction (MI) is a common reason for emergency hospital attendance and admission. Cardiac biomarker measurement is an essential element of diagnostic assessment of suspected MI. Although the cost of a routinely available biomarker may be small, the large patient population and consequences in terms of hospital admission and investigation mean that the economic impact of cardiac biomarker testing is substantial. Economic evaluation involves comparing the estimated costs and effectiveness (outcomes) of two or more interventions or care alternatives. This process creates some difficulties with respect to cardiac biomarkers. Estimating the effectiveness of cardiac biomarkers involves identifying how they help to improve health and how we can measure this improvement. Comparison to an appropriate alternative is also problematic. New biomarkers may be promoted on the basis of reducing hospital admission or length of stay, but hospital admission for low risk patients may incur significant costs while providing very little benefit, making it an inappropriate comparator. Finally, economic evaluation may conclude that a more sensitive biomarker strategy is more effective but, by detecting and treating more cases, is also more expensive. In these circumstances it is unclear whether we should use the more effective or the cheaper option. This article provides an introduction to health economics and addresses the specific issues relevant to cardiac biomarkers. It describes the key concepts relevant to economic evaluation of cardiac biomarkers in suspected MI and highlights key areas of uncertainty and controversy. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  11. How useful is gastroesophageal reflux scintigraphy in suspected childhood aspiration?

    International Nuclear Information System (INIS)

    Fawcett, H.D.; Adams, J.C.; Hayden, C.K.; Swischuk, L.E.

    1988-01-01

    It has been suggested that gastroesophageal reflux scintigraphy might be useful in assisting one in determining therapy for patients suspected of aspirating or becoming apneic secondary to gastroesophageal reflux. This, however, has not been our experience and in reviewing 23 patients with recurrent pneumonia and/or apnea who had gastroesophageal reflux scintigraphy, we were able to detect aspiration in only one. This was especially significant since 13 (59%) of these patients had demonstrable reflux, and of these, eight were treated successfully for suspected aspiration even though none was demonstrated isotopically. To be sure, the demonstration of pulmonary aspiration with gastroesophageal reflux scintigraphy had little influence on patient selection and response to therapy. For this reason we feel there is little justification in depending on the GRS for the specific purpose of trying to document pulmonary aspiration in infants and children who are refluxing. One of the more serious complications of gastroesophageal (GE) reflux is aspiration leading to recurrent pulmonary infections and/or apnea. However, it always has been difficult to demonstrate actual aspiration into the lungs, and to be sure, barium studies of the upper GI tract seldom reveal this complication. Recently, however, considerable interest has been generated in gastroesophageal scintigraphy (GRS) as a possible means of documenting such aspiration. Rationale for this stems from the fact that suspected patients can be studied over a longer period of time and in addition, delayed and overnight images can be obtained. However, our experience does not support GRS as being an adequate method for demonstrating aspiration. (orig.)

  12. How useful is gastroesophageal reflux scintigraphy in suspected childhood aspiration

    Energy Technology Data Exchange (ETDEWEB)

    Fawcett, H.D.; Adams, J.C.; Hayden, C.K.; Swischuk, L.E.

    1988-05-01

    It has been suggested that gastroesophageal reflux scintigraphy might be useful in assisting one in determining therapy for patients suspected of aspirating or becoming apneic secondary to gastroesophageal reflux. This, however, has not been our experience and in reviewing 23 patients with recurrent pneumonia and/or apnea who had gastroesophageal reflux scintigraphy, we were able to detect aspiration in only one. This was especially significant since 13 (59%) of these patients had demonstrable reflux, and of these, eight were treated successfully for suspected aspiration even though none was demonstrated isotopically. To be sure, the demonstration of pulmonary aspiration with gastroesophageal reflux scintigraphy had little influence on patient selection and response to therapy. For this reason we feel there is little justification in depending on the GRS for the specific purpose of trying to document pulmonary aspiration in infants and children who are refluxing. One of the more serious complications of gastroesophageal (GE) reflux is aspiration leading to recurrent pulmonary infections and/or apnea. However, it always has been difficult to demonstrate actual aspiration into the lungs, and to be sure, barium studies of the upper GI tract seldom reveal this complication. Recently, however, considerable interest has been generated in gastroesophageal scintigraphy (GRS) as a possible means of documenting such aspiration. Rationale for this stems from the fact that suspected patients can be studied over a longer period of time and in addition, delayed and overnight images can be obtained. However, our experience does not support GRS as being an adequate method for demonstrating aspiration.

  13. [Suspected pathogenic mutation identified in two cases with oculocutaneous albinism].

    Science.gov (United States)

    He, Jiangmei; Zheng, Meiling; Zhang, Guilin; Hua, Ailing

    2015-08-01

    To detect potential mutations in genes related with non-syndromic oculocutaneous albinism I-IV and ocular albinism type I in two couples who had given births to children with albinism. All exons of the non-syndromic albinism related genes TYR, OCA2, TYRP-1, MITF, SLC45A2 and GPR143 were subjected to deep sequencing. The results were verified with Sanger sequencing. For the two female carriers, the coding region of the TYR gene was found to harbor a frameshift mutation c.925_926insC, which was also suspected to have been pathogenic. In one of the male partners, a nonsense mutations c.832C>T was found, which was also known to be pathogenic. Another male partner was found to harbor a TYR gene mutation c.346C>T, which was also known to be a pathogenic nonsense mutation. The coding region of the TYR gene c.925_926insC (p.Thr309ThrfsX9) probably underlies the OCA1 disease phenotype.

  14. Lineup Composition, Suspect Position, and the Sequential Lineup Advantage

    Science.gov (United States)

    Carlson, Curt A.; Gronlund, Scott D.; Clark, Steven E.

    2008-01-01

    N. M. Steblay, J. Dysart, S. Fulero, and R. C. L. Lindsay (2001) argued that sequential lineups reduce the likelihood of mistaken eyewitness identification. Experiment 1 replicated the design of R. C. L. Lindsay and G. L. Wells (1985), the first study to show the sequential lineup advantage. However, the innocent suspect was chosen at a lower rate…

  15. Bacterial colonization of the ovarian bursa in dogs with clinically suspected pyometra and in controls.

    Science.gov (United States)

    Rubio, Alejandro; Boyen, Filip; Tas, Olaf; Kitshoff, Adriaan; Polis, Ingeborgh; Van Goethem, Bart; de Rooster, Hilde

    2014-10-15

    Septic peritonitis occurs relatively commonly in dogs. Secondary septic peritonitis is usually associated with perforation of intestines or infected viscera, such as the uterus in pyometra cases. The aim of this study was to evaluate the bacterial flora in the ovarian bursae of intact bitches as a potential source of contamination. One hundred forty dogs, clinically suspected of pyometra, were prospectively enrolled. The control group consisted of 26 dogs that underwent elective ovariohysterectomies and 18 dogs with mammary gland tumors that were neutered at the time of mastectomy. Bacteriology samples were taken aseptically at the time of surgery from the bursae and the uterus in all dogs. Twenty-two dogs that were clinically suspected of pyometra had sterile uterine content ("mucometra" cases); the remaining 118 had positive uterine cultures ("pyometra" cases) and septic peritoneal fluid was present in 10% of these cases. Of the 118 pyometra cases, 9 had unilateral and 15 had bilateral bacterial colonization of their ovarian bursae. However, the bacteria from the ovarian bursa were similar to those recovered from the uterine pus in only half of the cases. Furthermore, positive bursae were also seen in one mucometra dog (unilateral) and in four control dogs (two unilateral and two bilateral). The data illustrate that the canine ovarian bursa can harbor bacteria. The biological importance of these isolations remains unclear. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Measuring (1,3)-β-D-glucan in tracheal aspirate, bronchoalveolar lavage fluid, and serum for detection of suspected Candida pneumonia in immunocompromised and critically ill patients: a prospective observational study.

    Science.gov (United States)

    Su, Kang-Cheng; Chou, Kun-Ta; Hsiao, Yi-Han; Tseng, Ching-Min; Su, Vincent Yi-Fong; Lee, Yu-Chin; Perng, Diahn-Warng; Kou, Yu Ru

    2017-04-08

    While Candida pneumonia is life-threatening, biomarker measurements to early detect suspected Candida pneumonia are lacking. This study compared the diagnostic values of measuring levels of (1, 3)-β-D-glucan in endotracheal aspirate, bronchoalveolar lavage fluid, and serum to detect suspected Candida pneumonia in immunocompromised and critically ill patients. This prospective, observational study enrolled immunocompromised, critically ill, and ventilated patients with suspected fungal pneumonia in mixed intensive care units from November 2010 to October 2011. Patients with D-glucan confounding factors or other fungal infection were excluded. Endotracheal aspirate, bronchoalveolar lavage fluid and serum were collected from each patient to perform a fungal smear, culture, and D-glucan assay. After screening 166 patients, 31 patients completed the study and were categorized into non-Candida pneumonia/non-candidemia (n = 18), suspected Candida pneumonia (n = 9), and non-Candida pneumonia/candidemia groups (n = 4). D-glucan levels in endotracheal aspirate or bronchoalveolar lavage were highest in suspected Candida pneumonia, while the serum D-glucan level was highest in non-Candida pneumonia/candidemia. In all patients, the D-glucan value in endotracheal aspirate was positively correlated with that in bronchoalveolar lavage fluid. For the detection of suspected Candida pneumonia, the predictive performance (sensitivity/specificity/D-glucan cutoff [pg/ml]) of D-glucan in endotracheal aspirate and bronchoalveolar lavage fluid was 67%/82%/120 and 89%/86%/130, respectively, accounting for areas under the receiver operating characteristic curve of 0.833 and 0.939 (both P pneumonia in the absence of concurrent candidemia. D-glucan levels in both endotracheal aspirate and bronchoalveolar lavage, but not in serum, provide good diagnostic values to detect suspected Candida pneumonia and to serve as potential biomarkers for early detection in this patient population.

  17. Interviewing strategically to elicit admissions from guilty suspects

    OpenAIRE

    Tekin, Serra; Granhag, Pär Anders; Strömwall, Leif; Giolla, Erik Mac; Vrij, Aldert; Hartwig, Maria

    2015-01-01

    In this article we introduce a novel interviewing tactic to elicit admissions from guilty suspects. By influencing the suspects’ perception of the amount of evidence the interviewer holds against them, we aimed to shift the suspects’ counterinterrogation strategies from less to more forthcoming. The proposed tactic (SUE-Confrontation) is a development of the Strategic Use of Evidence (SUE) framework and aims to affect the suspects’ perception by confronting them with statement-evidence incons...

  18. The role of imaging in children with suspected appendicitis: the UK perspective

    International Nuclear Information System (INIS)

    Lander, Anthony

    2007-01-01

    The diagnosis of uncomplicated acute appendicitis is often straightforward, allowing timely appendicectomy without the need for expensive tests or imaging. Repeated clinical examination by an experienced surgeon has traditionally been the key to making the diagnosis in both straightforward and difficult cases. Nonetheless, all surgeons will remove some normal appendices. Sometimes it can be particularly difficult to make the diagnosis, especially in the child under 5 years of age, in teenage girls, in young women and in the elderly. When difficult to make, the diagnosis may be significantly delayed and since the pathology is progressive, the patient may suffer potentially avoidable complications. This paper looks at two potential roles for imaging. Firstly, can imaging, applied selectively, help make the difficult diagnosis less difficult and so reduce delays and morbidity? Secondly, could imaging all patients with suspected appendicitis reduce the number of normal appendices removed from children who seem to have all the signs and symptoms of straightforward uncomplicated acute appendicitis but who actually have presumed self-resolving non-appendiceal pathology? The answer to these questions may depend on three factors that are not entirely independent: a surgical unit's current audited negative appendicectomy rate, population base/case mix and the expertise of the examining surgeon. Individual surgeons and some surgical units, by policy, use modern imaging techniques with quite different frequencies that may be appropriate depending on these three factors. This article argues that a careful history and repeated clinical examination is the key to making the diagnosis, with imaging, primarily ultrasonography, being used in patients with a palpable mass or in those having had 48 h of hospital observation without progress. In Europe, imaging has played a limited role in the investigation of the child with suspected appendicitis with the diagnosis relying on repeated

  19. Not the usual suspects: addressing layers of vulnerability.

    Science.gov (United States)

    Luna, Florencia; Vanderpoel, Sheryl

    2013-07-01

    This paper challenges the traditional account of vulnerability in healthcare which conceptualizes vulnerability as a list of identifiable subpopulations. This list of 'usual suspects', focusing on groups from lower resource settings, is a narrow account of vulnerability. In this article we argue that in certain circumstances middle-class individuals can be also rendered vulnerable. We propose a relational and layered account of vulnerability and explore this concept using the case study of cord blood (CB) banking. In the first section, two different approaches to 'vulnerability' are contrasted: categorical versus layered. In the second section, we describe CB banking and present a case study of CB banking in Argentina. We examine the types of pressure that middle-class pregnant women feel when considering CB collection and storage. In section three, we use the CB banking case study to critique the categorical approach to vulnerability: this model is unable to account for the ways in which these women are vulnerable. A layered account of vulnerability identifies several ways in which middle-class women are vulnerable. Finally, by utilizing the layered approach, this paper suggests how public health policies could be designed to overcome vulnerabilities. © 2013 John Wiley & Sons Ltd.

  20. Cognitive Linguistic Performances of Multilingual University Students Suspected of Dyslexia

    Science.gov (United States)

    Lindgren, Signe-Anita; Laine, Matti

    2011-01-01

    High-performing adults with compensated dyslexia pose particular challenges to dyslexia diagnostics. We compared the performance of 20 multilingual Finnish university students with suspected dyslexia with 20 age-matched and education-matched controls on an extensive test battery. The battery tapped various aspects of reading, writing, word…

  1. Genotype-phenotype correlation in patients suspected of having Sotos syndrome

    NARCIS (Netherlands)

    de Boer, Lonneke; Kant, Sarina G.; Karperien, Marcel; van Beers, Lotte; Tjon, Jennifer; Vink, Geraldine R.; van Tol, Dewy; Dauwerse, Hans; le Cessie, Saskia; Beemer, Frits A.; van der Burgt, Ineke; Hamel, Ben C. J.; Hennekam, Raoul C.; Kuhnle, Ursula; Mathijssen, Inge B.; Veenstra-Knol, Hermine E.; Stumpel, Connie T. Schrander; Breuning, Martijn H.; Wit, Jan M.

    2004-01-01

    Background: Deletions and mutations in the NSD1 gene are the major cause of Sotos syndrome. We wanted to evaluate the genotype-phenotype correlation in patients suspected of having Sotos syndrome and determine the best discriminating parameters for the presence of a NSD1 gene alteration. Methods:

  2. Genotype-phenotype correlation in patients suspected of having sotos syndrome.

    NARCIS (Netherlands)

    Boer, L. de; Kant, S.; Karperien, M.; Beers, L. van; Tjon, J.; Vink, G.R.; Tol, D. van; Dauwerse, H.G.; Cessie, S. le; Beemer, F.A.; Burgt, C.J.A.M. van der; Hamel, B.C.J.; Hennekam, R.C.M.; Kuhnle, U.; Mathijssen, I.B.; Veenstra-Knol, H.E.; Stumpel, C.T.; Breuning, M.H.; Wit, J.M.

    2004-01-01

    BACKGROUND: Deletions and mutations in the NSD1 gene are the major cause of Sotos syndrome. We wanted to evaluate the genotype-phenotype correlation in patients suspected of having Sotos syndrome and determine the best discriminating parameters for the presence of a NSD1 gene alteration. METHODS:

  3. Is extended biopsy protocol justified in all patients with suspected ...

    African Journals Online (AJOL)

    2012-01-03

    Jan 3, 2012 ... Objective: To determine the significance of an extended 10-core transrectal biopsy protocol in different categories of patients with suspected prostate cancer using digital guidance. Materials and Methods: We studied 125 men who were being evaluated for prostate cancer. They all had an extended.

  4. Intraoperative ultrasonography in nine dogs with intra-abdominal neoplasm suspect

    Directory of Open Access Journals (Sweden)

    Daniella Matos da Silva

    Full Text Available ABSTRACT: Intraoperative ultrasonography (IOUS is used in medicine for diagnosis and guidance during oncologic surgery. The aims of this study were to assess the performance, feasibility, advantages and difficulties of the IOUS technique in dogs with suspected intra-abdominal tumors. The study included nine client-owed dogs that had suspected intra-abdominal tumors (spleen, liver or bowel based on transabdominal ultrasound examination and that were subsequently referred for exploratory laparotomy surgery. During surgery, IOUS was performed; results of preoperative transabdominal ultrasonography, inspection by the surgeon and IOUS were compared on a case-by-case basis. IOUS was helpful in determining lesion resection in all cases. Lesions detected solely by the use of IOUS were observed in seven out of nine cases. Analysis of these cases demonstrated that IOUS can be a tool to assist during oncology surgery on the liver, spleen or bowel. Dogs with hepatic tumors can have small non-palpable intraparenchymal nodules, which may be visible by IOUS.

  5. Conversion disorder as psychogenic nonepileptic seizures in suspected cancer: a case report.

    Science.gov (United States)

    Jimenez, Xavier F; Sharma, Jennifer S; Dar, Syma A

    2014-01-01

    Psychogenic nonepileptic seizures (PNES), a form of conversion disorder, are paroxysmal episodes resembling epilepsy while lacking electrographic correlation. The phenomenon has rarely been reported in elderly patients and has not been associated with a new-onset medical diagnosis. We present the case of an 81-year-old female with no past psychiatric or traumatic history who developed PNES within the context of a new, suspected cancer. To our knowledge, this is the first such reported case of a suspected cancer (or otherwise medical) diagnosis contributing directly and temporally to the development of PNES. Discussion of involved psychosocial variables follows the vignette, and a brief review of relevant literature is offered. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Analytic models of plausible gravitational lens potentials

    International Nuclear Information System (INIS)

    Baltz, Edward A.; Marshall, Phil; Oguri, Masamune

    2009-01-01

    Gravitational lenses on galaxy scales are plausibly modelled as having ellipsoidal symmetry and a universal dark matter density profile, with a Sérsic profile to describe the distribution of baryonic matter. Predicting all lensing effects requires knowledge of the total lens potential: in this work we give analytic forms for that of the above hybrid model. Emphasising that complex lens potentials can be constructed from simpler components in linear combination, we provide a recipe for attaining elliptical symmetry in either projected mass or lens potential. We also provide analytic formulae for the lens potentials of Sérsic profiles for integer and half-integer index. We then present formulae describing the gravitational lensing effects due to smoothly-truncated universal density profiles in cold dark matter model. For our isolated haloes the density profile falls off as radius to the minus fifth or seventh power beyond the tidal radius, functional forms that allow all orders of lens potential derivatives to be calculated analytically, while ensuring a non-divergent total mass. We show how the observables predicted by this profile differ from that of the original infinite-mass NFW profile. Expressions for the gravitational flexion are highlighted. We show how decreasing the tidal radius allows stripped haloes to be modelled, providing a framework for a fuller investigation of dark matter substructure in galaxies and clusters. Finally we remark on the need for finite mass halo profiles when doing cosmological ray-tracing simulations, and the need for readily-calculable higher order derivatives of the lens potential when studying catastrophes in strong lenses

  7. Baby Skyrme models for a class of potentials

    International Nuclear Information System (INIS)

    Eslami, P.; Zakrzewski, W.; Sarbishaei, M.

    2000-01-01

    We consider a class of (2+1)- dimensional baby Skyrme models with potentials that have more than one vacuum. These potentials are generalizations of old and new baby Skyrme models; they involve more complicated dependence on φ 3 . We find that when the potential is invariant under φ 3 → -φ 3 the configurations corresponding to the baby Skyrmions lying 'on top of each other' are the minima of the energy. However, when the potential breaks this symmetry the lowest field configurations correspond to separated baby skyrmions. We compute the energy distributions for skyrmions of degrees between one and eight and discuss their geometrical shapes and binding energies. We also compare the 2-skyrmion states for these potentials. Most of our work has been performed numerically with the model being formulated in terms of three real scalar fields (satisfying one constraint)

  8. Anterior segment changes after pharmacologic mydriasis using Pentacam and optical coherence tomography in angle closure suspects

    Directory of Open Access Journals (Sweden)

    Jing-Min Guo

    2015-10-01

    Full Text Available AIM:To compare the dynamic changes of anterior segment parameters especially iris morphology induced by pharmacologic mydriasis between angle closure suspects and normal controls.METHODS:The study group comprised 19 eyes of 19 angle closure suspects and 19 eyes of 19 age- and sex-matched normal open-angle eyes. Pentacam and optical coherence tomography measurements before and 30min after instillation of compound tropicamide eye drop were performed and compared. Biometric evaluations of iris tomography and anterior chamber angle were estimated by a customized image-processing software.RESULTS:Baseline axial length, iris cross sectional area and volume did not differ significantly between angle closure suspects and normal controls. Angle closure suspects had smaller pupil size, narrower anterior segment dimension and axial length, thinner iris with greater curve in comparison with normal controls. Pharmacologic mydriasis led to significant increments in iris thickness at 750 μm, anterior chamber depth and volume, whereas significant decrements in iris curve, cross sectional area and volume in both groups. Angle opening distance at 500 μm was increased significantly in normal controls (from 0.465±0.115 mm to 0.539±0.167 mm, P=0.009, but not in angle closure suspects (from 0.125±0.100 mm to 0.145±0.131 mm, P=0.326. Iris volume change per millimeter of pupil dilation (△IV/△PD decreased significantly less in angle closure suspects than normal controls (-2.47±1.33 mm2 vs -3.63±1.58 mm2, P=0.019. Linear regression analysis showed that the change of angle opening distance at 500 μm was associated most with the change of central anterior chamber depth (β=0.841, P=0.002 and △IV/△PD (β=0.028, P=0.002, followed by gender (β=0.062, P=0.032.CONCLUSION:Smaller iris volume decrement per millimeter of pupil dilation is related significantly with the less anterior angle opening in angle closure suspects after pharmacologic mydriasis. Dynamic

  9. Model potential for electron scattering from rubidium

    Energy Technology Data Exchange (ETDEWEB)

    Gien, T.E. (Memorial Univ. of Newfoundland, St. John' s, NF (Canada). Dept. of Physics)

    1992-11-28

    An analytic model potential for the e[sup -]-Rb[sup +] system is generated from experimental data, using an iteration method. The potential obtained can reproduce rather accurately the energy levels of rubidium. We employed it in the calculation of elastic differential cross sections for electron (and positron) scatterings from rubidium in the conventional Glauber approximation. The differential cross sections calculated in the model potential approach are compared to those in the frozen-core approach, employing either the Clementi-Roetti or the Szasz-McGinn wavefunctions. The core correlation and polarization effects are found to significantly affect the cross section results. (author).

  10. Model potential for electron scattering from rubidium

    International Nuclear Information System (INIS)

    Gien, T.E.

    1992-01-01

    An analytic model potential for the e - -Rb + system is generated from experimental data, using an iteration method. The potential obtained can reproduce rather accurately the energy levels of rubidium. We employed it in the calculation of elastic differential cross sections for electron (and positron) scatterings from rubidium in the conventional Glauber approximation. The differential cross sections calculated in the model potential approach are compared to those in the frozen-core approach, employing either the Clementi-Roetti or the Szasz-McGinn wavefunctions. The core correlation and polarization effects are found to significantly affect the cross section results. (author)

  11. Diagnostic accuracy and patient acceptance of MRI in children with suspected appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Thieme, Mai E.; Valdehueza, Zaldy D.; Wiarda, Bart M. [Medical Centre Alkmaar, Department of Radiology, Alkmaar (Netherlands); Leeuwenburgh, Marjolein M.N. [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam (Netherlands); Academic Medical Centre Amsterdam, Department of Surgery, Amsterdam (Netherlands); Bouman, Donald E. [Medical Spectrum Twente, Department of Radiology, Enschede (Netherlands); Bruin, Ivar G.J.M. de; Schreurs, W.H.; Houdijk, Alexander P.J. [Medical Centre Alkmaar, Department of Surgery, Alkmaar (Netherlands); Stoker, Jaap [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam (Netherlands)

    2014-03-15

    To compare magnetic resonance imaging (MRI) and ultrasound in children with suspected appendicitis. In a single-centre diagnostic accuracy study, children with suspected appendicitis were prospectively identified at the emergency department. All underwent abdominal ultrasound and MRI within 2 h, with the reader blinded to other imaging findings. An expert panel established the final diagnosis after 3 months. We evaluated the diagnostic accuracy of three imaging strategies: ultrasound only, conditional MRI after negative or inconclusive ultrasound, and MRI only. Significance between sensitivity and specificity was calculated using McNemar's test statistic. Between April and December 2009 we included 104 consecutive children (47 male, mean age 12). According to the expert panel, 58 patients had appendicitis. The sensitivity of MRI only and conditional MRI was 100 % (95 % confidence interval 92-100), that of ultrasound was significantly lower (76 %; 63-85, P < 0.001). Specificity was comparable among the three investigated strategies; ultrasound only 89 % (77-95), conditional MRI 80 % (67-89), MRI only 89 % (77-95) (P values 0.13, 0.13 and 1.00). In children with suspected appendicitis, strategies with MRI (MRI only, conditional MRI) had a higher sensitivity for appendicitis compared with a strategy with ultrasound only, while specificity was comparable. (orig.)

  12. Suspected post-vaccinal acute polyradiculoneuritis in a puppy : short communication

    Directory of Open Access Journals (Sweden)

    R. Gehring

    2001-07-01

    Full Text Available A 4-month-old German shepherd puppy developed hindquarter weakness after vaccination with a multivalent vaccine. This is suggestive of post-vaccinal polyradiculoneuritis. To date, only 1 similar case has been reported, which may be due to the under-reporting of suspected adverse drug reactions.

  13. Use of budesonide Turbuhaler in young children suspected of asthma

    DEFF Research Database (Denmark)

    Bisgaard, H; Pedersen, S; Nikander, K

    1994-01-01

    The question addressed in this study was the ability of young children to use a dry-powder inhaler, Turbuhaler. One hundred and sixty five children suspected of asthma, equally distributed in one year age-groups from 6 months to 8 yrs, inhaled from a Pulmicort Turbuhaler, 200 micrograms budesonide...

  14. Is extended biopsy protocol justified in all patients with suspected ...

    African Journals Online (AJOL)

    Objective: To determine the significance of an extended 10-core transrectal biopsy protocol in different categories of patients with suspected prostate cancer using digital guidance. Materials and Methods: We studied 125 men who were being evaluated for prostate cancer. They all had an extended 10-core digitally guided ...

  15. Baby Skyrme models without a potential term

    Science.gov (United States)

    Ashcroft, Jennifer; Haberichter, Mareike; Krusch, Steffen

    2015-05-01

    We develop a one-parameter family of static baby Skyrme models that do not require a potential term to admit topological solitons. This is a novel property as the standard baby Skyrme model must contain a potential term in order to have stable soliton solutions, though the Skyrme model does not require this. Our new models satisfy an energy bound that is linear in terms of the topological charge and can be saturated in an extreme limit. They also satisfy a virial theorem that is shared by the Skyrme model. We calculate the solitons of our new models numerically and observe that their form depends significantly on the choice of parameter. In one extreme, we find compactons while at the other there is a scale invariant model in which solitons can be obtained exactly as solutions to a Bogomolny equation. We provide an initial investigation into these solitons and compare them with the baby Skyrmions of other models.

  16. Suspect/Counterfeit Items Information Guide for Subcontractors/Suppliers

    Energy Technology Data Exchange (ETDEWEB)

    Tessmar, Nancy D. [Los Alamos National Laboratory; Salazar, Michael J. [Los Alamos National Laboratory

    2012-09-18

    Counterfeiting of industrial and commercial grade items is an international problem that places worker safety, program objectives, expensive equipment, and security at risk. In order to prevent the introduction of Suspect/Counterfeit Items (S/CI), this information sheet is being made available as a guide to assist in the implementation of S/CI awareness and controls, in conjunction with subcontractor's/supplier's quality assurance programs. When it comes to counterfeit goods, including industrial materials, items, and equipment, no market is immune. Some manufactures have been known to misrepresent their products and intentionally use inferior materials and processes to manufacture substandard items, whose properties can significantly cart from established standards and specifications. These substandard items termed by the Department of Energy (DOE) as S/CI, pose immediate and potential threats to the safety of DOE and contractor workers, the public, and the environment. Failure of certain systems and processes caused by an S/CI could also have national security implications at Los Alamos National Laboratory (LANL). Nuclear Safety Rules (federal Laws), DOE Orders, and other regulations set forth requirements for DOE contractors to implement effective controls to assure that items and services meet specified requirements. This includes techniques to implement and thereby minimizing the potential threat of entry of S/CI to LANL. As a qualified supplier of goods or services to the LANL, your company will be required to establish and maintain effective controls to prevent the introduction of S/CI to LANL. This will require that your company warrant that all items (including their subassemblies, components, and parts) sold to LANL are genuine (i.e. not counterfeit), new, and unused, and conform to the requirements of the LANL purchase orders/contracts unless otherwise approved in writing to the Los Alamos National Security (LANS) contract administrator

  17. What do potential jurors know about police interrogation techniques and false confessions?

    Science.gov (United States)

    Leo, Richard A; Liu, Brittany

    2009-01-01

    Psychological police interrogation methods in America inevitably involve some level of pressure and persuasion to achieve their goal of eliciting confessions of guilt from custodial suspects. In this article, we surveyed potential jurors about their perceptions of a range of psychological interrogation techniques, the likelihood that such techniques would elicit a true confession from guilty suspects, and the likelihood that such techniques could elicit a false confession from innocent suspects. Participants recognized that these interrogation techniques may be psychologically coercive and may elicit true confessions, but believed that psychologically coercive interrogation techniques are not likely to elicit false confessions. The findings from this survey study indicate that potential jurors believe that false confessions are both counter- intuitive and unlikely, even in response to psychologically coercive interrogation techniques that have been shown to lead to false confessions from the innocent. This study provides empirical support for the idea that expert witnesses may helpfully inform jurors about the social science research on psychologically coercive interrogation methods and how and why such interrogation techniques can lead to false confessions. (c) 2009 John Wiley & Sons, Ltd.

  18. Water supply interruptions and suspected cholera incidence: a time-series regression in the Democratic Republic of the Congo.

    Science.gov (United States)

    Jeandron, Aurélie; Saidi, Jaime Mufitini; Kapama, Alois; Burhole, Manu; Birembano, Freddy; Vandevelde, Thierry; Gasparrini, Antonio; Armstrong, Ben; Cairncross, Sandy; Ensink, Jeroen H J

    2015-10-01

    The eastern provinces of the Democratic Republic of the Congo have been identified as endemic areas for cholera transmission, and despite continuous control efforts, they continue to experience regular cholera outbreaks that occasionally spread to the rest of the country. In a region where access to improved water sources is particularly poor, the question of which improvements in water access should be prioritized to address cholera transmission remains unresolved. This study aimed at investigating the temporal association between water supply interruptions and Cholera Treatment Centre (CTC) admissions in a medium-sized town. Time-series patterns of daily incidence of suspected cholera cases admitted to the Cholera Treatment Centre in Uvira in South Kivu Province between 2009 and 2014 were examined in relation to the daily variations in volume of water supplied by the town water treatment plant. Quasi-poisson regression and distributed lag nonlinear models up to 12 d were used, adjusting for daily precipitation rates, day of the week, and seasonal variations. A total of 5,745 patients over 5 y of age with acute watery diarrhoea symptoms were admitted to the CTC over the study period of 1,946 d. Following a day without tap water supply, the suspected cholera incidence rate increased on average by 155% over the next 12 d, corresponding to a rate ratio of 2.55 (95% CI: 1.54-4.24), compared to the incidence experienced after a day with optimal production (defined as the 95th percentile-4,794 m3). Suspected cholera cases attributable to a suboptimal tap water supply reached 23.2% of total admissions (95% CI 11.4%-33.2%). Although generally reporting less admissions to the CTC, neighbourhoods with a higher consumption of tap water were more affected by water supply interruptions, with a rate ratio of 3.71 (95% CI: 1.91-7.20) and an attributable fraction of cases of 31.4% (95% CI: 17.3%-42.5%). The analysis did not suggest any association between levels of residual

  19. 18F-FDG PET/CT diagnosis of unexpected extracardiac septic embolisms in patients with suspected cardiac endocarditis

    International Nuclear Information System (INIS)

    Bonfiglioli, Rachele; Nanni, Cristina; Morigi, Joshua James; Ambrosini, Valentina; Fanti, Stefano; Graziosi, Maddalena; Rapezzi, Claudio; Trapani, Filippo; Bartoletti, Michele; Tumietto, Fabio; Viale, Pier Luigi; Ferretti, Alice; Rubello, Domenico

    2013-01-01

    Acute infective endocarditis is a potentially life-threatening disease. Its outcome strongly depends on systemic embolization and extracardiac infections. When present, these conditions usually lead to a more aggressive therapeutic approach. However, the diagnosis of peripheral septic embolism is very challenging. 18 F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT has proven to be accurate for the detection of inflammatory diseases and occult infections. The aim of this study was to assess the added value of 18 F-FDG PET/CT in the detection of extracardiac embolisms in the evaluation of patients with suspected valvular endocarditis (VE). Seventy-one patients with suspected infective endocarditis, enrolled between June 2010 and December 2012, underwent 18 F-FDG PET/CT with the standard procedure on a dedicated PET/CT scanner. Extracardiac findings were subsequently evaluated with other imaging procedures. Of the 71 patients with suspicion of infective endocarditis, we found unexpected extracardiac findings in 17 patients (24 %) without any clinical suspicion. Extracardiac findings were subsequently evaluated with other imaging procedures. PET/CT detected unexpected extra sites of infection in 24 % of cases, leading to changes in therapeutic management in a very relevant percentage of patients. These findings may have important therapeutic implications. (orig.)

  20. VEGF 936C > T Polymorphism and Association of BI-RADS Score in Women with Suspected Breast Cancer

    Directory of Open Access Journals (Sweden)

    M. Wehrschuetz

    2009-01-01

    Full Text Available Purpose Vascular endothelial growth factor (VEGF is a potent regulator of angiogenesis and thereby involved in the development and progression of solid tumors. A 936C> T polymorphism in the VEGF gene has been associated with reduced VEGF plasma levels. Purpose of the present study was to analyze the potential association between VEGF genotype and radiological appearance of breast lesions by mammography. Materials and Methods Fifty two women with 54 suspected breast lesions were analyzed by the use of mammography with the standard breast imaging reporting and data systems (BI-RADS. Germline VEGF genotype was determined in all subjects by allele-specific digestion of amplification products. An open biopsy was performed on all lesions. Results VEGF CC, CT and TT genotypes were found in 41 (79%, 9 (17% and 2 (4% patients. By mammography 26, 16 and 12 suspected breast lesions were classified as BI-RADS scores 3, 4 and 5, respectively. Both carriers of the TT genotype were classified as BI-RADS 5, whereas among CT or CC carriers, BI-RADS scores 3, 4 and 5 were found in 26, 16 and 10 subjects (P T polymorphism seems to be associated with a high BI-RADS score in women with suspicious breast lesions.

  1. Optical Coherence Tomography Angiography Vessel Density in Healthy, Glaucoma Suspect, and Glaucoma Eyes

    Science.gov (United States)

    Yarmohammadi, Adeleh; Zangwill, Linda M.; Diniz-Filho, Alberto; Suh, Min Hee; Manalastas, Patricia Isabel; Fatehee, Naeem; Yousefi, Siamak; Belghith, Akram; Saunders, Luke J.; Medeiros, Felipe A.; Huang, David; Weinreb, Robert N.

    2016-01-01

    Purpose The purpose of this study was to compare retinal nerve fiber layer (RNFL) thickness and optical coherence tomography angiography (OCT-A) retinal vasculature measurements in healthy, glaucoma suspect, and glaucoma patients. Methods Two hundred sixty-one eyes of 164 healthy, glaucoma suspect, and open-angle glaucoma (OAG) participants from the Diagnostic Innovations in Glaucoma Study with good quality OCT-A images were included. Retinal vasculature information was summarized as a vessel density map and as vessel density (%), which is the proportion of flowing vessel area over the total area evaluated. Two vessel density measurements extracted from the RNFL were analyzed: (1) circumpapillary vessel density (cpVD) measured in a 750-μm-wide elliptical annulus around the disc and (2) whole image vessel density (wiVD) measured over the entire image. Areas under the receiver operating characteristic curves (AUROC) were used to evaluate diagnostic accuracy. Results Age-adjusted mean vessel density was significantly lower in OAG eyes compared with glaucoma suspects and healthy eyes. (cpVD: 55.1 ± 7%, 60.3 ± 5%, and 64.2 ± 3%, respectively; P glaucoma and healthy eyes, the age-adjusted AUROC was highest for wiVD (0.94), followed by RNFL thickness (0.92) and cpVD (0.83). The AUROCs for differentiating between healthy and glaucoma suspect eyes were highest for wiVD (0.70), followed by cpVD (0.65) and RNFL thickness (0.65). Conclusions Optical coherence tomography angiography vessel density had similar diagnostic accuracy to RNFL thickness measurements for differentiating between healthy and glaucoma eyes. These results suggest that OCT-A measurements reflect damage to tissues relevant to the pathophysiology of OAG. PMID:27409505

  2. 48 CFR 3003.203 - Reporting suspected violations of the Gratuities clause.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Reporting suspected violations of the Gratuities clause. 3003.203 Section 3003.203 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY, HOMELAND SECURITY ACQUISITION REGULATION (HSAR) GENERAL IMPROPER BUSINESS...

  3. The role of the follow-up chest radiograph in suspected non-accidental injury

    Energy Technology Data Exchange (ETDEWEB)

    Anilkumar, Adikesavalu; Fender, Laura J; Broderick, Nigel J; Somers, John M; Halliday, Katharine E [Nottingham University Hospital NHS Trust, Department of Radiology, Queen' s Medical Centre, Nottingham (United Kingdom)

    2006-03-15

    Rib fractures in children under the age of 2 years have a strong correlation with non-accidental injury (NAI). Follow-up radiographs can improve detection. To evaluate the value of the follow-up chest radiograph in suspected non-accidental injury. The study included all children less than 2 years of age who were investigated for suspected NAI in our institution between January 1998 and October 2003. Prior to January 2000, only selected patients were asked to attend for a follow-up chest radiograph. From January 2000 onwards all children were asked to reattend. Of 200 children included in the study, 59 (29.5%) reattended for a follow-up chest radiograph. The follow-up film provided useful additional information in 7 (12%) of the 59 children. In two children rib fractures were noted only on the follow-up chest radiograph. In a further two patients additional rib fractures were noted. Additional dating information was obtained for two patients. For one child both additional fractures and dating information were noted. The follow-up chest radiograph provides useful information in children with suspected NAI and it is recommended that it should be included routinely in the imaging investigations of these children. (orig.)

  4. The role of the follow-up chest radiograph in suspected non-accidental injury

    International Nuclear Information System (INIS)

    Anilkumar, Adikesavalu; Fender, Laura J.; Broderick, Nigel J.; Somers, John M.; Halliday, Katharine E.

    2006-01-01

    Rib fractures in children under the age of 2 years have a strong correlation with non-accidental injury (NAI). Follow-up radiographs can improve detection. To evaluate the value of the follow-up chest radiograph in suspected non-accidental injury. The study included all children less than 2 years of age who were investigated for suspected NAI in our institution between January 1998 and October 2003. Prior to January 2000, only selected patients were asked to attend for a follow-up chest radiograph. From January 2000 onwards all children were asked to reattend. Of 200 children included in the study, 59 (29.5%) reattended for a follow-up chest radiograph. The follow-up film provided useful additional information in 7 (12%) of the 59 children. In two children rib fractures were noted only on the follow-up chest radiograph. In a further two patients additional rib fractures were noted. Additional dating information was obtained for two patients. For one child both additional fractures and dating information were noted. The follow-up chest radiograph provides useful information in children with suspected NAI and it is recommended that it should be included routinely in the imaging investigations of these children. (orig.)

  5. Frequency of suspected cases of neurocysticercosis detected by computed skull tomography in Santa Maria, RS, Brazil.

    Science.gov (United States)

    Silva, J E; Diefenthäler, A P; Palma, J K

    2000-01-01

    Due to the lack of studies about neurocysticercosis in the South of Brazil, an investigation was conducted to determine the percentage of suspected cases of neurocysticercosis in computed tomography diagnoses in Santa Maria, RS, from January 1997 to December 1998. Of 6300 computed tomographies (CT) of the skull performed at the private Hospital de Caridade Astrogildo de Azevedo, 80, i.e., 1.27% were suspected of neurocysticercosis. Fifty were women (62.5%) and 30 were men (37.5%). The most frequent radiological manifestation indicating neurocysticercosis was the presence of calcifications (isolated or associated), with a 95% rate (76 cases), while the presence of hypodense lesions reached a 5% rate (4 cases). After routine analysis, each CT was evaluated again and the suspected cases were confirmed. The percentage of suspected cases of neurocysticercosis detected by CT in the present study carried out in Santa Maria was considered low (1.27%). This can be explained by the fact that tomography is not accessible to the economically underprivileged population of Santa Maria. We hope that the present study can alert the population and the professionals to the fact that neurocysticercosis is a more frequent disease than indicated by the few diagnoses made.

  6. Dentists’ intention to report suspected violence: a cross-sectional study in eight Arab countries

    Science.gov (United States)

    Gaffar, Balgis; Arheiam, Arheiam; AbdelAziz, Wafaa; Al-Batayneh, Ola B; Alhoti, Mansur F; Al-Maweri, Sadeq; Dama, Mai A; Zaghez, Mounir; Hassan, Khalid Saddiq; Al-Sane, Mona; AbdelSalam, Maha; Sabbah, Wael; Owais, Arwa I; Abdelgawad, Fatma; Aldhelai, Thiyezen Abdullah; El Meligy, Omar Abd El Sadek; AlHumaid, Jehan; Al-Harbi, Fahad

    2018-01-01

    Objectives This study assessed dentists’ intention in eight Arab countries to report suspected exposure to violence among patients and factors associated with this intention based on the theory of planned behaviour. Methods A cross-sectional study was conducted in 2016 including a convenience sample of dentists practising in public, private and academic sectors in Algeria, Egypt, Jordan, Kuwait, Libya, Palestine, Saudi Arabia and Yemen. Respondents answered a self-administered questionnaire collecting information about personal and professional background and perceived ability to identify victims of violence. The questionnaire assessed (on a scale from 1 to 10 using six negative statements) dentists’ perception of healthcare system mandated reporting of suspected violence. Six statements were used to assess professional attitude towards reporting suspected violence. Logistic regression was used to assess the association between intention to report suspected violence and perceived ability, perception and attitude adjusting for confounders. Results The response rate was 65.2% (n=2936/4506) from general practitioners (70.9%) of mean age=31 years with 56.7% women. Of those, 68.8% intended to report and 52.2% considered themselves able to identify violence victims. The mean (SD) negative perception score=5.3/10 (2.1) and the mean (SD) professional attitude score=7.5/10 (1.9). In multivariate regression, intention to report was associated with professional attitude (OR 1.08, 95% CI 1.03 to 1.14), ability to identify violence victims (OR 1.76, 95% CI 1.45 to 2.12) and negative perception that reporting is not mandated (OR 0.89, 95% CI 0.85 to 0.94). Significant differences existed among countries in intention to report. Conclusion Most dentists intended to report suspected violence and their intention could be explained by the theory of planned behaviour which offers a framework for professional development to support violence victims. Sharing of training resources

  7. General practice performance in referral for suspected cancer: influence of number of cases and case-mix on publicly reported data.

    Science.gov (United States)

    Murchie, P; Chowdhury, A; Smith, S; Campbell, N C; Lee, A J; Linden, D; Burton, C D

    2015-05-26

    Publicly available data show variation in GPs' use of urgent suspected cancer (USC) referral pathways. We investigated whether this could be due to small numbers of cancer cases and random case-mix, rather than due to true variation in performance. We analysed individual GP practice USC referral detection rates (proportion of the practice's cancer cases that are detected via USC) and conversion rates (proportion of the practice's USC referrals that prove to be cancer) in routinely collected data from GP practices in all of England (over 4 years) and northeast Scotland (over 7 years). We explored the effect of pooling data. We then modelled the effects of adding random case-mix to practice variation. Correlations between practice detection rate and conversion rate became less positive when data were aggregated over several years. Adding random case-mix to between-practice variation indicated that the median proportion of poorly performing practices correctly identified after 25 cancer cases were examined was 20% (IQR 17 to 24) and after 100 cases was 44% (IQR 40 to 47). Much apparent variation in GPs' use of suspected cancer referral pathways can be attributed to random case-mix. The methods currently used to assess the quality of GP-suspected cancer referral performance, and to compare individual practices, are misleading. These should no longer be used, and more appropriate and robust methods should be developed.

  8. [Analysis on the role of Sirius combined topography and tomography system in screening for suspect keratoconus].

    Science.gov (United States)

    Zhang, Y; Chen, Y G; Yang, H Y; Xia, Y J; Zhao, R

    2018-01-11

    Objective: To evaluate the role of Sirius combined topography and tomography system in screening for suspect keratoconus among the corneal refractive surgery candidates. Methods: Retrospective case series study. Eight hundred and sixteen consecutive ametropic patients (1 632 eyes) who underwent routine examinations before corneal refractive surgery at Peking University Third Hospital from January 2016 to September 2016 were reviewed. All the cases were analyzed with Sirius combined topography and tomography system. Fifty-nine eyes of 37 patients, aged (28.9±7.4) years, classified as suspect keratoconus by the system were enrolled in the suspect group, including 25 females (40 eyes) and 12 males (19 eyes). A random eye of the first 59 patients, aged (27.1±6.4)years, whose both eyes were classified as normal by Sirius system were enrolled in the control group, including 38 females and 21 males. The corneal anterior surface, posterior surface and minimum thickness data of the suspect group were analyzed and then compared with the control group. The classified results were further verified by Pentacam system. Independent-samples t test and Mann-Whitney U test were applied to analyze the normal distribution and non-normal distribution data respectively. Results: The medians of anterior surface and posterior surface symmetry index and Baiocchi Calossi Versaci index of anterior surface and posterior surface of the suspect group were 0.84, 0.22, 0.58 and 0.51 D, and that of the control group were 0.05, 0.04, 0.09 and 0.06 D, and the differences were of statistical significance ( Z=- 18.764, -8.351, -12.248, -10.709, Ptopography and tomography and its integral automatic classification system is capable to screen out the suspect keratoconus simply and effectively. These indices maybe arranged in descending order in terms of the sensitivity as corneal posterior surface, followed by corneal anterior surface and then corneal thinnest point thickness. (Chin J Ophthalmol, 2018

  9. Stress Perfusion Coronary Flow Reserve Versus Cardiac Magnetic Resonance for Known or Suspected CAD.

    Science.gov (United States)

    Kato, Shingo; Saito, Naka; Nakachi, Tatsuya; Fukui, Kazuki; Iwasawa, Tae; Taguri, Masataka; Kosuge, Masami; Kimura, Kazuo

    2017-08-15

    Phase-contrast (PC) cine magnetic resonance imaging (MRI) of the coronary sinus is a noninvasive method to quantify coronary flow reserve (CFR). This study sought to compare the prognostic value of CFR by cardiac magnetic resonance (CMR) and stress perfusion CMR to predict major adverse cardiac events (MACE). Participants included 276 patients with known coronary artery disease (CAD) and 400 with suspected CAD. CFR was calculated as myocardial blood flow during adenosine triphosphate infusion divided by myocardial blood flow at rest using PC cine MRI of the coronary sinus. During a median follow-up of 2.3 years, 47 patients (7%) experienced MACE. Impaired CFR (10% ischemia on stress perfusion CMR were significantly associated with MACE in patients with known CAD (hazard ratio [HR]: 5.17 and HR: 5.10, respectively) and suspected CAD (HR: 14.16 and HR: 6.50, respectively). The area under the curve for predicting MACE was 0.773 for CFR and 0.731 for stress perfusion CMR (p = 0.58) for patients with known CAD, and 0.885 for CFR and 0.776 for stress perfusion CMR (p = 0.059) in the group with suspected CAD. In patients with known CAD, sensitivity, specificity, and positive and negative predictive values to predict MACE were 64%, 91%, 38%, and 97%, respectively, for CFR, and 82%, 59%, 15%, and 97%, respectively, for stress perfusion CMR. In the suspected CAD group, these values were 65%, 99%, 80%, and 97%, respectively, for CFR, and 72%, 83%, 22%, and 98%, respectively, for stress perfusion CMR. The predictive values of CFR and stress perfusion CMR for MACE were comparable in patients with known CAD. In patients with suspected CAD, CFR showed higher HRs and areas under the curve than stress perfusion CMR, suggesting that CFR assessment by PC cine MRI might provide better risk stratification for patients with suspected CAD. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. Use of biomarkers in triage of patients with suspected stroke.

    Science.gov (United States)

    Vanni, Simone; Polidori, Gianluca; Pepe, Giuseppe; Chiarlone, Melisenda; Albani, Alberto; Pagnanelli, Adolfo; Grifoni, Stefano

    2011-05-01

    The absence of a rapidly available and sensitive diagnostic test represents an important limitation in the triage of patients with suspected stroke. The aim of the present study was to investigate the triage accuracy of a novel test that measures blood-borne biomarkers (triage stroke panel, TSP) and to compare its accuracy with that of the Cincinnati Prehospital Stroke Scale (CPSS). Consecutive patients with suspected stroke presenting to the Emergency Departments of three Italian hospitals underwent triage by a trained nurse according to the CPSS and had blood drawn for TSP testing. The TSP simultaneously measures four markers (B-type natriuretic peptide, D-dimer, matrix metalloproteinase-9, and S100β) presenting a single composite result, the Multimarker Index (MMX). Stroke diagnosis was established by an expert committee blinded to MMX and CPSS results. There were 155 patients enrolled, 87 (56%) of whom had a final diagnosis of stroke. The area under the receiver operating characteristic (ROC) curve for CPSS was 0.77 (95% confidence interval [CI] 0.70-0.84) and that of MMX was 0.74 (95% CI 0.66-0.82) (p = 0.285). Thus, both tests, when used alone, failed to recognize approximately 25% of strokes. The area under the ROC curve of the combination of the two tests (0.86, 95% CI 0.79-0.91) was significantly greater than that of either single test (p = 0.01 vs. CPSS and p vs. TSP). In an emergency care setting, a panel test using multiple biochemical markers showed triage accuracy similar to that of CPSS. Further studies are needed before biomarkers can be introduced in the clinical work-up of patients with suspected stroke. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Nonlinear Growth Models as Measurement Models: A Second-Order Growth Curve Model for Measuring Potential.

    Science.gov (United States)

    McNeish, Daniel; Dumas, Denis

    2017-01-01

    Recent methodological work has highlighted the promise of nonlinear growth models for addressing substantive questions in the behavioral sciences. In this article, we outline a second-order nonlinear growth model in order to measure a critical notion in development and education: potential. Here, potential is conceptualized as having three components-ability, capacity, and availability-where ability is the amount of skill a student is estimated to have at a given timepoint, capacity is the maximum amount of ability a student is predicted to be able to develop asymptotically, and availability is the difference between capacity and ability at any particular timepoint. We argue that single timepoint measures are typically insufficient for discerning information about potential, and we therefore describe a general framework that incorporates a growth model into the measurement model to capture these three components. Then, we provide an illustrative example using the public-use Early Childhood Longitudinal Study-Kindergarten data set using a Michaelis-Menten growth function (reparameterized from its common application in biochemistry) to demonstrate our proposed model as applied to measuring potential within an educational context. The advantage of this approach compared to currently utilized methods is discussed as are future directions and limitations.

  12. Differential Diagnosis of Children with Suspected Childhood Apraxia of Speech

    Science.gov (United States)

    Murray, Elizabeth; McCabe, Patricia; Heard, Robert; Ballard, Kirrie J.

    2015-01-01

    Purpose: The gold standard for diagnosing childhood apraxia of speech (CAS) is expert judgment of perceptual features. The aim of this study was to identify a set of objective measures that differentiate CAS from other speech disorders. Method: Seventy-two children (4-12 years of age) diagnosed with suspected CAS by community speech-language…

  13. Relativistic ''potential model'' for N-particle systems

    International Nuclear Information System (INIS)

    Noyes, H.P.

    1986-08-01

    Neither quantum field theory nor S-Matrix theory have a well defined procedure for going over to an approximation that can be reliably used in non-relativistic models for nuclear physics. We meet the problem here by constructing a finite particle number relativistic scattering theory for (scalar) particles and mesons using integral equations of the Faddeev-Yakubovsky type. Restricted to N particles and one meson, we can go from the relativistic theory to a ''potential theory'' in the integral equation formulation by using boundary states which do not contain the meson asymptotically. The meson-particle input amplitudes contain a pole at the particle mass, and the particle-particle input amplitudes are null. This gives unique definition (numerically calculable) to the particle-particle off-shell amplitude, and hence to the covariant ''scattering potential'' (but not to the noninvariant concept of ''potential energy''). As we have commented before, if we take these scattering amplitudes as iput for relativistic Faddeev equations, the results are identical to those obtained from the same model starting from three particles and one meson. In this paper we explore how far we can extend this relativistic ''potential model'' to higher numbers of particles and mesons. 10 refs

  14. Suspect/foil identification in actual crimes and in the laboratory: a reality monitoring analysis.

    Science.gov (United States)

    Behrman, Bruce W; Richards, Regina E

    2005-06-01

    Four reality monitoring variables were used to discriminate suspect from foil identifications in 183 actual criminal cases. Four hundred sixty-one identification attempts based on five and six-person lineups were analyzed. These identification attempts resulted in 238 suspect identifications and 68 foil identifications. Confidence, automatic processing, eliminative processing and feature use comprised the set of reality monitoring variables. Thirty-five verbal confidence phrases taken from police reports were assigned numerical values on a 10-point confidence scale. Automatic processing identifications were those that occurred "immediately" or "without hesitation." Eliminative processing identifications occurred when witnesses compared or eliminated persons in the lineups. Confidence, automatic processing and eliminative processing were significant predictors, but feature use was not. Confidence was the most effective discriminator. In cases that involved substantial evidence extrinsic to the identification 43% of the suspect identifications were made with high confidence, whereas only 10% of the foil identifications were made with high confidence. The results of a laboratory study using the same predictors generally paralleled the archival results. Forensic implications are discussed.

  15. A new clinical tool for the quantification of myocardial CT perfusion imaging in patients with suspected Ischemic Heart Disease

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz Muñoz, A.; Dux-Santoy Hurtado, L.; Rodriguez Palomares, J.L.; Piella Fenoy, G.

    2016-07-01

    In the clinical practice, the evaluation of myocardial perfusion by using Computed Tomography (CT) Imaging is usually performed visually or semi-quantitatively. The scarcity of quantitative perfusion data not always allows a proper diagnose of patients which are suspected of suffering from some diseases, such as Ischemic Heart Disease (IHD). In this work, a clinical tool for the automatic quantification of myocardial perfusion in patients with suspected IHD is proposed. Myocardial perfusion is assessed based on a combined diagnosis protocol (CT/CTP protocol) which involves the acquisition of two contrastenhanced CT images, one obtained at rest and another acquired under pharmacological stress. The clinical tool allows the automatic quantification of perfusion in different myocardial segments defined according to the 16-AHA-segmentation model of the left ventricle, by providing the mean of Hounsfield Units in those regions. Based on this analysis, the clinicians can compare the values at baseline and at hyperemia, and they can better determine hypoperfusion defects in patients with IHD. The validation of the clinical tool was performed by comparing automatic and manual perfusion measurements of 10 patients with suspected IHD who were previously assessed with Single Photon Emission Computed Tomography (SPECT) for perfusion analysis. A strong linear correlation was found between the automatic and manual results. Afterwards, perfusion defects obtained from CT/CTP protocol were compared to perfusion defects from SPECT, to assess the applicability of this clinical tool for the diagnosis of IHD. (Author)

  16. Endosonography for suspected obstructive jaundice with no definite pathology on ultrasonography.

    Science.gov (United States)

    Chen, Chien-Hua; Yang, Chi-Chieh; Yeh, Yung-Hsiang; Yang, Tsang; Chung, Tieh-Chi

    2015-09-01

    Ultrasonography (US) cannot demonstrate all the etiologies of biliary tract dilatation in patients with jaundice. Thus, we evaluated the etiologic yield of endosonography (EUS) for suspected obstructive jaundice when no definite pathology was found on US. Additionally, we sought to identify the predictors of the most common etiologies. We performed a retrospective review of 123 consecutive patients who had undergone EUS for suspected obstructive jaundice when no definite pathology was identified on US. The most common diagnoses included no pathological obstruction (n = 43), pancreatobiliary malignancy (n = 41), and choledocholithiasis (n = 28). Pancreatobiliary malignancy was associated with common bile duct (CBD) dilatation, and fever and elevated alanine aminotransferase were predictors of choledocholithiasis (p jaundice, 100% (40/40) for no pathological finding, 100% (23/23) for ampullary cancer, 100% (13/13) for pancreatic cancer, 75% (3/4) for CBD cancer, and 92.9% (26/28) for choledocholithiasis, respectively. Besides the two patients with focal chronic pancreatitis misdiagnosed as with pancreatic cancer, EUS missed the lesions in one CBD cancer patient and two patients with choledocholithiasis. The overall accuracy of EUS in ascertaining pancreatobiliary malignancy and choledocholithiasis was comparable (97.6%, 40/41 vs. 92.9%, 26/28; p > 0.05). Marked CBD dilatation (≥12 mm) should remind us of the high risk of malignancy, and the presence of CBD dilatation and fever is suggestive of choledocholithiasis. Negative EUS findings cannot assure any pathological obstruction in patients with clinically suspected obstructive jaundice. Copyright © 2013. Published by Elsevier B.V.

  17. Comparison of CT and MRI for Diagnosis of Suspected Scaphoid Fractures

    NARCIS (Netherlands)

    Mallee, Wouter; Doornberg, Job N.; Ring, David; van Dijk, C. Niek; Maas, Mario; Goslings, J. Carel

    2011-01-01

    Background: There is no consensus on the optimum imaging method to use to confirm the diagnosis of true scaphoid fractures among patients with suspected scaphoid fractures. This study tested the null hypothesis that computed tomography (CT) and magnetic resonance imaging (MRI) have the same

  18. Treatment with Epinephrine (Adrenaline) in Suspected Anaphylaxis during Anesthesia in Denmark

    DEFF Research Database (Denmark)

    Garvey, Lene H; Belhage, Bo; Krøigaard, Mogens

    2011-01-01

    BACKGROUND:: Literature on the use of epinephrine in the treatment of anaphylaxis during anesthesia is very limited. The objective of this study was to investigate how often epinephrine is used in the treatment of suspected anaphylaxis during anesthesia in Denmark and whether timing of treatment ...

  19. Paediatric gastroenterology evaluation of overweight and obese children referred from primary care for suspected non-alcoholic fatty liver disease

    Science.gov (United States)

    Schwimmer, J B; Newton, K P; Awai, H I; Choi, L J; Garcia, M A; Ellis, L L; Vanderwall, K; Fontanesi, J

    2013-01-01

    Background Screening overweight and obese children for non-alcoholic fatty liver disease (NAFLD) is recommended by paediatric and endocrinology societies. However, gastroenterology societies have called for more data before making a formal recommendation. Aim To determine whether the detection of suspected NAFLD in overweight and obese children through screening in primary care and referral to paediatric gastroenterology resulted in a correct diagnosis of NAFLD. Methods Information generated in the clinical evaluation of 347 children identified with suspected NAFLD through screening in primary care and referral to paediatric gastroenterology was captured prospectively. Diagnostic outcomes were reported. The diagnostic performance of two times the upper limit of normal (ULN) for alanine aminotransferase (ALT) was assessed. Results Non-alcoholic fatty liver disease was diagnosed in 55% of children identified by screening and referral. Liver disease other than NAFLD was present in 18% of those referred. Autoimmune hepatitis was the most common alternative diagnosis. Children with NAFLD had significantly (P gastroenterology has the potential to identify clinically relevant liver pathology. Consensus is needed on how to value the risk and rewards of screening and referral, to identify children with liver disease in the most appropriate manner. PMID:24117728

  20. Influence of the potential well and the potential barrier on the density distribution of confined-model fluids

    CERN Document Server

    Lee, B H; Lee, C H; Seong Baek Seok

    2000-01-01

    A density functional perturbative approximation, which is based on the density functional expansion of the one-particle direct correlation function of model fluids with respect to the bulk density, has been employed to investigate the influence of the potential well and the potential barrier on the density behavior of confined-model fluids. The mean spherical approximation has been used to calculate the two-particle direct correlation function of the model fluids. At lower densities, the density distributions are strongly affected by the barrier height and the well depth of the model potential, the contribution from the short-range repulsive part being especially important. However, the effects of the barrier height and the well depth of the model potential decrease with increasing bulk density. The calculated results also show that in the region where the effect of the wall-fluid interaction is relatively weak, the square-barrier part of the model potential leads to a nonuniformity in the density distributio...

  1. The role of MRI in suspected inner ear malformations

    International Nuclear Information System (INIS)

    Koesling, S.; Juettemann, S.; Amaya, B.; Rasinski, C.; Bloching, M.; Koenig, E.

    2003-01-01

    Purpose: This is a prospective analysis of the value of MRI in suspected inner ear malformations. Materials and Methods: In 50 patients (43 children and young adults, 7 adults) with suspected inner ear malformation MRI (1.5 T) was performed. In addition, 42 of these patients underwent CT. For the analysis of the inner ear structures, the constructive interference in steady state (CISS) sequence with 0.7 mm slice thickness was used. Functional tests revealed a sensorineural hearing loss or deafness in 82 temporal bones (TB) and a combined hearing loss in 4 TB. The hearing loss was unilateral in 14 patients. MRI and CT findings were compared. Results: Imaging findings were normal in 58 TB. The pathological findings included inner ear malformations (35 TB), inflammatory changes (4 TB), partial obliteration of labyrinth (2 TB) and congenital aural atresia (1 TB). An isolated absence of the cochlear nerve (1 TB) could only be found by MRI. In the remaining cases, an inner ear malformation was diagnosed by MRI and CT with the same confidence but MRI was superior in displaying the fine details. Conclusions: MRI will become the method of choice in the diagnosis of inner ear malformations. (orig.) [de

  2. Value of noncontrast spiral CT for suspected acute appendicitis

    International Nuclear Information System (INIS)

    Choi, Pil Yeob; Lee, Sang Wook; Kwon, Jae Soo; Sung, Young Soon; Rho, Myoung Ho; Chang, Jeong A.

    1998-01-01

    To assess the diagnostic accuracy and clinical efficacy of noncontrast spiral CT in patients with suspected acute appendicitis. Over a six-month period, 100 patients with suspected acute appendicitis were prospectively evaluated with noncontrast spiral CT. All scans were obtained from the lower body of L3 to the symphysis pubis, with 5mm or 10mm collimation and pitch of 1 or 1.5, and without intravenous or oral contrast material. Diagnosis was established by means of surgical or clinical follow-up. Prospective diagnosis based on CT findings was compared with surgical results and clinical follow-up. Acute appendicitis was confirmed in 47 of 100 patients. On the basis of the Ct findings, SI patients were prospectively interpreted as positive for appendicitis, but in six the diagnosis was false-positive. Two of the 47 with acute appendicitis were prospectively interpreted as normal. The preoperative diagnosis of acute appendicitis was, thus, 45 true-positive, 47 true-negative, six false-positive and two false-negative yielding a sensitivity of 96%, a specificity of 89%, an accuracy of 92%, a positive predictive value of 88%, and a negative predictive value of 96%. Using CT, an alternative diagnosis was established in 14 patients. Noncontrast spiral CT is a useful technique for diagnosing acute appendicitis. =20

  3. 32 CFR 644.530 - Conditions in conveying land suspected of contamination.

    Science.gov (United States)

    2010-07-01

    ... contamination. 644.530 Section 644.530 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY... Contamination from Proposed Excess Land and Improvements § 644.530 Conditions in conveying land suspected of contamination. The following conditions, appropriately modified to conform to local law, will be included in...

  4. Neurological signs in 23 dogs with suspected rostral cerebellar ischaemic stroke

    DEFF Research Database (Denmark)

    Thomsen, Barbara Blicher; Garosi, Laurent; Skerritt, Geoff

    2016-01-01

    Background: In dogs with ischaemic stroke, a very common site of infarction is the cerebellum. The aim of this study was to characterise neurological signs in relation to infarct topography in dogs with suspected cerebellar ischaemic stroke and to report short-term outcome confined to the hospita...

  5. Cost-effectiveness analysis of endoscopic ultrasound versus magnetic resonance cholangiopancreatography in patients with suspected common bile duct stones.

    Directory of Open Access Journals (Sweden)

    Stephen Morris

    Full Text Available Patients with suspected common bile duct (CBD stones are often diagnosed using endoscopic retrograde cholangiopancreatography (ERCP, an invasive procedure with risk of significant complications. Using endoscopic ultrasound (EUS or Magnetic Resonance CholangioPancreatography (MRCP first to detect CBD stones can reduce the risk of unnecessary procedures, cut complications and may save costs.This study sought to compare the cost-effectiveness of initial EUS or MRCP in patients with suspected CBD stones.This study is a model based cost-utility analysis estimating mean costs and quality-adjusted life years (QALYs per patient from the perspective of the UK National Health Service (NHS over a 1 year time horizon. A decision tree model was constructed and populated with probabilities, outcomes and cost data from published sources, including one-way and probabilistic sensitivity analyses.Using MRCP to select patients for ERCP was less costly than using EUS to select patients or proceeding directly to ERCP ($1299 versus $1753 and $1781, respectively, with similar QALYs accruing to each option (0.998, 0.998 and 0.997 for EUS, MRCP and direct ERCP, respectively. Initial MRCP was the most cost-effective option with the highest monetary net benefit, and this result was not sensitive to model parameters. MRCP had a 61% probability of being cost-effective at $29,000, the maximum willingness to pay for a QALY commonly used in the UK.From the perspective of the UK NHS, MRCP was the most cost-effective test in the diagnosis of CBD stones.

  6. Construction of high-quality NN potential models

    International Nuclear Information System (INIS)

    Stoks, V.G.J.; Klomp, R.A.M.; Terheggen, C.P.F.; de Swart, J.J.

    1994-01-01

    We present an updated version (Nijm93) of the Nijmegen soft-core potential, which gives a much better description of the np data than the older version (Nijm78). The χ 2 per datum is 1.87. The configuration-space and momentum-space versions of this potential are exactly equivalent, a unique feature among meson-theoretical potentials. We also present three new NN potential models: a nonlocal Reid-like Nijmegen potential (Nijm I), a local version (Nijm II), and an updated regularized version (Reid 93) of the Reid soft-core potential. These three potentials all have a nearly optimal χ 2 per datum and can therefore be considered as alternative partial-wave analyses. All potentials contain the proper charge-dependent one-pion-exchange tail

  7. Prevalence of IgE sensitization in Danish children with suspected asthma

    DEFF Research Database (Denmark)

    Hoffmann-Petersen, Benjamin; Høst, Arne; Larsen, Kirsten Toksvig

    2013-01-01

    OBJECTIVE: The aim of this article was to estimate the prevalence of IgE sensitization in Danish children with suspected asthma and to characterize the pattern of sensitization. STUDY DESIGN: We performed a cross-sectional study including 1744 children from 0 to 15 yr suspected of asthma who were...... referred to pediatric outpatient clinics in the region of southern Denmark from 2003 to 2005. The children were subjected to an extensive questionnaire-based interview, clinical examination, and both skin prick testing (SPT) and IgE measurements for 17 allergens. RESULTS: Asthma was confirmed in 1024...... of the 1744 children. Among the children in whom the asthma diagnosis was confirmed, sensitization to one or more of the 17 allergens tested was found in 67.5% by either SPT or s-IgE ≥ class 2. Sensitization to any food allergen was found in 31.1%, to any outdoor allergen in 36.2%, and to any indoor allergen...

  8. Aerial medical evacuation of health workers with suspected Ebola virus disease in Guinea Conakry-interest of a negative pressure isolation pod-a case series.

    Science.gov (United States)

    Dindart, Jean-Michel; Peyrouset, Olivier; Palich, Romain; Bing, Abdoul; Kojan, Richard; Barbe, Solenne; Harouna, Souley; Blackwell, Nikki

    2017-03-11

    We report 4 cases of Health Workers (HW) suspected of having contracted Ebola Virus Disease (EVD), transported from the Alliance for International Medical Action (ALIMA) Ebola Treatment Centre (ETC) in N'Zerekore, Guinea to the Treatment Centre for Carers run by the medical corps of the French army in Conakry, the capital of Guinea, which was established on 17 January 2015 and closed on 7 July 2015. In total more than 500 HWs have died from EVD since the epidemic began. This mortality has had significant effects on the ability of local services to respond appropriately to the disaster. The HWs were transported by air in the "Human Stretcher Transit Isolator-Total Containment (Oxford) Limited" (HSTI-TCOL) negative pressure isolation pod. Medical evacuation of patients with suspected, potentially fatal, infectious diseases is feasible with the use of a light isolator for patients without critical dysfunctions.

  9. Unjamming in models with analytic pairwise potentials

    NARCIS (Netherlands)

    Kooij, S.; Lerner, E.

    Canonical models for studying the unjamming scenario in systems of soft repulsive particles assume pairwise potentials with a sharp cutoff in the interaction range. The sharp cutoff renders the potential nonanalytic but makes it possible to describe many properties of the solid in terms of the

  10. Exploring the Diagnostic Utility of Facial Composites: Beliefs of Guilt Can Bias Perceived Similarity between Composite and Suspect

    Science.gov (United States)

    Charman, Steve D.; Gregory, Amy Hyman; Carlucci, Marianna

    2009-01-01

    Facial composite research has generally focused on the investigative utility of composites--using composites to find suspects. However, almost no work has examined the diagnostic utility of facial composites--the extent to which composites can be used as evidence against a suspect. For example, detectives and jurors may use the perceived…

  11. Should there be a standardised approach to the diagnostic workup of suspected adult encephalitis? a case series from Australia

    Directory of Open Access Journals (Sweden)

    Williams David

    2010-12-01

    Full Text Available Abstract Background The clinical diagnosis of encephalitis is often difficult and identification of a causative organism is infrequent. The encephalitis syndrome may herald the emergence of novel pathogens with outbreak potential. Individual treatment and an effective public health response rely on identifying a specific pathogen. In Australia there have been no studies to try to improve the identification rate of encephalitis pathogens. This study aims to review the diagnostic assessment of adult suspected encephalitis cases. Methods A retrospective clinical audit was performed, of all adult encephalitis presentations between July 1998 and December 2007 to the three hospitals with adult neurological services in the Hunter New England area, northern New South Wales, Australia. Case notes were examined for evidence of relevant history taking, clinical features, physical examination, laboratory and neuroradiology investigations, and outcomes. Results A total of 74 cases were included in the case series. Amongst suspected encephalitis cases, presenting symptoms and signs included fever (77.0%, headache (62.1%, altered consciousness (63.5%, lethargy (32.4%, seizures (25.7%, focal neurological deficits (31.1% and photophobia (17.6%. The most common diagnostic laboratory test performed was cerebrospinal fluid (CSF analysis (n = 67, 91%. Herpes virus polymerase chain reaction (n = 53, 71.6% and cryptococcal antigen (n = 46, 62.2% were the antigenic tests most regularly performed on CSF. Neuroradiological procedures employed were computerized tomographic brain scanning (n = 68, 91.9% and magnetic resonance imaging of the brain (n = 35, 47.3%. Thirty-five patients (47.3% had electroencephalograms. The treating clinicians suspected a specific causative organism in 14/74 cases (18.9%, of which nine (12.1% were confirmed by laboratory testing. Conclusions The diagnostic assessment of patients with suspected encephalitis was not standardised. Appropriate

  12. {sup 18}F-FDG PET/CT diagnosis of unexpected extracardiac septic embolisms in patients with suspected cardiac endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Bonfiglioli, Rachele; Nanni, Cristina; Morigi, Joshua James; Ambrosini, Valentina; Fanti, Stefano [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Nuclear Medicine, Bologna (Italy); Graziosi, Maddalena; Rapezzi, Claudio [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Cardiology, Bologna (Italy); Trapani, Filippo; Bartoletti, Michele; Tumietto, Fabio; Viale, Pier Luigi [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Infective Diseases, Bologna (Italy); Ferretti, Alice; Rubello, Domenico [Azienda Ospedaliera S. Maria della Misericordia, Nuclear Medicine, Radiology, Neuroradiology, Medical Physics, Rovigo (Italy)

    2013-08-15

    Acute infective endocarditis is a potentially life-threatening disease. Its outcome strongly depends on systemic embolization and extracardiac infections. When present, these conditions usually lead to a more aggressive therapeutic approach. However, the diagnosis of peripheral septic embolism is very challenging. {sup 18}F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT has proven to be accurate for the detection of inflammatory diseases and occult infections. The aim of this study was to assess the added value of {sup 18}F-FDG PET/CT in the detection of extracardiac embolisms in the evaluation of patients with suspected valvular endocarditis (VE). Seventy-one patients with suspected infective endocarditis, enrolled between June 2010 and December 2012, underwent {sup 18}F-FDG PET/CT with the standard procedure on a dedicated PET/CT scanner. Extracardiac findings were subsequently evaluated with other imaging procedures. Of the 71 patients with suspicion of infective endocarditis, we found unexpected extracardiac findings in 17 patients (24 %) without any clinical suspicion. Extracardiac findings were subsequently evaluated with other imaging procedures. PET/CT detected unexpected extra sites of infection in 24 % of cases, leading to changes in therapeutic management in a very relevant percentage of patients. These findings may have important therapeutic implications. (orig.)

  13. Water Supply Interruptions and Suspected Cholera Incidence: A Time-Series Regression in the Democratic Republic of the Congo

    Science.gov (United States)

    Jeandron, Aurélie; Saidi, Jaime Mufitini; Kapama, Alois; Burhole, Manu; Birembano, Freddy; Vandevelde, Thierry; Gasparrini, Antonio; Armstrong, Ben; Cairncross, Sandy; Ensink, Jeroen H. J.

    2015-01-01

    Background The eastern provinces of the Democratic Republic of the Congo have been identified as endemic areas for cholera transmission, and despite continuous control efforts, they continue to experience regular cholera outbreaks that occasionally spread to the rest of the country. In a region where access to improved water sources is particularly poor, the question of which improvements in water access should be prioritized to address cholera transmission remains unresolved. This study aimed at investigating the temporal association between water supply interruptions and Cholera Treatment Centre (CTC) admissions in a medium-sized town. Methods and Findings Time-series patterns of daily incidence of suspected cholera cases admitted to the Cholera Treatment Centre in Uvira in South Kivu Province between 2009 and 2014 were examined in relation to the daily variations in volume of water supplied by the town water treatment plant. Quasi-poisson regression and distributed lag nonlinear models up to 12 d were used, adjusting for daily precipitation rates, day of the week, and seasonal variations. A total of 5,745 patients over 5 y of age with acute watery diarrhoea symptoms were admitted to the CTC over the study period of 1,946 d. Following a day without tap water supply, the suspected cholera incidence rate increased on average by 155% over the next 12 d, corresponding to a rate ratio of 2.55 (95% CI: 1.54–4.24), compared to the incidence experienced after a day with optimal production (defined as the 95th percentile—4,794 m3). Suspected cholera cases attributable to a suboptimal tap water supply reached 23.2% of total admissions (95% CI 11.4%–33.2%). Although generally reporting less admissions to the CTC, neighbourhoods with a higher consumption of tap water were more affected by water supply interruptions, with a rate ratio of 3.71 (95% CI: 1.91–7.20) and an attributable fraction of cases of 31.4% (95% CI: 17.3%–42.5%). The analysis did not suggest any

  14. A computer model for DNAPL potential migration study

    International Nuclear Information System (INIS)

    Yan, S.; Landry, G.R.; Tate, T.

    1994-01-01

    A computer model, named DNAPMIG (DNAPL Potential Migration), was developed to calculate the dense nonaqueous phase liquid (DNAPL) critical length required to initiate movement and direction of potential migration at locations within an area of interest. The model takes into consideration the potentiometric gradient, bottom structure elevation, DNAPL density, interfacial tension, contact angle, soil grain size, partitioning coefficient, effective solubility, and water saturation. The model is interfaced with SURFER graphics software to use vectors to indicate the DNAPL critical length and the potential migration direction. The potential for DNAPL existence and migration at a specific site can be estimated by relating chemical concentration in the ground water to its solubility limit and the DNAPL critical length. The possibility of vertical migration can also be determined. This model can be used to determine and compare the effectiveness of existing or alternative recovery well systems to capture a DNAPL plume or arrest its movement; to help determine optimum locations and pumping rates of recovery wells; and to help determine the optimum location of environmental borings to locate DNAPL. This paper presents two hypothetical examples and two site applications in south Louisiana

  15. Testing the potential model in the UPSILON system

    International Nuclear Information System (INIS)

    Cooper, S.

    1985-01-01

    Tests of the non-relativistic potential model for bound b anti b states are discussed, using results from the Crystal Ball and ARGUS detectors at DORIS II (DESY) and the CUSB and CLEO detectors at CESR (Cornell). There are many many people who have developed potential models. While the author tries to be complete in reviewing the experimental data, he limits his discussion of potentials to a few contrasting examples. The talk is divided into two main parts. In the first he discusses the 3 S 1 b anti b states UPSILON, UPSILON', ..., whose measured masses, leptonic widths, and leptonic branching ratios are used to check the static potential V(r) and the strong coupling constant α 3 . In the second part, results on the 3 P, b anti b states chi/sub b/, chi'/sub b/ are used to check the spin dependence of the potential. There are several other classes of states (c anti c, s anti s, c anti q, b anti q, and the as-yet-not seen eta/sub b/ and 1 P 1 of the b anti b family) which are also important in testing the potential model, but which he did not cover in this talk. 47 references

  16. Multidetector computed tomography angiography in clinically suspected hyperacute ischemic stroke in the anterior circulation: an etiological workup in a cohort of Brazilian patients

    OpenAIRE

    Pacheco, Felipe Torres; Littig, Ingrid Aguiar; Gagliardi, Rubens Jose; Rocha, Antônio Jose da

    2015-01-01

    Objective The potential of computed tomography angiography (CTA) was assessed for early determination of stroke subtypes in a Brazilian cohort of patients with stroke. Method From July 2011 to July 2013, we selected patients with suspected hyperacute stroke (< 6 hours). Intracranial and cervical arteries were scrutinized on CTA and their imaging features were correlated with concurrent subtype of stroke. Results Stroke was documented in 50/106 selected patients (47.2%) based on both clinical ...

  17. Suboptimal performance on neuropsychological tests in patients with suspected chronic toxic encephalopathy

    NARCIS (Netherlands)

    van Hout, Moniek S. E.; Schmand, Ben; Wekking, Ellie M.; Hageman, Gerard; Deelman, Betto G.

    2003-01-01

    Suboptimal performance during neuropsychological testing can seriously complicate assessment in behavioral neurotoxicology. We present data on the prevalence of suboptimal performance in a group of Dutch patients with suspected chronic toxic encephalopathy (CTE) after long-term occupational exposure

  18. Suboptimal performance on neuropsychological tests in patients with suspected chronic toxic encephalopathy

    NARCIS (Netherlands)

    van Hout, MSE; Schmand, B; Wekking, EM; Hageman, G; Deelman, BG

    Suboptimal performance during neuropsychological testing can seriously complicate assessment in behavioral neurotoxicology. We present data on the prevalence of suboptimal performance in a group of Dutch patients with suspected chronic toxic encephalopathy (CTE) after long-term occupational exposure

  19. Sonography as an initial study in patients with suspected ureteral stone

    International Nuclear Information System (INIS)

    Lee, Jae Gue; Lim, Joo Won; Ko, Young Tae; Lee, Dong Ho; Lee, Hye Won; Oh, Joo Hyeong; Yoon, Yup; Lee, Sun Ju

    1999-01-01

    To evaluate the usefulness of sonography as an initial study in patients with suspected ureteral stone. We have undertaken a prospective study for 106 patients with suspected ureteral stone during 15 months. All the patients subsequently underwent urography at a mean interval of 1.8 days after the abdominopelvic sonography. We had only a clinical impression at the sonography and didn't refer to the other study such as KUB. We observed the degree of hydronephrosis using a grading system by Ellenbogen et aland location and size of stone. Seventy four patients had ureteral stone disease. The sonographic findings of these 74 patients showed a stone with hydronephrosis in 61 patients, a stone without hydronephrosis in 9, only hydronephrosis without stone in 2, and unremarkable finding in 2. In 3 of the remaining 32 patients, sonography showed hydronephrosis without stone. Locations of stone were 9 patients of ureteropelvic junction(UPJ), 19 of proximal ureter, 30 of distal ureter, and 16 of ureterovesical junction(UVJ). The sensitivity of sonography for stone was 95% and the specificity was 100%. When a ureteral stone was present, ipsilateral hydronephrosis was detected in 85% of cases on sonography. When only hydronephrosis without stone was detected on sonography, a ureteral stone was diagnosed in 2(40%) of 5 patients. Mean discrepancy of stone size between sonography and KUB was 3.1mm and stone size on sonography was larger. Grade of hydronephrosis between sonography and urography was the same in 32(59%) of 54 patients, whose stones were not expelled until urography after sonography. Sonography could be used as an initial study in patients with suspected ureteral stone.

  20. Preoperative local MRI-staging of patients with a suspected pancreatic mass.

    Science.gov (United States)

    Fischer, U; Vosshenrich, R; Horstmann, O; Becker, H; Salamat, B; Baum, F; Grabbe, E

    2002-02-01

    The aim of this study was to define the value of MRI of the pancreas for preoperative local staging of patients with a suspected pancreatic mass. Ninety-four patients (41 women, 53 men; age range 32-87 years) with a suspected pancreatic tumor underwent preoperative staging with MRI on a 1.5-T system. The MRI protocol included breath-hold MR cholangiopancreatography in turbo spin-echo technique, biphasic contrast-enhanced 3D MR angiography, and MRI of the upper abdomen with breath-hold T2-weighted half-Fourier acquired single-shot turbo spin-echo and T1-weighted fast-low-angle-shot (pre- and postcontrast) sequences. Data were collected prospectively and analyzed by two radiologists in agreement modality. Evaluation criteria were vascular involvement, resectability, and a characterization benign vs malignant. Results were compared to histopathology in 78 patients. Sixteen patients were followed-up. In 74 of 94 patients a solid tumor or an inflammation of the pancreas ( n=62) or the papilla ( n=12) was detected. In this group, MRI had a sensitivity of 98%, a specificity of 92%, and an accuracy of 96% in the characterization of malignant tumors. Regarding only the solid tumors, the positive predictive value of MRI was 87% with respect to resectability. Other pathologic findings included adenoma or inflammation of the duodenum ( n=5), carcinoma or benign stenosis of the choledochus duct ( n=7) and carcinoma of the gall bladder ( n=2). In 6 patients MRI did not depict any pathologic findings, and follow-up confirmed this interpretation. Magnetic resonance imaging allows a local preoperative staging in patients with suspected pancreatic tumor. Limitations, however, concern to the diagnostics of peritoneal and/or liver metastases.

  1. Emergency Department Management of Suspected Calf-Vein Deep Venous Thrombosis: A Diagnostic Algorithm

    Directory of Open Access Journals (Sweden)

    Levi Kitchen

    2016-06-01

    Full Text Available Introduction: Unilateral leg swelling with suspicion of deep venous thrombosis (DVT is a common emergency department (ED presentation. Proximal DVT (thrombus in the popliteal or femoral veins can usually be diagnosed and treated at the initial ED encounter. When proximal DVT has been ruled out, isolated calf-vein deep venous thrombosis (IC-DVT often remains a consideration. The current standard for the diagnosis of IC-DVT is whole-leg vascular duplex ultrasonography (WLUS, a test that is unavailable in many hospitals outside normal business hours. When WLUS is not available from the ED, recommendations for managing suspected IC-DVT vary. The objectives of the study is to use current evidence and recommendations to (1 propose a diagnostic algorithm for IC-DVT when definitive testing (WLUS is unavailable; and (2 summarize the controversy surrounding IC-DVT treatment. Discussion: The Figure combines D-dimer testing with serial CUS or a single deferred FLUS for the diagnosis of IC-DVT. Such an algorithm has the potential to safely direct the management of suspected IC-DVT when definitive testing is unavailable. Whether or not to treat diagnosed IC-DVT remains widely debated and awaiting further evidence. Conclusion: When IC-DVT is not ruled out in the ED, the suggested algorithm, although not prospectively validated by a controlled study, offers an approach to diagnosis that is consistent with current data and recommendations. When IC-DVT is diagnosed, current references suggest that a decision between anticoagulation and continued follow-up outpatient testing can be based on shared decision-making. The risks of proximal progression and life-threatening embolization should be balanced against the generally more benign natural history of such thrombi, and an individual patient’s risk factors for both thrombus propagation and complications of anticoagulation. [West J Emerg Med. 2016;17(4384-390.

  2. Emergency Department Management of Suspected Calf-Vein Deep Venous Thrombosis: A Diagnostic Algorithm.

    Science.gov (United States)

    Kitchen, Levi; Lawrence, Matthew; Speicher, Matthew; Frumkin, Kenneth

    2016-07-01

    Unilateral leg swelling with suspicion of deep venous thrombosis (DVT) is a common emergency department (ED) presentation. Proximal DVT (thrombus in the popliteal or femoral veins) can usually be diagnosed and treated at the initial ED encounter. When proximal DVT has been ruled out, isolated calf-vein deep venous thrombosis (IC-DVT) often remains a consideration. The current standard for the diagnosis of IC-DVT is whole-leg vascular duplex ultrasonography (WLUS), a test that is unavailable in many hospitals outside normal business hours. When WLUS is not available from the ED, recommendations for managing suspected IC-DVT vary. The objectives of the study is to use current evidence and recommendations to (1) propose a diagnostic algorithm for IC-DVT when definitive testing (WLUS) is unavailable; and (2) summarize the controversy surrounding IC-DVT treatment. The Figure combines D-dimer testing with serial CUS or a single deferred FLUS for the diagnosis of IC-DVT. Such an algorithm has the potential to safely direct the management of suspected IC-DVT when definitive testing is unavailable. Whether or not to treat diagnosed IC-DVT remains widely debated and awaiting further evidence. When IC-DVT is not ruled out in the ED, the suggested algorithm, although not prospectively validated by a controlled study, offers an approach to diagnosis that is consistent with current data and recommendations. When IC-DVT is diagnosed, current references suggest that a decision between anticoagulation and continued follow-up outpatient testing can be based on shared decision-making. The risks of proximal progression and life-threatening embolization should be balanced against the generally more benign natural history of such thrombi, and an individual patient's risk factors for both thrombus propagation and complications of anticoagulation.

  3. Quadratic adaptive algorithm for solving cardiac action potential models.

    Science.gov (United States)

    Chen, Min-Hung; Chen, Po-Yuan; Luo, Ching-Hsing

    2016-10-01

    An adaptive integration method is proposed for computing cardiac action potential models accurately and efficiently. Time steps are adaptively chosen by solving a quadratic formula involving the first and second derivatives of the membrane action potential. To improve the numerical accuracy, we devise an extremum-locator (el) function to predict the local extremum when approaching the peak amplitude of the action potential. In addition, the time step restriction (tsr) technique is designed to limit the increase in time steps, and thus prevent the membrane potential from changing abruptly. The performance of the proposed method is tested using the Luo-Rudy phase 1 (LR1), dynamic (LR2), and human O'Hara-Rudy dynamic (ORd) ventricular action potential models, and the Courtemanche atrial model incorporating a Markov sodium channel model. Numerical experiments demonstrate that the action potential generated using the proposed method is more accurate than that using the traditional Hybrid method, especially near the peak region. The traditional Hybrid method may choose large time steps near to the peak region, and sometimes causes the action potential to become distorted. In contrast, the proposed new method chooses very fine time steps in the peak region, but large time steps in the smooth region, and the profiles are smoother and closer to the reference solution. In the test on the stiff Markov ionic channel model, the Hybrid blows up if the allowable time step is set to be greater than 0.1ms. In contrast, our method can adjust the time step size automatically, and is stable. Overall, the proposed method is more accurate than and as efficient as the traditional Hybrid method, especially for the human ORd model. The proposed method shows improvement for action potentials with a non-smooth morphology, and it needs further investigation to determine whether the method is helpful during propagation of the action potential. Copyright © 2016 Elsevier Ltd. All rights

  4. Dentists' intention to report suspected violence: a cross-sectional study in eight Arab countries.

    Science.gov (United States)

    El Tantawi, Maha; Gaffar, Balgis; Arheiam, Arheiam; AbdelAziz, Wafaa; Al-Batayneh, Ola B; Alhoti, Mansur F; Al-Maweri, Sadeq; Dama, Mai A; Zaghez, Mounir; Hassan, Khalid Saddiq; Al-Sane, Mona; AbdelSalam, Maha; Sabbah, Wael; Owais, Arwa I; Abdelgawad, Fatma; Aldhelai, Thiyezen Abdullah; El Meligy, Omar Abd El Sadek; AlHumaid, Jehan; Al-Harbi, Fahad

    2018-03-30

    This study assessed dentists' intention in eight Arab countries to report suspected exposure to violence among patients and factors associated with this intention based on the theory of planned behaviour. A cross-sectional study was conducted in 2016 including a convenience sample of dentists practising in public, private and academic sectors in Algeria, Egypt, Jordan, Kuwait, Libya, Palestine, Saudi Arabia and Yemen. Respondents answered a self-administered questionnaire collecting information about personal and professional background and perceived ability to identify victims of violence. The questionnaire assessed (on a scale from 1 to 10 using six negative statements) dentists' perception of healthcare system mandated reporting of suspected violence. Six statements were used to assess professional attitude towards reporting suspected violence. Logistic regression was used to assess the association between intention to report suspected violence and perceived ability, perception and attitude adjusting for confounders. The response rate was 65.2% (n=2936/4506) from general practitioners (70.9%) of mean age=31 years with 56.7% women. Of those, 68.8% intended to report and 52.2% considered themselves able to identify violence victims. The mean (SD) negative perception score=5.3/10 (2.1) and the mean (SD) professional attitude score=7.5/10 (1.9). In multivariate regression, intention to report was associated with professional attitude (OR 1.08, 95% CI 1.03 to 1.14), ability to identify violence victims (OR 1.76, 95% CI 1.45 to 2.12) and negative perception that reporting is not mandated (OR 0.89, 95% CI 0.85 to 0.94). Significant differences existed among countries in intention to report. Most dentists intended to report suspected violence and their intention could be explained by the theory of planned behaviour which offers a framework for professional development to support violence victims. Sharing of training resources, policies and guidelines is needed to ensure

  5. Effective potential models for hadrons

    International Nuclear Information System (INIS)

    Lucha, W.

    1995-12-01

    The aim of these lectures is to give a self-contained introduction to nonrelativistic potential models, to their formulation as well as to their possible applications. At the price of some lack of (in a mathematical sense) rigorous derivations, we try to give a feeling and understanding for the simplest conceivable method to extract the explicit form of the forces acting between quarks from the interplay between experimental observations and theoretical considerations. According to this spirit, we demonstrate, in detail, how to obtain the underlying Hamiltonian and how to determine the Lorentz structure of the quark-(anti-)quark interaction potential from well-established experimental facts. (author)

  6. Comparison of potential models through heavy quark effective theory

    International Nuclear Information System (INIS)

    Amundson, J.F.

    1995-01-01

    I calculate heavy-light decay constants in a nonrelativistic potential model. The resulting estimate of heavy quark symmetry breaking conflicts with similar estimates from lattice QCD. I show that a semirelativistic potential model eliminates the conflict. Using the results of heavy quark effective theory allows me to identify and compensate for shortcomings in the model calculations in addition to isolating the source of the differences in the two models. The results lead to a rule as to where the nonrelativistic quark model gives misleading predictions

  7. Using Internet Artifacts to Profile a Child Pornography Suspect

    Directory of Open Access Journals (Sweden)

    Marcus K. Rogers

    2014-03-01

    Full Text Available Digital evidence plays a crucial role in child pornography investigations. However, in the following case study, the authors argue that the behavioral analysis or “profiling” of digital evidence can also play a vital role in child pornography investigations. The following case study assessed the Internet Browsing History (Internet Explorer Bookmarks, Mozilla Bookmarks, and Mozilla History from a suspected child pornography user’s computer. The suspect in this case claimed to be conducting an ad hoc law enforcement investigation. After the URLs were classified (Neutral; Adult Porn; Child Porn; Adult Dating sites; Pictures from Social Networking Profiles; Chat Sessions; Bestiality; Data Cleaning; Gay Porn, the Internet history files were statistically analyzed to determine prevalence and trends in Internet browsing. First, a frequency analysis was used to determine a baseline of online behavior. Results showed 54% (n = 3205 of the URLs were classified as “neutral” and 38.8% (n = 2265 of the URLs were classified as a porn website. Only 10.8% of the URLs were classified as child pornography websites. However when the IE history file was analyzed by visit, or “hit,” count, the Pictures/Profiles (31.5% category had the highest visit count followed by Neutral (19.3%, Gay Porn (17%, and Child Porn (16.6%. When comparing the frequency of URLs to the Hit Count for each pornography type, it was noted that the accused was accessing gay porn, child porn, chat rooms, and picture profiles (i.e., from Facebook more often than adult porn and neutral websites. The authors concluded that the suspect in this case was in fact a child pornography user and not an ad hoc investigator, and the findings from the behavioral analysis were admitted as evidence in the sentencing hearing for this case. The authors believe this case study illustrates the ability to conduct a behavioral analysis of digital evidence. More work is required to further validate the

  8. Randomized clinical trial of preoperative dexamethasone on postoperative nausea and vomiting after laparoscopy for suspected appendicitis

    DEFF Research Database (Denmark)

    Kleif, J.; Kirkegaard, A.; Vilandt, J.

    2017-01-01

    Background: Few studies have investigated the effects of preoperative dexamethasone in acute surgical patients. This study examined the effects of 8 mg dexamethasone administered intravenously 30 min before surgery for suspected acute appendicitis. Methods: A multicentre, parallel-group, double......-blind, placebo-controlled study was conducted at two university hospitals in Denmark. Adults undergoing laparoscopic surgery for suspected appendicitis were eligible for inclusion. Participants, healthcare staff and investigators were blinded until all data analysis had been done. The primary outcome...

  9. The paramilitary speech Alias '39': suspects, offenders and redeemed in La Mesa, Cesar

    Directory of Open Access Journals (Sweden)

    José Gregorio Pérez V.

    2016-08-01

    Full Text Available The paper aims to characterize the paramilitary speech in the village of La Mesa, Cesar, whose practices of power-knowledge are not registered only in the coercive field, but extend to forms of communication, where the control and subjugation of the population, legitimation and de-legitimation of the main enemy (FARC and ELN, and suspects and the problematic resident (offenders, acquire a particular form of registration in the individualities and the social body, and extends to the soccer field, the school, the streets, the workplaces, the artifacts (stone and soccer arches present in the territory. In addition to suspects and offenders, the paramilitary leader, David Hernández Rojas, alias ‘39’, led to another subject registered in the speech, the redeemed/collaborators.

  10. High-velocity penetrating thoracic trauma with suspected cardiac involvement in a combat support hospital

    International Nuclear Information System (INIS)

    Dominguez, F.; Gentlesk, P.J.; Eckart, R.E.; Beekley, A.C.; Huffer, L.L.

    2011-01-01

    The most common cardiac injuries in the United States are blunt trauma from motor vehicle accidents or low-velocity trauma from stabbings. During military conflict, high-velocity injuries, including gunshot wounds (GSW) and fragment injury from improvised explosive devices (IED), are relatively more common. This is a retrospective review of cases with high-velocity penetrating injury and suspected myocardial involvement during a 6-month period in Baghdad, Iraq, at a United States Army hospital during Operation Iraqi Freedom. Eleven cases survived to admission (GSW in 5, IED in 6). The mean age of the all-male cohort was 27 years (range, 3-54 years). Eight of the 11 patients (73%) were victims of polytrauma. The entrance involved the right ventricle (n=3), right atrium (n=2), left ventricle (n=1), or mediastinum and pericardial reflections (n=5). Echocardiography was performed in all 11 patients. In 7 patients, no foreign body was identifiable, and in 2 patients the foreign body was identified within the pericardial fat pad. Three patients were identified as having a suspected ventricular septal defect, ranging in size from 2 to 8 mm. The most common electrocardiographic abnormality was atrioventricular block and right bundle branch block. In 4 patients, the management of the chest injury was nonsurgical, and in 1 patient the treatment was a chest tube only. Four of the patients underwent median sternotomy, 1 underwent emergent lateral thoracotomy, and 1 underwent an infradiaphragmatic approach. This case series is too small to draw definitive conclusions; however, a multidisciplinary approach to high-velocity injuries with potential for cardiac involvement augments preoperative assessment for myocardial injury and may allow selective nonoperative management. (author)

  11. A potential model for quark confinement

    International Nuclear Information System (INIS)

    Thaler, J.; Iqbal, M.J.

    1985-02-01

    A static quark potential model obtained from a relativistic wave-equation is considered. The long-part of the quadratic terms is suppressed by a glueball exchange mechanism and compatibility with the meson spectra is shown

  12. A single quark effective potential model

    International Nuclear Information System (INIS)

    Bodmann, B.E.J.; Vasconcellos, C.A.Z.

    1994-01-01

    In the present work we construct a radial spherical symmetric single quark potential model for the nucleon, consistent with asymptotic freedom and confinement. The quark mass enters as potential parameter and that way induces indirectly an isospin dependence in the interaction. As a consequence, a contribution to the negative charge square radius of the neutron arises an an effect of the quark core, which simulates an isospin symmetry breaking effect in the nucleon due to strong interaction. (author)

  13. A case of suspected 'Bickerstaff's encephalitis' and its CT findings

    International Nuclear Information System (INIS)

    Moto, Atsufumi; Endo, Shunro; Ohmori, Tomoaki; Oka, Nobuo; Takaku, Akira

    1985-01-01

    A case of suspected ''Bickerstaff's encephalitis'' was presented with special reference to the CT findings. A 4-year-old girl exhibited fever and nausea after the beginning of December, 1983, followed by unsteady gait on January 1, 1984. She was admitted to another hospital and diagnosed by means of a spinalfluid examination as having aseptic meningitis. Her symptoms subsided transiently, but then she began again to suffer recurrently from unsteady gait on January 27. After that she developed dysarthria and dysphagia, a disturbance of eye movement was observed, and she became lethargic and disoriented. On February 6, she was transferred to our hospital. Plain CT scan on admission revealed a low-density area on the left cerebellar peduncle and the inferior medial part of the left temporal lobe. Moreover, the low-density area was heterogenously enhanced with the contrast medium. Angiography showed no abnormal findings. Considering these CT findings, we suspected a pontine tumor. Four days after her admission, however, her symptoms and signs began rapidly to subside, and also the abnormal findings on the CT scan diminished gradually as the symptoms were relieved. On March 2, she was discharged without any neurological abnormality. (author)

  14. Review of serious events in cases of (suspected) child abuse and/or neglect: A RoSE by any other name?

    Science.gov (United States)

    Raman, Shanti; Maiese, Michelle; Vasquez, Viviana; Gordon, Paola; Jones, Jennifer M

    2017-08-01

    Child abuse and neglect (CAN) cases presenting to health-services may be complex; when things go seriously wrong such as a child death or near miss, cases are reviewed and health-services and professionals subject to intense scrutiny. While there are a variety of mechanisms to review critical incidents in health-services no formal process for the review of cases where child protection is the primary concern exists in Australia. We aimed to develop a systematic process to review serious events in cases of suspected CAN across two health districts in Sydney, so that shared learnings could fuel system change. Drawing upon mapping, case review, literature findings and using quality improvement methodology, we developed a model named Review of Serious Events (RoSE), in suspected cases of CAN. The RoSE model has the key features of: being child focused; seeking to examine care over a period of time; using child protection staff as lead reviewers; involving health professionals/services in the review who have been involved with the child; and actioning systems change at local levels. The RoSE model was trialled through 2014-2015. Eight cases were reviewed using RoSE; cases were similar to those reviewed prior to having a model. Participant feedback from RoSE group processes was overwhelmingly positive; outputs were transparent and accessible to key stakeholders, there was mixed progress with implementation. The RoSE model is a serious case review process that is strongly child-focused, is both investigative and reflective, led by child protection experts; and can be adapted to other settings and systems. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  15. Suspected-target pesticide screening using gas chromatography-quadrupole time-of-flight mass spectrometry with high resolution deconvolution and retention index/mass spectrum library.

    Science.gov (United States)

    Zhang, Fang; Wang, Haoyang; Zhang, Li; Zhang, Jing; Fan, Ruojing; Yu, Chongtian; Wang, Wenwen; Guo, Yinlong

    2014-10-01

    A strategy for suspected-target screening of pesticide residues in complicated matrices was exploited using gas chromatography in combination with hybrid quadrupole time-of-flight mass spectrometry (GC-QTOF MS). The screening workflow followed three key steps of, initial detection, preliminary identification, and final confirmation. The initial detection of components in a matrix was done by a high resolution mass spectrum deconvolution; the preliminary identification of suspected pesticides was based on a special retention index/mass spectrum (RI/MS) library that contained both the first-stage mass spectra (MS(1) spectra) and retention indices; and the final confirmation was accomplished by accurate mass measurements of representative ions with their response ratios from the MS(1) spectra or representative product ions from the second-stage mass spectra (MS(2) spectra). To evaluate the applicability of the workflow in real samples, three matrices of apple, spinach, and scallion, each spiked with 165 test pesticides in a set of concentrations, were selected as the models. The results showed that the use of high-resolution TOF enabled effective extractions of spectra from noisy chromatograms, which was based on a narrow mass window (5 mDa) and suspected-target compounds identified by the similarity match of deconvoluted full mass spectra and filtering of linear RIs. On average, over 74% of pesticides at 50 ng/mL could be identified using deconvolution and the RI/MS library. Over 80% of pesticides at 5 ng/mL or lower concentrations could be confirmed in each matrix using at least two representative ions with their response ratios from the MS(1) spectra. In addition, the application of product ion spectra was capable of confirming suspected pesticides with specificity for some pesticides in complicated matrices. In conclusion, GC-QTOF MS combined with the RI/MS library seems to be one of the most efficient tools for the analysis of suspected-target pesticide residues

  16. Quark model and equivalent local potential

    International Nuclear Information System (INIS)

    Takeuchi, Sachiko; Shimizu, Kiyotaka

    2002-01-01

    In this paper, we investigate the short-range repulsion given by the quark cluster model employing an inverse scattering problem. We find that the local potential which reproduces the same phase shifts as those given by the quark cluster model has a strong repulsion at short distances in the NN 1 S 0 channel. There, however, appears an attractive pocket at very short distances due to a rather weak repulsive behavior at very high energy. This repulsion-attractive-pocket structure becomes more manifest in the channel which has an almost forbidden state, ΣN(T=3/2) 3 S 1 . In order to see what kinds of effects are important to reproduce the short-range repulsion in the quark cluster model, we investigate the contribution coming from the one-gluon-exchange potential and the normalization separately. It is clarified that the gluon exchange constructs the short-range repulsion in the NN 1 S 0 while the quark Pauli-blocking effect governs the feature of the repulsive behavior in the ΣN(T=3/2) 3 S 1 channel

  17. Self-reported care needs of Dutch homeless people with and without a suspected intellectual disability: a 1.5-year follow-up study.

    Science.gov (United States)

    Van Straaten, Barbara; Rodenburg, Gerda; Van der Laan, Jorien; Boersma, Sandra N; Wolf, Judith R L M; Van de Mheen, Dike

    2017-01-01

    Cognitive impairment is a prevalent problem among the homeless and seems related to more psychosocial problems. However, little is known about the care needs of the subgroup of homeless people with an intellectual disability compared to those without an intellectual disability and how their care needs develop over time. This study explores self-reported care needs within a broad range of life domains among Dutch homeless people with and without a suspected intellectual disability to gain insight into the transition of self-reported care needs from baseline to follow-up in both subgroups. This longitudinal study is part of a cohort study among homeless people who had been accepted for an individual programme plan in four major Dutch cities. The initial cohort consisted of 513 participants who were interviewed in 2011. At 1.5-year follow-up, 336 participants (65.5%) were also interviewed and screened for intellectual disability. Of these participants, 31% (95% CI 26.2-36.1) had a suspected intellectual disability. For both groups, between baseline and follow-up, the number of 'unmet care needs' decreased significantly and the number of 'no care needs' increased significantly, while at follow-up, participants with a suspected intellectual disability reported 'no care needs' on significantly fewer life domains than those without a suspected intellectual disability (mean numbers 16.4 vs. 17.5). Between baseline and follow-up, 'met care needs' decreased significantly on housing for both groups, and increased on finances and dental care for participants with a suspected intellectual disability. At follow-up, participants with a suspected intellectual disability more often preferred housing support available by appointment than those without a suspected intellectual disability. These findings suggest that homeless people who had been accepted for an individual programme plan with a suspected intellectual disability have care needs for a longer period of time than those

  18. Potential immediate hypersensitivity reactions following immunization in preschool aged children in Victoria, Australia.

    Science.gov (United States)

    Baxter, C-M; Clothier, H J; Perrett, K P

    2018-04-06

    Immediate hypersensitivity reactions (IHR) are rare but potentially serious adverse events following immunization (AEFI). Surveillance of Adverse Events following Vaccination in the Community (SAEFVIC) is an enhanced passive surveillance system that collects, analyses and reports information about AEFI in Victoria, Australia. We describe the incidence, timing and type of potential IHR following vaccination in preschool children reported over an 8-year period. A total of 2110 AEFI were reported in 1620 children, of which 23.5% (496) were classified as potential IHR. Of these, 37.1% (184) were suspected to be IgE-mediated, (including anaphylaxis, angioedema and/or urticaria) and 83.5% (414) occurred within 15 minutes of vaccination. The incidence of potential IHR was 5.4 per 100,000 doses, with that of suspected IgE-mediated IHR being 2.0 per 100,000 doses. The incidence of anaphylaxis was extremely low (0.13 per 100,000 doses) and is consistent with other published studies. Potential IHR following immunization should be reported to appropriate local pharmacovigilance systems and patients reviewed by specialists able to evaluate, investigate and manage future vaccinations.

  19. A user-friendly risk-score for predicting in-hospital cardiac arrest among patients admitted with suspected non ST-elevation acute coronary syndrome - The SAFER-score.

    Science.gov (United States)

    Faxén, Jonas; Hall, Marlous; Gale, Chris P; Sundström, Johan; Lindahl, Bertil; Jernberg, Tomas; Szummer, Karolina

    2017-12-01

    To develop a simple risk-score model for predicting in-hospital cardiac arrest (CA) among patients hospitalized with suspected non-ST elevation acute coronary syndrome (NSTE-ACS). Using the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART), we identified patients (n=242 303) admitted with suspected NSTE-ACS between 2008 and 2014. Logistic regression was used to assess the association between 26 candidate variables and in-hospital CA. A risk-score model was developed and validated using a temporal cohort (n=126 073) comprising patients from SWEDEHEART between 2005 and 2007 and an external cohort (n=276 109) comprising patients from the Myocardial Ischaemia National Audit Project (MINAP) between 2008 and 2013. The incidence of in-hospital CA for NSTE-ACS and non-ACS was lower in the SWEDEHEART-derivation cohort than in MINAP (1.3% and 0.5% vs. 2.3% and 2.3%). A seven point, five variable risk score (age ≥60 years (1 point), ST-T abnormalities (2 points), Killip Class >1 (1 point), heart rate Model discrimination was good in the derivation cohort (c-statistic 0.72) and temporal validation cohort (c-statistic 0.74), and calibration was reasonable with a tendency towards overestimation of risk with a higher sum of score points. External validation showed moderate discrimination (c-statistic 0.65) and calibration showed a general underestimation of predicted risk. A simple points score containing five variables readily available on admission predicts in-hospital CA for patients with suspected NSTE-ACS. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Virtual patients: an effective educational intervention to improve paediatric basic specialist trainee education in the management of suspected child abuse?

    LENUS (Irish Health Repository)

    McEvoy, M M

    2011-09-01

    Child abuse is a particularly difficult subject to teach at both undergraduate and postgraduate level. Most doctors are dissatisfied with their training in child abuse recognition and management. We developed an interactive video based Virtual Patient to provide formal training for paediatric Basic Specialist Trainees in the recognition of suspected child abuse. The Virtual Patient case revolves around the management of suspected physical abuse in a seven month old child, who initially presents to the Emergency Department with viral upper respiratory tract symptoms. This Virtual Patient was used to facilitate a case discussion with Basic Specialist Trainees. A questionnaire was developed to determine their perception of the value of the Virtual Patient as an educational tool. Twenty five Basic Specialist Trainees completed the questionnaire. Upon completion of the case, 23\\/25 (92%) participants reported greater self confidence in their ability to recognize cases of suspected child abuse and 24\\/25 (96%) of participants reported greater self confidence in their ability to report cases of suspected child abuse. Basic Specialist Trainees perceived the Virtual Patient to be a useful educational tool. Virtual Patients may have a role to play in enhancing postgraduate training in the recognition of suspected child abuse.

  1. PMS2 involvement in patients suspected of Lynch syndrome.

    Science.gov (United States)

    Niessen, Renée C; Kleibeuker, Jan H; Westers, Helga; Jager, Paul O J; Rozeveld, Dennie; Bos, Krista K; Boersma-van Ek, Wytske; Hollema, Harry; Sijmons, Rolf H; Hofstra, Robert M W

    2009-04-01

    It is well-established that germline mutations in the mismatch repair genes MLH1, MSH2, and MSH6 cause Lynch syndrome. However, mutations in these three genes do not account for all Lynch syndrome (suspected) families. Recently, it was shown that germline mutations in another mismatch repair gene, PMS2, play a far more important role in Lynch syndrome than initially thought. To explore this further, we determined the prevalence of pathogenic germline PMS2 mutations in a series of Lynch syndrome-suspected patients. Ninety-seven patients who had early-onset microsatellite instable colorectal or endometrial cancer, or multiple Lynch syndrome-associated tumors and/or were from an Amsterdam Criteria II-positive family were selected for this study. These patients carried no pathogenic germline mutation in MLH1, MSH2, or MSH6. When available, tumors were investigated for immunohistochemical staining (IHC) for PMS2. PMS2 was screened in all patients by exon-by-exon sequencing. We identified four patients with a pathogenic PMS2 mutation (4%) among the 97 patients we selected. IHC of PMS2 was informative in one of the mutation carriers, and in this case, the tumor showed loss of PMS2 expression. In conclusion, our study confirms the finding of previous studies that PMS2 is more frequently involved in Lynch syndrome than originally expected.

  2. Dark energy exponential potential models as curvature quintessence

    International Nuclear Information System (INIS)

    Capozziello, S; Cardone, V F; Piedipalumbo, E; Rubano, C

    2006-01-01

    It has been recently shown that, under some general conditions, it is always possible to find a fourth-order gravity theory capable of reproducing the same dynamics as a given dark energy model. Here, we discuss this approach for a dark energy model with a scalar field evolving under the action of an exponential potential. In the absence of matter, such a potential can be recovered from a fourth-order theory via a conformal transformation. Including the matter term, the function f(R) entering the generalized gravity Lagrangian can be reconstructed according to the dark energy model

  3. A case of hypopharyngeal fistula suspected of late complication due to irradiation

    International Nuclear Information System (INIS)

    Fuchigami, Teruhiko; Karaho, Takehiro; Hyodo, Yoshihiro; Tanabe, Tetsuya; Kitahara, Satoshi

    2003-01-01

    We report a case of hypopharyngeal fistula which was suspected of being a late complication due to radiotherapy. The patient was 54-year-old female who had undergone total thyroidectomy for thyroid carcinoma in 1967, receiving a total of 75 Gy postoperative irradiation. In 2001 she came to our hospital complaining of neck pain and difficulty in swallowing. On pharyngoesophagogram we found a hypopharyngeal fistula. The fistula was located under the posterior wall of the hypopharynx between C4 and C7. It was undetectable with flexible fiberscope but was detected with rigid endoscope under the general anesthesia. We suspected it was a late complication of the irradiation. We performed endoscopic laser surgery (KTP), resected the tissue between the upper and lower openings of the fistula, and vertically exposed the fistula in the hypopharyngeal space. Her dysphagia improved. We discuss the mechanism of fistula formation in this case. (author)

  4. A case of hypopharyngeal fistula suspected of late complication due to irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Fuchigami, Teruhiko; Karaho, Takehiro; Hyodo, Yoshihiro; Tanabe, Tetsuya; Kitahara, Satoshi [National Defense Medical Coll., Tokorozawa, Saitama (Japan)

    2003-05-01

    We report a case of hypopharyngeal fistula which was suspected of being a late complication due to radiotherapy. The patient was 54-year-old female who had undergone total thyroidectomy for thyroid carcinoma in 1967, receiving a total of 75 Gy postoperative irradiation. In 2001 she came to our hospital complaining of neck pain and difficulty in swallowing. On pharyngoesophagogram we found a hypopharyngeal fistula. The fistula was located under the posterior wall of the hypopharynx between C4 and C7. It was undetectable with flexible fiberscope but was detected with rigid endoscope under the general anesthesia. We suspected it was a late complication of the irradiation. We performed endoscopic laser surgery (KTP), resected the tissue between the upper and lower openings of the fistula, and vertically exposed the fistula in the hypopharyngeal space. Her dysphagia improved. We discuss the mechanism of fistula formation in this case. (author)

  5. Effective potential in Lorentz-breaking field theory models

    Energy Technology Data Exchange (ETDEWEB)

    Baeta Scarpelli, A.P. [Centro Federal de Educacao Tecnologica, Nova Gameleira Belo Horizonte, MG (Brazil); Setor Tecnico-Cientifico, Departamento de Policia Federal, Belo Horizonte, MG (Brazil); Brito, L.C.T. [Universidade Federal de Lavras, Departamento de Fisica, Lavras, MG (Brazil); Felipe, J.C.C. [Universidade Federal de Lavras, Departamento de Fisica, Lavras, MG (Brazil); Universidade Federal dos Vales do Jequitinhonha e Mucuri, Instituto de Engenharia, Ciencia e Tecnologia, Veredas, Janauba, MG (Brazil); Nascimento, J.R.; Petrov, A.Yu. [Universidade Federal da Paraiba, Departamento de Fisica, Joao Pessoa, Paraiba (Brazil)

    2017-12-15

    We calculate explicitly the one-loop effective potential in different Lorentz-breaking field theory models. First, we consider a Yukawa-like theory and some examples of Lorentz-violating extensions of scalar QED. We observe, for the extended QED models, that the resulting effective potential converges to the known result in the limit in which Lorentz symmetry is restored. Besides, the one-loop corrections to the effective potential in all the cases we study depend on the background tensors responsible for the Lorentz-symmetry violation. This has consequences for physical quantities like, for example, in the induced mass due to the Coleman-Weinberg mechanism. (orig.)

  6. Effective potential in Lorentz-breaking field theory models

    International Nuclear Information System (INIS)

    Baeta Scarpelli, A.P.; Brito, L.C.T.; Felipe, J.C.C.; Nascimento, J.R.; Petrov, A.Yu.

    2017-01-01

    We calculate explicitly the one-loop effective potential in different Lorentz-breaking field theory models. First, we consider a Yukawa-like theory and some examples of Lorentz-violating extensions of scalar QED. We observe, for the extended QED models, that the resulting effective potential converges to the known result in the limit in which Lorentz symmetry is restored. Besides, the one-loop corrections to the effective potential in all the cases we study depend on the background tensors responsible for the Lorentz-symmetry violation. This has consequences for physical quantities like, for example, in the induced mass due to the Coleman-Weinberg mechanism. (orig.)

  7. Study of Grape Polyphenols by Liquid Chromatography-High-Resolution Mass Spectrometry (UHPLC/QTOF and Suspect Screening Analysis

    Directory of Open Access Journals (Sweden)

    Riccardo Flamini

    2015-01-01

    Full Text Available Suspect screening analysis is a targeted metabolomics method in which the identification of compounds relies on specific available information, such as their molecular formula and isotopic pattern. This method, coupled to liquid chromatography-high-resolution mass spectrometry, is effective in the study of grape metabolomics, in particular for characterization of flavonols, stilbene derivatives, and anthocyanins. For identification of compounds expected in the samples, a new database of putative compounds was expressly constructed by using the molecular information on potential metabolites of grape and wine from the literature and other electronic databases. Currently, this database contains around 1,100 compounds. The method allows identification of several hundred grape metabolites with two analyses (positive and negative ionization modes, and performing of data reprocessing using “untargeted” algorithms also provided the identification of some flavonols and resveratrol trimers and tetramers in grape for the first time. This approach can be potentially used in the study of metabolomics of varieties of other plant species.

  8. Preoperative local MRI-staging of patients with a suspected pancreatic mass

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, U.; Vosshenrich, R.; Salamat, B.; Baum, F.; Grabbe, E. [Department of Radiology, Georg August University, Goettingen (Germany); Horstmann, O.; Becker, H. [Department of Surgery, Georg August University, Goettingen (Germany)

    2002-02-01

    The aim of this study was to define the value of MRI of the pancreas for preoperative local staging of patients with a suspected pancreatic mass. Ninety-four patients (41 women, 53 men; age range 32-87 years) with a suspected pancreatic tumor underwent preoperative staging with MRI on a 1.5-T system. The MRI protocol included breath-hold MR cholangiopancreatography in turbo spin-echo technique, biphasic contrast-enhanced 3D MR angiography, and MRI of the upper abdomen with breath-hold T2-weighted half-Fourier acquired single-shot turbo spin-echo and T1-weighted fast-low-angle-shot (pre- and postcontrast) sequences. Data were collected prospectively and analyzed by two radiologists in agreement modality. Evaluation criteria were vascular involvement, resectability, and a characterization benign vs malignant. Results were compared to histopathology in 78 patients. Sixteen patients were followed-up. In 74 of 94 patients a solid tumor or an inflammation of the pancreas (n=62) or the papilla (n=12) was detected. In this group, MRI had a sensitivity of 98%, a specificity of 92%, and an accuracy of 96% in the characterization of malignant tumors. Regarding only the solid tumors, the positive predictive value of MRI was 87% with respect to resectability. Other pathologic findings included adenoma or inflammation of the duodenum (n=5), carcinoma or benign stenosis of the choledochus duct (n=7) and carcinoma of the gall bladder (n=2). In 6 patients MRI did not depict any pathologic findings, and follow-up confirmed this interpretation. Magnetic resonance imaging allows a local preoperative staging in patients with suspected pancreatic tumor. Limitations, however, concern to the diagnostics of peritoneal and/or liver metastases. (orig.)

  9. Preoperative local MRI-staging of patients with a suspected pancreatic mass

    International Nuclear Information System (INIS)

    Fischer, U.; Vosshenrich, R.; Salamat, B.; Baum, F.; Grabbe, E.; Horstmann, O.; Becker, H.

    2002-01-01

    The aim of this study was to define the value of MRI of the pancreas for preoperative local staging of patients with a suspected pancreatic mass. Ninety-four patients (41 women, 53 men; age range 32-87 years) with a suspected pancreatic tumor underwent preoperative staging with MRI on a 1.5-T system. The MRI protocol included breath-hold MR cholangiopancreatography in turbo spin-echo technique, biphasic contrast-enhanced 3D MR angiography, and MRI of the upper abdomen with breath-hold T2-weighted half-Fourier acquired single-shot turbo spin-echo and T1-weighted fast-low-angle-shot (pre- and postcontrast) sequences. Data were collected prospectively and analyzed by two radiologists in agreement modality. Evaluation criteria were vascular involvement, resectability, and a characterization benign vs malignant. Results were compared to histopathology in 78 patients. Sixteen patients were followed-up. In 74 of 94 patients a solid tumor or an inflammation of the pancreas (n=62) or the papilla (n=12) was detected. In this group, MRI had a sensitivity of 98%, a specificity of 92%, and an accuracy of 96% in the characterization of malignant tumors. Regarding only the solid tumors, the positive predictive value of MRI was 87% with respect to resectability. Other pathologic findings included adenoma or inflammation of the duodenum (n=5), carcinoma or benign stenosis of the choledochus duct (n=7) and carcinoma of the gall bladder (n=2). In 6 patients MRI did not depict any pathologic findings, and follow-up confirmed this interpretation. Magnetic resonance imaging allows a local preoperative staging in patients with suspected pancreatic tumor. Limitations, however, concern to the diagnostics of peritoneal and/or liver metastases. (orig.)

  10. Interviewing Suspects in Denial: On How Different Evidence Disclosure Modes Affect the Elicitation of New Critical Information

    Science.gov (United States)

    May, Lennart; Granhag, Pär Anders; Tekin, Serra

    2017-01-01

    This study examines how different evidence disclosure modes affect the elicitation of new critical information. Two modes derived from the Strategic Use of Evidence (SUE) framework were compared against an early disclosure mode (i.e., the evidence was disclosed at the outset of the interview). Participants (N = 88) performed a mock crime consisting of several actions before they were interviewed as suspects. In both SUE conditions the interviewer elicited and disclosed statement-evidence inconsistencies in two phases after an introductory phase. For the SUE-Confrontation (SUE-C) condition, the interview was introduced in a business-like manner, and the interviewer confronted the suspects with the in/consistencies without giving them a chance to comment on these. For the SUE-Introduce-Present-Respond (SUE-IPR) condition, the interviewer introduced the interview in a non-guilt-presumptive way, presented the in/consistencies and allowed the suspects to comment on these, and then responded to their comments; at all times in a non-judgmental manner. Both SUE conditions generated comparatively more statement-evidence inconsistencies. The SUE-IPR condition resulted in more new critical information about the phase of the crime for which the interviewer lacked information, compared to the Early disclosure condition. A likely explanation for this was that (for the SUE-IPR condition) the interviewer used the inconsistencies to create a fostering interview atmosphere and made the suspects overestimate the interviewer's knowledge about the critical phase of the crime. In essence, this study shows that in order to win the game (i.e., obtaining new critical information), the interviewer needs to keep the suspect in the game (i.e., by not being too confrontational and judgmental). PMID:28769829

  11. Prognostic value of atherosclerotic burden and coronary vascular function in patients with suspected coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Assante, Roberta; Zampella, Emilia; Nappi, Carmela; Mainolfi, Ciro Gabriele; Cuocolo, Alberto [University Federico II, Department of Advanced Biomedical Sciences, Naples (Italy); Acampa, Wanda [University Federico II, Department of Advanced Biomedical Sciences, Naples (Italy); Institute of Biostructure and Bioimaging, National Council of Research, Naples (Italy); Arumugam, Parthiban; Tonge, Christine M. [Central Manchester University Teaching Hospitals, Nuclear Medicine Center, Manchester (United Kingdom); Gaudieri, Valeria; Panico, Mariarosaria; Magliulo, Mario [Institute of Biostructure and Bioimaging, National Council of Research, Naples (Italy); Petretta, Mario [University Federico II, Department of Translational Medical Sciences, Naples (Italy)

    2017-12-15

    To evaluate the prognostic value of coronary atherosclerotic burden, assessed by coronary artery calcium (CAC) score, and coronary vascular function, assessed by coronary flow reserve (CFR) in patients with suspected coronary artery disease (CAD). We studied 436 patients undergoing hybrid {sup 82}Rb positron emission tomography/computed tomography imaging. CAC score was measured according to the Agatston method, and patients were categorized into three groups (0, <400, and ≥400). CFR was calculated as the ratio of hyperemic to baseline myocardial blood flow, and it was considered reduced when <2. Follow-up was 94% complete during a mean period of 47±15 months. During follow-up, 17 events occurred (4% cumulative event rate). Event-free survival decreased with worsening of CAC score category (p < 0.001) and in patients with reduced CFR (p < 0.005). At multivariable analysis, CAC score ≥400 (p < 0.01) and CFR (p < 0.005) were independent predictors of events. Including CFR in the prognostic model, continuous net reclassification improvement was 0.51 (0.14 in patients with events and 0.37 in those without). At classification and regression tree analysis, the initial split was on CAC score. For patients with a CAC score < 400, no further split was performed, while patients with a CAC score ≥400 were further stratified by CFR values. Decision curve analyses indicate that the model including CFR resulted in a higher net benefit across a wide range of decision threshold probabilities. In patients with suspected CAD, CFR provides significant incremental risk stratification over established cardiac risk factors and CAC score for prediction of adverse cardiac events. (orig.)

  12. Follow-up of Mothers with Suspected Postpartum Depression from Pediatrics Clinics

    Directory of Open Access Journals (Sweden)

    Nerissa S. Bauer

    2017-10-01

    Full Text Available PurposePediatric providers are increasingly screening for postpartum depression (PD, yet, it is unknown how often mothers comply with recommendations to seek treatment. The objectives were to describe the rate at which mothers with suspected PD seek treatment and explore factors that predict help-seeking behavior.Design and methodsMothers were recruited from four pediatric clinics after identification using the Child Health Improvement through Computer Automation (CHICA system. Mothers with a positive screen were invited to participate in a telephone interview between January 2012 and December 2014. Mothers reported if they sought treatment or called a community resource.Results73 of 133 eligible mothers participated (55% response rate. Fifty women recalled a recommendation to seek help. Only 43.8% (32/73 made a follow-up appointment with an adult provider and even fewer kept the appointment.ConclusionA majority of mothers suspected of having PD recalled a referral for further intervention; yet, less than half took action. Further investigation of barriers of help-seeking behavior is warranted.

  13. Three-Body Potentials in α-Particle Model of Light Nuclei

    International Nuclear Information System (INIS)

    Ishikawa, Souichi

    2017-01-01

    In three-body model calculations of atomic nuclei, e.g., the "1"2C nucleus as α-α-α system and the "9Be nucleus as α-α-n system, the Hamiltonians of the systems consisting of two- and three-body potentials are important inputs. However, our knowledge of three-body potentials is quite restricted. In this paper, I will examine a relation between α-α-α and α-α-n three-body potentials that is obtained in a simple cluster model picture, which gives a phenomenological constraint condition on the three-body potential models to be used. (author)

  14. Video Game Effects--Confirmed, Suspected, and Speculative: A Review of the Evidence

    Science.gov (United States)

    Barlett, Christopher P.; Anderson, Craig A.; Swing, Edward L.

    2009-01-01

    This literature review focuses on the confirmed, suspected, and speculative effects of violent and non-violent video game exposure on negative and positive outcomes. Negative outcomes include aggressive feelings, aggressive thoughts, aggressive behavior, physiological arousal, and desensitization, whereas positive outcomes include various types of…

  15. Research on potential user identification model for electric energy substitution

    Science.gov (United States)

    Xia, Huaijian; Chen, Meiling; Lin, Haiying; Yang, Shuo; Miao, Bo; Zhu, Xinzhi

    2018-01-01

    The implementation of energy substitution plays an important role in promoting the development of energy conservation and emission reduction in china. Energy service management platform of alternative energy users based on the data in the enterprise production value, product output, coal and other energy consumption as a potential evaluation index, using principal component analysis model to simplify the formation of characteristic index, comprehensive index contains the original variables, and using fuzzy clustering model for the same industry user’s flexible classification. The comprehensive index number and user clustering classification based on constructed particle optimization neural network classification model based on the user, user can replace electric potential prediction. The results of an example show that the model can effectively predict the potential of users’ energy potential.

  16. In-111 labeled leukocyte scintigraphy in patients with suspected inflammation after failed antibiotic therapy

    International Nuclear Information System (INIS)

    Nasu, Reiko; Akagi, Kiyoshi; Murata, Takashi; Uokawa, Kyousuke; Isoda, Hiroyoshi; Tanaka, Yoshimasa; Itagaki, Yasushi

    1998-01-01

    In-111 labeled leukocyte scintigrapy (In-111 WBC scan) was performed in 16 patients with inflammation suspected on the basis of laboratory findings, symptoms, and diagnostic imaging, but who had failed antibiotic therapy. In-111 WBC scans revealed an abnormal focus of radiotracer activity (positive scans) in five of 16 patients. No correlation was found between the peripheral WBC count and accumulation of In-111 WBC. Inflammatory disease suspected on the basis of the CRP level should be considered when In-111 WBC scanning results in negative findings. Our results indicated that In-111 WBC scanning has low sensitivity after antibiotic therapy. Selection of patients on the basis of persistent elevation of CRP may be valuable. (author)

  17. Systolically gated 3D phase contrast MRA of mesenteric arteries in suspected mesenteric ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Wasser, M.N.; Schultze Kool, L.J.; Roos, A. de [Leiden Univ. Hospital (Netherlands)] [and others

    1996-03-01

    Our goal was to assess the value of MRA for detecting stenoses in the celiac (CA) and superior mesenteric (SMA) arteries in patients suspected of having chronic mesenteric ischemia, using an optimized systolically gated 3D phase contrast technique. In an initial study in 24 patients who underwent conventional angiography of the abdominal vessels for different clinical indications, a 3D phase contrast MRA technique (3D-PCA) was evaluated and optimized to image the CAs and SMAs. Subsequently, a prospective study was performed to assess the value of systolically gated 3D-PCA in evaluation of the mesenteric arteries in 10 patients with signs and symptoms of chronic mesenteric ischemia. Intraarterial digital subtraction angiography and surgical findings were used as the reference standard. In the initial study, systolic gating appeared to be essential in imaging the SMA on 3D-PCA. In 10 patients suspected of mesenteric ischemia, systolically gated 3D-PCA identified significant proximal disease in the two mesenteric vessels in 4 patients. These patients underwent successful reconstruction of their stenotic vessels. Cardiac-gated MRA may become a useful tool in selection of patients suspected of having mesenteric ischemia who may benefit from surgery. 16 refs., 6 figs., 4 tabs.

  18. Modelling assessment of End Pit Lakes meromictic potential

    International Nuclear Information System (INIS)

    2006-11-01

    The use of End Pit Lakes have been proposed as a remediation solution for oil sands reclamation and operational waters. This report modelled the main factors controlling the occurrence of stratification in Pit Lakes in order to establish design and management guidelines for the Cumulative Environmental Management Association's End Pit Lake Sub-group. The study focused on End Pit Lake size, depth, starting lake salinity concentrations, inflow rates and inflow salinity flux, and investigated their influence on density gradients. One-dimensional modelling and limited 2-D modelling simulations were conducted to examine meromictic potential for a large range of End Pit Lake configurations and conditions. Modelling results showed that fall is the governing season for determining meromixis. The expelling of salt from saline water upon ice formation and its effect on stratification potential and the effect of fresh water loading on stratification potential during spring melt events were not observed to be dominant factors governing meromictic potential for the scenarios examined in the study. Results suggested that shallow End Pit Lakes showed a high turn-over rate with seasonal heating and cooling cycles. Moderately deep End Pit Lakes demonstrated a meromictic potential that was inversely proportional to lake size and require higher starting salinities. With a 2 or 10 million m 3 /yr inflow rate and a 5 parts per thousand starting salinity, a 50 m deep End Pit Lake achieved meromixis at all 3 size ranges considered in the study. Results also showed that the rate of influent salinity decrease was the least important of the parameters influencing meromixis. It was observed that meromixis was a temporary condition in all of the End Pit Lake scenarios envisioned due to the lack of a constant, positive salt replenishment over the long term. It was concluded that further 3-D modelling is required to represent littoral areas as well as to account for extreme winter conditions. A

  19. Simple inflationary quintessential model. II. Power law potentials

    Science.gov (United States)

    de Haro, Jaume; Amorós, Jaume; Pan, Supriya

    2016-09-01

    The present work is a sequel of our previous work [Phys. Rev. D 93, 084018 (2016)] which depicted a simple version of an inflationary quintessential model whose inflationary stage was described by a Higgs-type potential and the quintessential phase was responsible due to an exponential potential. Additionally, the model predicted a nonsingular universe in past which was geodesically past incomplete. Further, it was also found that the model is in agreement with the Planck 2013 data when running is allowed. But, this model provides a theoretical value of the running which is far smaller than the central value of the best fit in ns , r , αs≡d ns/d l n k parameter space where ns, r , αs respectively denote the spectral index, tensor-to-scalar ratio and the running of the spectral index associated with any inflationary model, and consequently to analyze the viability of the model one has to focus in the two-dimensional marginalized confidence level in the allowed domain of the plane (ns,r ) without taking into account the running. Unfortunately, such analysis shows that this model does not pass this test. However, in this sequel we propose a family of models runs by a single parameter α ∈[0 ,1 ] which proposes another "inflationary quintessential model" where the inflation and the quintessence regimes are respectively described by a power law potential and a cosmological constant. The model is also nonsingular although geodesically past incomplete as in the cited model. Moreover, the present one is found to be more simple compared to the previous model and it is in excellent agreement with the observational data. In fact, we note that, unlike the previous model, a large number of the models of this family with α ∈[0 ,1/2 ) match with both Planck 2013 and Planck 2015 data without allowing the running. Thus, the properties in the current family of models compared to its past companion justify its need for a better cosmological model with the successive

  20. Prevalence of vulvovaginitis and relation to physical findings in girls assessed for suspected child sexual abuse.

    Science.gov (United States)

    Rahman, Gisel; Ocampo, Dolores; Rubinstein, Anahí; Risso, Paula

    2015-10-01

    The presence of sexually transmitted infections (STIs) in patients with suspected sexual abuse is uncommon in the field of pediatrics. To establish the prevalence of anogenital findings and their relation to the presence of STIs in girls referred for suspected child sexual abuse. Retrospective study conducted between January 1st, 2003 and December 31st, 2013. Physical findings and detection of STIs in girls with suspected child sexual abuse were analyzed. One thousand thirty-four patients were included. Their median age was 7.9 years old. Anogenital findings were classified as class I (normal):38.4%, class II (nonspecific):38.1%, class III (specific):19.9% and class IV (definitive):3.6%. STIs were observed in 42 patients (4.1%). A relation was established between STIs and the classification of physical findings: 10 (class II: 9; class III: 1) Neisseria gonorrhoeae, 17 (class I: 2; class II: 8; class III: 7) Chlamydia trachomatis, 15 (class I: 2; class II: 10; class III: 3) Trichomonas vaginalis. Statistically significant differences for Trichomonas vaginalis (p= 0.01) and Neisseria gonorrhoeae (p < 0.0001) were observed, with predominance of nonspecific clinical signs. Both nonspecific and specific findings were similarly observed for Chlamydia trachomatis (p= 0.03). Most cases of girls with suspected child sexual abuse had normal or nonspecific anogenital findings. The prevalence of STIs in these girls is low. Trichomonas vaginalis and Neisseria gonorrhoeae were related to nonspecific findings, while both nonspecific and specific findings were observed for Chlamydia trachomatis.

  1. [30-year-old Patient with suspected Marfan Syndrome and Progressive Gait disturbance].

    Science.gov (United States)

    Balke, Maryam; Lehmann, Helmar C; Fink, Gereon R; Wunderlich, Gilbert

    2017-07-01

    History  A 30-year-old man presented with a history of progressive muscle weakness, difficulty in concentrating, and a slender habitus since early childhood. Marfan syndrome was suspected since the age of 14. Examinations  13 years later he was examined by Marfan experts and by genetic testing and Marfan syndrome could not be confirmed. Further neurological examination revealed the suspected diagnosis of myotonic dystrophy type 1, which was confirmed by genetic testing. Treatment and course  Similar to Marfan syndrome, myotonic dystrophy is a multisystemic disorder with the risk of cardiac arrythmias. It is necessary to provide an interdisciplinary care by neurologists, internists, ophthalmologists, speech therapists, and physiotherapists. Conclusion  It is not enough to take the habitus as the principle sign to diagnose Marfan syndrome. Furthermore, it is essential to consider symptoms that are not typical for Marfan syndrome, such as cognitive deficiencies or progressive paresis. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Current Animal Models of Postoperative Spine Infection and Potential Future Advances

    Directory of Open Access Journals (Sweden)

    Alexandra eStavrakis

    2015-05-01

    Full Text Available Implant related infection following spine surgery is a devastating complication for patients and can potentially lead to significant neurological compromise, disability, morbidity, and even mortality. This paper provides an overview of the existing animal models of postoperative spine infection and highlights the strengths and weaknesses of each model. In addition there is discussion regarding potential modifications to these animal models to better evaluate preventative and treatment strategies for this challenging complication. Current models are effective in simulating surgical procedures but fail to evaluate infection longitudinally using multiple techniques. Potential future modifications to these models include using advanced imaging technologies to evaluate infection, use of bioluminescent bacterial species, and testing of novel treatment strategies against multiple bacterial strains. There is potential to establish a postoperative spine infection model using smaller animals, such as mice, as these would be a more cost-effective screening tool for potential therapeutic interventions.

  3. Are maternal social networks and perceptions of trust associated with suspected autism spectrum disorder in offspring? A population-based study in Japan.

    Directory of Open Access Journals (Sweden)

    Takeo Fujiwara

    Full Text Available To investigate the associations of maternal social networks and perceptions of trust with the prevalence of suspected autism spectrum disorders in 18-month-old offspring in Japan.Questionnaires included measurements of maternal social networks (number of relatives or friends they could call upon for assistance, maternal perceptions of trust, mutual assistance (i.e. individual measures of "cognitive social capital", and social participation (i.e. individual measures of "structural social capital" as well as the Modified Checklist for Autism in Toddlers to detect suspected autism spectrum disorder (ASD. These tools were mailed to all families with 18-month-old toddlers in Chiba, a city near Tokyo (N = 6061; response rate: 64%. The association between social capital or social network indicators and suspected ASD were analyzed, adjusted for covariates by logistic regression analysis.Low maternal social trust was found to be significantly positively associated with suspected ASD in toddlers compared with high maternal social trust (adjusted odds ratio [OR]: 1.82, 95% confidence interval [CI]: 1.38 to 2.40; mutual aid was also significantly positively related (low vs. high: OR, 2.08, 95% CI: 1.59 to 2.73 [corrected]. However, maternal community participation showed U-shape association with suspected ASD of offspring. Maternal social network showed consistent inverse associations with suspected ASD of offspring, regardless of the type of social connection (e.g., relatives, neighbors, or friends living outside of their neighborhood.Mothers' cognitive social capital and social networks, but not structural social capital, might be associated with suspected ASD in offspring.

  4. Are maternal social networks and perceptions of trust associated with suspected autism spectrum disorder in offspring? A population-based study in Japan.

    Science.gov (United States)

    Fujiwara, Takeo; Kawachi, Ichiro

    2014-01-01

    To investigate the associations of maternal social networks and perceptions of trust with the prevalence of suspected autism spectrum disorders in 18-month-old offspring in Japan. Questionnaires included measurements of maternal social networks (number of relatives or friends they could call upon for assistance), maternal perceptions of trust, mutual assistance (i.e. individual measures of "cognitive social capital"), and social participation (i.e. individual measures of "structural social capital") as well as the Modified Checklist for Autism in Toddlers to detect suspected autism spectrum disorder (ASD). These tools were mailed to all families with 18-month-old toddlers in Chiba, a city near Tokyo (N = 6061; response rate: 64%). The association between social capital or social network indicators and suspected ASD were analyzed, adjusted for covariates by logistic regression analysis. Low maternal social trust was found to be significantly positively associated with suspected ASD in toddlers compared with high maternal social trust (adjusted odds ratio [OR]: 1.82, 95% confidence interval [CI]: 1.38 to 2.40); mutual aid was also significantly positively related (low vs. high: OR, 2.08, 95% CI: 1.59 to 2.73 [corrected]). However, maternal community participation showed U-shape association with suspected ASD of offspring. Maternal social network showed consistent inverse associations with suspected ASD of offspring, regardless of the type of social connection (e.g., relatives, neighbors, or friends living outside of their neighborhood). Mothers' cognitive social capital and social networks, but not structural social capital, might be associated with suspected ASD in offspring.

  5. Detecting special nuclear materials in suspect containers using high-energy gamma rays emitted by fission products

    Science.gov (United States)

    Norman, Eric B [Oakland, CA; Prussin, Stanley G [Kensington, CA

    2009-01-27

    A method and a system for detecting the presence of special nuclear materials in a suspect container. The system and its method include irradiating the suspect container with a beam of neutrons, so as to induce a thermal fission in a portion of the special nuclear materials, detecting the gamma rays that are emitted from the fission products formed by the thermal fission, to produce a detector signal, comparing the detector signal with a threshold value to form a comparison, and detecting the presence of the special nuclear materials using the comparison.

  6. Potential-well model in acoustic tweezers.

    Science.gov (United States)

    Kang, Shih-Tsung; Yeh, Chih-Kuang

    2010-06-01

    Standing-wave acoustic tweezers are popularly used for non-invasive and non-contact particle manipulation. Because of their good penetration in biological tissue, they also show promising prospects for in vivo applications. According to the concept of an optical vortex, we propose an acoustics-vortex- based trapping model of acoustic tweezers. A four-element 1-MHz planar transducer was used to generate 1-MHz sine waves at 1 MPa, with adjacent elements being driven with a pi/2-rad phase difference. Each element was a square with a side length of 5.08 mm, with kerfs initially set at 0.51 mm. An acoustic vortex constituting the spiral motion of an acoustic wave around the beam axis was created, with an axial null. Applying Gor'kov's theory in the Rayleigh regime yielded the potential energy and radiation force for use in subsequent analysis. In the transverse direction, the vortex structure behaved as a series of potential wells that tended to drive a suspended particle toward the beam axis. They were highly fragmented in the near field that is very close to the transducer where there was spiral interference, and well-constructed in the far field. We found that the significant trapping effect was only present between these two regions in the transverse direction--particles were free to move along the beam axis, and a repulsive force was observed in the outer acoustic vortex. Because the steepness of the potential gradient near an axial null dominates the trapping effect, the far field of the acoustic vortex is inappropriate for trapping. Particles too close to the transducer are not sufficiently trapped because of the fragmented potential pattern. We suggest that the ideal distance from the transducer for trapping particles is in front of one-fourth of the Rayleigh distance, based on the superposition of the wavefronts. The maximum trapping force acting on a 13-mum polystyrene sphere in the produced acoustic vortex was 50.0 pN, and it was possible to trap

  7. Cost-effectiveness of routine imaging of suspected appendicitis.

    Science.gov (United States)

    D'Souza, N; Marsden, M; Bottomley, S; Nagarajah, N; Scutt, F; Toh, S

    2018-01-01

    Introduction The misdiagnosis of appendicitis and consequent removal of a normal appendix occurs in one in five patients in the UK. On the contrary, in healthcare systems with routine cross-sectional imaging of suspected appendicitis, the negative appendicectomy rate is around 5%. If we could reduce the rate in the UK to similar numbers, would this be cost effective? This study aimed to calculate the financial impact of negative appendicectomy at the Queen Alexandra Hospital and to explore whether a policy of routine imaging of such patients could reduce hospital costs. Materials and methods We performed a retrospective analysis of all appendicectomies over a 1-year period at our institution. Data were extracted on outcomes including appendix histology, operative time and length of stay to calculate the negative appendicectomy rate and to analyse costs. Results A total of 531 patients over 5 years of age had an appendicectomy. The negative appendicectomy rate was 22% (115/531). The additional financial costs of negative appendicectomy to the hospital during this period were £270,861. Universal imaging of all patients with right iliac fossa pain that could result in a 5% negative appendicectomy rate would cost between £67,200 and £165,600 per year but could save £33,896 (magnetic resonance imaging), £105,896 (computed tomography) or £132,296 (ultrasound) depending on imaging modality used. Conclusions Negative appendicectomy is still too frequent and results in additional financial burden to the health service. Routine imaging of patients with suspected appendicitis would not only reduce the negative appendicectomy rate but could lead to cost savings and a better service for our patients.

  8. Clinical value of somatostatin receptor imaging in patients with suspected head and neck paragangliomas

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, Matthias; Dietlein, Markus; Weber, Kerstin; Moka, Detlef; Schicha, Harald [Klinik und Poliklinik fuer Nuklearmedizin, Universitaet zu Koeln, Joseph-Stelzmann-Strasse 9, 50924 Koeln (Germany); Fischer, Eva; Michel, Olaf; Stennert, Eberhard [Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenheilkunde, Universitaet zu Koeln, Koeln (Germany)

    2002-12-01

    Paragangliomas or glomus tumours of the head and neck region are rare somatostatin receptor-expressing neuroendocrine tumours. Precise preoperative diagnosis is of special importance in order to adequately weigh the potential benefit of the operation against the inherent risks of the procedure. In this study, the clinical value of somatostatin receptor imaging was assessed in 19 patients who underwent somatostatin receptor scintigraphy because of known or suspected paraganglioma of the head and neck region. The results were compared with the results of computed tomography and/or magnetic resonance imaging, histology and clinical follow-up. [{sup 111}In-DTPA-D-Phe{sup 1}]-octreotide scintigraphy was performed 4-6 and 24 h after i.v. injection of 140-220 MBq {sup 111}In-octreotide. Whole-body and planar images as well as single-photon emission tomography images were acquired and lesions were graded according to qualitative tracer uptake. Somatostatin receptor imaging was positive in nine patients, identifying paragangliomas for the first time in three patients and recurrent disease in six patients. In one patient, a second, previously unknown paraganglioma site was identified. Negative results were obtained in ten patients. These patients included one suffering from chronic hyperplastic otitis externa, one with granuloma tissue and an organised haematoma, one with an acoustic neuroma, one with an asymmetric internal carotid artery, two with ectasia of the bulbus venae jugularis and one with a jugular vein thrombosis. In two patients with a strong family history of paraganglioma, individual involvement could be excluded. In only one patient did somatostatin receptor imaging and magnetic resonance imaging yield false negative results in respect of recurrent paraganglioma tissue. It is concluded that somatostatin receptor scintigraphy provides important information in patients with suspected paragangliomas of the head and neck region and has a strong impact on further

  9. Usefulness of the Negative Multidetector CT Angiography in Patients with Suspected Pulmonary Embolism

    International Nuclear Information System (INIS)

    Holguin Holguin, Alfonso Jose; Lombana, Milton; Collazos, Giovanny; Bravo, Hector; Abella Calle, Jose

    2012-01-01

    Objective: The aim of the study is to evaluate alternative findings in pulmonary CT angiography using MDCT reported as negative in patients with suspected pulmonary embolism. Material and method: Cross sectional study with 178 patients. We recognized other findings reported in pulmonary CT angiography using MDCT whose result was negative. Subsequently these findings were classified into six different categories of clinical relevance and their association with clinical scenario was analyzed. Results: from November 2004 to June 2007 we requested 231 pulmonary CT angiography using MDCT in patients with suspected pulmonary embolism. 217 patients were included in the final analysis. Of these, 39 (185) were positive for pulmonary embolism. The 178 remaining negative studies, 8.43% were normal, 53.37% were classified as category A, 20.79% category B, 14.04% category C; category D 1.12% and 2.25% were not interpretable. The most frequent diagnoses were pneumonia, interstitial lung disease and cardiogenic pulmonary edema. It was less likely to find a normal report whether the study was requested in the hospital department in emergency patients (OR = 0.38 95% 0.16 to 0.88, p = 0.0007). No differences were found in other categories or between patients younger or older than 65 years (p = 0.436). Conclusion: Pulmonary CT angiography as first line imaging tool in patients with suspected pulmonary embolism is useful, offering alternative diagnoses in hospitalized and emergency room patients, regardless of their age and clinical findings.

  10. Atypical case of Wolfram syndrome revealed through targeted exome sequencing in a patient with suspected mitochondrial disease.

    Science.gov (United States)

    Lieber, Daniel S; Vafai, Scott B; Horton, Laura C; Slate, Nancy G; Liu, Shangtao; Borowsky, Mark L; Calvo, Sarah E; Schmahmann, Jeremy D; Mootha, Vamsi K

    2012-01-06

    Mitochondrial diseases comprise a diverse set of clinical disorders that affect multiple organ systems with varying severity and age of onset. Due to their clinical and genetic heterogeneity, these diseases are difficult to diagnose. We have developed a targeted exome sequencing approach to improve our ability to properly diagnose mitochondrial diseases and apply it here to an individual patient. Our method targets mitochondrial DNA (mtDNA) and the exons of 1,600 nuclear genes involved in mitochondrial biology or Mendelian disorders with multi-system phenotypes, thereby allowing for simultaneous evaluation of multiple disease loci. Targeted exome sequencing was performed on a patient initially suspected to have a mitochondrial disorder. The patient presented with diabetes mellitus, diffuse brain atrophy, autonomic neuropathy, optic nerve atrophy, and a severe amnestic syndrome. Further work-up revealed multiple heteroplasmic mtDNA deletions as well as profound thiamine deficiency without a clear nutritional cause. Targeted exome sequencing revealed a homozygous c.1672C > T (p.R558C) missense mutation in exon 8 of WFS1 that has previously been reported in a patient with Wolfram syndrome. This case demonstrates how clinical application of next-generation sequencing technology can enhance the diagnosis of patients suspected to have rare genetic disorders. Furthermore, the finding of unexplained thiamine deficiency in a patient with Wolfram syndrome suggests a potential link between WFS1 biology and thiamine metabolism that has implications for the clinical management of Wolfram syndrome patients.

  11. Atypical case of Wolfram syndrome revealed through targeted exome sequencing in a patient with suspected mitochondrial disease

    Directory of Open Access Journals (Sweden)

    Lieber Daniel S

    2012-01-01

    Full Text Available Abstract Background Mitochondrial diseases comprise a diverse set of clinical disorders that affect multiple organ systems with varying severity and age of onset. Due to their clinical and genetic heterogeneity, these diseases are difficult to diagnose. We have developed a targeted exome sequencing approach to improve our ability to properly diagnose mitochondrial diseases and apply it here to an individual patient. Our method targets mitochondrial DNA (mtDNA and the exons of 1,600 nuclear genes involved in mitochondrial biology or Mendelian disorders with multi-system phenotypes, thereby allowing for simultaneous evaluation of multiple disease loci. Case Presentation Targeted exome sequencing was performed on a patient initially suspected to have a mitochondrial disorder. The patient presented with diabetes mellitus, diffuse brain atrophy, autonomic neuropathy, optic nerve atrophy, and a severe amnestic syndrome. Further work-up revealed multiple heteroplasmic mtDNA deletions as well as profound thiamine deficiency without a clear nutritional cause. Targeted exome sequencing revealed a homozygous c.1672C > T (p.R558C missense mutation in exon 8 of WFS1 that has previously been reported in a patient with Wolfram syndrome. Conclusion This case demonstrates how clinical application of next-generation sequencing technology can enhance the diagnosis of patients suspected to have rare genetic disorders. Furthermore, the finding of unexplained thiamine deficiency in a patient with Wolfram syndrome suggests a potential link between WFS1 biology and thiamine metabolism that has implications for the clinical management of Wolfram syndrome patients.

  12. Endoscopic ultrasound-guided fine-needle aspiration cytology in the evaluation of suspected tuberculosis in patients with isolated mediastinal lymphadenopathy

    DEFF Research Database (Denmark)

    Puri, R.; Vilmann, P.; Sud, R.

    2010-01-01

    Patients with suspected tuberculosis without pulmonary lesions and with mediastinal lymphadenopathy often pose a diagnostic challenge. Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) cytology is an established modality to evaluate mediastinal and abdominal lesions. The aim...... of the present study was to evaluate the role of EUS-FNA in isolated mediastinal lymphadenopathy in patients suspected of having tuberculosis....

  13. MRI diagnosis of suspected atlanto-occipital dissociation in childhood

    International Nuclear Information System (INIS)

    Grabb, B.C.; Frye, T.A.; Hedlund, G.L.; Vaid, Y.N.; Royal, S.A.; Grabb, P.A.

    1999-01-01

    Objective. To demonstrate the utility of magnetic resonance (MR) imaging in the diagnosis of complete and partial ligamentous injuries in patients with suspected atlanto-occipital dissociation (AOD). Materials and methods. Five patients with suspected AOD had MR imaging performed within an average of 4 days after injury. MR scans were reviewed with specific analysis of craniocervical ligamentous structures. Charts were reviewed to obtain clinical information regarding presentation, treatment, hospital course, and outcome. Results. Two patients demonstrated MR evidence of complete AOD. One had disruption of all visualized major ligamentous structures at the craniocervical junction with anterolisthesis and evidence of cord damage. The second had injuries to the tectorial membrane, superior band of the cruciform ligament, apical ligament, and interspinous ligament at C 1-2. The remaining three patients sustained incomplete severance of the ligamentous structures at the craniocervical junction. All patients demonstrated subtle radiographic findings suggestive of AOD, including soft tissue swelling at the craniocervical junction without fracture. The two patients with complete AOD died. The three patients with partial AOD were treated with stabilization. On follow-up, these three children were asymptomatic following their craniocervical injury. Conclusion. MR imaging of acute AOD provides accurate identification of the craniocervical ligaments injured, classification of full versus partial ligamentous disruption, and analysis of accompanying spinal cord injury. This information is important for early appropriate neurosurgical management and preservation of neurologic function in survivors. (orig.)

  14. A neonate with intestinal volvulus without malrotation exhibiting early jaundice with a suspected fetal onset.

    Science.gov (United States)

    Hara, Kaori; Kinoshita, Mari; Kin, Takane; Arimitsu, Takeshi; Matsuzaki, Yohei; Ikeda, Kazushige; Tomita, Hiroshi; Fujino, Akihiro; Kuroda, Tatsuo

    2015-01-01

    Intestinal volvulus without malrotation is a rare disease that causes volvulus of the small intestine despite normal intestinal rotation and fixation. We encountered a neonate with this disease who developed early jaundice and was suspected to have a fetal onset. This patient was characterized by early jaundice complicating intestinal volvulus without malrotation and is considered to have exhibited reduced fetal movement and early jaundice as a result of volvulus, necrosis, and hemorrhage of the small intestine in the fetal period. If abdominal distention accompanied by early jaundice is noted in a neonate, intestinal volvulus without malrotation and associated intraabdominal hemorrhage should be suspected and promptly treated.

  15. Bedside Ultrasound in the Emergency Department to Detect Hydronephrosis for the Evaluation of Suspected Ureteric Colic.

    Science.gov (United States)

    Shrestha, R; Shakya, R M; Khan A, A

    2016-01-01

    Background Renal colic is a common emergency department presentation. Hydronephrosis is indirect sign of urinary obstruction which may be due to obstructing ureteric calculus and can be detected easily by bedside ultrasound with minimal training. Objective To compare the accuracy of detection of hydronephrosis performed by the emergency physician with that of radiologist's in suspected renal colic cases. Method This was a prospective observational study performed over a period of 6 months. Patients >8 years with provisional diagnosis of renal colic with both the bedside ultrasound and the formal ultrasound performed were included. Presence of hydronephrosis in both ultrasounds and size and location of ureteric stone if present in formal ultrasound was recorded. The accuracy of the emergency physician detection of hydronephrosis was determined using the scan reported by the radiologists as the "gold standard" as computed tomography was unavailable. Statistical analysis was executed using SPSS 17.0. Result Among the 111 included patients, 56.7% had ureteric stone detected in formal ultrasound. The overall sensitivity, specificity, positive predictive value and negative predictive value of bedside ultrasound performed by emergency physician for detection of hydronephrosis with that of formal ultrasound performed by radiologist was 90.8%., 78.3%, 85.5% and 85.7% respectively. Bedside ultrasound and formal ultrasound both detected hydronephrosis more often in patients with larger stones and the difference was statistically significant (p=.000). Conclusion Bedside ultrasound can be potentially used as an important tool in detecting clinically significant hydronephrosis in emergency to evaluate suspected ureteric colic. Focused training in ultrasound could greatly improve the emergency management of these patients.

  16. Reliability of diagnostic imaging techniques in suspected acute appendicitis: proposed diagnostic protocol

    International Nuclear Information System (INIS)

    Cura del, J. L.; Oleaga, L.; Grande, D.; Vela, A. C.; Ibanez, A. M.

    2001-01-01

    To study the utility of ultrasound and computed tomography (CT) in case of suspected appendicitis. To determine the diagnostic yield in terms of different clinical contexts and patient characteristics. to assess the costs and benefits of introducing these techniques and propose a protocol for their use. Negative appendectomies, complications and length of hospital stay in a group of 152 patients with suspected appendicitis who underwent ultrasound and CT were compared with those of 180 patients who underwent appendectomy during the same time period, but had not been selected for the first group: these patients costs for each group were calculated. In the first group, the diagnostic value of the clinical signs was also evaluated. The reliability of the clinical signs was limited, while the results with ultrasound and CT were excellent. The incidence of negative appendectomy was 9.6% in the study group and 12.2% in the control group. Moreover, there were fewer complications and a shorter hospital stay in the first group. Among men, however, the rate of negative appendectomy was lower in the control group. The cost of using ultrasound and CT in the management of appendicitis was only slightly higher than that of the control group. Although ultrasound and CT are not necessary in cases in which the probability of appendicitis is low or in men presenting clear clinical evidence, the use of these techniques is indicated in the remaining cases in which appendicitis is suspected. In children, ultrasound is the technique of choice. In all other patients, if negative results are obtained with one of the two techniques, the other should be performed. (Author) 49 refs

  17. N-N potentials in QCD-motivated quark models

    International Nuclear Information System (INIS)

    Bender, I.; Dosch, H.G.

    1982-01-01

    Nucleon-nucleon interaction has been investigated in different QCD-inspired quark models, particularly the influence of configuration mixing. A string-motivated model is advocated, which yields a realistic short-range part of the nucleon-nucleon potential. (author)

  18. Unjamming in models with analytic pairwise potentials

    Science.gov (United States)

    Kooij, Stefan; Lerner, Edan

    2017-06-01

    Canonical models for studying the unjamming scenario in systems of soft repulsive particles assume pairwise potentials with a sharp cutoff in the interaction range. The sharp cutoff renders the potential nonanalytic but makes it possible to describe many properties of the solid in terms of the coordination number z , which has an unambiguous definition in these cases. Pairwise potentials without a sharp cutoff in the interaction range have not been studied in this context, but should in fact be considered to understand the relevance of the unjamming phenomenology in systems where such a cutoff is not present. In this work we explore two systems with such interactions: an inverse power law and an exponentially decaying pairwise potential, with the control parameters being the exponent (of the inverse power law) for the former and the number density for the latter. Both systems are shown to exhibit the characteristic features of the unjamming transition, among which are the vanishing of the shear-to-bulk modulus ratio and the emergence of an excess of low-frequency vibrational modes. We establish a relation between the pressure-to-bulk modulus ratio and the distance to unjamming in each of our model systems. This allows us to predict the dependence of other key observables on the distance to unjamming. Our results provide the means for a quantitative estimation of the proximity of generic glass-forming models to the unjamming transition in the absence of a clear-cut definition of the coordination number and highlight the general irrelevance of nonaffine contributions to the bulk modulus.

  19. Potential exposure to endocrine disrupting chemicals and selected adverse pregnancy outcomes

    DEFF Research Database (Denmark)

    Bengtsson, Jessica; Thygesen, Pernille Søgaard; Kaerlev, Linda

    2017-01-01

    potential occupational exposure to endocrine disrupting chemicals (EDC) of the mother during pregnancy is associated with preterm birth and low birth weight. Methods: Pregnant women referred to an Occupational Health Clinic (OHC) in two Danish regions (Copenhagen or Aarhus) between 1984 and 2010, suspected...

  20. Investigation of suspected TRALI cases in 2006–2011

    Directory of Open Access Journals (Sweden)

    Marjeta Maček Kvanka

    2012-12-01

    Methods: In 2006–2011, eight suspected TRALI cases that met consensus clinical criteria and had chest radiograph were investigated in the Blood Transfusion Center of Slovenia. Patients and all donors of blood components transfused within 6 hours before the onset of acute respiratory distress were investigated for leukocyte antibodies against HLA class I and II antigens, and antibodies against neutrophil antigens HNA. All cases were investigated for patient, donor and blood component characteristics. In cooperation with clinicians, chest radiographs and alternative risk factors for acute lung injury (ALI were evaluated.

  1. Experiences of School Counselors during and after Making Suspected Child Abuse Reports

    Science.gov (United States)

    Sikes, April; Remley, Theodore P., Jr.; Hays, Danica G.

    2010-01-01

    The purpose of this study was to explore the experiences of school counselors during and after making suspected child abuse and neglect reports. A total of 847 school counselors who were members of the American School Counselor Association (ASCA) participated in this study. Results showed that professional school counselors encountered some…

  2. Presentation of suspected pediatric uveitis.

    Science.gov (United States)

    Saeed, Muhammad Usman; Raza, Syed Hamid; Goyal, Sudeshna; Cleary, Gavin; Newman, William David; Chandna, Arvind

    2014-01-01

    Presentation of suspected pediatric uveitis: Pediatric uveitis is usually managed in specialized ophthalmic centers in the UK. Meaningful data acquisition in these clinics may be helpful in clinical governance, and healthcare planning in a specialty that is gradually changing due to changes in treatment choices. Retrospective analysis of prospectively acquired data in the Liverpool pediatric uveitis database was performed. Analysis of our data, based on 147 patients, with a mean age of 10 years, indicated a female to male ratio of 2:1. 99% of patients were Caucasian. Our data indicates 86% of all patients attending the uveitis clinic were diagnosed with juvenile idiopathic arthritis, followed by intermediate uveitis 5% and idiopathic uveitis 4%. 46% of patients required treatment. Systemic treatment included methotrexate (34%), prednisolone (14%), etanercept (6%), ciclosporin (6%), mycophenolate (3%), and infliximab (1%). Severe visual loss (defined by counting fingers or below vision) was seen in 10 eyes despite appropriately treated chronic uveitis. Our data shows uveitis-related ocular morbidity in a predominantly pediatric Caucasian population. Patients with severe and chronic uveitis may experience significant uveitis-related complications and subsequent visual loss despite aggressive treatment.

  3. Weak interaction potentials of nucleons in the Weinberg-Salam model

    International Nuclear Information System (INIS)

    Lobov, G.A.

    1979-01-01

    Weak interaction potentials of nucleons due to the nonet vector meson exchange are obtained in the Weinberg-Salam model using the vector-meson dominance. Contribution from the hadronic neutral currents to the weak interaction potential due to the charged pion exchange is obtained. The isotopic structure of the obtained potentials, that is unambiguous in the Weinberg-Salam model, is investigated. Enhancement of the nucleon weak interaction in nuclei resulting from the hadronic neutral currents is discussed. A nuclear one-particle weak interaction potential is presented that is a result of averaging of the two-particle potential over the states of the nuclear core. An approach to the nucleon weak interaction based on the quark model, is discussed. Effects of the nucleon weak interaction in the radiative capture of a thermal neutron by a proton, are considered

  4. Usefulness of PC based 3D volume rendering technique in the evaluation of suspected aneurysm on brain MRA

    International Nuclear Information System (INIS)

    Baek, Seung Il; Lee, Ghi Jai; Shim, Jae Chan; Bang, Sun Woo; Ryu, Seok Jong; Kim, Ho Kyun

    2002-01-01

    To evaluated usefulness of volume rending technique using 3D visualization software on PC in patients with suspected intracranial aneurysm on brain MRA. We analyzed prospectively 21 patients with suspected aneurysms on the routine MIP images which were obtained 15 .deg. C increment along axial and sagittal plane, among 135 patients in whom brain MRA was done due to stroke symptoms for recent 5 months. The locations were the anterior communicating artery (A-com) in 8 patients, the posterior communicating artery (P-com) in 3, the ICA bifurcation in 5, the MCA bifurcation in 4, and the basilar tip in one. Male to female ratio was 14:7 and mean age was 62 years. MRA source images were sent to PC through LAN, and the existence of aneurysm was evaluated with volume rendering technique using 3D visualization software on PC. The presence or absence of aneurysm on MIP and volume rendering images was decided by the consensus of two radiologists. We found the aneurysms with volume rendering technique, from 1 patient among 8 patients with suspected aneurysm at A-com and also 1 patient among 3 patients with suspected aneurysm at P=com on routine MIP images. Confirmative angiography and interventional procedures were done in these 2 patients. The causes for mimicking the aneurysm on MIP were flow displacement artifact in 9, normal P-com infundibulum in 2, and overlapped or narrowed vessels in 8 patients, and among them confirmative angiography was done in 2 patient. Volume rendering technique using visualization software on PC is useful to scrutinize the suspected aneurysm on routine MIP images and to avoid further invasive angiography

  5. Fungi isolated from the skin lesions of Ghezel and Makui sheep with suspected ringworm in Urmia, Iran

    Directory of Open Access Journals (Sweden)

    A Araghi – Sooreh

    2012-05-01

    Full Text Available Non-dermatophytic fungi are frequently isolated on the cultures used in surveys of animals suspected of having ringworm. The present study was conducted to identify of saprophytic fungi and dermatophyte isolated from sheep with suspected ringworm in Urmia, Iran. A total of 1323 sheep from two breeds of Ghezel (n = 727 and Makui (n = 596 were examined for skin lesions. Only 4(0.035 % lesions with hair loss and scaling were found on ears of Ghezel sheep. Samples were examined microscopically by KOH and cultured ontoSabouraud’s dextrose agar and Sabouraud’s dextrose with chloramphenicol and cycloheximide, incubated at 25 and 37 ° C and examined for 4weeks. All (100% of the specimens yielded positive culture. Fungal isolates were Alternariaspp. (3 cases, 75 % and Mucor spp. (2 cases, 50%. No dermatophyte fungi were cultured from suspected ringworm lesions. Saprophytic fungi isolated in the present study may not be considered as cause of skin lesions in Ghezel sheep.

  6. Seroprevalence of toxoplasma-specific antibodies in patients suspected to have active toxoplasmosis: A cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Abbas Ali Eskandarian

    2014-01-01

    Full Text Available Background: The aim of this study was to investigate the presence and distribution of anti-toxoplasma-specific IgM and IgG tantibodies in patients suspected to have toxoplasmosis and investigate for any association between IgM and IgG antibodies and some toxoplasmosis risk factors as well. Materials and Methods: In a comparative cross-sectional study, 70 patients suspected to had active toxoplasmosis and 30 control volunteers, who gave informed consent, entered the study. In each group, patient age, sex, signs of appearance, education level, residency status (urban / rural, occupation, frequency of toxoplasma-specific IgG and IgM antibodies, abortion history, and some risk factors (Direct cat exposure, Occupational exposure to raw meat, and Raw vegetable consumption were recorded. The enzyme-linked immunosorbent assay (ELISA kits (EUROIMMUN®, United Kingdom were used for the evaluation of anti-toxoplasma IgG and IgM antibodies according to the manufacturer›s instructions. All analyses were done using SPSS-20. Results: The frequency of toxoplasma-specific IgG and IgM antibodies like: Direct cat exposures, Occupational exposure to raw meat, and Raw vegetable consumption were not statistically significant between the two groups (P > 0.05. The history of previous abortions in women in the toxoplasmosis-suspected group was significantly higher than that in the controls (31.4% versus 6.7%; P = 0.009. Conclusion: The frequency of specific IgM and IgG antibodies in toxoplasmosis suspected in the toxoplasmosis and control groups was not statistically significant.

  7. The Anti-Acetylcholine Receptor Antibody Test in Suspected Ocular Myasthenia Gravis

    Directory of Open Access Journals (Sweden)

    Jung Jin Lee

    2014-01-01

    Full Text Available Aim. To estimate the clinical significance of anti-acetylcholine receptor antibody (anti-AChR-Ab levels in suspected ocular myasthenia gravis. Methods. In total, 144 patients complaining of fluctuating diplopia and ptosis were evaluated for serum levels of anti-acetylcholine receptor antibody and their medical charts were retrospectively reviewed. Subjects were classified into three groups: variable diplopia only, ptosis only, and both variable diplopia and ptosis. We investigated serum anti-AChR-Ab titer levels and performed thyroid autoantibody tests. Results. Patients’ chief complaints were diplopia (N=103, ptosis (N=12, and their concurrence (N=29. Abnormal anti-AChR-Ab was observed in 21 of 144 patients (14.1%. Between the three groups, mean age, number of seropositive patients, and mean anti-AChR-Ab level were not significantly different (P=0.224, 0.073, and 0.062, resp.. Overall, 27.5% of patients had abnormal thyroid autoantibodies. Conclusion. The sensitivity of anti-AChR-Ab was 14.1% in suspected ocular myasthenia gravis and seropositivity in myasthenia gravis patients showed a high correlation with the presence of thyroid autoantibodies.

  8. Retributive reactions to suspected offenders: The importance of social categorizations and guilt probability

    NARCIS (Netherlands)

    van Prooijen, J.W.

    2006-01-01

    In the current research, the author investigates the influence of social categorizations on retributive emotions (e.g., anger) and punishment intentions when people evaluate suspected offenders as independent observers. It is argued that information that guilt is certain or uncertain (i.e., guilt

  9. Ultrasonography, computed tomography, and cholescintigraphy in suspected obstructive jaundice--a prospective comparative study

    DEFF Research Database (Denmark)

    Matzen, P; Malchow-Møller, A; Brun, B

    1983-01-01

    In order to compare their capacity to visualize the bile ducts, ultrasonography, computed tomography, and cholescintigraphy were performed in 56 consecutive jaundiced patients in whom extrahepatic cholestasis was clinically suspected. The predictions as to the patency of the large bill ducts were...

  10. Two-body potentials in the collective model

    International Nuclear Information System (INIS)

    Draayer, J.P.; Rosensteel, G.; Arizona State Univ., Tempe

    1982-01-01

    The question, 'How well can a 1+2-body shell-model interaction represent a many-body potential.', is addressed by optimally expanding the (1+2+3)-body potential β 3 cos 3γ and the (1+2+3+4)-body potential β 4 of the Bohr-Mottelson collective model in terms of (1+2)-body operators. It is found that the correlation of β 4 with its approximation is greater than 97% throughout the sd shell. Although β 3 cos 3γ is also well approximated in the first half of the sd shell where it has more than 80% correlation with its approximation, the correlation drops abruptly at 28 Si to 50% and remains low in the second half of the shell. The approximations are primarily sums of the various components of the quadrupole-quadrupole interaction connecting different major oscillator shells. The results suggest that axially-symmetric deformation can be represented by simple (1+2)-body operators, whereas asymmetric shapes require non-simple 3-body terms. (orig.)

  11. Computed tomography compared to magnetic resonance imaging in occult or suspect hip fractures. A retrospective study in 44 patients

    Energy Technology Data Exchange (ETDEWEB)

    Collin, David; Goethlin, Jan H. [Sahlgrenska University Hospital, Department of Radiology, Moelndal (Sweden); Geijer, Mats [Lund University, Department of Medical Imaging and Physiology, Skaane University Hospital, Lund (Sweden)

    2016-11-15

    Computed tomography (CT) for evaluation of occult and suspect hip fractures has been proposed as a good second-line investigation. The diagnostic precision compared to magnetic resonance imaging (MRI) is unclear. To compare the diagnostic performance of CT and MRI in a retrospective study on patients with suspect and occult hip fractures. Forty-four elderly consecutive patients with low-energy trauma to the hip were identified where negative or suspect CT was followed by MRI. Primary reporting and review by two observers as well as the diagnostic performance of the two modalities were compared. Surgical treatment and clinical course were used as outcomes. Compared to the primary reports, the CT reviewers found fewer normal and no suspect cases. MRI changed the primary diagnoses in 27 cases, and in 14 and 15 cases, respectively, at review. There was no disagreement on MRI diagnoses. In our patient population, MRI was deemed a more reliable modality for hip fracture diagnosis in comparison to CT. For clinical decision making, MRI seems to have a higher accuracy than CT. A negative CT finding cannot completely rule out a hip fracture in patients where clinical findings of hip fracture persevere. (orig.)

  12. Clinical Characteristics, Management, and Outcomes of Suspected Poststroke Acute Coronary Syndrome

    OpenAIRE

    Biso, Sylvia Marie; Lu, Marvin; De Venecia, Toni Anne; Wongrakpanich, Supakanya; Rodriguez-Ziccardi, Mary; Yadlapati, Sujani; Kishlyansky, Marina; Rammohan, Harish Seetha; Figueredo, Vincent M.

    2017-01-01

    Background Acute coronary syndrome (ACS) can complicate acute ischemic stroke, causing significant morbidity and mortality. To date, literatures that describe poststroke acute coronary syndrome and its morbidity and mortality burden are lacking. Methods This is a single center, retrospective study where clinical characteristics, cardiac evaluation, and management of patients with suspected poststroke ACS were compared and analyzed for their association with inpatient mortality and 1-year all-...

  13. The impact of ultrasound in suspected acute appendicitis

    International Nuclear Information System (INIS)

    Gracey, D.; McClure, M.J.

    2007-01-01

    Aims: To evaluate prospectively the impact of an appendix ultrasound (US) service on the clinical management of patients presenting with suspected acute appendicitis. Materials and methods: The referring clinician completed a proforma for patients presenting with suspected acute appendicitis. Two visual analogue scales assessed clinical suspicion before and after knowledge of laboratory results. The clinician also indicated if they intended to operate had US been unavailable. During a 3-year period, 327 patients were examined by graded-compression US and diagnosed 'positive' or 'negative' for acute appendicitis. Findings were correlated with histopathology results. The referring clinician completed a retrospective audit questionnaire to assess user satisfaction. Results: Clinical suspicion was altered by knowledge of laboratory results. The decision to operate if US had been unavailable, was 'yes' in 70 cases (group A), 'no' in 231 (group B), and incomplete in 26 (group C). In group A, 31 patients (44.3%) had a negative US and 25 avoided surgery. US identified 39 cases of appendicitis and 37 appendicectomies confirmed appendicitis in 34 cases. In group B, 72 (31.2%) patients had a positive US and 66 appendicectomies confirmed 51 cases of appendicitis. The sensitivity of US was 94.7% in group A, 93.3% in group B and 93.8% overall. Specificity was 90.6% in group A, 91.2% in group B and 91.3% overall. US findings were contrary to intended surgical management in 103 cases. Management was altered in 97 cases (32.2%), with a positive outcome in 85 (28.2%). The referrers found US of appendix very useful in planning appropriate management. Conclusion: US of the appendix increases diagnostic accuracy, alters management and is more sensitive and specific than clinical impression, either alone, or in conjunction with laboratory results

  14. General Potential-Current Model and Validation for Electrocoagulation

    International Nuclear Information System (INIS)

    Dubrawski, Kristian L.; Du, Codey; Mohseni, Madjid

    2014-01-01

    A model relating potential and current in continuous parallel plate iron electrocoagulation (EC) was developed for application in drinking water treatment. The general model can be applied to any EC parallel plate system relying only on geometric and tabulated input variables without the need of system-specific experimentally derived constants. For the theoretical model, the anode and cathode were vertically divided into n equipotential segments in a single pass, upflow, and adiabatic EC reactor. Potential and energy balances were simultaneously solved at each vertical segment, which included the contribution of ionic concentrations, solution temperature and conductivity, cathodic hydrogen flux, and gas/liquid ratio. We experimentally validated the numerical model with a vertical upflow EC reactor using a 24 cm height 99.99% pure iron anode divided into twelve 2 cm segments. Individual experimental currents from each segment were summed to determine total current, and compared with the theoretically derived value. Several key variables were studied to determine their impact on model accuracy: solute type, solute concentration, current density, flow rate, inter-electrode gap, and electrode surface condition. Model results were in good agreement with experimental values at cell potentials of 2-20 V (corresponding to a current density range of approximately 50-800 A/m 2 ), with mean relative deviation of 9% for low flow rate, narrow electrode gap, polished electrodes, and 150 mg/L NaCl. Highest deviation occurred with a large electrode gap, unpolished electrodes, and Na 2 SO 4 electrolyte, due to parasitic H 2 O oxidation and less than unity current efficiency. This is the first general model which can be applied to any parallel plate EC system for accurate electrochemical voltage or current prediction

  15. Food-stimulated cholescintigraphy as a supplement to ERC in patients with suspected bile flow obstruction

    International Nuclear Information System (INIS)

    Hansen, H.H.; Toftgaard, C.; Rokkjor, M.J.; Kruse, A.; Funch-Jensen, P.; Thommesen, P.; Municipal Hospital, Aarhus

    1990-01-01

    Cholescintigraphy after food stimulation was carried out in 40 patients (13 patients with biliary enteric bypass, 14 patients with bile duct stenosis, demonstrated by ERC, 5 patients with endoprothesis and 8 patients with clinically suspected post-cholecystectomy syndrome). Biliary-bowel transit time of one hour or less was considered to be normal. It is concluded that in patients with biliary enteric bypass (hepatico-jejunostomia) or biliary strictures a biliary-bowel transit time of one hour will be discriminatory between normal and abnormal conditions. This is in contrast to patients with endoprothesis and suspected sphincter of Oddi dysmotility, where a transit time of one hour only will have limited predictive value. (orig.) [de

  16. Baryons electromagnetic mass splittings in potential models

    International Nuclear Information System (INIS)

    Genovese, M.; Richard, J.-M.; Silvestre-Brac, B.; Varga, K.

    1998-01-01

    We study electromagnetic mass splittings of charmed baryons. We point out discrepancies among theoretical predictions in non-relativistic potential models; none of these predictions seems supported by experimental data. A new calculation is presented

  17. Early diagnosis of dengue virus infection in clinically suspected cases

    International Nuclear Information System (INIS)

    Afridi, N.K.; Ahmed, S.; Ali, N.; Khan, S.A.

    2016-01-01

    Objective: Comparison of real time reverse transcriptase polymerase chain reaction (RTPCR) and immunoglobulin M (IgM) capture enzyme linked immunosorbent assay (ELISA) for diagnosis of dengue virus infection in first week of illness in clinically suspected patients of dengue fever. Study Design: Cross sectional study. Place and Duration of Study: Department of haematology, Armed Forces Institute of Pathology (AFIP) Rawalpindi from Jan 2013 to Nov 2013. Material and Methods: A cross sectional study including 68 clinically suspected patients of dengue fever according to the World Health Organization (WHO) criteria. IgM capture ELISA and RT PCR for dengue virus ribonucleic acid (RNA) was performed on samples collected from patients having fever for 1 to 7 days. These were divided into two groups. Patients in group 1 presented with fever of 4 days or less, patients in group 2 had fever of 5 to 7 days duration. Results: In group 1, 72 percent of the patients were positive by RT PCR while 31 percent were positive by IgM capture ELISA. In group 2, 43 percent of the patients were positive by RT PCR while 97 percent were positive by ELISA. Conclusion: RT PCR can be used for early detection of dengue virus infection in the first few days of fever while IgM ELISA is diagnostic afterwards. (author)

  18. Intravenous contrast enhanced computed tomography colonoscopy in children with suspected colonic polyps

    International Nuclear Information System (INIS)

    Bhatia, Anmol; Saxena, Akshay K.; Kalra, Naveen; Sodhi, Kushaljit S.; Thapa, Babu R.; Rao, Katragadda L.N.; Khandelwal, Niranjan

    2013-01-01

    Objective: The purpose of this study was to evaluate the diagnostic performance of intravenous contrast enhanced computed tomographic colonoscopy (IVCTC) in the diagnosis of clinically suspected colorectal polyps in children, using conventional colonoscopy (CC) as the gold standard. Methods: This was a prospective study conducted between July 2008 and June 2010. 30 pediatric patients with history of rectal bleeding and clinically suspected to have colorectal polyps were enrolled. All of the patients underwent IVCTC followed by CC. 30 IVCTC and 31 CC were performed in 30 patients. The findings of IVCTC were compared with those of CC. Statistical analysis was performed to obtain diagnostic performance values of IVCTC on per polyp (sensitivity and positive predictive value) and per patient (sensitivity, specificity, positive predictive value and negative predictive value) basis. Results: By IVCTC, 63 polyps were detected in 28 patients of which 53 polyps were eligible for inclusion in the statistical analysis. 60 polyps were detected by CC in 28 patients of which 50 polyps were eligible for inclusion in the statistical analysis. The per polyp sensitivity and positive predictive values were 94% and 88.6% respectively. The per patient sensitivity, specificity, positive predictive value, and negative predictive values were 96.4, 50, 96.4, and 50% respectively. Twenty polyps, in 10 patients, were visualized only after intravenous contrast administration of which 5 polyps, in 5 patients, were likely to have been missed in the absence of the intravenous contrast injection as these polyps were submerged in fluid. Four patients would have had a false negative CTC examination if the intravenous contrast had not been injected; while in another patient, the number of polyps would have been underestimated. Conclusion: CTC is capable of serving as a safe and efficient non-invasive tool for evaluating children with clinically suspected colorectal polyps. Administration of

  19. Strategies for diagnosis and treatment of suspected leptospirosis: a cost-benefit analysis.

    Directory of Open Access Journals (Sweden)

    Yupin Suputtamongkol

    Full Text Available BACKGROUND: Symptoms and signs of leptospirosis are non-specific. Several diagnostic tests for leptospirosis are available and in some instances are being used prior to treatment of leptospirosis-suspected patients. There is therefore a need to evaluate the cost-effectiveness of the different treatment strategies in order to avoid misuse of scarce resources and ensure best possible health outcomes for patients. METHODS: The study population was adult patients, presented with uncomplicated acute febrile illness, without an obvious focus of infection or malaria or typical dengue infection. We compared the cost and effectiveness of 5 management strategies: 1 no patients tested or given antibiotic treatment; 2 all patients given empirical doxycycline treatment; patients given doxycycline when a patient is tested positive for leptospirosis using: 3 lateral flow; 4 MCAT; 5 latex test. The framework used is a cost-benefit analysis, accounting for all direct medical costs in diagnosing and treating patients suspected of leptospirosis. Outcomes are measured in length of fever after treatment which is then converted to productivity losses to capture the full economic costs. FINDINGS: Empirical doxycycline treatment was the most efficient strategy, being both the least costly alternative and the one that resulted in the shortest duration of fever. The limited sensitivity of all three diagnostic tests implied that their use to guide treatment was not cost-effective. The most influential parameter driving these results was the cost of treating patients with complications for patients who did not receive adequate treatment as a result of incorrect diagnosis or a strategy of no-antibiotic-treatment. CONCLUSIONS: Clinicians should continue treating suspected cases of leptospirosis on an empirical basis. This conclusion holds true as long as policy makers are not prioritizing the reduction of use of antibiotics, in which case the use of the latex test would be

  20. Severe Fever with Thrombocytopenia Syndrome in Patients Suspected of Having Scrub Typhus.

    Science.gov (United States)

    Wi, Yu Mi; Woo, Hye In; Park, Dahee; Lee, Keun Hwa; Kang, Cheol-In; Chung, Doo Ryeon; Peck, Kyong Ran; Song, Jae-Hoon

    2016-11-01

    To determine prevalence of severe fever with thrombocytopenia syndrome in South Korea, we examined serum samples from patients with fever and insect bite history in scrub typhus-endemic areas. During the 2013 scrub typhus season, prevalence of this syndrome among patients suspected of having scrub typhus was high (23.0%), suggesting possible co-infection.

  1. Which children could benefit from additional diagnostic tools in case of suspected appendicitis?

    NARCIS (Netherlands)

    van den Broek, W. T.; van der Ende, E. D.; Bijnen, A. B.; Breslau, P. J.; Gouma, D. J.

    2004-01-01

    Background: New diagnostic tools such as ultrasound scan, computed tomography (CT) scan, and diagnostic laparoscopy, have become available for children with suspected appendicitis but should be reserved for equivocal cases. The aim of this study was to develop a scoring system to identify this

  2. A Suspected Pelvic Aneurysmal Bone Cyst in Pregnancy

    Directory of Open Access Journals (Sweden)

    Rayan Elkattah

    2013-01-01

    Full Text Available Albeit rare, the majority of identified bone lesions in pregnancy spare the pelvis. Once encountered with a pelvic bone lesion in pregnancy, the obstetrician may face a challenging situation as it is difficult to determine and predict the effects that labor and parturition impart on the pelvic bones. Bone changes and pelvic bone fractures have been well documented during childbirth. The data regarding clinical outcomes and management of pregnancies complicated by pelvic ABCs is scant. Highly suspected to represent an aneurysmal bone cyst, the clinical evaluation of a pelvic lesion in the ilium of a pregnant individual is presented, and modes of delivery in such a scenario are discussed.

  3. Inflation with hyperbolic potential in the braneworld model

    Indian Academy of Sciences (India)

    In this paper we study inflationary dynamics with a scalar field in an inverse coshyperbolic potential in the braneworld model. We note that a sufficient inflation may be obtained with the potential considering slow-roll approximation in the high energy limit. We determine the minimum values of the initial inflaton field required ...

  4. Utilization of serology for the diagnosis of suspected Lyme borreliosis in Denmark: Survey of patients seen in general practice

    Directory of Open Access Journals (Sweden)

    Skarphedinsson Sigurdur

    2010-11-01

    Full Text Available Abstract Background Serological testing for Lyme borreliosis (LB is frequently requested by general practitioners for patients with a wide variety of symptoms. Methods A survey was performed in order to characterize test utilization and clinical features of patients investigated for serum antibodies to Borrelia burgdorferi sensu lato. During one calendar year a questionnaire was sent to the general practitioners who had ordered LB serology from patients in three Danish counties (population 1.5 million inhabitants. Testing was done with a commercial ELISA assay with purified flagella antigen from a Danish strain of B. afzelii. Results A total of 4,664 patients were tested. The IgM and IgG seropositivity rates were 9.2% and 3.3%, respectively. Questionnaires from 2,643 (57% patients were available for analysis. Erythema migrans (EM was suspected in 38% of patients, Lyme arthritis/disseminated disease in 23% and early neuroborreliosis in 13%. Age 0-15 years and suspected EM were significant predictors of IgM seropositivity, whereas suspected acrodermatitis was a predictor of IgG seropositivity. LB was suspected in 646 patients with arthritis, but only 2.3% were IgG seropositive. This is comparable to the level of seropositivity in the background population indicating that Lyme arthritis is a rare entity in Denmark, and the low pretest probability should alert general practitioners to the possibility of false positive LB serology. Significant predictors for treating the patient were a reported tick bite and suspected EM. Conclusions A detailed description of the utilization of serology for Lyme borreliosis with rates of seropositivity according to clinical symptoms is presented. Low rates of seropositivity in certain patient groups indicate a low pretest probability and there is a notable risk of false positive results. 38% of all patients tested were suspected of EM, although this is not a recommended indication due to a low sensitivity of

  5. Evaluation of basophil activation test in suspected food hypersensitivity.

    Science.gov (United States)

    Pignatti, Patrizia; Yacoub, Mona-Rita; Testoni, Claudia; Pala, Gianni; Corsetti, Maura; Colombo, Giselda; Meriggi, Antonio; Moscato, Gianna

    2017-07-01

    Food hypersensitivity is characterized by a wide range of symptoms. The relationship between symptoms and food is more frequently suspected than objectively proven. Basophil activation test (BAT) is based on the evaluation of activation markers on blood basophils in vitro stimulated with drugs or allergens. The aim of the study was to evaluate the usefulness of BAT when introduced in the routine work-up of suspected food hypersensitivity. BAT was requested in subjects with food adverse reactions when a discrepancy existed among history and skin prick test (SPT) and/or specific IgE. Data from 150 subjects were analysed using CD63 as basophil activation marker. Thirty controls were evaluated for cut-offs. Immunoblots was performed with the sera of representative subjects positive for BAT and negative for SPT and sIgE. 1,024 BAT were carried out, the agreement (positive/positive and negative/negative) was 78.5% for BAT vs. SPT and 78.3% for BAT vs. IgE. Atopic patients, but not atopic controls, more frequently had a positive BAT than non-atopic patients (P tested food) and both negative sIgE and SPT. Immunoblots revealed the presence of sIgE for the tested foods in representative patients with positive BAT, negative SPT and sIgE. Introduction of BAT in routine of food hypersensitivity, limited to subjects with a discrepancy between history and traditional tests, might be useful particularly when total IgE are low. © 2015 International Clinical Cytometry Society. © 2015 International Clinical Cytometry Society.

  6. High prevalence of smoking among patients with suspected tuberculosis in South Africa.

    Science.gov (United States)

    Brunet, L; Pai, M; Davids, V; Ling, D; Paradis, G; Lenders, L; Meldau, R; van Zyl Smit, R; Calligaro, G; Allwood, B; Dawson, R; Dheda, K

    2011-07-01

    There is growing evidence that tobacco smoking is an important risk factor for tuberculosis (TB). There are no data validating the accuracy of self-reported smoking in TB patients and limited data about the prevalence of smoking in TB patients from high-burden settings. We performed a cross-sectional analysis of 500 patients with suspected TB in Cape Town, South Africa. All underwent comprehensive diagnostic testing. The accuracy of their self-reported smoking status was determined against serum cotinine levels. Of the 424 patients included in the study, 56 and 60% of those with active and latent TB infection (LTBI), respectively, were current smokers. Using plasma cotinine as a reference standard, the sensitivity of self-reported smoking was 89%. No statistically significant association could be found between smoking and active TB or LTBI. In Cape Town, the prevalence of smoking among patients with suspected and confirmed TB was much higher than in the general South African population. Self-reporting is an accurate measure of smoking status. These results suggest the need to actively incorporate tobacco cessation programmes into TB services in South Africa.

  7. Analytical local electron-electron interaction model potentials for atoms

    International Nuclear Information System (INIS)

    Neugebauer, Johannes; Reiher, Markus; Hinze, Juergen

    2002-01-01

    Analytical local potentials for modeling the electron-electron interaction in an atom reduce significantly the computational effort in electronic structure calculations. The development of such potentials has a long history, but some promising ideas have not yet been taken into account for further improvements. We determine a local electron-electron interaction potential akin to those suggested by Green et al. [Phys. Rev. 184, 1 (1969)], which are widely used in atom-ion scattering calculations, electron-capture processes, and electronic structure calculations. Generalized Yukawa-type model potentials are introduced. This leads, however, to shell-dependent local potentials, because the origin behavior of such potentials is different for different shells as has been explicated analytically [J. Neugebauer, M. Reiher, and J. Hinze, Phys. Rev. A 65, 032518 (2002)]. It is found that the parameters that characterize these local potentials can be interpolated and extrapolated reliably for different nuclear charges and different numbers of electrons. The analytical behavior of the corresponding localized Hartree-Fock potentials at the origin and at long distances is utilized in order to reduce the number of fit parameters. It turns out that the shell-dependent form of Green's potential, which we also derive, yields results of comparable accuracy using only one shell-dependent parameter

  8. Plant water potential improves prediction of empirical stomatal models.

    Directory of Open Access Journals (Sweden)

    William R L Anderegg

    Full Text Available Climate change is expected to lead to increases in drought frequency and severity, with deleterious effects on many ecosystems. Stomatal responses to changing environmental conditions form the backbone of all ecosystem models, but are based on empirical relationships and are not well-tested during drought conditions. Here, we use a dataset of 34 woody plant species spanning global forest biomes to examine the effect of leaf water potential on stomatal conductance and test the predictive accuracy of three major stomatal models and a recently proposed model. We find that current leaf-level empirical models have consistent biases of over-prediction of stomatal conductance during dry conditions, particularly at low soil water potentials. Furthermore, the recently proposed stomatal conductance model yields increases in predictive capability compared to current models, and with particular improvement during drought conditions. Our results reveal that including stomatal sensitivity to declining water potential and consequent impairment of plant water transport will improve predictions during drought conditions and show that many biomes contain a diversity of plant stomatal strategies that range from risky to conservative stomatal regulation during water stress. Such improvements in stomatal simulation are greatly needed to help unravel and predict the response of ecosystems to future climate extremes.

  9. Effectiveness of a fluid chart in outpatient management of suspected dengue fever: A pilot study.

    Science.gov (United States)

    Nasir, Nazrila Hairin; Mohamad, Mohazmi; Lum, Lucy Chai See; Ng, Chirk Jenn

    2017-01-01

    Dengue infection is the fastest spreading mosquito-borne viral disease in the world. One of the complications of dengue is dehydration which, if not carefully monitored and treated, may lead to shock, particularly in those with dengue haemorrhagic fever. WHO has recommended oral fluid intake of five glasses or more for adults who are suspected to have dengue fever. However, there have been no published studies looking at self-care intervention measures to improve oral fluid intake among patients suspected of dengue fever. To assess the feasibility and effectiveness of using a fluid chart to improve oral fluid intake in patients with suspected dengue fever in a primary care setting. This feasibility study used a randomized controlled study design. The data was collected over two months at a primary care clinic in a teaching hospital. The inclusion criteria were: age > 12 years, patients who were suspected to have dengue fever based on the assessment by the primary healthcare clinician, fever for > three days, and thrombocytopenia (platelets dengue home care card. The intervention group received the fluid chart and a cup (200ml). Baseline clinical and laboratory data, 24-hour fluid recall (control group), and fluid chart were collected. The main outcomes were: hospitalization rates, intravenous fluid requirement and total oral fluid intake. Among the 138 participants who were included in the final analysis, there were fewer hospital admissions in the intervention group (n = 7, 10.0%) than the control group (n = 12, 17.6%) (p = 0.192). Similarly, fewer patients (n = 9, 12.9%) in the intervention group required intravenous fluid compared to the control group (n = 15, 22.1%), (p = 0.154). There was an increase in the amount of daily oral fluid intake in the intervention group (about 3,000 ml) compared to the control group (about 2,500 ml, p = 0.521). However, these differences did not reach statistical significance. This is a feasible and acceptable study to perform in

  10. Survey of laboratory findings in suspected cases of bovine spongiform encephalopathy in Denmark from 1990 to 2000

    DEFF Research Database (Denmark)

    Agerholm, J.S.; Tegtmeier, C.L.; Nielsen, T.K.

    2002-01-01

    A survey of the laboratory findings in suspected cases of bovine spongiform encephalopathy (BSE) in Denmark from I June 1990 to '31 December 2000 is presented. During this period BSE was a notifiable disease, and the heads of suspected cases were submitted according to the legislation on BSE....... A total of 176 submissions were made, mostly from bovines with neurological disorders and mainly during the last 3 years of this period. Lesions or other laboratory findings consistent with severe neurological disorders were found in 115 cases. The most frequent diagnosis was encephalic 41 p listeriosis...

  11. Chemical structure-based predictive model for methanogenic anaerobic biodegradation potential.

    Science.gov (United States)

    Meylan, William; Boethling, Robert; Aronson, Dallas; Howard, Philip; Tunkel, Jay

    2007-09-01

    Many screening-level models exist for predicting aerobic biodegradation potential from chemical structure, but anaerobic biodegradation generally has been ignored by modelers. We used a fragment contribution approach to develop a model for predicting biodegradation potential under methanogenic anaerobic conditions. The new model has 37 fragments (substructures) and classifies a substance as either fast or slow, relative to the potential to be biodegraded in the "serum bottle" anaerobic biodegradation screening test (Organization for Economic Cooperation and Development Guideline 311). The model correctly classified 90, 77, and 91% of the chemicals in the training set (n = 169) and two independent validation sets (n = 35 and 23), respectively. Accuracy of predictions of fast and slow degradation was equal for training-set chemicals, but fast-degradation predictions were less accurate than slow-degradation predictions for the validation sets. Analysis of the signs of the fragment coefficients for this and the other (aerobic) Biowin models suggests that in the context of simple group contribution models, the majority of positive and negative structural influences on ultimate degradation are the same for aerobic and methanogenic anaerobic biodegradation.

  12. Robust global identifiability theory using potentials--Application to compartmental models.

    Science.gov (United States)

    Wongvanich, N; Hann, C E; Sirisena, H R

    2015-04-01

    This paper presents a global practical identifiability theory for analyzing and identifying linear and nonlinear compartmental models. The compartmental system is prolonged onto the potential jet space to formulate a set of input-output equations that are integrals in terms of the measured data, which allows for robust identification of parameters without requiring any simulation of the model differential equations. Two classes of linear and non-linear compartmental models are considered. The theory is first applied to analyze the linear nitrous oxide (N2O) uptake model. The fitting accuracy of the identified models from differential jet space and potential jet space identifiability theories is compared with a realistic noise level of 3% which is derived from sensor noise data in the literature. The potential jet space approach gave a match that was well within the coefficient of variation. The differential jet space formulation was unstable and not suitable for parameter identification. The proposed theory is then applied to a nonlinear immunological model for mastitis in cows. In addition, the model formulation is extended to include an iterative method which allows initial conditions to be accurately identified. With up to 10% noise, the potential jet space theory predicts the normalized population concentration infected with pathogens, to within 9% of the true curve. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Audit of the practice of sputum smear examination for patients with suspected pulmonary tuberculosis in Fiji.

    Science.gov (United States)

    Gounder, Shakti; Tayler-Smith, Katherine; Khogali, Mohammed; Raikabula, Maopa; Harries, Anthony D

    2013-07-01

    In Fiji, patients with suspected pulmonary tuberculosis (PTB) currently submit three sputum specimens for smear microscopy for acid-fast bacilli, but there is little information about how well this practice is carried out. A cross-sectional retrospective review was carried out in all four TB diagnostic laboratories in Fiji to determine among new patients presenting with suspected PTB in 2011: the quality of submitted sputum; the number of sputum samples submitted; the relationship between quality and number of submitted samples to smear-positivity; and positive yield from first, second and third samples. Of 1940 patients with suspected PTB, 3522 sputum samples were submitted: 997 (51.4%) patients submitted one sample, 304 (15.7%) patients submitted two samples and 639 (32.9%) submitted three samples. Sputum quality was recorded in 2528 (71.8%) of samples, of which 1046 (41.4%) were of poor quality. Poor quality sputum was more frequent in females, inpatients and children (0-14 years). Good quality sputum and a higher number of submitted samples positively correlated with smear-positivity for acid-fast bacilli. There were 122 (6.3%) patients with suspected PTB who were sputum smear positive. Of those, 89 had submitted three sputum samples: 79 (89%) were diagnosed based on the first sputum sample, 6 (7%) on the second sample and 4 (4%) on the third sample. This study shows that there are deficiencies in the practice of sputum smear examination in Fiji with respect to sputum quality and recommended number of submitted samples, although the results support the continued use of three sputum samples for TB diagnosis. Ways to improve sputum quality and adherence to recommended guidelines are needed.

  14. A case report of suspected malignant hyperthermia where patient survived the episode

    OpenAIRE

    Iqbal, Asif; Badoo, Shoaib; Naqeeb, Ruqsana

    2017-01-01

    Malignant hyperthermia is rare inherited disorder in our part of the world; there are only few cases reported in literature in India who were suspected of having this condition. The overall incidence of malignant hyperthermia during general anesthesia is estimated to range from 1: 5000 to 1: 50,000–100,000 and mortality rate is estimated to be

  15. Four-quark states in potential model

    International Nuclear Information System (INIS)

    Badalyan, A.M.; Kitoroage, D.I.

    1987-01-01

    The mass spectrum of S-wave q 2 q -2 mesons of u, d, s quarks is calculated in the framework of the nonrelativistic potential model and compared with the bag model predictions. The spin-spin splittings of almost all four-quark mesons with J PC = 0 ++ , 2 ++ , 1 +- are shown to coincide with an accuracy of ∼ 50 MeV in both approaches. Two exceptions are O S (9), C π S (9) mesons for which the discrepancy is ∼ 300 MeV. Calculated centers of gravity of the multiplets are systematically ∼ 120 MeV higher than the MIT bag predictions

  16. Determination of neuronal antibodies in suspected and definite Creutzfeldt-Jakob disease

    OpenAIRE

    Grau-Rivera, O.; Sánchez del Valle Díaz, Raquel; Saiz Hinajeros, Albert; Molinuevo, José L.; Bernabé, Reyes; Munteis, Elvira; Pujadas, Francesc; Salvador, Antoni; Saura, Júlia; Ugarte, Antonio; Titulaer, Maarten; Dalmau Obrador, Josep; Graus Ribas, Francesc

    2014-01-01

    IMPORTANCE Creutzfeldt-Jakob disease (CJD) and autoimmune encephalitis with antibodies against neuronal surface antigens (NSA-abs) may present with similar clinical features. Establishing the correct diagnosis has practical implications in the management of care for these patients. OBJECTIVE To determine the frequency of NSA-abs in the cerebrospinal fluid of patients with suspected CJD and in patients with pathologically confirmed (ie, definite) CJD. DESIGN, SETTING, AND PARTICIPANTS A mixed ...

  17. The mass spectrum of double heavy baryons in new potential quark models

    Directory of Open Access Journals (Sweden)

    Kovalenko Vladimir

    2017-01-01

    Full Text Available A new approach to study the mass spectrum of double heavy baryons (QQ′q containing strange and charmed quarks is proposed. It is based on the separation of variables in the Schrodinger equation in the prolate spheroidal coordinates. Two nonrelativistic potential models are considered. In the first model, the interaction potential of the quarks is the sum of the Coulomb and non-spherically symmetrical linear confinement potential. In the second model it is assumed that the quark confinement provided by a spherically symmetric harmonic oscillator potential. In both models the mass spectrum is calculated, and a comparison with previous results from other models is performed.

  18. Sex disparities in tuberculosis suspect evaluation: a cross-sectional analysis in rural Uganda.

    Science.gov (United States)

    Miller, C R; Davis, J L; Katamba, A; Sserwanga, A; Kakeeto, S; Kizito, F; Cattamanchi, A

    2013-04-01

    Six primary health care centers in rural Uganda. To compare the quality of tuberculosis (TB) evaluation for men and women presenting to primary health care facilities in high-burden settings. Cross-sectional study using indicators derived from the International Standards of Tuberculosis Care (ISTC) to compare the quality of TB evaluation services provided to men and women. Of 161 230 patient visits between January 2009 and December 2010, 112 329 (69.7%) were women. We considered 3308 (2.1%) patients with cough ≥2 weeks as TB suspects, of whom 1871 (56.6%) were women. Female TB suspects were less likely to be referred for sputum smear examination (45.9% vs. 61.6%, P ISTC (33.0% vs. 45.6%, P ISTC-recommended care (RR 0.79, 95%CI 0.72-0.86, P < 0.001). Strategies to ensure that women receive appropriate TB evaluation could provide a valuable opportunity for increasing case detection while also promoting equitable and universal access to care.

  19. Modelling piezoelectric energy harvesting potential in an educational building

    International Nuclear Information System (INIS)

    Li, Xiaofeng; Strezov, Vladimir

    2014-01-01

    Highlights: • Energy harvesting potential of commercialized piezoelectric tiles is analyzed. • The parameters which will affect the energy harvesting efficiency are determined. • The potential could cover 0.5% of the total energy usage of the library building. • A simplified evaluation indicator is proposed to test the considered paving area. - Abstract: In this paper, potential application of a commercial piezoelectric energy harvester in a central hub building at Macquarie University in Sydney, Australia is examined and discussed. Optimization of the piezoelectric tile deployment is presented according to the frequency of pedestrian mobility and a model is developed where 3.1% of the total floor area with the highest pedestrian mobility is paved with piezoelectric tiles. The modelling results indicate that the total annual energy harvesting potential for the proposed optimized tile pavement model is estimated at 1.1 MW h/year. This potential energy generation may be further increased to 9.9 MW h/year with a possible improvement in piezoelectric energy conversion efficiency integrated into the system. This energy harvesting potential would be sufficient to meet close to 0.5% of the annual energy needs of the building. The study confirms that locating high traffic areas is critical for optimization of the energy harvesting efficiency, as well as the orientation of the tile pavement significantly affects the total amount of the harvested energy. A Density Flow evaluation is recommended in this study to qualitatively evaluate the piezoelectric power harvesting potential of the considered area based on the number of pedestrian crossings per unit time

  20. The clinical utility of FDG PET/CT among solid organ transplant recipients suspected of malignancy or infection

    International Nuclear Information System (INIS)

    Wareham, Neval E.; Lundgren, J.D.; Cunha-Bang, C. da; Sengeloev, H.; Gustafsson, F.; Iversen, M.; Johannesen, H.H.; Kjaer, A.; Fischer, B.M.; Rasmussen, A.; Soerensen, S.S.

    2017-01-01

    Solid organ transplant (SOT) recipients are at high risk of developing infections and malignancies. 18 F-FDG PET/CT may enable timely detection of these diseases and help to ensure early intervention. We aimed to describe the clinical utility of FDG PET/CT in consecutive, diagnostic unresolved SOT recipients transplanted from January 2004 to May 2015. Recipients with a post-transplant FDG PET/CT performed as part of diagnostic work-up were included. Detailed chart reviews were done to extract relevant clinical information and determine the final diagnosis related to the FDG PET/CT. Based on a priori defined criteria and the final diagnosis, results from each scan were classified as true or false, and diagnostic values determined. Among the 1,814 recipients in the cohort, 145 had an FDG PET/CT performed; 122 under the indication of diagnostically unresolved symptoms with a suspicion of malignancy or infection. The remaining (N = 23) had an FDG PET/CT to follow-up on a known disease or to stage a known malignancy. The 122 recipients underwent a total of 133 FDG PET/CT scans performed for a suspected malignancy (66 %) or an infection (34 %). Sensitivity, specificity, and positive and negative predictive values of the FDG PET/CT in diagnosing these conditions were 97, 84, 87, and 96 %, respectively. FDG PET/CT is an accurate diagnostic tool for the work-up of diagnostic unresolved SOT recipients suspected of malignancy or infection. The high sensitivity and NPV underlines the potential usefulness of PET/CT for excluding malignancy or focal infections in this often complex clinical situation. (orig.)

  1. CTA/V detection of bilateral sigmoid sinus dehiscence and suspected idiopathic intracranial hypertension in unilateral pulsatile tinnitus

    International Nuclear Information System (INIS)

    Xu, Shuaishuai; Xu, Jianrong; Ruan, Shidong; Liu, Shanfeng; Gong, Ruozhen

    2018-01-01

    This aimed to evaluate the prevalence and extent of bilateral sigmoid sinus dehiscence (SSD) and to explore the presence of idiopathic intracranial hypertension (IIH) in patients with unilateral pulsatile tinnitus (PT) with CTA/V. Sixty PT patients (52 females; 40.4 ± 11.6 years [20-72]) who underwent CTA/V and 30 non-PT patients (27 females; 38.4 ± 14.7 years [12-62]) were enrolled in this study. The primary outcome measure was the radiographic presence of SSD. The index of transverse sinus stenosis (ITSS) was obtained by multiplying the stenosis scale values for each transverse sinus, and once was ≥ 4, the presence of IIH was suspected. The prevalence and extent of SSD on symptomatic side (78%; maximum transverse diameter, MTD 0.49 ± 0.23; maximum vertical diameter, MVD 0.50 ± 0.26 cm) were significantly higher and larger than those on asymptomatic side (50%, P < 0.001; MTD 0.35 ± 0.18, P = 0.006; MVD 0.30 ± 0.15 cm, P < 0.001) in the study group and those (20%, P < 0.001; MTD 0.36 ± 0.18, P = 0.073; MVD 0.30 ± 0.22 cm, P < 0.048) in the control group. The presence of SSD showed significant correlation with both PT (logistic regression analysis, OR 4.167 [1.450-11.97]; P = 0.008) and suspected IIH (OR 16.25 [1.893-139.5]; P = 0.011). In PT patients, SSD has a significant correlation with PT and a potential correlation with IIH. (orig.)

  2. Suspected acute pulmonary emboli: cost-effectiveness of chest helical computed tomography versus a standard diagnostic algorithm incorporating ventilation-perfusion scintigraphy

    International Nuclear Information System (INIS)

    Larcos, G.; Chi, K.K.G.; Berry, G.; Westmead Hospital, Sydney, NSW; Shiell, A.

    2000-01-01

    There is a controversy regarding the investigation of patients with suspected acute pulmonary embolism (PE). To compare the cost-effectiveness of alternative methods of diagnosing acute PE, chest helical computed tomography (CT) alone and in combination with venous ultrasound (US) of legs and pulmonary angiography (PA) were compared to a conventional algorithm using ventilation-perfusion (V/Q) scintigraphy supplemented in selected cases by US and PA. A decision-analytical model was constructed to model the costs and effects of the three diagnostic strategies in a hypothetical cohort of 1000 patients each. Transition probabilities were based on published data. Life years gained by each strategy were estimated from published mortality rates. Schedule fees were used to estimate costs. The V/Q protocol is both more expensive and more effective than CT alone resulting in 20.1 additional lives saved at a (discounted) cost of $940 per life year gained. An additional 2.5 lives can be saved if CT replaces V/Q scintigraphy in the diagnostic algorithm but at a cost of $23,905 per life year saved. It resulted that the more effective diagnostic strategies are also more expensive. In patients with suspected PE, the incremental cost-effectiveness of the V/Q based strategy over CT alone is reasonable in comparison with other health interventions. The cost-effectiveness of the supplemented CT strategy is more questionable. Copyright (2000) The Australasian College of Physicians

  3. Derivation of potential model for LiAlO2 by simple and effective optimization of model parameters

    International Nuclear Information System (INIS)

    Tsuchihira, H.; Oda, T.; Tanaka, S.

    2009-01-01

    Interatomic potentials of LiAlO 2 were constructed by a simple and effective method. In this method, the model function consists of multiple inverse polynomial functions with an exponential truncation function, and parameters in the potential model can be optimized as a solution of simultaneous linear equations. Potential energies obtained by ab initio calculation are used as fitting targets for model parameter optimization. Lattice constants, elastic properties, defect-formation energy, thermal expansions and the melting point were calculated under the constructed potential models. The results showed good agreement with experimental values and ab initio calculation results, which underscores the validity of the presented method.

  4. Modeling transient streaming potentials in falling-head permeameter tests.

    Science.gov (United States)

    Malama, Bwalya; Revil, André

    2014-01-01

    We present transient streaming potential data collected during falling-head permeameter tests performed on samples of two sands with different physical and chemical properties. The objective of the work is to estimate hydraulic conductivity (K) and the electrokinetic coupling coefficient (Cl ) of the sand samples. A semi-empirical model based on the falling-head permeameter flow model and electrokinetic coupling is used to analyze the streaming potential data and to estimate K and Cl . The values of K estimated from head data are used to validate the streaming potential method. Estimates of K from streaming potential data closely match those obtained from the associated head data, with less than 10% deviation. The electrokinetic coupling coefficient was estimated from streaming potential vs. (1) time and (2) head data for both sands. The results indicate that, within limits of experimental error, the values of Cl estimated by the two methods are essentially the same. The results of this work demonstrate that a temporal record of the streaming potential response in falling-head permeameter tests can be used to estimate both K and Cl . They further indicate the potential for using transient streaming potential data as a proxy for hydraulic head in hydrogeology applications. © 2013, National Ground Water Association.

  5. Abdominal CT Does Not Improve Outcome for Children with Suspected Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Danielle I. Miano

    2015-12-01

    Full Text Available Introduction: Acute appendicitis in children is a clinical diagnosis, which often requires preoperative confirmation with either ultrasound (US or computed tomography (CT studies. CTs expose children to radiation, which may increase the lifetime risk of developing malignancy. US in the pediatric population with appropriate clinical follow up and serial exam may be an effective diagnostic modality for many children without incurring the risk of radiation. The objective of the study was to compare the rate of appendiceal rupture and negative appendectomies between children with and without abdominal CTs; and to evaluate the same outcomes for children with and without USs to determine if there were any associations between imaging modalities and outcomes. Methods: We conducted a retrospective chart review including emergency department (ED and inpatient records from 1/1/2009–2/31/2010 and included patients with suspected acute appendicitis. Results: 1,493 children, aged less than one year to 20 years, were identified in the ED with suspected appendicitis. These patients presented with abdominal pain who had either a surgical consult or an abdominal imaging study to evaluate for appendicitis, or were transferred from an outside hospital or primary care physician office with the stated suspicion of acute appendicitis. Of these patients, 739 were sent home following evaluation in the ED and did not return within the subsequent two weeks and were therefore presumed not to have appendicitis. A total of 754 were admitted and form the study population, of which 20% received a CT, 53% US, and 8% received both. Of these 57%, 95% CI [53.5,60.5] had pathology-proven appendicitis. Appendicitis rates were similar for children with a CT (57%, 95% CI [49.6,64.4] compared to those without (57%, 95% CI [52.9,61.0]. Children with perforation were similar between those with a CT (18%, 95% CI [12.3,23.7] and those without (13%, 95% CI [10.3,15.7]. The proportion of

  6. Constraints on constituent quark masses from potential models

    International Nuclear Information System (INIS)

    Silvestre-Brac, B.

    1998-01-01

    Starting from reasonable hypotheses, the magnetic moments for the baryons are revisited dat the light of general space wave functions. They allow to put very severe bounds on the quark masses as derived from usual potential models. The experimental situation cannot be explained in the framework of such models. (author)

  7. A Parametric Computational Model of the Action Potential of Pacemaker Cells.

    Science.gov (United States)

    Ai, Weiwei; Patel, Nitish D; Roop, Partha S; Malik, Avinash; Andalam, Sidharta; Yip, Eugene; Allen, Nathan; Trew, Mark L

    2018-01-01

    A flexible, efficient, and verifiable pacemaker cell model is essential to the design of real-time virtual hearts that can be used for closed-loop validation of cardiac devices. A new parametric model of pacemaker action potential is developed to address this need. The action potential phases are modeled using hybrid automaton with one piecewise-linear continuous variable. The model can capture rate-dependent dynamics, such as action potential duration restitution, conduction velocity restitution, and overdrive suppression by incorporating nonlinear update functions. Simulated dynamics of the model compared well with previous models and clinical data. The results show that the parametric model can reproduce the electrophysiological dynamics of a variety of pacemaker cells, such as sinoatrial node, atrioventricular node, and the His-Purkinje system, under varying cardiac conditions. This is an important contribution toward closed-loop validation of cardiac devices using real-time heart models.

  8. The fusion of heavy ions in an interaction potential model

    International Nuclear Information System (INIS)

    Zipper, W.

    1980-01-01

    The paper contains the problems connected with fusion processes in heavy ions collision. Results of experimental fusion data for reactions: 9 Be + 12 C, 6 Li + 28 Si, 9 Be + 28 Si, 12 C + 28 Si, 12 C + 16 O and 16 O + 16 O are presented. Comparison of measured fusion cross sections with predictions of the fusion potential model have been made. The validity of this model for both light systems, like 9 Be + 12 C and heavy systems, like 35 Cl + 62 Ni, have been discussed. In conclusion, it should be stated that fusion cross sections could be correctly predicted by the potential model with a potential describing the elastic scattering data. (author)

  9. Clinical Characteristics, Management, and Outcomes of Suspected Poststroke Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Sylvia Marie Biso

    2017-01-01

    Full Text Available Background. Acute coronary syndrome (ACS can complicate acute ischemic stroke, causing significant morbidity and mortality. To date, literatures that describe poststroke acute coronary syndrome and its morbidity and mortality burden are lacking. Methods. This is a single center, retrospective study where clinical characteristics, cardiac evaluation, and management of patients with suspected poststroke ACS were compared and analyzed for their association with inpatient mortality and 1-year all-cause mortality. Results. Of the 82 patients, 32% had chest pain and 88% had ischemic ECG changes; mean peak troponin level was 18, and mean ejection fraction was 40%. The medical management group had older individuals (73 versus 67 years, p<0.05, lower mean peak troponin levels (12 versus 49, p<0.05, and lower mean length of stay (12 versus 25 days, p<0.05 compared to those who underwent stent or CABG. Troponin levels were significantly associated with 1-year all-cause mortality. Conclusion. Age and troponin level appear to play a role in the current clinical decision making for patient with suspected poststroke ACS. Troponin level appears to significantly correlate with 1-year all-cause mortality. In the management of poststroke acute coronary syndrome, optimal medical therapy had similar inpatient and all-cause mortality compared to PCI and/or CABG.

  10. Clinical Characteristics, Management, and Outcomes of Suspected Poststroke Acute Coronary Syndrome

    Science.gov (United States)

    De Venecia, Toni Anne; Wongrakpanich, Supakanya; Rodriguez-Ziccardi, Mary; Yadlapati, Sujani; Kishlyansky, Marina; Rammohan, Harish Seetha; Figueredo, Vincent M.

    2017-01-01

    Background Acute coronary syndrome (ACS) can complicate acute ischemic stroke, causing significant morbidity and mortality. To date, literatures that describe poststroke acute coronary syndrome and its morbidity and mortality burden are lacking. Methods This is a single center, retrospective study where clinical characteristics, cardiac evaluation, and management of patients with suspected poststroke ACS were compared and analyzed for their association with inpatient mortality and 1-year all-cause mortality. Results Of the 82 patients, 32% had chest pain and 88% had ischemic ECG changes; mean peak troponin level was 18, and mean ejection fraction was 40%. The medical management group had older individuals (73 versus 67 years, p < 0.05), lower mean peak troponin levels (12 versus 49, p < 0.05), and lower mean length of stay (12 versus 25 days, p < 0.05) compared to those who underwent stent or CABG. Troponin levels were significantly associated with 1-year all-cause mortality. Conclusion Age and troponin level appear to play a role in the current clinical decision making for patient with suspected poststroke ACS. Troponin level appears to significantly correlate with 1-year all-cause mortality. In the management of poststroke acute coronary syndrome, optimal medical therapy had similar inpatient and all-cause mortality compared to PCI and/or CABG. PMID:29130017

  11. Quality of CT pulmonary angiography for suspected pulmonary embolus in pregnancy

    International Nuclear Information System (INIS)

    U-King-Im, Jean Marie; Freeman, Susan J.; Boylan, Teresa; Cheow, Heok K.

    2008-01-01

    The main objective of this study was to assess the quality of CT pulmonary angiography (CTPA) for suspected pulmonary embolus (PE) in the pregnant population. We retrospectively identified 40 consecutive pregnant patients who underwent CTPA from January 2005 to December 2006. Forty consecutive age-matched non-pregnant women were used as a control group. Studies were subjectively graded according to overall image quality by two readers in consensus, in randomised and blinded manner. Moreover, contrast enhancement of pulmonary arteries was subjectively and objectively evaluated. The proportion of sub-optimal studies was more than three times higher in the pregnant group (27.5%, n = 11) compared with the non-pregnant group (7.5%, n = 3; p = 0.015). Mean contrast enhancement was consistently higher in the non-pregnant group compared with pregnant group, both subjectively and objectively. The percentage of inadequately opacified vascular segments was more than two times higher in the pregnant group (28.7%, n = 264) than in the non-pregnant group (13.3%, n 122; p = 0.0001). The incidence of sub-optimal CTPA studies is higher in pregnancy when compared with an age-matched non-pregnant control group. In addition to radiation issues, this should also be considered when implementing diagnostic strategies for suspected PE in pregnancy. (orig.)

  12. Influence on intraocular pressure of the postural change and daily activities in the early morning in suspected glaucoma patients

    Directory of Open Access Journals (Sweden)

    Ting Chen

    2014-05-01

    Full Text Available AIM:To evaluate the influence on intraocular pressure(IOPof the postural change and daily activities in the early morning in suspected glaucoma patients.METHODS:The supine and sitting IOP were measured and analyzed on 51 suspected glaucoma patients(100 eyeswith Icare rebound tonometer before and after getting up and daily activities in the early morning. RESULTS: The mean of sitting IOP of 51 patients was 17.12±4.53mmHg, which was significantly lower than the mean of supine IOP(19.14±5.51mmHg. The mean of IOP before and after daily activity of 51 patients were 17.12±4.53mmHg and 14.44±3.90mmHg respectively, which showed significantly difference. CONCLUSION:Postural change and daily activities can result in significant changes of IOP in suspected glaucoma patients.

  13. Efficacy of Patient Selection for Diagnostic Coronary Angiography in Suspected Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Francisco Flávio Costa Filho

    2015-11-01

    Full Text Available AbstractBackground:Guidelines recommend that in suspected stable coronary artery disease (CAD, a clinical (non-invasive evaluation should be performed before coronary angiography.Objective:We assessed the efficacy of patient selection for coronary angiography in suspected stable CAD.Methods:We prospectively selected consecutive patients without known CAD, referred to a high-volume tertiary center. Demographic characteristics, risk factors, symptoms and non-invasive test results were correlated to the presence of obstructive CAD. We estimated the CAD probability based on available clinical data and the incremental diagnostic value of previous non-invasive tests.Results:A total of 830 patients were included; median age was 61 years, 49.3% were males, 81% had hypertension and 35.5% were diabetics. Non-invasive tests were performed in 64.8% of the patients. At coronary angiography, 23.8% of the patients had obstructive CAD. The independent predictors for obstructive CAD were: male gender (odds ratio [OR], 3.95; confidence interval [CI] 95%, 2.70 - 5.77, age (OR for 5 years increment, 1.15; CI 95%, 1.06 - 1.26, diabetes (OR, 2.01; CI 95%, 1.40 - 2.90, dyslipidemia (OR, 2.02; CI 95%, 1.32 - 3.07, typical angina (OR, 2.92; CI 95%, 1.77 - 4.83 and previous non-invasive test (OR 1.54; CI 95% 1.05 - 2.27.Conclusions:In this study, less than a quarter of the patients referred for coronary angiography with suspected CAD had the diagnosis confirmed. A better clinical and non-invasive assessment is necessary, to improve the efficacy of patient selection for coronary angiography.

  14. Decay rates of quarkonia and potential models

    International Nuclear Information System (INIS)

    Rai, Ajay Kumar; Pandya, J N; Vinodkumar, P C

    2005-01-01

    The decay rates of cc-bar and b-barb mesons have been studied with contributions from different correction terms. The corrections based on hard processes involved in the decays are quantitatively studied in the framework of different phenomenological potential models

  15. Quantifying sociodemographic and income disparities in medical therapy and lifestyle among symptomatic patients with suspected coronary artery disease: a cross-sectional study in North America

    Science.gov (United States)

    Ladapo, Joseph A; Coles, Adrian; Dolor, Rowena J; Mark, Daniel B; Cooper, Lawton; Lee, Kerry L; Goldberg, Jonathan; Shapiro, Michael D; Hoffmann, Udo; Douglas, Pamela S

    2017-01-01

    Objectives To evaluate potential gaps in preventive medical therapy and healthy lifestyle practices among symptomatic patients with suspected coronary artery disease (CAD) seeing primary care physicians and cardiologists and how gaps vary by sociodemographic characteristics and baseline cardiovascular risk. Design Cross-sectional study assessing potential preventive gaps. Participants 10 003 symptomatic outpatients evaluated by primary care physicians, cardiologists or other specialists for suspected CAD. Setting PROspective Multicenter Imaging Study for Evaluation of Chest Painfrom 2010 to 2014. Measures Primary measures were absence of an antihypertensive, statin or angiotensin-converting enzyme inhibitor/angiotensin receptor blocker for renal protection in patients with hypertension, dyslipidaemia or diabetes, respectively, and being sedentary, smoking or being obese. Results Preventive treatment gaps affected 14% of patients with hypertension, 36% of patients with dyslipidaemia and 32% of patients with diabetes. Overall, 49% of patients were sedentary, 18% currently smoked and 48% were obese. Women were significantly more likely to not take a statin for dyslipidaemia and to be sedentary. Patients with lower socioeconomic status were also significantly more likely to not take a statin. Compared with Whites, Blacks were significantly more likely to be obese, while Asians were less likely to smoke or be obese. High-risk patients sometimes experienced larger preventive care gaps than low-risk patients. For patients with dyslipidaemia, the presence of a treatment gap was associated with a higher risk of an adverse event (HR 1.35, 95% CI 1.02 to 1.82). Conclusions Among contemporary, symptomatic patients with suspected CAD, significant gaps exist in preventive care and lifestyle practices, and high-risk patients sometimes had larger gaps. Differences by sex, age, race/ethnicity, socioeconomic status and geography are modest but contribute to disparities and have

  16. First report of suspected ethylene glycol poisoning in 2 dogs in South Africa : clinical communication

    Directory of Open Access Journals (Sweden)

    N. Keller

    2005-06-01

    Full Text Available Ethylene glycol (anti-freeze toxicity is a serious emergency in both veterinary and human medicine. Ethylene glycol (E/G is the active anti-freeze principle in radiator water additives. It is odourless, colourless and has a sweet taste. As little as 5 mℓ or 20 mℓ is sufficient to kill a cat or a dog, respectively. Ethylene glycol is rapidly absorbed and metabolised in the liver to oxalate, which is deposited as calcium oxalate in the kidneys causing irreversible damage. This report describes 2 dogs that were suspected to have ingested ethylene glycol. The report contains a description of the 3 stages of ethylene glycol toxicity as well as a short discussion of the treatment. Public awareness about the dangers of anti-freeze will help in limiting exposure of pets and humans to this potentially fatal toxin. Veterinarians need to be aware of anti-freeze toxicity as delayed recognition and treatment will lead to the death of the patient.

  17. Equivalent magnetic vector potential model for low-frequency magnetic exposure assessment

    Science.gov (United States)

    Diao, Y. L.; Sun, W. N.; He, Y. Q.; Leung, S. W.; Siu, Y. M.

    2017-10-01

    In this paper, a novel source model based on a magnetic vector potential for the assessment of induced electric field strength in a human body exposed to the low-frequency (LF) magnetic field of an electrical appliance is presented. The construction of the vector potential model requires only a single-component magnetic field to be measured close to the appliance under test, hence relieving considerable practical measurement effort—the radial basis functions (RBFs) are adopted for the interpolation of discrete measurements; the magnetic vector potential model can then be directly constructed by summing a set of simple algebraic functions of RBF parameters. The vector potentials are then incorporated into numerical calculations as the equivalent source for evaluations of the induced electric field in the human body model. The accuracy and effectiveness of the proposed model are demonstrated by comparing the induced electric field in a human model to that of the full-wave simulation. This study presents a simple and effective approach for modelling the LF magnetic source. The result of this study could simplify the compliance test procedure for assessing an electrical appliance regarding LF magnetic exposure.

  18. Suspected nitrite poisoning in pigs caused by Capsella bursa-pastoris (L. Medik. ('herderstassie', shepherd's purse : case report

    Directory of Open Access Journals (Sweden)

    W.J. Wiese

    2001-07-01

    Full Text Available Nitrite poisoning in pigs was suspected when 4 of 18 pigs died in a piggery near Ellisras in the Northern Province. The pigs showed typical brownish discolouration of the blood at autopsy. It was established that they ingested vegetable tops and weeds from the adjacent garden as part of their daily ration. Of the available plants, only Capsella bursa-pastoris contained nitrites. The drinking water and some of the other plants tested positive for nitrates but not for nitrites. This is the first report of suspected nitrite poisoning in pigs caused by Capsella bursa-pastoris.

  19. Transient accelerating scalar models with exponential potentials

    International Nuclear Information System (INIS)

    Cui Wen-Ping; Zhang Yang; Fu Zheng-Wen

    2013-01-01

    We study a known class of scalar dark energy models in which the potential has an exponential term and the current accelerating era is transient. We find that, although a decelerating era will return in the future, when extrapolating the model back to earlier stages (z ≳ 4), scalar dark energy becomes dominant over matter. So these models do not have the desired tracking behavior, and the predicted transient period of acceleration cannot be adopted into the standard scenario of the Big Bang cosmology. When couplings between the scalar field and matter are introduced, the models still have the same problem; only the time when deceleration returns will be varied. To achieve re-deceleration, one has to turn to alternative models that are consistent with the standard Big Bang scenario.

  20. Parity doublers in chiral potential quark models

    International Nuclear Information System (INIS)

    Kalashnikova, Yu. S.; Nefediev, A. V.; Ribeiro, J. E. F. T.

    2007-01-01

    The effect of spontaneous breaking of chiral symmetry over the spectrum of highly excited hadrons is addressed in the framework of a microscopic chiral potential quark model (Generalised Nambu-Jona-Lasinio model) with a vectorial instantaneous quark kernel of a generic form. A heavy-light quark-antiquark bound system is considered, as an example, and the Lorentz nature of the effective light-quark potential is identified to be a pure Lorentz-scalar, for low-lying states in the spectrum, and to become a pure spatial Lorentz vector, for highly excited states. Consequently, the splitting between the partners in chiral doublets is demonstrated to decrease fast in the upper part of the spectrum so that neighboring states of an opposite parity become almost degenerate. A detailed microscopic picture of such a 'chiral symmetry restoration' in the spectrum of highly excited hadrons is drawn and the corresponding scale of restoration is estimated

  1. Clinical value of FDG-PET/CT in suspected paraneoplastic syndromes: a retrospective analysis of 137 patients

    Energy Technology Data Exchange (ETDEWEB)

    Bjoern Kristensen, Stine; Hess, Soeren; Petersen, Henrik; Hoeilund-Carlsen, Poul Flemming [Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark)

    2015-12-15

    Paraneoplastic syndromes (PNS) are relatively infrequent manifestations appearing before or after a cancer declares itself. Autoimmune mechanisms may be involved, but their cause and pathogenesis are often unknown. Due to disparity of symptoms, PNS remain a major diagnostic challenge. We examined the value of FDG-PET/CT for ruling in or out malignancy in a heterogeneous group of patients with suspected PNS. We retrospectively extracted data from all patients referred 2009-2013 with suspected PNS. Data included age, sex, follow-up period, scan report, further diagnostic procedures, and final clinical diagnosis. Conclusions of the scan reports were compared to the final follow-up outcome as determined during an average follow-up of 31 months (range 6-51.5) in patients who were not diagnosed with cancer in immediate continuation of a positive PET/CT scan. A total of 137 patients were included. Main causes for referral were neurological (n = 67), rheumatological (n = 25), dermatological (n = 18), nephrological (n = 6), haematological (n = 2), abnormal biochemistry (n = 11), and others (n = 8). The cancer prevalence was 8.8 %. The FDG-PET/CT results were as follows: nine true positives, 22 false positives, 103 true negatives, and three false negatives. Corresponding diagnostic values were: sensitivity 75 %, specificity 82 %, accuracy 82 %, and positive and negative predictive values of 29 % and 97 %, respectively. FDG-PET/CT has in patients with suspected PNS an impressively high negative predictive value and may be of value in ruling out PNS, the more so, the more the number of false positives can be minimized or used in differential diagnosis. We believe that FDG-PET/CT may become an important adjunct to the work-up and triage of patients with suspected PNS. (orig.)

  2. Comparison of RPR 'teardrop' card test, VDRL and FTA-ABS tests results on sera from persons with suspected yaws in Columbia.

    Science.gov (United States)

    Hopkins, D R; Florez, D

    1977-08-01

    A small study comparing results of the rapid plasma reagin (RPR) teardrop card test performed in the field, with results of Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody absorption (FTA-ABS) tests performed in the laboratory on venous blood specimens from the same suspected yaws patients was undertaken in Columbia in July 1975. The results suggest that the RPR teardrop card test may be used to screen for infectious, or potentially infectious, yaws patients under field conditions, but that it will not reliably detect patients with VDRL titres of 1:2 or less, or all patients in whom sera are reactive in the FTA-ABS test.

  3. Semirelativistic potential model for three-gluon glueballs

    International Nuclear Information System (INIS)

    Mathieu, Vincent; Semay, Claude; Silvestre-Brac, Bernard

    2008-01-01

    The three-gluon glueball states are studied with the generalization of a semirelativistic potential model giving good results for two-gluon glueballs. The Hamiltonian depends only on 3 parameters fixed on two-gluon glueball spectra: the strong coupling constant, the string tension, and a gluon size which removes singularities in the potential. The Casimir scaling determines the structure of the confinement. Our results are in good agreement with other approaches and lattice calculation for the odderon trajectory but differ strongly from lattice in the J +- sector. We propose a possible explanation for this problem.

  4. A computer simulation of a potential derived from the gay-berne potential for lattice model

    Directory of Open Access Journals (Sweden)

    Habtamu Zewdie

    2000-06-01

    Full Text Available The lattice model of elongated molecules interacting via a potential derived from the Gay-Berne pair potential is proposed. We made a systematic study of the effect of varying the molecular elongation and intermolecular vector orientation dependence of the pair potential on the thermodynamic as well as the structural properties of liquid crystals. A Monte Carlo simulations of molecules placed at the site of a simple cubic lattice and interacting via the modified Gay-Berne potential with its nearest neighbours is performed. The internal energy, heat capacity, angular pair correlation function and scalar order parameter are obtained. The results are compared against predictions of molecular field theory, experimental results and that of other related simulations wherever possible. It is shown that for more elongated molecules the nematic-isotropic transition becomes stronger first order transition. For a given molecular elongation as the intermolecular vector orientation dependence becomes larger the nematic-isotropic transition becomes a stronger first order transition as measured by the rate of change of the order parameter and the divergence of the heat capacity. Scaling the potential well seems to have dramatic change on the effect of the potential well anisotropy on trends of nematic-isotropic transition temperature and divergence of the heat capacity. It is shown that the behaviour of many nematics can be described by proposed model with the elongation ratio of molecules and potential well anisotropy ranging from 3 to 5.

  5. A method based on temporal concept analysis for detecting and profiling human trafficking suspects

    NARCIS (Netherlands)

    Poelmans, J.; Elzinga, P.; Viaene, S.; Dedene, G.; Hamza, M.H.

    2010-01-01

    Human trafficking and forced prostitution are a serious problem for the Amsterdam-Amstelland police (the Netherlands). In this paper, we present a method based on Temporal Concept Analysis for detecting and profiling human trafficking suspects. Using traditional Formal Concept Analysis, we first

  6. Magnetic resonance imaging in the evaluation of suspected osteonecrosis of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Pollack, M S; Dalinka, M K; Kressel, H Y; Spritzer, C E; Lotke, P A

    1987-02-01

    Magnetic resonance imaging (MRI) was performed on 19 patients with suspected or proven osteonecrosis of the knee. The results were compared to radionuclide and plain radiographic studies when possible. The patients were grouped into one of three categories: patients with disease predisposing them to osteonecrosis (e.g. systemic lupus erythematosus (SLE), steroid use, and renal transplants), older patients without risk factors with acute onset of symptoms, and patients with knee pain months or years following trauma. In six patients with symptoms and predisposing diseases, MRI was abnormal in four cases, all of whom had bilateral abnormalities. In the ten older patients with classical symptoms, MRI was abnormal in seven, and bilateral abnormalities were present in three patients. The three patients with a history of antecedent trauma had normal MRI studies. Two patients with history and scintigraphic evidence of osteonecrosis had negative MRI scans. MRI may be of value in patients with suspected or proven osteonecrosis of the knee by demonstrating bilateral disease in patients with unilateral symptoms, showing the extent of involvement, and establishing the presence or absence of bone marrow changes in patients with positive bone scans and negative plain films.

  7. Coronary 64-slice CT angiography predicts outcome in patients with known or suspected coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Gaemperli, Oliver; Valenta, Ines; Schepis, Tiziano [University Hospital Zurich NUK C 32, Cardiovascular Center, Zurich (Switzerland); Husmann, Lars; Scheffel, Hans; Desbiolles, Lotus; Leschka, Sebastian; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich NUK C 32, Cardiovascular Center, Zurich (Switzerland); University of Zurich, Zurich Center for Integrative Human Physiology (ZIHP), Zurich (Switzerland)

    2008-06-15

    The aim of this study was to assess the prognostic value of 64-slice CT angiography (CTA) in patients with known or suspected coronary artery disease (CAD). Sixty-four-slice coronary CTA was performed in 220 patients [mean age 63 {+-} 11 years, 77 (35%) female] with known or suspected CAD. CTA images were analyzed with regard to the presence and number of coronary lesions. Patients were followed-up for the occurrence of the following clinical endpoints: death, nonfatal myocardial infarction, unstable angina, and coronary revascularization. During a mean follow-up of 14 {+-} 4 months, 59 patients (27%) reached at least one of the predefined clinical endpoints. Patients with abnormal coronary arteries on CTA (i.e., presence of coronary plaques) had a 1st-year event rate of 34%, whereas in patients with normal coronary arteries no events occurred (event rate, 0%, p < 0.001). Similarly, obstructive lesions ({>=}50% luminal narrowing) on CTA were associated with a high first-year event rate (59%) compared to patients without stenoses (3%, p < 0.001). The presence of obstructive lesions was a significant independent predictor of an adverse cardiac outcome. Sixty-four-slice CTA predicts cardiac events in patients with known or suspected CAD. Conversely, patients with normal coronary arteries on CTA have an excellent mid-term prognosis. (orig.)

  8. [18F]Fluorodeoxyglucose (FDG)-Positron Emission Tomography (PET)/Computed Tomography (CT) in Suspected Recurrent Breast Cancer

    DEFF Research Database (Denmark)

    Hildebrandt, Malene Grubbe; Gerke, Oke; Baun, Christina

    2016-01-01

    PURPOSE: To prospectively investigate the diagnostic accuracy of [(18)F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) with dual-time-point imaging, contrast-enhanced CT (ceCT), and bone scintigraphy (BS) in patients with suspected breast cancer recurrence....... PATIENTS AND METHODS: One hundred women with suspected recurrence of breast cancer underwent 1-hour and 3-hour FDG-PET/CT, ceCT, and BS within approximately 10 days. The study was powered to estimate the precision of the individual imaging tests. Images were visually interpreted using a four...

  9. Relation of body mass index to outcome in patients with known or suspected coronary artery disease.

    Science.gov (United States)

    Galal, Wael; van Domburg, Ron T; Feringa, Harm H H; Schouten, Olaf; Elhendy, Abdou; Bax, Jeroen J; Awara, Adel M M; Klein, Jan; Poldermans, Don

    2007-06-01

    Increased body mass index (BMI), a parameter of total body fat content, is associated with an increased mortality in the general population. However, recent studies have shown a paradoxic relation between BMI and mortality in specific patient populations. This study investigated the association of BMI with long-term mortality in patients with known or suspected coronary artery disease. In a retrospective cohort study of 5,950 patients (mean age 61 +/- 13 years; 67% men), BMI, cardiovascular risk markers (age, gender, hypertension, diabetes, current smoking, angina pectoris, old myocardial infarction, heart failure, hypercholesterolemia, and previous coronary revascularization), and outcome were noted. The patient population was categorized as underweight, normal, overweight, and obese based on BMI according to the World Health Organization classification. Mean follow-up time was 6 +/- 2.6 years. Incidences of long-term mortality in underweight, normal, overweight, and obese were 39%, 35%, 24%, and 20%, respectively. In a multivariate analysis model, the hazard ratio (HR) for mortality in underweight patients was 2.4 (95% confidence interval [CI] 1.7 to 3.7). Overweight and obese patients had a significantly lower mortality than patients with a normal BMI (HR 0.65, 95% CI 0.6 to 0.7, for overweight; HR 0.61, 95% CI 0.5 to 0.7, for obese patients). In conclusion, BMI is inversely related to long-term mortality in patients with known or suspected coronary artery disease. A lower BMI was an independent predictor of long-term mortality, whereas an improved outcome was observed in overweight and obese patients.

  10. Separable-potential model for the pion--nucleon interaction

    International Nuclear Information System (INIS)

    Nutt, W.T.

    1976-01-01

    A separable potential which fits the low and intermediate π-N scattering is proposed which is more convenient for application than those separable models which use Regge parameterizations of the very high energy phase shifts. The form factors for this model are equal to zero for momenta q greater than 1 GeV/c, and are expected to provide more reasonable off-shell behavior than the form factors obtained from those models based on the Regge extrapolation

  11. Non-frontal Model Based Approach to Forensic Face Recognition

    NARCIS (Netherlands)

    Dutta, A.; Veldhuis, Raymond N.J.; Spreeuwers, Lieuwe Jan

    2012-01-01

    In this paper, we propose a non-frontal model based approach which ensures that a face recognition system always gets to compare images having similar view (or pose). This requires a virtual suspect reference set that consists of non-frontal suspect images having pose similar to the surveillance

  12. A new generic model potential for mesogenic systems: square well line potential of variable range.

    Science.gov (United States)

    Varga, Szabolcs; Vesely, Franz J

    2009-11-21

    A single-site pair potential is derived to approximate the linear n-site square well interaction. The resulting square well line (SWL) potential is analytical, fairly smooth, and reproduces the distance and orientation dependence of the multisite pair energy. It contains only three control parameters n, L, and s(2), in addition to the units of length s(1) and energy epsilon. The advantages of the new model over the traditional potentials such as Gay-Berne and Kihara are that n, L, and s(2) are physically meaningful quantities and that no additional adjustable parameters are introduced. With the SWL potential even very long square well chain molecules may be treated in Monte Carlo (MC) simulations; moreover the model is well suited for perturbation theory. Using Onsager-like theories we test the effect of molecular elongation, temperature, and the range of the square well potential on the vapor-liquid and nematic-smectic A (NS) phase transitions. We find that the vapor-liquid binodal of the SWL fluid is in good agreement with MC results for square well dumbbells. For repulsive SWL particles, varying the interaction range s(2) results in a similar effect on the NS transition as the change in the ionic strength in a real suspension of fd viruses.

  13. The model of evaluation of innovative potential of enterprise

    Directory of Open Access Journals (Sweden)

    Ганна Ігорівна Заднєпровська

    2015-06-01

    Full Text Available The basic components of the enterprise’s innovative potential evaluation process are investigated. It is offered the conceptual model of evaluation of the innovative potential that includes: subjects, objects, purpose, provision of information, principles, methods, criteria, indicators. It is noted that the innovative capacity characterizes the transition from the current to the strategic level of innovation potential and, thus, characterizes the composition of objects from position of user

  14. Pre-admission antibiotics for suspected cases of meningococcal disease.

    Science.gov (United States)

    Sudarsanam, Thambu D; Rupali, Priscilla; Tharyan, Prathap; Abraham, Ooriapadickal Cherian; Thomas, Kurien

    2017-06-14

    Meningococcal disease can lead to death or disability within hours after onset. Pre-admission antibiotics aim to reduce the risk of serious disease and death by preventing delays in starting therapy before confirmation of the diagnosis. To study the effectiveness and safety of pre-admission antibiotics versus no pre-admission antibiotics or placebo, and different pre-admission antibiotic regimens in decreasing mortality, clinical failure, and morbidity in people suspected of meningococcal disease. We searched CENTRAL (6 January 2017), MEDLINE (1966 to 6 January 2017), Embase (1980 to 6 January 2017), Web of Science (1985 to 6 January 2017), LILACS (1982 to 6 January 2017), and prospective trial registries to January 2017. We previously searched CAB Abstracts from 1985 to June 2015, but did not update this search in January 2017. Randomised controlled trials (RCTs) or quasi-RCTs comparing antibiotics versus placebo or no intervention, in people with suspected meningococcal infection, or different antibiotics administered before admission to hospital or confirmation of the diagnosis. Two review authors independently assessed trial quality and extracted data from the search results. We calculated the risk ratio (RR) and 95% confidence interval (CI) for dichotomous data. We included only one trial and so did not perform data synthesis. We assessed the overall quality of the evidence using the GRADE approach. We found no RCTs comparing pre-admission antibiotics versus no pre-admission antibiotics or placebo. We included one open-label, non-inferiority RCT with 510 participants, conducted during an epidemic in Niger, evaluating a single dose of intramuscular ceftriaxone versus a single dose of intramuscular long-acting (oily) chloramphenicol. Ceftriaxone was not inferior to chloramphenicol in reducing mortality (RR 1.21, 95% CI 0.57 to 2.56; N = 503; 308 confirmed meningococcal meningitis; 26 deaths; moderate-quality evidence), clinical failures (RR 0.83, 95% CI 0.32 to

  15. The Watanabe model for 6Li-nucleus optical potential

    International Nuclear Information System (INIS)

    Abul-Magd, A.Y.; Rabie, A.; El-Gazzar, M.A.

    1980-09-01

    Optical potentials for the scattering of 6 Li projectiles are calculated using the Watanabe model and an α+d cluster model wave function for 6 Li. Reasonable fits to the elastic differential cross-section and vector polarization are obtained. (author)

  16. Clinical feasibility of two-step streptavidin/111In-biotin scintigraphy in patients with suspected vertebral osteomyelitis

    International Nuclear Information System (INIS)

    Lazzeri, Elena; Erba, Paola A.; Volterrani, Duccio; Bottoni, Antonio; Mariani, Giuliano; Pauwels, Ernest K.J.; Manca, Mario; Bodei, Lisa; Trippi, Donatella; Cristofani, Renza; Consoli, Vincenzo; Palestro, Christopher J.

    2004-01-01

    Streptavidin accumulates at sites of inflammation and infection as a result of increased capillary permeability. In addition to being utilised by bacteria for their own growth, biotin forms a stable, high-affinity non-covalent complex with avidin. The objective of this investigation was to determine the diagnostic performance of two-step streptavidin/ 111 In-biotin imaging for evaluating patients with suspected vertebral osteomyelitis. We evaluated 55 consecutive patients with suspected vertebral osteomyelitis (34 women and 21 men aged 27-86 years), within 2 weeks after the onset of clinical symptoms. Thirty-two of the patients underwent magnetic resonance imaging (MRI) and 24, computed tomography (CT). DTPA-conjugated biotin was radiolabelled by incubating 500 μg of DTPA-biotin with 111 MBq of 111 In-chloride. Two-step scintigraphy was performed by first infusing 3 mg streptavidin intravenously, followed 4 h later by 111 In-biotin. Imaging was begun 60 min later. Streptavidin/ 111 In-biotin scintigraphy was positive in 32/34 patients with spinal infection (94.12% sensitivity). The study was negative in 19/21 patients without infection (95.24% specificity). The corresponding results for MRI and CT were 54.17% and 35.29% (sensitivity), and 75% and 57.14% (specificity), respectively. All statistical parameters of diagnostic performance (Youden's J index, kappa measure of agreement with correct classification, accuracy, sensitivity, specificity, positive likelihood and negative likelihood) were clearly better for streptavidin/ 111 In-biotin scintigraphy than for either MRI or CT. Streptavidin/ 111 In-biotin scintigraphy is highly sensitive and specific for detecting vertebral osteomyelitis in the first 2 weeks after the onset of clinical symptoms, and is potentially very useful for guiding clinical decisions on instituting appropriate therapy. (orig.)

  17. The clinical utility of FDG PET/CT among solid organ transplant recipients suspected of malignancy or infection

    Energy Technology Data Exchange (ETDEWEB)

    Wareham, Neval E.; Lundgren, J.D. [Rigshospitalet, Centre for Health and Infectious Disease Research (CHIP), Department of Infectious Diseases, Copenhagen (Denmark); Cunha-Bang, C. da; Sengeloev, H. [Rigshospitalet, Department of Haematology, Copenhagen (Denmark); Gustafsson, F.; Iversen, M. [Rigshospitalet, Department of Cardiology, Copenhagen (Denmark); Johannesen, H.H.; Kjaer, A.; Fischer, B.M. [Rigshospitalet, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen (Denmark); Rasmussen, A. [Rigshospitalet, Department of Surgical Gastroenterology, Copenhagen (Denmark); Soerensen, S.S. [Rigshospitalet, Department of Nephrology, Copenhagen (Denmark)

    2017-03-15

    Solid organ transplant (SOT) recipients are at high risk of developing infections and malignancies. {sup 18}F-FDG PET/CT may enable timely detection of these diseases and help to ensure early intervention. We aimed to describe the clinical utility of FDG PET/CT in consecutive, diagnostic unresolved SOT recipients transplanted from January 2004 to May 2015. Recipients with a post-transplant FDG PET/CT performed as part of diagnostic work-up were included. Detailed chart reviews were done to extract relevant clinical information and determine the final diagnosis related to the FDG PET/CT. Based on a priori defined criteria and the final diagnosis, results from each scan were classified as true or false, and diagnostic values determined. Among the 1,814 recipients in the cohort, 145 had an FDG PET/CT performed; 122 under the indication of diagnostically unresolved symptoms with a suspicion of malignancy or infection. The remaining (N = 23) had an FDG PET/CT to follow-up on a known disease or to stage a known malignancy. The 122 recipients underwent a total of 133 FDG PET/CT scans performed for a suspected malignancy (66 %) or an infection (34 %). Sensitivity, specificity, and positive and negative predictive values of the FDG PET/CT in diagnosing these conditions were 97, 84, 87, and 96 %, respectively. FDG PET/CT is an accurate diagnostic tool for the work-up of diagnostic unresolved SOT recipients suspected of malignancy or infection. The high sensitivity and NPV underlines the potential usefulness of PET/CT for excluding malignancy or focal infections in this often complex clinical situation. (orig.)

  18. Reliability of Examination Findings in Suspected Community-Acquired Pneumonia.

    Science.gov (United States)

    Florin, Todd A; Ambroggio, Lilliam; Brokamp, Cole; Rattan, Mantosh S; Crotty, Eric J; Kachelmeyer, Andrea; Ruddy, Richard M; Shah, Samir S

    2017-09-01

    The authors of national guidelines emphasize the use of history and examination findings to diagnose community-acquired pneumonia (CAP) in outpatient children. Little is known about the interrater reliability of the physical examination in children with suspected CAP. This was a prospective cohort study of children with suspected CAP presenting to a pediatric emergency department from July 2013 to May 2016. Children aged 3 months to 18 years with lower respiratory signs or symptoms who received a chest radiograph were included. We excluded children hospitalized ≤14 days before the study visit and those with a chronic medical condition or aspiration. Two clinicians performed independent examinations and completed identical forms reporting examination findings. Interrater reliability for each finding was reported by using Fleiss' kappa (κ) for categorical variables and intraclass correlation coefficient (ICC) for continuous variables. No examination finding had substantial agreement (κ/ICC > 0.8). Two findings (retractions, wheezing) had moderate to substantial agreement (κ/ICC = 0.6-0.8). Nine findings (abdominal pain, pleuritic pain, nasal flaring, skin color, overall impression, cool extremities, tachypnea, respiratory rate, and crackles/rales) had fair to moderate agreement (κ/ICC = 0.4-0.6). Eight findings (capillary refill time, cough, rhonchi, head bobbing, behavior, grunting, general appearance, and decreased breath sounds) had poor to fair reliability (κ/ICC = 0-0.4). Only 3 examination findings had acceptable agreement, with the lower 95% confidence limit >0.4: wheezing, retractions, and respiratory rate. In this study, we found fair to moderate reliability of many findings used to diagnose CAP. Only 3 findings had acceptable levels of reliability. These findings must be considered in the clinical management and research of pediatric CAP. Copyright © 2017 by the American Academy of Pediatrics.

  19. SUSPECTED HYPERVITAMINOSIS D IN RED-RUMPED AGOUTI ( DASYPROCTA LEPORINA) RECEIVING A COMMERCIAL RODENT DIET.

    Science.gov (United States)

    Anderson, Kadie M; Lewandowski, Albert; Dennis, Patricia M

    2018-03-01

    An 8 yr, intact male red-rumped agouti ( Dasyprocta leporina) was evaluated for weight loss. Examination revealed poor body condition, hypercalcemia, elevated serum 25-hydroxyvitamin D, metastatic calcification of soft tissues, and hyperechoic kidneys. The diet, formulated for laboratory rodents, contained elevated levels of vitamin D 3 . Histopathology from a female conspecific that died 5 mo prior identified dystrophic mineralization and nephrosclerosis, suggestive of a vitamin D 3 toxicity. The male agouti responded well to a dietary reduction in vitamin D 3 and calcium. Six months into therapy, progressive renal failure was identified and was further managed with enalapril, phosphorus binders, and dietary manipulation. Suspected vitamin D 3 toxicity has been reported in pacas ( Cuniculus paca) and agouti and has been linked to exposure to New World primate diets. In this brief communication, an agouti developed suspected hypervitaminosis D after receiving a commercial rodent diet commonly fed to this species in captivity.

  20. GC-MS quantification of suspected volatile allergens in fragrances. 2. Data treatment strategies and method performances.

    Science.gov (United States)

    Bassereau, Maud; Chaintreau, Alain; Duperrex, Stéphanie; Joulain, Daniel; Leijs, Hans; Loesing, Gerd; Owen, Neil; Sherlock, Alan; Schippa, Christine; Thorel, Pierre-Jean; Vey, Matthias

    2007-01-10

    The performances of the GC-MS determination of suspected allergens in fragrance concentrates have been investigated. The limit of quantification was experimentally determined (10 mg/L), and the variability was investigated for three different data treatment strategies: (1) two columns and three quantification ions; (2) two columns and one quantification ion; and (3) one column and three quantification ions. The first strategy best minimizes the risk of determination bias due to coelutions. This risk was evaluated by calculating the probability of coeluting a suspected allergen with perfume constituents exhibiting ions in common. For hydroxycitronellal, when using a two-column strategy, this may statistically occur more than once every 36 analyses for one ion or once every 144 analyses for three ions in common.

  1. Evaluation of continuing education of family health strategy teams for the early identification of suspected cases of cancer in children.

    Science.gov (United States)

    Costa, Ana Maria Aranha Magalhaes; Magluta, Cynthia; Gomes Junior, Saint Clair

    2017-09-07

    This study evaluated the influence of continuing education of family health strategy teams by the Ronald McDonald Institute program on the early diagnosis of cancer in children and adolescents. The study applied Habicht's model to evaluate the adequacy and plausibility of continuing education by using as outcome the number of children with suspected cancer who were referred to the hospital of references in the 1 year before and 1 year after intervention and the number of patients referred by intervention group and control group family health strategy teams. Medical records from each hospital of reference were used to collect information of suspect cases of cancer. Descriptive analyses were performed using frequencies and mean values. Chi-square tests were used to assess statistically significant differences between the groups and periods by using p-values family health strategy teams that underwent the intervention referred 3.6 times more number of children to hospital of references than did the control group. Only the intervention group showed an increase in the number of confirmed cases. This evaluation of a continuing education program for early identification of pediatric cancer showed that the program was adequate in achieving the established goals and that the results could be attributed to the program.

  2. Calculation of real optical model potential for heavy ions in the framework of the folding model

    International Nuclear Information System (INIS)

    Goncharov, S.A.; Timofeyuk, N.K.; Kazacha, G.S.

    1987-01-01

    The code for calculation of a real optical model potential in the framework of the folding model is realized. The program of numerical Fourier-Bessel transformation based on Filon's integration rule is used. The accuracy of numerical calculations is ∼ 10 -4 for a distance interval up to a bout (2.5-3) times the size of nuclei. The potentials are calculated for interactions of 3,4 He with nuclei from 9 Be to 27 Al with different effective NN-interactions and densities obtained from electron scattering data. Calculated potentials are similar to phenomenological potentials in Woods-Saxon form. With calculated potentials the available elastic scattering data for the considered nuclei in the energy interval 18-56 MeV are analysed. The needed renormalizations for folding potentials are < or approx. 20%

  3. Analytical model for screening potential CO2 repositories

    Science.gov (United States)

    Okwen, R.T.; Stewart, M.T.; Cunningham, J.A.

    2011-01-01

    Assessing potential repositories for geologic sequestration of carbon dioxide using numerical models can be complicated, costly, and time-consuming, especially when faced with the challenge of selecting a repository from a multitude of potential repositories. This paper presents a set of simple analytical equations (model), based on the work of previous researchers, that could be used to evaluate the suitability of candidate repositories for subsurface sequestration of carbon dioxide. We considered the injection of carbon dioxide at a constant rate into a confined saline aquifer via a fully perforated vertical injection well. The validity of the analytical model was assessed via comparison with the TOUGH2 numerical model. The metrics used in comparing the two models include (1) spatial variations in formation pressure and (2) vertically integrated brine saturation profile. The analytical model and TOUGH2 show excellent agreement in their results when similar input conditions and assumptions are applied in both. The analytical model neglects capillary pressure and the pressure dependence of fluid properties. However, simulations in TOUGH2 indicate that little error is introduced by these simplifications. Sensitivity studies indicate that the agreement between the analytical model and TOUGH2 depends strongly on (1) the residual brine saturation, (2) the difference in density between carbon dioxide and resident brine (buoyancy), and (3) the relationship between relative permeability and brine saturation. The results achieved suggest that the analytical model is valid when the relationship between relative permeability and brine saturation is linear or quasi-linear and when the irreducible saturation of brine is zero or very small. ?? 2011 Springer Science+Business Media B.V.

  4. Two loop effective Kahler potential of (non)-renormalizable supersymmetric models

    International Nuclear Information System (INIS)

    Groot Nibbelink, S.; Nyawelo, T.S.

    2005-10-01

    We perform a supergraph computation of the effective Kahler potential at one and two loops for general four dimensional N=1 supersymmetric theories described by arbitrary Kahler potential, superpotential and gauge kinetic function. We only insist on gauge invariance of the Kahler potential and the superpotential as we heavily rely on its consequences in the quantum theory. However, we do not require gauge invariance for the gauge kinetic functions, so that our results can also be applied to anomalous theories that involve the Green-Schwarz mechanism. We illustrate our two loop results by considering a few simple models: the (non-)renormalizable Wess-Zumino model and Super Quantum Electrodynamics. (author)

  5. Overview of suspected adverse reactions to veterinary medicinal products reported in South Africa (March 2001 - February 2002 : report

    Directory of Open Access Journals (Sweden)

    V. Naidoo

    2002-07-01

    Full Text Available An overview of reports of suspected adverse drug reactions received by the Veterinary Pharmacovigilance and Medicines Information Centre during the period March 2001 to February 2002 is given. A total of 77 reports were received. The majority of reports involved suspected adverse reactions that occurred in dogs and cats. Most products implicated in the reports were Stock Remedies. The products were predominantly administered either by veterinarians or trained paraveterinary professionals. Although the majority of reports were received from veterinary pharmaceutical companies, the proportion of reports received directly from veterinarians increased compared with previous years.

  6. Cytogenetic dosimetry in suspected cases of ionizing radiation occupational exposure

    International Nuclear Information System (INIS)

    Ramalho, Adriana T.; Costa, Maria Lucia P.; Oliveira, Monica S.; Silva, Francisco Cesar A. da

    2001-01-01

    Cytogenetic dosimetry is very useful in routine as well as in serious accident situations in which exposed individuals do not wear physical dosimeters. Since 1984, the technique of cytogenetic dosimetry has been used as a routine in our laboratory at IRD/CNEN to complement the data of physical dosimetry. In the period from 1984 to 2000, 138 cases of occupational overexposure of individual dosimeters were investigated by us. In total, only in 36 of the 138 cases investigated the overexposure was confirmed by cytogenetic dosimetry. The data indicates a total confirmation index of just 26% of the suspected cases.(author)

  7. Spatial and frequency domain ring source models for the single muscle fiber action potential

    DEFF Research Database (Denmark)

    Henneberg, Kaj-åge; R., Plonsey

    1994-01-01

    In the paper, single-fibre models for the extracellular action potential are developed that will allow the potential to the evaluated at an arbitrary field point in the extracellular space. Fourier-domain models are restricted in that they evaluate potentials at equidistant points along a line...... parallel to the fibre axis. Consequently, they cannot easily evaluate the potential at the boundary nodes of a boundary-element electrode model. The Fourier-domain models employ axial-symmetric ring source models, and thereby provide higher accuracy that the line source model, where the source is lumped...... including anisotropy show that the spatial models require extreme care in the integration procedure owing to the singularity in the weighting functions. With adequate sampling, the spatial models can evaluate extracellular potentials with high accuracy....

  8. Modelling the potential distribution of Betula utilis in the Himalaya

    Directory of Open Access Journals (Sweden)

    Maria Bobrowski

    2017-07-01

    Full Text Available Developing sustainable adaptation pathways under climate change conditions in mountain regions requires accurate predictions of treeline shifts and future distribution ranges of treeline species. Here, we model for the first time the potential distribution of Betula utilis, a principal Himalayan treeline species, to provide a basis for the analysis of future range shifts. Our target species Betula utilis is widespread at alpine treelines in the Himalayan mountains, the distribution range extends across the Himalayan mountain range. Our objective is to model the potential distribution of B. utilis in relation to current climate conditions. We generated a dataset of 590 occurrence records and used 24 variables for ecological niche modelling. We calibrated Generalized Linear Models using the Akaike Information Criterion (AIC and evaluated model performance using threshold-independent (AUC, Area Under the Curve and threshold-dependent (TSS, True Skill Statistics characteristics as well as visual assessments of projected distribution maps. We found two temperature-related (Mean Temperature of the Wettest Quarter, Temperature Annual Range and three precipitation-related variables (Precipitation of the Coldest Quarter, Average Precipitation of March, April and May and Precipitation Seasonality to be useful for predicting the potential distribution of B. utilis. All models had high predictive power (AUC ≥ 0.98 and TSS ≥ 0.89. The projected suitable area in the Himalayan mountains varies considerably, with most extensive distribution in the western and central Himalayan region. A substantial difference between potential and real distribution in the eastern Himalaya points to decreasing competitiveness of B. utilis under more oceanic conditions in the eastern part of the mountain system. A comparison between the vegetation map of Schweinfurth (1957 and our current predictions suggests that B. utilis does not reach the upper elevational limit in

  9. Suspected resistance of MDT-MB in Multibacillary Leprosy of Hansen's disease: Two case reports

    Directory of Open Access Journals (Sweden)

    Yudo Irawan

    2016-12-01

    Full Text Available Resistance to multidrug therapy (MDT is one of the complications in the treatment of Hansen’s disease/Morbus Hansen (MH. There are two types of resistancy, which are primary and secondary. MDT-multibacillary (MB resistance must be suspected when no clinical improvement and the acid-fast bacilli (AFB index is not reduced after 12 months of therapy. A 28-year-old woman with paresthesia on her face, arms and legs since 2.5 years ago, accompanied by thickening of the right posterior tibial nerve. The AFB examination showed a bacteriological index (BI of 15/6 and morphological index (MI of 0.50%. The second case, a 42-year-old man came with paresthetic lesions on his face, chest, back, both arms and legs since 2 years ago, accompanied by thickening of ulnar and lateral peroneal nerve. The BI was 12/5 and the MI was 0.40%. Both patients were diagnosed with borderline lepromatous type of MH and received MDT-MB for 12 months. Diagnosis of suspected resistance was established because no clinical improvement or any significant decrease of AFB index after completing the MDT treatment. The patients had secondary resistance after polymerase chain reaction evaluation showed that they were still rifampicin-sensitive. There was clinical improvement and significant decrease in FAB index after the patients continued the MDT-MB treatment with 600 mg additional rifampicin. The diagnosis of bacterial resistance should be made based on clinical evaluation before completion of treatment. Based on the two case reports, the resistance suspected may be secondary. Treatment using additional regimen can be initiated once the resistance has been proven.

  10. V/P SPECT as a diagnostic tool for pregnant women with suspected pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Bajc, Marika; Olsson, Berit; Joegi, Jonas [Skaane University Hospital and Lund University, Clinical Physiology and Nuclear Medicine, Lund (Sweden); Gottsaeter, Anders [Skaane University Hospital, Vascular Diseases, Malmoe (Sweden); Hindorf, Cecilia [Skaane University Hospital, Radiation Physics, Lund (Sweden)

    2015-07-15

    The purpose of the study was to assess the prevalence of pulmonary embolism (PE) and other lung diseases among pregnant women with suspected PE and to calculate the radiation exposure to patient and fetus in this population. As a secondary aim, we evaluated the negative predictive value of a normal ventilation/perfusion single photon emission computed tomography (V/P SPECT) examination in pregnancy. We studied all 127 pregnant women who had suspected PE and had undergone V/P SPECT at our institution in the course of a 5-year period. Radiation exposure to patient and fetus and the negative predictive value of a normal V/P SPECT examination were also measured. V/P SPECT identified PE in 11 women (9 %). Moreover, in 15 women (12 %) the examination revealed pneumonia (in 2 cases in addition to PE) and in 1 woman signs of airway obstruction were revealed. Among the 116/127 women (91 %) where PE was ruled out by V/P SPECT, none was diagnosed subsequently with PE or deep venous thrombosis (DVT) during the same pregnancy or puerperal period. For P SPECT, the calculated fetal absorbed dose was < 0.6 mGy,and the calculated breast absorbed dose 0.6 mGy. For V SPECT, the calculated fetal absorbed dose was < 0.014 mGy and the breast absorbed dose 0.25 mGy. The prevalence of PE was low (9 %) among pregnant women with suspected disease. Pneumonia was diagnosed in 12 % of patients. The negative predictive value of V/P SPECT was high, and the radiation exposure from V/P SPECT was low both for fetus and patient. (orig.)

  11. Mortality among PCR negative admitted Ebola suspects during the 2014/15 outbreak in Conakry, Guinea: A retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Brecht Ingelbeen

    Full Text Available Non-cases are suspect Ebola Virus Disease (EVD cases testing negative by EVD RT-PCR after admission to an Ebola Treatment Centre (ETC. Admitting non-cases to an ETC prompts concerns on case- and workload in the ETC, risk for nosocomial EVD infection, and delays in diagnosis and disease-specific treatment. We retrospectively analysed characteristics, outcomes and determinants of death of EVD cases and non-cases admitted to the Conakry ETC in Guinea between 03/2014 and 09/2015. Of the 2362 admitted suspects who underwent full confirmatory PCR testing, 1540 (65.2% were non-cases; among them 727 needed repeated confirmatory PCR testing resulting in 2.5 days (average in the ETC isolation ward. Twenty-one patients tested positive on the repeat test, most in a period of flawed sampling for the initial test and none after introduction of PCR confirmation with geneXpert. No readmissions following nosocomial EVD infection were recorded. No combination of symptoms yielded acceptable sensitivity and specificity to allow differentiating confirmed from non-cases. Symptoms as ocular bleeding/redness have high specificity, but limited usefulness as not common. Admission delay and age distribution were not different for both groups. In total, 98 (20.6% of 475 deaths in the ETC were non-cases. Most died within 24 hours after admission. Living in Conakry (aOR 1.78 (1.08-2.96 was the strongest risk factor for death. Weeks with higher admission load had lower case fatality among non-cases, probably because more acute (and treatable illnesses of contacts of known cases were admitted. These findings show high numbers of potentially critically ill non-cases need to be considered when setting up triage and referral of EVD suspect cases. Symptoms and risk factors alone do not allow differentiating the non-cases. Integration of highly-sensitive EVD diagnostic methods with short turnaround time in the triage of peripheral hospitals and dropping the systematic 2nd PCR for

  12. Mortality among PCR negative admitted Ebola suspects during the 2014/15 outbreak in Conakry, Guinea: A retrospective cohort study.

    Science.gov (United States)

    Ingelbeen, Brecht; Bah, Elhadj Ibrahima; Decroo, Tom; Balde, Idrissa; Nordenstedt, Helena; van Griensven, Johan; De Weggheleire, Anja

    2017-01-01

    Non-cases are suspect Ebola Virus Disease (EVD) cases testing negative by EVD RT-PCR after admission to an Ebola Treatment Centre (ETC). Admitting non-cases to an ETC prompts concerns on case- and workload in the ETC, risk for nosocomial EVD infection, and delays in diagnosis and disease-specific treatment. We retrospectively analysed characteristics, outcomes and determinants of death of EVD cases and non-cases admitted to the Conakry ETC in Guinea between 03/2014 and 09/2015. Of the 2362 admitted suspects who underwent full confirmatory PCR testing, 1540 (65.2%) were non-cases; among them 727 needed repeated confirmatory PCR testing resulting in 2.5 days (average) in the ETC isolation ward. Twenty-one patients tested positive on the repeat test, most in a period of flawed sampling for the initial test and none after introduction of PCR confirmation with geneXpert. No readmissions following nosocomial EVD infection were recorded. No combination of symptoms yielded acceptable sensitivity and specificity to allow differentiating confirmed from non-cases. Symptoms as ocular bleeding/redness have high specificity, but limited usefulness as not common. Admission delay and age distribution were not different for both groups. In total, 98 (20.6%) of 475 deaths in the ETC were non-cases. Most died within 24 hours after admission. Living in Conakry (aOR 1.78 (1.08-2.96)) was the strongest risk factor for death. Weeks with higher admission load had lower case fatality among non-cases, probably because more acute (and treatable) illnesses of contacts of known cases were admitted. These findings show high numbers of potentially critically ill non-cases need to be considered when setting up triage and referral of EVD suspect cases. Symptoms and risk factors alone do not allow differentiating the non-cases. Integration of highly-sensitive EVD diagnostic methods with short turnaround time in the triage of peripheral hospitals and dropping the systematic 2nd PCR for symptomatic

  13. Modeling of action potential generation in NG108-15 cells.

    Science.gov (United States)

    Molnar, Peter; Hickman, James J

    2014-01-01

    In order to explore the possibility of identifying toxins based on their effect on the shape of action potentials, we created a computer model of the action potential generation in NG108-15 cells (a neuroblastoma/glioma hybrid cell line). To generate the experimental data for model validation, voltage-dependent sodium, potassium and high-threshold calcium currents, as well as action potentials, were recorded from NG108-15 cells with conventional whole-cell patch-clamp methods. Based on the classic Hodgkin-Huxley formalism and the linear thermodynamic description of the rate constants, ion-channel parameters were estimated using an automatic fitting method. Utilizing the established parameters, action potentials were generated using the Hodgkin-Huxley formalism and were fitted to the recorded action potentials. To demonstrate the applicability of the method for toxin detection and discrimination, the effect of tetrodotoxin (a sodium channel blocker) and tefluthrin (a pyrethroid that is a sodium channel opener) were studied. The two toxins affected the shape of the action potentials differently, and their respective effects were identified based on the predicted changes in the fitted parameters.

  14. Patch testing in Israeli children with suspected allergic contact dermatitis: A retrospective study and literature review.

    Science.gov (United States)

    Zafrir, Yaron; Trattner, Akiva; Hodak, Emmillia; Eldar, Oren; Lapidoth, Moshe; Ben Amitai, Dan

    2018-01-01

    Childhood allergic contact dermatitis is recognized as a significant clinical problem. The objective was to evaluate the rate of positive patch tests in Israeli children with clinically suspected allergic contact dermatitis, identify possible sex and age differences, compare results with those in Israeli adults, and review pediatric studies in the literature. The study sample included 343 children and adolescents (197 female, 146 male; 1-18 years of age, mean age 11.8 years) with clinically suspected allergic contact dermatitis who underwent patch testing with a standard pediatric series of 23 allergens at a tertiary medical center from 1999 to 2012. Data on clinical characteristics and test results were collected retrospectively from the medical files. Ninety-eight subjects (28.6%) (75 girls [38.1%], 23 boys [15.8%]) had at least one positive reaction. The most frequent reactions were to nickel sulfate, followed by potassium dichromate and cobalt chloride. Nickel sulfate sensitivity was more common in girls, especially those younger than 3 years and older than 12 years. The prevalence of contact sensitization was similar in subjects with and without atopic dermatitis (50% and 51%, respectively). Nickel is the most common allergen in Israeli children, especially girls. Patch testing should be performed in children with clinically suspected allergic contact dermatitis regardless of atopic background. © 2017 Wiley Periodicals, Inc.

  15. Mandatory imaging cuts costs and reduces the rate of unnecessary surgeries in the diagnostic work-up of patients suspected of having appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Lahaye, M.J.; Lambregts, D.M.J.; Mutsaers, E.; Beets-Tan, R.G.H. [Maastricht University Medical Centre, Department of Radiology, Maastricht (Netherlands); Essers, B.A.B. [Maastricht University Medical Centre, Department of Epidemiology and Medical Technology, Maastricht (Netherlands); Breukink, S.; Beets, G.L. [Maastricht University Medical Centre, Department of Surgery, Maastricht (Netherlands); Cappendijk, V.C. [Jeroen Bosch Hospital, Department of Radiology, ' s Hertogenbosch (Netherlands)

    2015-05-01

    To evaluate whether mandatory imaging is an effective strategy in suspected appendicitis for reducing unnecessary surgery and costs. In 2010, guidelines were implemented in The Netherlands recommending the mandatory use of preoperative imaging to confirm/refute clinically suspected appendicitis. This retrospective study included 1,556 consecutive patients with clinically suspected appendicitis in 2008-2009 (756 patients/group I) and 2011-2012 (800 patients/group II). Imaging use (none/US/CT and/or MRI) was recorded. Additional parameters were: complications, medical costs, surgical and histopathological findings. The primary study endpoint was the number of unnecessary surgeries before and after guideline implementation. After clinical examination by a surgeon, 509/756 patients in group I and 540/800 patients in group II were still suspected of having appendicitis. In group I, 58.5% received preoperative imaging (42% US/12.8% CT/3.7% both), compared with 98.7% after the guidelines (61.6% US/4.4% CT/ 32.6% both). The percentage of unnecessary surgeries before the guidelines was 22.9%. After implementation, it dropped significantly to 6.2% (p<0.001). The surgical complication rate dropped from 19.9% to 14.2%. The average cost-per-patient decreased by 594 EUR from 2,482 to 1,888 EUR (CL:-1081; -143). Increased use of imaging in the diagnostic work-up of patients with clinically suspected appendicitis reduced the rate of negative appendectomies, surgical complications and costs. (orig.)

  16. Early Chest Computed Tomography Scan to Assist Diagnosis and Guide Treatment Decision for Suspected Community-acquired Pneumonia.

    Science.gov (United States)

    Claessens, Yann-Erick; Debray, Marie-Pierre; Tubach, Florence; Brun, Anne-Laure; Rammaert, Blandine; Hausfater, Pierre; Naccache, Jean-Marc; Ray, Patrick; Choquet, Christophe; Carette, Marie-France; Mayaud, Charles; Leport, Catherine; Duval, Xavier

    2015-10-15

    Clinical decision making relative to community-acquired pneumonia (CAP) diagnosis is difficult. Chest radiograph is key in establishing parenchymal lung involvement. However, radiologic performance may lead to misdiagnosis, rendering questionable the use of chest computed tomography (CT) scan in patients with clinically suspected CAP. To assess whether early multidetector chest CT scan affects diagnosis and management of patients visiting the emergency department with suspected CAP. A total of 319 prospectively enrolled patients with clinically suspected CAP underwent multidetector chest CT scan within 4 hours. CAP diagnosis probability (definite, probable, possible, or excluded) and therapeutic plans (antibiotic initiation/discontinuation, hospitalization/discharge) were established by emergency physicians before and after CT scan results. The adjudication committee established the final CAP classification on Day 28. Chest radiograph revealed a parenchymal infiltrate in 188 patients. CAP was initially classified as definite in 143 patients (44.8%), probable or possible in 172 (53.8%), and excluded in 4 (1.2%). CT scan revealed a parenchymal infiltrate in 40 (33%) of the patients without infiltrate on chest radiograph and excluded CAP in 56 (29.8%) of the 188 with parenchymal infiltrate on radiograph. CT scan modified classification in 187 (58.6%; 95% confidence interval, 53.2-64.0), leading to 50.8% definite CAP and 28.8% excluded CAP, and 80% of modifications were in accordance with adjudication committee classification. Because of CT scan, antibiotics were initiated in 51 (16%) and discontinued in 29 (9%), and hospitalization was decided in 22 and discharge in 23. In CAP-suspected patients visiting the emergency unit, early CT scan findings complementary to chest radiograph markedly affect both diagnosis and clinical management. Clinical trial registered with www.clinicaltrials.gov (NCT 01574066).

  17. A direct comparison of decision rules for early discharge of suspected acute coronary syndromes in the era of high sensitivity troponin.

    Science.gov (United States)

    Chew, Pei Gee; Frost, Fredrick; Mullen, Liam; Fisher, Michael; Zadeh, Heidar; Grainger, Ruth; Albouaini, Khaled; Dodd, James; Patel, Bilal; Velavan, Periaswamy; Kunadian, Babu; Rawat, Anju; Obafemi, Toba; Tong, Sarah; Jones, Julia; Khand, Aleem

    2018-02-01

    We tested the hypothesis that a single high sensitivity troponin at limits of detection (LOD HSTnT) (Acute Coronary Events (GRACE) (acute coronary syndrome. In a prospective cohort study, risk scores were computed in consecutive patients with suspected acute coronary syndrome presenting to the Emergency Room of a large English hospital. Adjudication of myocardial infarction, as per third universal definition, involved a two-physician, blinded, independent review of all biomarker positive chest pain re-presentations to any national hospital. The primary and secondary outcome was a composite of type 1 myocardial infarction, unplanned coronary revascularisation and all cause death (MACE) at six weeks and one year. Of 3054 consecutive presentations with chest pain 1642 had suspected acute coronary syndrome (52% male, median age 59 years, 14% diabetic, 20% previous myocardial infarction). Median time from chest pain to presentation was 9.7 h. Re-presentations occurred in eight hospitals with 100% follow-up achieved. Two hundred and eleven (12.9%) and 279 (17%) were adjudicated to suffer MACE at six weeks and one year respectively. Only HEART ≤3 (negative predictive value MACE 99.4%, sensitivity 97.6%, %discharge 53.4) and LOD HSTnT strategy (negative predictive value MACE 99.8%, sensitivity 99.5%, %discharge 36.9) achieved pre-specified negative predictive value of >99% for MACE at six weeks. For type 1 myocardial infarction alone the negative predictive values at six weeks and one year were identical, for both HEART ≤3 and LOD HSTnT at 99.8% and 99.5% respectively. HEART ≤3 or LOD HSTnT strategy rules out short and medium term myocardial infarction with ≥99.5% certainty, and short-term MACE with >99% certainty, allowing for early discharge of 53.4% and 36.9% respectively of suspected acute coronary syndrome. Adoption of either strategy has the potential to greatly reduce Emergency Room pressures and minimise follow-up investigations. Very early presenters (<3 h

  18. Microscopic optical model potential based on Brueckner-Hartree-Fock theory

    International Nuclear Information System (INIS)

    Li Lulu; Zhao Enguang; Zhou Shangui; Li Zenghua; Zuo Wei; Bonaccorso, Angela; Lonbardo, Umberto

    2010-01-01

    The optical model is one of the most important models in the study of nuclear reactions. In the optical model, the elastic channel is considered to be dominant and the contributions of all other absorption channels are described by introducing an imaginary potential, Koning and Delaroche obtained empirically the so-called KDR optical potentials based on a best-fitting of massive experimental data on nucleon-nucleus scattering reactions. The volume part is found to be dominant in the real component of the OMP at low energies. Using the Bruckner-Hartree-Fock theory with Bonn B potential plus self consistent three body force, the nucleon-nucleus optical potential is studied in this thesis. In the Bruckner theory, the on-shell self energy, is corresponding to the depth of the volume part of the optical model potential (OMP) for nucleon-nucleus scattering. Using Bruckner-Hartree-Fock theory, the nucleon on-shell self energy is calculated based on Hughenoltz-Van Hove (HVH) theorem. The microscopic optical potentials thus obtained agree well with the volume part of the KDR potentials. Furthermore, the isospin splitting in the volume part of the OMP is also reproduced satisfactorily. The isospin effect in the volume part of the OMP is directly related to the isospin splitting of the effective mass of the nucleon. According to our results, the isospin splitting of neutron to proton effective mass is such that the neutron effective mass increases with isospin, whereas the proton effective mass decreases. The isovector potential U n (E) - U p (E) vanishes at energy E ≈ 200 MeV and then changes sign indicating a possible inversion in the effective mass isospin spitting. We also calculated from the Bruckner theory the imaginary part of the OMP, and the microscopic calculations predict that the isospin splitting exists also in the imaginary OMP whereas the empirical KDR potentials do not show this feature. The shape of the real component of the nucleon-nucleus OMP is

  19. Dental postoperative bleeding complications in patients with suspected and documented liver disease.

    Science.gov (United States)

    Hong, C H; Scobey, M W; Napenas, J J; Brennan, M T; Lockhart, P B

    2012-10-01

    The aims of this study were to determine the frequency of bleeding complications following dental procedures in patients with known or suspected chronic liver disease and whether international normalized ratio (INR) determination could aid in predicting bleeding complications in these patients. We identified 90 patients (mean age: 51 ± 9 years) in this retrospective chart review. Sixty-nine patients had a known history of chronic liver disease and 21 had suspected chronic liver disease. Descriptive statistics were determined. Independent sample t-test and one-way variance test were utilized for continuous variables and chi-square test for dichotomous variables. The mean INR value for all patients was 1.2 ± 0.3. The INR value was significantly associated with the diagnosis of liver cirrhosis, the diagnoses of Hepatitis B and C together, the presence of ascites alone, and the number of clinical signs and symptoms (i.e. ascites, jaundice and encephalopathy) present. Nine patients with INR values between 1.5 and 2 underwent invasive dental procedures without postoperative bleeding complications. There were no episodes of postoperative bleeding in patients. The findings suggest that clinicians should not rely solely on an INR value to predict post-procedure bleeding in patients with liver disease. © 2012 John Wiley & Sons A/S.

  20. All rights reserved Intermolecular Model Potentials and Virial ...

    African Journals Online (AJOL)

    ADOWIE PERE

    Intermolecular Model Potentials and Virial Coefficients from Acoustic Data. 1* ... method of cluster expansion. Its merit is that, ... their determination is by the analyses of isothermal p- ρ-y data ... Carlo simulation method to calculate volumetric.

  1. 'Relativistic' quark model for mesons with flavour-independent potential

    International Nuclear Information System (INIS)

    Kroesen, G.

    1987-01-01

    On the base of the Bethe-Salpeter equation in instantaneous approximation a unified model for the mass spectrum of the mesons was designed. The 'relativistic' structure of the Bethe-Salpeter equation allows a natural inclusion of the spin dependences and an extension of the model to small quark masses. The model contains as essential property two potential contributions where one represents the one-gluon exchange while the other represents the confinement potential. The annihilation of qanti q into gluons was not regarded. The spectrum and the amplitudes of the Bethe-Salpeter equation were solved approximatively in numerical way for the lowest states. The free parameters of the model were determined by a fit of the spectrum to a wellknown part of the meson spectrum. The results yield even at small quark masses a quantitatively good picture for all meson families. The result shows that the spectra of the heavy and light mesons can be described by a flavor-independent potential which contains 5 free parameters. Both the internal spin dependent structure and the absolute position of the families can so correctly be described. Especially the position of the D, D s , and B states and the position of the uanti u, danti d states can be simultaneously described by a constant C in the long-range part of the potential. The constant C is thereby essentially determined by the splitting between the Υ family and the B family repectively Ψ and D family. The 3 S 1- 3 D 1 respectively the 3 P 2 - 3 F 2 configuration mixing was regarded. The results show that this mixing is negligibly small. (orig./HSI) [de

  2. K- nuclear potentials from in-medium chirally motivated models

    International Nuclear Information System (INIS)

    Cieply, A.; Gazda, D.; Mares, J.; Friedman, E.; Gal, A.

    2011-01-01

    A self-consistent scheme for constructing K - nuclear optical potentials from subthreshold in-medium KN s-wave scattering amplitudes is presented and applied to analysis of kaonic atoms data and to calculations of K - quasibound nuclear states. The amplitudes are taken from a chirally motivated meson-baryon coupled-channel model, both at the Tomozawa-Weinberg leading order and at the next to leading order. Typical kaonic atoms potentials are characterized by a real part -Re V K - chiral =85±5 MeV at nuclear matter density, in contrast to half this depth obtained in some derivations based on in-medium KN threshold amplitudes. The moderate agreement with data is much improved by adding complex ρ- and ρ 2 -dependent phenomenological terms, found to be dominated by ρ 2 contributions that could represent KNN→YN absorption and dispersion, outside the scope of meson-baryon chiral models. Depths of the real potentials are then near 180 MeV. The effects of p-wave interactions are studied and found secondary to those of the dominant s-wave contributions. The in-medium dynamics of the coupled-channel model is discussed and systematic studies of K - quasibound nuclear states are presented.

  3. Neurohormonal activation and diagnostic value of cardiac peptides in patients with suspected mild heart failure

    DEFF Research Database (Denmark)

    Mikkelsen, Kirsten V.; Bie, Peter; Møller, Jacob E.

    2006-01-01

    accuracy of cardiac peptides to detect any left ventricular dysfunction (LVD) in patients referred from primary care with suspected HF before institution of medical therapy. METHODS: Of 166 referred patients 150 were consecutively included (14 were excluded and two refused consent). Echocardiography...

  4. Semirelativistic potential model for low-lying three-gluon glueballs

    International Nuclear Information System (INIS)

    Mathieu, Vincent; Semay, Claude; Silvestre-Brac, Bernard

    2006-01-01

    The three-gluon glueball states are studied with the generalization of a semirelativistic potential model giving good results for two-gluon glueballs. The Hamiltonian depends only on 3 parameters fixed on two-gluon glueball spectra: the strong coupling constant, the string tension, and a gluon size which removes singularities in the potential. The Casimir scaling determines the structure of the confinement. Low-lying J PC states are computed and compared with recent lattice calculations. A good agreement is found for 1 -- and 3 -- states, but our model predicts a 2 -- state much higher in energy than the lattice result. The 0 -+ mass is also computed

  5. Impact of round-the-clock CSF Gram stain on empirical therapy for suspected central nervous system infections.

    Science.gov (United States)

    Tissot, F; Prod'hom, G; Manuel, O; Greub, G

    2015-09-01

    The impact of round-the-clock cerebrospinal fluid (CSF) Gram stain on overnight empirical therapy for suspected central nervous system (CNS) infections was investigated. All consecutive overnight CSF Gram stains between 2006 and 2011 were included. The impact of a positive or a negative test on empirical therapy was evaluated and compared to other clinical and biological indications based on institutional guidelines. Bacterial CNS infection was documented in 51/241 suspected cases. Overnight CSF Gram stain was positive in 24/51. Upon validation, there were two false-positive and one false-negative results. The sensitivity and specificity were 41 and 99 %, respectively. All patients but one had other indications for empirical therapy than Gram stain alone. Upon obtaining the Gram result, empirical therapy was modified in 7/24, including the addition of an appropriate agent (1), addition of unnecessary agents (3) and simplification of unnecessary combination therapy (3/11). Among 74 cases with a negative CSF Gram stain and without formal indication for empirical therapy, antibiotics were withheld in only 29. Round-the-clock CSF Gram stain had a low impact on overnight empirical therapy for suspected CNS infections and was associated with several misinterpretation errors. Clinicians showed little confidence in CSF direct examination for simplifying or withholding therapy before definite microbiological results.

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

    Science.gov (United States)

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

    2015-04-01

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

  7. [Colorectal Carcinoma with Suspected Lynch Syndrome: A Multidisciplinary Algorithm].

    Science.gov (United States)

    Schneider, R; Schneider, C; Büttner, R; Reinacher-Schick, A; Tannapfel, A; Fürst, A; Rüschoff, J; Jakobeit, C; Royer-Pokora, B; Möslein, G

    2015-12-01

    Lynch syndrome is the most frequent hereditary cancer syndrome, accounting for approximately 3-5 % of all colorectal cancers. In addition, it is the most frequent predisposing hereditary cause of endometrial cancer and is also associated with gastric cancer, ovarian cancer, cancer of the urinary tract as well as several other cancers. In clinical practise Lynch syndrome is frequently not detected and many clinicians admit uncertainties regarding diagnostic procedures. Also, counselling of patients is considered difficult regarding therapeutic - especially prophylactic surgical and chemopreventive options and recommendations. Based on a review of available literature we discuss optimized strategies for improved detection of suspected Lynch syndrome patients. The aim of this review is to establish a clinical algorithm of how to proceed on a diagnostic level and to discuss surgical options at the time of a colorectal cancer. In order to identify patients with Lynch syndrome, family history should be ascertained and evaluated in regards to fulfilment of the Amsterdam-II- and/or the revised Bethesda criteria. Subsequently immunohistochemical staining for the mismatch-repair-genes, BRAF testing for MLH1 loss of expression, as well as testing for microsatellite instability in some, followed by genetic counselling and mutation analysis when indicated, is recommended. Pathological identification of suspected Lynch syndrome is readily feasible and straightforward. However, the need of performing these analyses in the tumor biopsy at the time of (gastroenterological) diagnosis of CRC neoplasia is essential, in order to offer patients the option of a prophylactically extended surgery and - as recommended in the German S3 guidelines - to discuss the option of a merely prophylactical hysterectomy and oophorectomy (if postmenopausal) in women. Close cooperation between gastroenterologists, pathologists and surgeons is warranted, so that patients may benefit from options of

  8. GIS modelling of solar potential in Toplica region

    Directory of Open Access Journals (Sweden)

    Valjarević Aleksandar

    2016-01-01

    Full Text Available In this paper we investigated possible potential solar area on Toplica region based on GIS (Geographical Information system and using a special kriging method with the help of open sources GIS software Quantum GIS. This kriging method is very special to vectorized and calculated the small area. The statistical approach calculated between datasets of three meteorological stations (Niš, Prokuplje, Kuršumlija. Data using of insolation from that meteorological stations from the period of (1953-2013 is useful for a solution to calculating solar potential. The also used parameter is hypsometry of relief of the whole area of Toplica region. Area of Toplica region is 2.231 km2 with a population of 90600 citizens. Divided into fourth municipalities (Prokuplje, Žitoradja, Black, Kuršumlija. The GIS modeling indicates that ideal areas for solar development are located the potential places in Toplica region. Only 13.6 km2 of the head model scores that were in the 90-100% range. However, given the statewide high insolation values with minimal variance, solar projects may be better suited for small-scale residential or commercial projects.

  9. Reimbursement and Insurance Coverage in Cases of Suspected Sexual Abuse in the Emergency Department.

    Science.gov (United States)

    Kupfer, Gary M.; Giardino, Angelo P.

    1995-01-01

    Emergency department charts of 186 suspected preadolescent victims of sexual abuse (SSA) were compared with 623 patients evaluated for upper limb fracture. Hospital costs of SSA patients were more often and to a greater degree underwritten by the hospital itself because of lower reimbursement and a higher percentage of uninsured and publicly…

  10. Feasibility of abdominal plain film images in evaluation suspected drug smuggler

    International Nuclear Information System (INIS)

    Sormaala, Markus J.; Salonen, Hanna-Mari; Mattila, Ville M.; Kivisaari, Arto; Autti, Taina

    2012-01-01

    Objective: Drug smuggling in the gastrointestinal tract has soared within the last 20 years. Though illegal substances in the gastrointestinal tract can be visualized with ultrasound, MRI and CT, the abdominal radiograph has by far remained the most frequently used way of detecting smuggled drugs. The purpose of the study was to evaluate the inter-radiologist interpretation error and the reliability of the abdominal radiograph in detecting smuggled drugs. Materials and methods: A total of 279 abdominal radiographs of suspected smugglers were classified by three radiologists as clearly positive or negative for drug smuggling. All available information about the cases was collected from the customs officers and police. Results: Out of these cases 203 (73%) were interpreted as negative and 35 (13%) as positive by all three radiologists. In 86% of the cases there was, therefore, an inter-radiological agreement in interpreting the images. In 41 (14%) cases, however, there was an inter-radiologist disagreement. Kappa-value for inter-observer variability was 0.70. Conclusions: In up to a seventh of the abdominal radiographs the interpretation can be challenging even for an experienced radiologist. False positive interpretation can lead to innocent passengers being detained in vain. As negatively interpreted images usually result in releasing of the suspect, there is no way of knowing how many false negative occur. This makes the abdominal radiograph a suboptimal examination, and low dose CT should be considered as the screening modality for gastrointestinal drug smugglers

  11. Feasibility of abdominal plain film images in evaluation suspected drug smuggler

    Energy Technology Data Exchange (ETDEWEB)

    Sormaala, Markus J., E-mail: markus.sormaala@welho.com [Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland); Salonen, Hanna-Mari, E-mail: hanna-mari.salonen@hus.fi [Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland); Mattila, Ville M., E-mail: ville.mattila@uta.fi [Department of Orthopedic Surgery and Trauma, Tampere University Hospital, Tampere (Finland); Kivisaari, Arto, E-mail: arto.kivisaari@hus.fi [Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland); Autti, Taina, E-mail: taina.autti@hus.fi [Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland)

    2012-09-15

    Objective: Drug smuggling in the gastrointestinal tract has soared within the last 20 years. Though illegal substances in the gastrointestinal tract can be visualized with ultrasound, MRI and CT, the abdominal radiograph has by far remained the most frequently used way of detecting smuggled drugs. The purpose of the study was to evaluate the inter-radiologist interpretation error and the reliability of the abdominal radiograph in detecting smuggled drugs. Materials and methods: A total of 279 abdominal radiographs of suspected smugglers were classified by three radiologists as clearly positive or negative for drug smuggling. All available information about the cases was collected from the customs officers and police. Results: Out of these cases 203 (73%) were interpreted as negative and 35 (13%) as positive by all three radiologists. In 86% of the cases there was, therefore, an inter-radiological agreement in interpreting the images. In 41 (14%) cases, however, there was an inter-radiologist disagreement. Kappa-value for inter-observer variability was 0.70. Conclusions: In up to a seventh of the abdominal radiographs the interpretation can be challenging even for an experienced radiologist. False positive interpretation can lead to innocent passengers being detained in vain. As negatively interpreted images usually result in releasing of the suspect, there is no way of knowing how many false negative occur. This makes the abdominal radiograph a suboptimal examination, and low dose CT should be considered as the screening modality for gastrointestinal drug smugglers.

  12. Barriers and Motivators for Referral of Patients with Suspected Lynch Syndrome to Cancer Genetic Services: A Qualitative Study

    Science.gov (United States)

    Tan, Yen Y.; Fitzgerald, Lisa J.

    2014-01-01

    This article explores the views of general practitioners and specialists on their referral of patients with suspected Lynch syndrome to cancer genetic services. Using a purposive maximum variation sampling strategy, we conducted semi-structured interviews face-to-face with 28 general practitioners and specialists in public or private hospitals and specialist clinics between March and August 2011. General practitioners and specialists were recruited in a major metropolitan area in Australia. Interview transcripts were reviewed by two independent researchers, and thematic analysis was performed using NVivo10 software. The main barriers and motivators identified were: (1) clinician-related (e.g., familiarity with Lynch syndrome and family history knowledge); (2) patient-related (e.g., patients’ interests and personal experience with cancer); and (3) organizational-related (e.g., access to services, guidelines and referral pathway). Referral of patients with suspected Lynch syndrome to cancer genetic services is motivated and hindered by a range of individual, interpersonal and organizational factors. In order to improve the care and quality of life of patients and family with suspected Lynch syndrome, further research is needed to develop supportive tools for clinicians. PMID:25562140

  13. Barriers and Motivators for Referral of Patients with Suspected Lynch Syndrome to Cancer Genetic Services: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Yen Y. Tan

    2014-02-01

    Full Text Available This article explores the views of general practitioners and specialists on their referral of patients with suspected Lynch syndrome to cancer genetic services. Using a purposive maximum variation sampling strategy, we conducted semi-structured interviews face-to-face with 28 general practitioners and specialists in public or private hospitals and specialist clinics between March and August 2011. General practitioners and specialists were recruited in a major metropolitan area in Australia. Interview transcripts were reviewed by two independent researchers, and thematic analysis was performed using NVivo10 software. The main barriers and motivators identified were: (1 clinician-related (e.g., familiarity with Lynch syndrome and family history knowledge; (2 patient-related (e.g., patients’ interests and personal experience with cancer; and (3 organizational-related (e.g., access to services, guidelines and referral pathway. Referral of patients with suspected Lynch syndrome to cancer genetic services is motivated and hindered by a range of individual, interpersonal and organizational factors. In order to improve the care and quality of life of patients and family with suspected Lynch syndrome, further research is needed to develop supportive tools for clinicians.

  14. Overview of suspected adverse reactions to veterinary medicinal products reported in South Africa (March 2002 – February 2003

    Directory of Open Access Journals (Sweden)

    V. Naidoo

    2003-07-01

    Full Text Available The Veterinary Pharmacovigilance and Medicines Information Centre is responsible for the monitoring of veterinary adverse drug reactions in South Africa. An overview of reports of suspected adverse drug reactions received by the centre during the period March 2002 to February 2003 is given. In total, 40 reports were received. This had declined from the previous year. Most reports involved suspected adverse reactions that occurred in dogs and cats. Most of the products implicated were Stock Remedies. The animal owner predominantly administered these products. Only 1 report was received from a veterinary pharmaceutical company. Increasing numbers of reports are being received from veterinarians.

  15. Empathy in the field: Towards a taxonomy of empathic communication in information gathering interviews with suspected sex offenders

    Directory of Open Access Journals (Sweden)

    Coral June Dando

    2016-01-01

    Full Text Available Research suggests that those suspected of sexual offending might be more willing to reveal information about their crimes if interviewers display empathic behaviour. However, the literature concerning investigative empathy is in its infancy, and so as yet is not well understood. This study explores empathy in a sample of real-life interviews conducted by police officers in England with suspected sex offenders. Using qualitative methodology, the presence and type of empathic verbal behaviours displayed was examined. Resulting categories were quantitatively analysed to investigate their occurrence overall, and across interviewer gender. We identified four distinct types of empathy, some of which were used significantly more often

  16. Evaluation of a new fluorescent reagent, fluorescent brightener 85, for the diagnosis of suspected onychomycosis compared with potassium hydroxide.

    Science.gov (United States)

    Yue, Xueping; Wang, Aiping; Wang, Hongwei; Li, Qing; Yue, Xiuling

    2018-04-01

    Onychomycosis is a common fungal infection in dermatology clinics. The commonly used diagnostic method, potassium hydroxide (KOH) direct microscopy, does not have a high-positive detection rate. Therefore, a new diagnostic method is needed to confirm onychomycosis. The objective of this research was to use fluorescent brightener 85 (FB 85), a new fluorescent reagent for fungi detection, and to evaluate this new method based on the diagnostic positive rate, accuracy and efficiency in suspected onychomycosis compared with the KOH method. Subungual debris was collected from clinically suspected onychomycosis cases and divided into two parts. The parts were examined by FB 85 and 10% KOH solution, respectively. In total, 108 patients with suspected onychomycosis were recruited. The positive rates of FB 85 and KOH were 88.9% and 55.6%, respectively. The patients showed significant statistical differences (P < .001). Compared with the KOH method, the FB 85 fluorescent method was an accurate and efficient method with a higher positive rate. This method could increase the diagnostic accuracy and efficiency of onychomycosis detection. © 2017 Blackwell Verlag GmbH.

  17. Distemper in raccoons and foxes suspected of having rabies

    Science.gov (United States)

    Habermann, R.T.; Herman, C.M.; Williams, F.P.

    1958-01-01

    1) Twenty-one raccoons and 3 red foxes were collected from areas where suspected rabies occurred. All were found to be nonrabid. 2) Distemper was diagnosed in 14 of the 21 raccoons by demonstrating intracytoplasmic and intranuclear inclusions in the brain and visceral tissues. Two of the 3 foxes were considered to have distemper; the clinical signs were typical and mouse inoculation tests were negative for rabies. 3) Deaths of the other 7 raccoons were attributed to: leishmaniasis 1, gastritis 1, bronchopneumonia 1, parasitism 2, car injury 1; 1 showed no significant lesions. The death of 1 fox was attributed to parasitism. 4) Distemper may be a frequent cause of death in raccoons and foxes, in epizootics which simulate rabies.

  18. Results of photorefractive keratectomy in keratoconus suspects at 4 years.

    Science.gov (United States)

    Bilgihan, K; Ozdek, S C; Konuk, O; Akata, F; Hasanreisoglu, B

    2000-01-01

    We studied the long-term results of photorefractive keratectomy (PRK) in keratoconus suspects detected by videokeratography (TMS). Bilateral inferior corneal steepening was detected in 6 candidates for PRK presenting with moderate myopia or astigmatism. Mean follow-up was 44.5 +/- 4.4 months (range, 38 to 54 mo). Mean spherical equivalent refraction was -5.18 +/- 1.60 D (mean sphere, -4.73 D; mean cyclinder, -0.92 D) which was stable for at least the preceding year. The quantitative measurement of inferior corneal steepening (I-S value) was greater than +1.60 (mean, 1.83 +/- 0.11) in all eyes. An Aesculap Meditec Mel 60 excimer laser was used for the PRK procedures and mean follow-up was 44.5 months. Postoperative pachymetric measurements were also performed in 6 eyes. Postoperative uncorrected visual acuity was 20/20 in 8 eyes (66.6%) and 20/32 or better in all eyes with a mean postoperative spherical equivalent refraction of -0.70 +/- 0.74 D (mean sphere, -0.63 D; mean cyclinder, -0.39 D). Five eyes (41.6%) were within +/- 0.50 D spherical equivalent refraction. Inferior steepening was associated with thinning of the inferior cornea which was statistically significantly thinner than the superior thickness (Student's t-test, P < .05). There were no wound healing problems or any sign that the excimer laser adversely affected the cornea during follow-up. Photorefractive keratectomy seems to be a safe procedure for reducing or eliminating myopia or astigmatism in keratoconus suspect eyes-most probably forme fruste keratoconus-with a stable refraction, but this may be different in eyes with early keratoconus, known to be a progressive disease.

  19. On equal constituent quark masses in different heavy quarkonia potential models

    International Nuclear Information System (INIS)

    Lewin, K.; Motz, G.

    1989-01-01

    In a representative number of more or less QCD-motivated QQ-bar potentials the simultaneous transformations of potentials V' j (r)=V i (r)-V i (r 0 ), m' Qi +1/2V j (r 0 ) (i -model index) introduce approximately equal constituent quark masses m' Qi ≅m Q (Q=b,c) for all considered models. The known model independence of m bi -m ci is explained and the influence of the transformation on data reproduction is studied. 16 refs.; 4 figs.; 1 tab

  20. Relationship of the Williams-Poulios and Manning-Rosen Potential Energy Models for Diatomic Molecules

    Science.gov (United States)

    Jia, Chun-Sheng; Liang, Guang-Chuan; Peng, Xiao-Long; Tang, Hong-Ming; Zhang, Lie-Hui

    2014-06-01

    By employing the dissociation energy and the equilibrium bond length for a diatomic molecule as explicit parameters, we generate an improved form of the Williams-Poulios potential energy model. It is found that the negative Williams-Poulios potential model is equivalent to the Manning-Rosen potential model for diatomic molecules. We observe that the Manning-Rosen potential is superior to the Morse potential in reproducing the interaction potential energy curves for the {{a}3 Σu+} state of the 6Li2 molecule and the {{X}1 sum+} state of the SiF+ molecule.

  1. Evaluation of potential crushed-salt constitutive models

    International Nuclear Information System (INIS)

    Callahan, G.D.; Loken, M.C.; Sambeek, L.L. Van; Chen, R.; Pfeifle, T.W.; Nieland, J.D.; Hansen, F.D.

    1995-12-01

    Constitutive models describing the deformation of crushed salt are presented in this report. Ten constitutive models with potential to describe the phenomenological and micromechanical processes for crushed salt were selected from a literature search. Three of these ten constitutive models, termed Sjaardema-Krieg, Zeuch, and Spiers models, were adopted as candidate constitutive models. The candidate constitutive models were generalized in a consistent manner to three-dimensional states of stress and modified to include the effects of temperature, grain size, and moisture content. A database including hydrostatic consolidation and shear consolidation tests conducted on Waste Isolation Pilot Plant and southeastern New Mexico salt was used to determine material parameters for the candidate constitutive models. Nonlinear least-squares model fitting to data from the hydrostatic consolidation tests, the shear consolidation tests, and a combination of the shear and hydrostatic tests produces three sets of material parameter values for the candidate models. The change in material parameter values from test group to test group indicates the empirical nature of the models. To evaluate the predictive capability of the candidate models, each parameter value set was used to predict each of the tests in the database. Based on the fitting statistics and the ability of the models to predict the test data, the Spiers model appeared to perform slightly better than the other two candidate models. The work reported here is a first-of-its kind evaluation of constitutive models for reconsolidation of crushed salt. Questions remain to be answered. Deficiencies in models and databases are identified and recommendations for future work are made. 85 refs

  2. Cerebrospinal Fluid Lumbar Tapping Utilization for Suspected Ventriculoperitoneal Shunt Under-Drainage Malfunctions.

    Science.gov (United States)

    Lee, Jong-Beom; Ahn, Ho-Young; Lee, Hong-Jae; Yang, Ji-Ho; Yi, Jin-Seok; Lee, Il-Woo

    2017-01-01

    The diagnosis of shunt malfunction can be challenging since neuroimaging results are not always correlated with clinical outcomes. The purpose of this study was to evaluate the efficacy of a simple, minimally invasive cerebrospinal fluid (CSF) lumbar tapping test that predicts shunt under-drainage in hydrocephalus patients. We retrospectively reviewed the clinical and radiological features of 48 patients who underwent routine CSF lumbar tapping after ventriculoperitoneal shunt (VPS) operation using a programmable shunting device. We compared shunt valve opening pressure and CSF lumbar tapping pressure to check under-drainage. The mean pressure difference between valve opening pressure and CSF lumbar tapping pressure of all patients were 2.21±24.57 mmH 2 O. The frequency of CSF lumbar tapping was 2.06±1.26 times. Eighty five times lumbar tapping of 41 patients showed that their VPS function was normal which was consistent with clinical improvement and decreased ventricle size on computed tomography scan. The mean pressure difference in these patients was -3.69±19.20 mmH 2 O. The mean frequency of CSF lumbar tapping was 2.07±1.25 times. Fourteen cases of 10 patients revealed suspected VPS malfunction which were consistent with radiological results and clinical symptoms, defined as changes in ventricle size and no clinical improvement. The mean pressure difference was 38.07±23.58 mmH 2 O. The mean frequency of CSF lumbar tapping was 1.44±1.01 times. Pressure difference greater than 35 mmH 2 O was shown in 2.35% of the normal VPS function group (2 of 85) whereas it was shown in 64.29% of the suspected VPS malfunction group (9 of 14). The difference was statistically significant ( p =0.000001). Among 10 patients with under-drainage, 5 patients underwent shunt revision. The causes of the shunt malfunction included 3 cases of proximal occlusion and 2 cases of distal obstruction and valve malfunction. Under-drainage of CSF should be suspected if CSF lumbar tapping

  3. Cost analysis of inappropriate treatments for suspected dermatomycoses

    Directory of Open Access Journals (Sweden)

    Emanuela Fiammenghi

    2015-06-01

    Full Text Available Superficial mycoses are estimated to affect more than 20-25% of the world’s population with a consistent increase over the years. Most patients referred to our clinic for suspected dermatomycoses have already been treated with pharmacotherapy, without a previous mycological examination and many show changes in the clinical manifestations. Indeed, some medications, such as steroids, antiviral, antibiotics and antihistamines are not able to erase a fungal infection, but also they can cause atypical clinical manifestations. The consequences of inappropriate treatment include delayed diagnosis, prolonged healing time, and additional costs. The aims of this study were (1 to evaluate the incidence of increased costs attributable to inappropriate therapy sustained by the National Health Service and patients and (2 to highlight the importance of mycological evaluation before starting treatment, in order to improve diagnostic accuracy. An observational retrospective and prospective study was performed from September 2013 to February 2014, in 765 patients referred to our center (University Hospital “ Federico II” in Naples, Italy, for suspected mycological infection. The following treatments (alone or in combination were defined as inappropriate: (1 cortisone in a patient with at least one positive site; (2 antifungals in (a patients with all negative sites or (b ineffective antifungal treatment (in terms of drug chosen, dose or duration in those with all positive sites; or (3 antibiotics; (4 antivirals or (5 antihistamines, in patients with ≥ 1 positive site. Five hundred and fifty patients were using medications before the assessment visit. The total amount of avoidable costs related to inappropriate previous treatments was € 121,417, representing 74% of the total treatment costs. 253/550 patients received drugs also after the visit. For these patients, the cost of treatment prescribed after mycological testing was € 42,952, with a decrease

  4. Isolation & characterization of Brucella melitensis isolated from patients suspected for human brucellosis in India

    Science.gov (United States)

    Barua, Anita; Kumar, Ashu; Thavaselvam, Duraipandian; Mangalgi, Smita; Prakash, Archana; Tiwari, Sapana; Arora, Sonia; Sathyaseelan, Kannusamy

    2016-01-01

    Background & objectives: Brucellosis is endemic in the southern part of India. A combination of biochemical, serological and molecular methods is required for identification and biotyping of Brucella. The present study describes the isolation and biochemical, molecular characterization of Brucella melitensis from patients suspected for human brucellosis. Methods: The blood samples were collected from febrile patients suspected to have brucellosis. A total of 18 isolates were obtained from 102 blood samples subjected to culture. The characterization of these 18 isolates was done by growth on Brucella specific medium, biochemical reactions, CO2 requirement, H2S production, agglutination with A and M mono-specific antiserum, dye sensitivity to basic fuchsin and thionin. Further, molecular characterization of the isolates was done by amplification of B. melitensis species specific IS711 repetitive DNA fragment and 16S (rRNA) sequence analysis. PCR-restriction fragment length polymorphism (RFLP) analysis of omp2 locus and IS711 gene was also done for molecular characterization. Results: All 102 suspected samples were subjected to bacteria isolation and of these, 18 isolates could be recovered on blood culture. The biochemical, PCR and PCR-RFLP and 16s rRNA sequencing revealed that all isolates were of B. melitensis and matched exactly with reference strain B. melitensis 16M. Interpretation & conclusions: The present study showed an overall isolation rate of 17.64 per cent for B. melitensis. There is a need to establish facilities for isolation and characterization of Brucella species for effective clinical management of the disease among patients as well as surveillance and control of infection in domestic animals. Further studies are needed from different geographical areas of the country with different level of endemicity to plan and execute control strategies against human brucellosis. PMID:27488010

  5. Left atrial appendage morphology in patients with suspected cardiogenic stroke without known atrial fibrillation.

    Directory of Open Access Journals (Sweden)

    Miika Korhonen

    Full Text Available The left atrial appendage (LAA is the typical origin for intracardiac thrombus formation. Whether LAA morphology is associated with increased stroke/TIA risk is controversial and, if it does, which morphological type most predisposes to thrombus formation. We assessed LAA morphology in stroke patients with cryptogenic or suspected cardiogenic etiology and in age- and gender-matched healthy controls. LAA morphology and volume were analyzed by cardiac computed tomography in 111 patients (74 males; mean age 60 ± 11 years with acute ischemic stroke of cryptogenic or suspected cardiogenic etiology other than known atrial fibrillation (AF. A subgroup of 40 patients was compared to an age- and gender-matched control group of 40 healthy individuals (21 males in each; mean age 54 ± 9 years. LAA was classified into four morphology types (Cactus, ChickenWing, WindSock, CauliFlower modified with a quantitative qualifier. The proportions of LAA morphology types in the main stroke group, matched stroke subgroup, and control group were as follows: Cactus (9.0%, 5.0%, 20.0%, ChickenWing (23.4%, 37.5%, 10.0%, WindSock (47.7%, 35.0%, 67.5%, and CauliFlower (19.8%, 22.5%, 2.5%. The distribution of morphology types differed significantly (P<0.001 between the matched stroke subgroup and control group. The proportion of single-lobed LAA was significantly higher (P<0.001 in the matched stroke subgroup (55% than the control group (6%. LAA volumes were significantly larger (P<0.001 in both stroke study groups compared to controls patients. To conclude, LAA morphology differed significantly between stroke patients and controls, and single-lobed LAAs were overrepresented and LAA volume was larger in patients with acute ischemic stroke of cryptogenic or suspected cardiogenic etiology.

  6. The role of bone scintigraphy in the evaluation of the suspected abused child

    International Nuclear Information System (INIS)

    Sty, J.R.; Starshak, R.J.

    1983-01-01

    A comparison was made of the radiographic and scintigraphic skeletal surveys of 261 children and produced false-negative results in 32; scintigraphy was positive in 120 children and produced false-negative results in two. Although radiography has traditionally been used to assess the skeletal injuries of battered children, the authors conclude that scintigraphy should be the screening procedure of choice for children suspected of having been abused

  7. 41 CFR 102-38.50 - What must we do when an executive agency suspects violations of 40 U.S.C. 559, fraud, bribery, or...

    Science.gov (United States)

    2010-07-01

    ... executive agency suspects violations of 40 U.S.C. 559, fraud, bribery, or criminal collusion in connection... an executive agency suspects violations of 40 U.S.C. 559, fraud, bribery, or criminal collusion in.... 559, fraud, bribery, or criminal collusion in connection with the disposal of personal property, the...

  8. 111indium-antimyosin immunoscintigraphy in suspected myocarditis

    International Nuclear Information System (INIS)

    Krause, T.; Schuemichen, C.; Joseph, A.; Moser, E.; Zeiher, A.

    1991-01-01

    111 Indium-monoclonal antimyosin scans were carried out in 21 patients with suspected myocarditis, confirmed by reduced ejection volume, pericardial effusion and clinical follow up in 12 patients. Coronary heart disease was excluded angiographically in all cases. Quantitative evaluation of myocardial 111 In-antimyosin accumulation 48 hours after injection showed a pathological uptake in 10/12 patients with increased heart/lung ratios (Q 48 >1,58). Ratios were also elevated in 2 patients with cardiomyopathy, 2 suffering from vasculitis and 1 with dermatomyositis. Four patients without proven cardiac disease had normal ratios (Q 48 ≤1,58). Examination after 24 hours was of limited value, depending on the residual blood pool activity. Visual analysis of the scans showed a high interobserver variation despite a positive correlation with quantitative analysis (48 h p.i.: r=0,72; p 111 In-antimyosin scan as a screening method prior to myocardial biopsy. However, scintigraphy cannot definitely elucidate the cause of myocardial damage. Therefore, myocardial biopsy is still recommended after positive antimyosin scans. (orig.) [de

  9. Two-loop effective potential for Wess-Zumino model using superfields

    International Nuclear Information System (INIS)

    Santos, R.P. dos; Srivastava, P.P.

    1989-01-01

    For the case of several interacting chiral superfields the propagators for the unconstrained superfield potentials in the 'shifted' theory, where the supersymmetry is explicity broken, are derived in a compact form. They are used to compute the one-loop effective potential in the general case, while a superfield calculation of the renormalized effective potential to two loops for the Wess-Zumino models is performed. (authors) [pt

  10. A quark-antiquark potential from a superconducting model of confinement

    Directory of Open Access Journals (Sweden)

    J.W. Alcock

    1983-10-01

    Full Text Available The Landau-Ginzburg phenomenological theory of superconductivity is used as a model of flux confinement. A monopole pair of sources is included to simulate a quark-antiquark system. The interaction energy is found in the static approximation appropriate for heavy quark systems, and equated with the interquark potential. This potential is compared with other suggested phenomenological potentials and succeeds in reproducing heavy quark spectra.

  11. Introduction of a standardized multimodality image protocol for navigation-guided surgery of suspected low-grade gliomas.

    Science.gov (United States)

    Mert, Aygül; Kiesel, Barbara; Wöhrer, Adelheid; Martínez-Moreno, Mauricio; Minchev, Georgi; Furtner, Julia; Knosp, Engelbert; Wolfsberger, Stefan; Widhalm, Georg

    2015-01-01

    OBJECT Surgery of suspected low-grade gliomas (LGGs) poses a special challenge for neurosurgeons due to their diffusely infiltrative growth and histopathological heterogeneity. Consequently, neuronavigation with multimodality imaging data, such as structural and metabolic data, fiber tracking, and 3D brain visualization, has been proposed to optimize surgery. However, currently no standardized protocol has been established for multimodality imaging data in modern glioma surgery. The aim of this study was therefore to define a specific protocol for multimodality imaging and navigation for suspected LGG. METHODS Fifty-one patients who underwent surgery for a diffusely infiltrating glioma with nonsignificant contrast enhancement on MRI and available multimodality imaging data were included. In the first 40 patients with glioma, the authors retrospectively reviewed the imaging data, including structural MRI (contrast-enhanced T1-weighted, T2-weighted, and FLAIR sequences), metabolic images derived from PET, or MR spectroscopy chemical shift imaging, fiber tracking, and 3D brain surface/vessel visualization, to define standardized image settings and specific indications for each imaging modality. The feasibility and surgical relevance of this new protocol was subsequently prospectively investigated during surgery with the assistance of an advanced electromagnetic navigation system in the remaining 11 patients. Furthermore, specific surgical outcome parameters, including the extent of resection, histological analysis of the metabolic hotspot, presence of a new postoperative neurological deficit, and intraoperative accuracy of 3D brain visualization models, were assessed in each of these patients. RESULTS After reviewing these first 40 cases of glioma, the authors defined a specific protocol with standardized image settings and specific indications that allows for optimal and simultaneous visualization of structural and metabolic data, fiber tracking, and 3D brain

  12. Suspected primary immune deficiency in a Donge de Bordeaux dog : short communication

    Directory of Open Access Journals (Sweden)

    R.G. Lobetti

    2002-07-01

    Full Text Available A young Donge de Bordeaux dog was presented with chronic intermittent antibiotic responsive gastrointestinal and respiratory disease. Further evaluation showed bacterial lymphadenitis, bacterial tracheitis, normal white cell and differential cell counts, hypogammaglobulinaemia, and the absence of B-lymphocytes but the presence of T-lymphocytes in the lymphoid tissue stained with lymphocyte markers. As the dog came from a narrow genetic base, with related dogs showing similar clinical signs, possible B-cell congenital immune deficiency was suspected.

  13. Image-guided biopsy in patients with suspected ovarian carcinoma: a safe and effective technique?

    International Nuclear Information System (INIS)

    Griffin, Nyree; Grant, Lee A.; Freeman, Susan J.; Berman, Laurence H.; Sala, Evis; Jimenez-Linan, Mercedes; Earl, Helena; Ahmed, Ahmed Ashour; Crawford, Robin; Brenton, James

    2009-01-01

    In patients with suspected advanced ovarian carcinoma, a precise histological diagnosis is required before commencing neo-adjuvant chemotherapy. This study aims to determine the diagnostic accuracy and complication rate of percutaneous biopsies performed under ultrasound or computed tomography guidance. Between 2002 to 2007, 60 consecutive image-guided percutaneous biopsies were performed in patients with suspected ovarian cancer. The following variables were recorded: tissue biopsied, imaging technique, experience of operator, biopsy needle gauge, number of passes, complications, and final histology. Forty-seven patients had omental biopsies, 12 pelvic mass biopsies, and 1 para-aortic lymph node biopsy. Thirty-five biopsies were performed under ultrasound, 25 under computed tomography guidance. Biopsy needle gauges ranged from 14-20 swg with two to five passes for each patient. There were no complications. Histology was obtained in 52 (87%) patients. Percutaneous image-guided biopsy of peritoneal disease or pelvic mass is safe with high diagnostic accuracy. The large-gauge biopsy needle is as safe as the small gauge needle, but has the added value of obtaining tissue samples for immunohistochemistry and genomic studies. (orig.)

  14. Comparison of Three Model Concepts for Streaming Potential in Unsaturated Porous Media

    Science.gov (United States)

    Huisman, J. A.; Satenahalli, P.; Zimmermann, E.; Vereecken, H.

    2017-12-01

    Streaming potential is the electric potential generated by fluid flow in a charged porous medium. Although streaming potential in saturated conditions is well understood, there still is considerable debate about the adequate modelling of streaming potential signals in unsaturated soil because different concepts are available to estimate the effective excess charge in unsaturated conditions. In particular, some studies have relied on the volumetric excess charge, whereas others proposed to use the flux-averaged excess charge derived from the water retention or relative permeability function. The aim of this study is to compare measured and modelled streaming potential signals for two different flow experiments with sand. The first experiment is a primary gravity drainage of a long column equipped with non-polarizing electrodes and tensiometers, as presented in several previous studies. Expected differences between the three concepts for the effective excess charge are only moderate for this set-up. The second experiment is a primary drainage of a short soil column equipped with non-polarizing electrodes and tensiometers using applied pressure, where differences between the three concepts are expected to be larger. A comparison of the experimental results with a coupled model of streaming potential for 1D flow problems will provide insights in the ability of the three model concepts for effective excess charge to describe observed streaming potentials.

  15. Accurate analytic model potentials for D2 and H2 based on the perturbed-Morse--oscillator model

    International Nuclear Information System (INIS)

    Huffaker, J.N.; Cohen, D.I.

    1986-01-01

    Model potentials with as few as 19 free parameters are fitted to published ab initio abiabatic potentials for D 2 and H 2 , with accuracy such that rovibrational eigenvalues are in error by only about 10 -2 cm -1 . A three-parameter model is suggested for describing nonadiabatic effects on eigenvalues, with the intention that such a model might be suitable for all hydrides. Dunham coefficients are calculated from the perturbed-Morse--oscillator series expansion of the model, permitting a critical evaluation of convergence properties of both the Dunham series and the WKB series

  16. Prevalence of symptomatic and silent stress-induced perfusion defects in diabetic patients with suspected coronary artery disease referred for myocardial perfusion scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Prior, John O.; Calcagni, Maria-Lucia; Bischof Delaloye, Angelika [Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Nuclear Medicine, Lausanne (Switzerland); Monbaron, David; Ruiz, Juan [Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Endocrinology, Diabetology and Metabolism, Lausanne (Switzerland); Koehli, Melanie [Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Nuclear Medicine, Lausanne (Switzerland); Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Endocrinology, Diabetology and Metabolism, Lausanne (Switzerland)

    2005-01-01

    Silent myocardial ischaemia - as evaluated by stress-induced perfusion defects on myocardial perfusion scintigraphy (MPS) in patients without a history of chest pain - is frequent in diabetes and is associated with increased rates of cardiovascular events. Its prevalence has been determined in asymptomatic diabetic patients, but remains largely unknown in diabetic patients with suspected coronary artery disease (CAD) in the clinical setting. In this study we therefore sought (a) to determine the prevalence of symptomatic and silent perfusion defects in diabetic patients with suspected CAD and (b) to characterise the eventual predictors of abnormal perfusion. The patient population comprised 133 consecutive diabetic patients with suspected CAD who had been referred for MPS. Studies were performed with exercise (41%) or pharmacological stress testing (1-day protocol, {sup 99m}Tc-sestamibi, {sup 201}Tl or both). We used semi-quantitative analysis (20-segment polar maps) to derive the summed stress score (SSS) and the summed difference score (SDS). Abnormal MPS (SSS{>=}4) was observed in 49 (37%) patients (SSS=4.9{+-}8.4, SDS=2.4{+-}4.7), reversible perfusion defects (SDS{>=}2) in 40 (30%) patients [SSS=13.3{+-}10.9; SDS=8.0{+-}5.6; 20% moderate to severe (SDS>4), 7% multivessel] and fixed defects in 21 (16%) patients. Results were comparable between patients with and patients without a history of chest pain. Of 75 patients without a history of chest pain, 23 (31%, 95% CI=21-42%) presented reversible defects (SSS=13.9{+-}11.3; SDS=7.4{+-}1.2), indicative of silent ischaemia. Reversible defects were associated with inducible ST segment depression during MPS stress (odds ratio (OR)=3.2, p<0.01). Fixed defects were associated with erectile dysfunction in males (OR=3.7, p=0.02) and lower aspirin use (OR=0.25, p=0.02). Silent stress-induced perfusion defects occurred in 31% of the patients, a rate similar to that in patients with a history of chest pain. MPS could identify

  17. Diagnostic and prognostic value of non-invasive imaging in known or suspected coronary artery disease

    International Nuclear Information System (INIS)

    Schuijf, J.D.; Poldermans, D.; Shaw, L.J.; Jukema, J.W.; Wall, E.E. van der; Lamb, H.J.; Roos, A. de; Wijns, W.; Bax, J.J.

    2006-01-01

    The role of non-invasive imaging techniques in the evaluation of patients with suspected or known coronary artery disease (CAD) has increased exponentially over the past decade. The traditionally available imaging modalities, including nuclear imaging, stress echocardiography and magnetic resonance imaging (MRI), have relied on detection of CAD by visualisation of its functional consequences (i.e. ischaemia). However, extensive research is being invested in the development of non-invasive anatomical imaging using computed tomography or MRI to allow detection of (significant) atherosclerosis, eventually at a preclinical stage. In addition to establishing the presence of or excluding CAD, identification of patients at high risk for cardiac events is of paramount importance to determine post-test management, and the majority of non-invasive imaging tests can also be used for this purpose. The aim of this review is to provide an overview of the available non-invasive imaging modalities and their merits for the diagnostic and prognostic work-up in patients with suspected or known CAD. (orig.)

  18. Suspected adverse drug reactions in elderly patients reported to the Committee on Safety of Medicines.

    Science.gov (United States)

    Castleden, C M; Pickles, H

    1988-10-01

    1. Spontaneous reports of suspected adverse drug reactions (ADRs) reported to the Committee on Safety of Medicines (CSM) have been studied in relation to patient age. 2. The proportion of reports received for the elderly increased between 1965 and 1983. 3. There was a correlation between the use of drugs and the number of ADR reports. Thus age-related prescription figures for two non-steroidal anti-inflammatory drugs (NSAI) and co-trimoxazole matched ADR reports for each drug in each age group. 4. The reported ADR was more likely to be serious or fatal in the elderly. 5. The commonest ADRs reported for the elderly affected the gastrointestinal (GIT) and haemopoietic systems, where more reports were received than would be expected from prescription figures. 6. The drug suspected of causing a GIT reaction was a NSAI in 75% of the reports. 7. Ninety-one per cent of fatal reports of GIT bleeds and perforations associated with NSAI drugs were in patients over 60 years of age.

  19. Fisher information and quantum potential well model for finance

    Energy Technology Data Exchange (ETDEWEB)

    Nastasiuk, V.A., E-mail: nasa@i.ua

    2015-09-25

    The probability distribution function (PDF) for prices on financial markets is derived by extremization of Fisher information. It is shown how on that basis the quantum-like description for financial markets arises and different financial market models are mapped by quantum mechanical ones. - Highlights: • The financial Schrödinger equation is derived using the principle of minimum Fisher information. • Statistical models for price variation are mapped by the quantum models of coupled particle. • The model of quantum particle in parabolic potential well corresponds to Efficient market.

  20. Fisher information and quantum potential well model for finance

    International Nuclear Information System (INIS)

    Nastasiuk, V.A.

    2015-01-01

    The probability distribution function (PDF) for prices on financial markets is derived by extremization of Fisher information. It is shown how on that basis the quantum-like description for financial markets arises and different financial market models are mapped by quantum mechanical ones. - Highlights: • The financial Schrödinger equation is derived using the principle of minimum Fisher information. • Statistical models for price variation are mapped by the quantum models of coupled particle. • The model of quantum particle in parabolic potential well corresponds to Efficient market

  1. A simple MRI protocol in patients with clinically suspected appendicitis: results in 138 patients and effect on outcome of appendectomy

    International Nuclear Information System (INIS)

    Cobben, Lodewijk; Groot, Ingrid; Kingma, Lucas; Coerkamp, Emile; Puylaert, Julien; Blickman, Johan

    2009-01-01

    To establish the value of breathhold magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis. Over a 14-month period, 138 patients clinically suspected of having appendicitis were evaluated prospectively with MRI and comprised the study group. Fast turbo spin-echo breathhold T1, T2 and T2 fat suppression sequences were used in coronal and axial planes. The imaging results were recorded separately and subsequently correlated with clinical, radiological and histopathological follow-up. The effect of imaging strategies in patients suspected of appendicitis on hospital resources was calculated. Sixty-two of the 138 patients had a histopathologically proven appendicitis. MRI determined appendicitis in 63 patients, with one examination being false positive. The resulting sensitivity and specificity were 100% and 99%, respectively. MRI showed an alternative diagnosis in 41 of the 75 remaining patients. In 22 of the remaining 34 patients, a normal appendix was depicted with MRI. In two patients, where MRI showed no appendicitis, an alternative diagnosis or normal appendix, an unnecessary appendectomy was performed. The overall effect of using MRI in patients suspected of appendicitis on the use of hospital resources could have been a net saving between EUR 55,746 and EUR 72,534. MRI has a high accuracy in detecting and excluding appendicitis, an alternative diagnosis or showing the normal appendix, and can be a valuable and cost-effective tool in the workup of patients clinically suspected of having appendicitis. (orig.)

  2. A simple MRI protocol in patients with clinically suspected appendicitis: results in 138 patients and effect on outcome of appendectomy

    Energy Technology Data Exchange (ETDEWEB)

    Cobben, Lodewijk [Medisch Centrum Haaglanden, Department of Radiology, Leidschendam (Netherlands); Groot, Ingrid [Medisch Centrum Haaglanden, Department of Surgery, Leidschendam (Netherlands); Kingma, Lucas; Coerkamp, Emile; Puylaert, Julien [Medisch Centrum Haaglanden, Department of Radiology, Den Haag (Netherlands); Blickman, Johan [Universitair Medisch Centrum St Radboud, Department of Radiology, Geert Grooteplein 10, GA, Nijmegen (Netherlands)

    2009-05-15

    To establish the value of breathhold magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis. Over a 14-month period, 138 patients clinically suspected of having appendicitis were evaluated prospectively with MRI and comprised the study group. Fast turbo spin-echo breathhold T1, T2 and T2 fat suppression sequences were used in coronal and axial planes. The imaging results were recorded separately and subsequently correlated with clinical, radiological and histopathological follow-up. The effect of imaging strategies in patients suspected of appendicitis on hospital resources was calculated. Sixty-two of the 138 patients had a histopathologically proven appendicitis. MRI determined appendicitis in 63 patients, with one examination being false positive. The resulting sensitivity and specificity were 100% and 99%, respectively. MRI showed an alternative diagnosis in 41 of the 75 remaining patients. In 22 of the remaining 34 patients, a normal appendix was depicted with MRI. In two patients, where MRI showed no appendicitis, an alternative diagnosis or normal appendix, an unnecessary appendectomy was performed. The overall effect of using MRI in patients suspected of appendicitis on the use of hospital resources could have been a net saving between EUR 55,746 and EUR 72,534. MRI has a high accuracy in detecting and excluding appendicitis, an alternative diagnosis or showing the normal appendix, and can be a valuable and cost-effective tool in the workup of patients clinically suspected of having appendicitis. (orig.)

  3. Modelling streambank erosion potential using maximum entropy in a central Appalachian watershed

    Directory of Open Access Journals (Sweden)

    J. Pitchford

    2015-03-01

    Full Text Available We used maximum entropy to model streambank erosion potential (SEP in a central Appalachian watershed to help prioritize sites for management. Model development included measuring erosion rates, application of a quantitative approach to locate Target Eroding Areas (TEAs, and creation of maps of boundary conditions. We successfully constructed a probability distribution of TEAs using the program Maxent. All model evaluation procedures indicated that the model was an excellent predictor, and that the major environmental variables controlling these processes were streambank slope, soil characteristics, bank position, and underlying geology. A classification scheme with low, moderate, and high levels of SEP derived from logistic model output was able to differentiate sites with low erosion potential from sites with moderate and high erosion potential. A major application of this type of modelling framework is to address uncertainty in stream restoration planning, ultimately helping to bridge the gap between restoration science and practice.

  4. Map-based model of the cardiac action potential

    International Nuclear Information System (INIS)

    Pavlov, Evgeny A.; Osipov, Grigory V.; Chan, C.K.; Suykens, Johan A.K.

    2011-01-01

    A simple computationally efficient model which is capable of replicating the basic features of cardiac cell action potential is proposed. The model is a four-dimensional map and demonstrates good correspondence with real cardiac cells. Various regimes of cardiac activity, which can be reproduced by the proposed model, are shown. Bifurcation mechanisms of these regimes transitions are explained using phase space analysis. The dynamics of 1D and 2D lattices of coupled maps which model the behavior of electrically connected cells is discussed in the context of synchronization theory. -- Highlights: → Recent experimental-data based models are complicated for analysis and simulation. → The simplified map-based model of the cardiac cell is constructed. → The model is capable for replication of different types of cardiac activity. → The spatio-temporal dynamics of ensembles of coupled maps are investigated. → Received data are analyzed in context of biophysical processes in the myocardium.

  5. Map-based model of the cardiac action potential

    Energy Technology Data Exchange (ETDEWEB)

    Pavlov, Evgeny A., E-mail: genie.pavlov@gmail.com [Department of Computational Mathematics and Cybernetics, Nizhny Novgorod State University, 23, Gagarin Avenue, 603950 Nizhny Novgorod (Russian Federation); Osipov, Grigory V. [Department of Computational Mathematics and Cybernetics, Nizhny Novgorod State University, 23, Gagarin Avenue, 603950 Nizhny Novgorod (Russian Federation); Chan, C.K. [Institute of Physics, Academia Sinica, 128 Sec. 2, Academia Road, Nankang, Taipei 115, Taiwan (China); Suykens, Johan A.K. [K.U. Leuven, ESAT-SCD/SISTA, Kasteelpark Arenberg 10, B-3001 Leuven (Heverlee) (Belgium)

    2011-07-25

    A simple computationally efficient model which is capable of replicating the basic features of cardiac cell action potential is proposed. The model is a four-dimensional map and demonstrates good correspondence with real cardiac cells. Various regimes of cardiac activity, which can be reproduced by the proposed model, are shown. Bifurcation mechanisms of these regimes transitions are explained using phase space analysis. The dynamics of 1D and 2D lattices of coupled maps which model the behavior of electrically connected cells is discussed in the context of synchronization theory. -- Highlights: → Recent experimental-data based models are complicated for analysis and simulation. → The simplified map-based model of the cardiac cell is constructed. → The model is capable for replication of different types of cardiac activity. → The spatio-temporal dynamics of ensembles of coupled maps are investigated. → Received data are analyzed in context of biophysical processes in the myocardium.

  6. Diagnostic accuracy of 18F-FDG PET/CT for detection of suspected recurrence in patients with oesophageal carcinoma

    International Nuclear Information System (INIS)

    Sharma, Punit; Jain, Sachin; Karunanithi, Sellam; Malhotra, Arun; Bal, Chandrasekhar; Kumar, Rakesh; Pal, Sujoy; Julka, Pramod Kumar; Thulkar, Sanjay

    2014-01-01

    To evaluate the role of 18 F-FDG PET/CT in the detection of recurrence in patients with oesophageal carcinoma, suspected clinically or following conventional investigations. This was a retrospective study. Data from 180 patients (age 56.3 ± 10.4 years; 126 men, 54 women) with histopathologically proven oesophageal carcinoma (squamous cell 115, adenocarcinoma 59, neuroendocrine carcinoma 4, small cell 1, poorly differentiated 1) who had undergone 227 18 F-FDG PET/CT studies for suspected recurrence were analysed. Recurrence was suspected clinically or following conventional investigations. PET/CT images were revaluated by two nuclear medicine physicians in consensus. Findings were grouped into local, nodal and distant recurrence. Results were compared to those from contrast-enhanced (CE) CT when available (109 patients). Clinical/imaging follow-up (minimum 6 months) with histopathology (when available) was taken as the reference standard. Of the 227 18 F-FDG PET/CT studies,166 were positive and 61 were negative for recurrent disease. PET/CT showed local recurrence in 134, nodal recurrence in 115 and distant recurrence in 47, with more than one site of recurrence in 34. The PET/CT findings were true-positive in 153 studies, true-negative in 54, false-positive in 13 and false-negative in 7. The sensitivity of 18 F-FDG PET/CT was 96 %, the specificity was 81 %, the positive and negative predictive values were 92 % and 89 %, respectively, and the accuracy was 91 %. PET/CT showed similar accuracy in patients with squamous cell carcinoma and in those with adenocarcinoma (P = 0.181). 18 F-FDG PET/CT was more specific than CECT (67 % vs. 21 %; P 18 F-FDG PET/CT shows high accuracy in the detection of suspected recurrence in patients with oesophageal carcinoma. It is more specific than and is superior to CECT in the detection of nodal recurrence. (orig.)

  7. The impact of failing to identify suspect effort in patients undergoing adult attention-deficit/hyperactivity disorder (ADHD) assessment.

    Science.gov (United States)

    Marshall, Paul S; Hoelzle, James B; Heyerdahl, Danielle; Nelson, Nathaniel W

    2016-10-01

    [Correction Notice: An Erratum for this article was reported in Vol 28(10) of Psychological Assessment (see record 2016-22725-001). In the article, the penultimate sentence of the abstract should read “These results suggest that a significant percentage of those making a suspect effort will be diagnosed with ADHD using the most commonly employed assessment methods: an interview alone (71%); an interview and ADHD behavior rating scales combined (65%); and an interview, behavior rating scales, and most continuous performance tests combined (62%).” All versions of this article have been corrected.] This retrospective study examines how many adult patients would plausibly receive a diagnosis of attention-deficit/hyperactivity disorder (ADHD) if performance and symptom validity measures were not administered during neuropsychological evaluations. Five hundred fifty-four patients were extracted from an archival clinical dataset. A total of 102 were diagnosed with ADHD based on cognitive testing, behavior rating scales, effort testing, and clinical interview; 115 were identified as putting forth suspect effort in accordance with the Slick, Sherman, and Iverson (1999) criteria. From a clinical decision-making perspective, suspect effort and ADHD groups were nearly indistinguishable on ADHD behavior, executive function, and functional impairment rating scales, as well as on cognitive testing and key clinical interview questions. These results suggest that a significant percentage of those making a suspect effort will be diagnosed with ADHD using the most commonly employed assessment methods: an interview alone (71%); an interview and ADHD behavior rating scales combined (65%); and an interview, behavior rating scales, and most continuous performance tests combined (62%) [corrected]. This research makes clear that it is essential to evaluate task engagement and possible symptom amplification during clinical evaluations. PsycINFO Database Record (c) 2016 APA, all rights

  8. The incidence of suspected myocardial infarction in Dutch general practice in the period 1978-1994.

    NARCIS (Netherlands)

    Pal-de Bruin, K.M. van der; Verkleij, H.; Jansen, J.; Bartelds, A.; Kromhout, D.

    1998-01-01

    Aim: To evaluate how the incidence of suspected myocardial infarction has developed from 1978 to 1994 and to study the incidence of confirmed acute myocardial infarction in Dutch general practices during the period 1991-1994. Methods: In three periods (1978, 1983-1985 and 1991-1994) the incidence of

  9. Bag-model motivated NN potentials and the three-nucleon system

    International Nuclear Information System (INIS)

    Grach, I.L.; Narodetskij, I.M.

    1986-01-01

    Few examples are presented of the short-range energy-dependent NN potentials derived in the quark compound bag model which satisfy the classical causality condition and show that for the radii of the NN interactions b=1.35-1.40 fm these potentials reproduce the trinucleon binding energy

  10. The evaluation of the patients who admitted to a regional hospital emergency service with suspect of rabies

    Directory of Open Access Journals (Sweden)

    Nurettin Tunç

    2012-09-01

    Full Text Available Objectives: Rabies is one of the highest mortality ratesinfectious disease. The aim was the evaluation of the patientswho admitted to The Batman Regional State HospitalEmergency Service with suspect of rabies in the datesbetween June 2011 and November 2011.Materials and methods: Totally, 166 cases who admittedto our center was recorded according to the followingdata: place of residence (rural/urban, contact type andwound information, time after the contact, whether vaccineor immunoglobulin is applied or not and also the species,breed and being owned of suspected animal.Results: Our study population consisted of a total of 166cases including 38 women (23%, 128 men (77% withthe mean age of 22.01 ± 17.90 years. Of all subjects, 105(63% lived in urban and 61 (37% lived in rural areas.Eighty-five percent of suspicious animals (51% had anowner, while 81 animals were unattended.Conclusions: Our results showed that all admitted patientswere vaccinated and the ones contacted with petsor had a surface wound were vaccinated with 3 doses.Moreover, since the 49% of our cases were contactedwith animals which cannot be follow-up, our study obviouslyreveals that in our country deficiencies in the controlof waifs still is a public health problem and increases thecost of vaccination. J Clin Exp Invest 2012; 3 (3: 383-386Key words: Rabies, suspected bite, rabies prophylaxis

  11. Abdominal and pelvic CT in cases of suspected abuse: can clinical and laboratory findings guide its use?

    International Nuclear Information System (INIS)

    Trout, Andrew T.; Strouse, Peter J.; Mohr, Bethany A.; Khalatbari, S.; Myles, Jamie D.

    2011-01-01

    Incomplete history and concern for occult injury in suspected child abuse occasionally results in CT screenings of the abdomen and pelvis. At our institution, we noted that these exams were infrequently positive. To identify clinical or laboratory criteria that may predict intra-abdominal injury and guide the use of abdominal and pelvic CT in this population. This retrospective review involved 68 children older than 36 months who had a CT of the abdomen/pelvis for suspected abuse. CT results and patient charts were reviewed for physical exam and historical and laboratory variables. CTs were positive in 16% of patients (11/68). Hypoactive/absent bowel sounds (P = 0.01, specificity = 94.7%) and AST and ALT values greater than twice normal (P = 0.004 and P = 0.003 respectively, NPV = 93.6%) were significantly associated with positive CTs. Multiple abnormal physical exam or laboratory findings were also significantly associated with positive CTs (P = 0.03 and P = 0.002 respectively, specificity = 91.3% and NPV = 93.6% respectively). CTs of the abdomen and pelvis are infrequently positive in cases of suspected abuse. To reduce radiation exposure, CTs should only be ordered if there are findings indicating that they may be positive. In our population, these findings include absent/hypoactive bowel sounds, LFTs greater than twice normal and ≥2 abnormal labs or physical exam findings. (orig.)

  12. Abdominal and pelvic CT in cases of suspected abuse: can clinical and laboratory findings guide its use?

    Energy Technology Data Exchange (ETDEWEB)

    Trout, Andrew T.; Strouse, Peter J. [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Mohr, Bethany A. [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Pediatrics, Ann Arbor, MI (United States); Khalatbari, S.; Myles, Jamie D. [University of Michigan, Michigan Institute for Clinical and Health Research, Ann Arbor, MI (United States)

    2011-01-15

    Incomplete history and concern for occult injury in suspected child abuse occasionally results in CT screenings of the abdomen and pelvis. At our institution, we noted that these exams were infrequently positive. To identify clinical or laboratory criteria that may predict intra-abdominal injury and guide the use of abdominal and pelvic CT in this population. This retrospective review involved 68 children older than 36 months who had a CT of the abdomen/pelvis for suspected abuse. CT results and patient charts were reviewed for physical exam and historical and laboratory variables. CTs were positive in 16% of patients (11/68). Hypoactive/absent bowel sounds (P = 0.01, specificity = 94.7%) and AST and ALT values greater than twice normal (P = 0.004 and P = 0.003 respectively, NPV = 93.6%) were significantly associated with positive CTs. Multiple abnormal physical exam or laboratory findings were also significantly associated with positive CTs (P = 0.03 and P = 0.002 respectively, specificity = 91.3% and NPV = 93.6% respectively). CTs of the abdomen and pelvis are infrequently positive in cases of suspected abuse. To reduce radiation exposure, CTs should only be ordered if there are findings indicating that they may be positive. In our population, these findings include absent/hypoactive bowel sounds, LFTs greater than twice normal and {>=}2 abnormal labs or physical exam findings. (orig.)

  13. Modelling assessment of oil sands pit lakes turn-over potential

    International Nuclear Information System (INIS)

    Mackenzie, I.; Vandenberg, J.; Lauzon, N.; Takyi, A.

    2006-01-01

    Pit lakes form when surface mining operations are discontinued and dewatering is terminated. Their use as a treatment step for oil sands surface mining reclamation waters was discussed. The goal of the End Pit Lake Subgroup of the Cumulative Environmental Management Association is to establish guidelines that will enable operators to achieve acceptable water quality for these lakes. Although both biological and physical processes affect turn-over potential, this presentation focused on the size of pit lakes, their depth, starting lake salinity concentrations, inflow rates and inflow salinity flux. These parameters where selected because of their influence on density gradients and turn-over potential. One-dimensional and two-dimensional modelling simulations were performed to examine turnover potential for a large range of pit lake configurations and conditions. The pit lake scenarios chosen for this modelling study included a wide range of changes in 3 lake sizes (1, 4 and 8 km 2 ), 3 lake depths (5, 20 and 50 m), 2 lake starting salinities (1 and 5 parts per thousand), 2 inflow rates (2 and 10 million m 3 per year), 3 starting inflow salinity concentrations (1, 2 and 4 parts per thousand) and 2 rates of influent salinity decrease (6- and 28- year half-life). Simulations showed that autumn is the governing season for determining turn-over potential. For the scenarios examined in this study, the expelling of salt from saline water upon ice formation and the effect of fresh water loading during spring melt events were not found to be significant factors governing turn-over potential. This presentation reviewed the DYRESM, CE-QUAL-W2, and RMA models used in this study. The conclusions reached by each model was also reviewed along with ongoing follow-up work

  14. Potential application of population models in the European ecological risk assessment of chemicals. II. Review of models and their potential to address environmental protection aims.

    Science.gov (United States)

    Galic, Nika; Hommen, Udo; Baveco, J M Hans; van den Brink, Paul J

    2010-07-01

    Whereas current chemical risk assessment (RA) schemes within the European Union (EU) focus mainly on toxicity and bioaccumulation of chemicals in individual organisms, most protection goals aim at preserving populations of nontarget organisms rather than individuals. Ecological models are tools rarely recommended in official technical documents on RA of chemicals, but are widely used by researchers to assess risks to populations, communities and ecosystems. Their great advantage is the relatively straightforward integration of the sensitivity of species to chemicals, the mode of action and fate in the environment of toxicants, life-history traits of the species of concern, and landscape features. To promote the usage of ecological models in regulatory risk assessment, this study tries to establish whether existing, published ecological modeling studies have addressed or have the potential to address the protection aims and requirements of the chemical directives of the EU. We reviewed 148 publications, and evaluated and analyzed them in a database according to defined criteria. Published models were also classified in terms of 5 areas where their application would be most useful for chemical RA. All potential application areas are well represented in the published literature. Most models were developed to estimate population-level responses on the basis of individual effects, followed by recovery process assessment, both in individuals and at the level of metapopulations. We provide case studies for each of the proposed areas of ecological model application. The lack of clarity about protection goals in legislative documents made it impossible to establish a direct link between modeling studies and protection goals. Because most of the models reviewed here were not developed for regulatory risk assessment, there is great potential and a variety of ecological models in the published literature. (c) 2010 SETAC.

  15. Clinical problems of colorectal cancer and endometrial cancer cases with unknown cause of tumor mismatch repair deficiency (suspected Lynch syndrome).

    Science.gov (United States)

    Buchanan, Daniel D; Rosty, Christophe; Clendenning, Mark; Spurdle, Amanda B; Win, Aung Ko

    2014-01-01

    Carriers of a germline mutation in one of the DNA mismatch repair (MMR) genes have a high risk of developing numerous different cancers, predominantly colorectal cancer and endometrial cancer (known as Lynch syndrome). MMR gene mutation carriers develop tumors with MMR deficiency identified by tumor microsatellite instability or immunohistochemical loss of MMR protein expression. Tumor MMR deficiency is used to identify individuals most likely to carry an MMR gene mutation. However, MMR deficiency can also result from somatic inactivation, most commonly methylation of the MLH1 gene promoter. As tumor MMR testing of all incident colorectal and endometrial cancers (universal screening) is becoming increasingly adopted, a growing clinical problem is emerging for individuals who have tumors that show MMR deficiency who are subsequently found not to carry an MMR gene mutation after genetic testing using the current diagnostic approaches (Sanger sequencing and multiplex ligation-dependent probe amplification) and who also show no evidence of MLH1 methylation. The inability to determine the underlying cause of tumor MMR deficiency in these "Lynch-like" or "suspected Lynch syndrome" cases has significant implications on the clinical management of these individuals and their relatives. When the data from published studies are combined, 59% (95% confidence interval [CI]: 55% to 64%) of colorectal cancers and 52% (95% CI: 41% to 62%) of endometrial cancers with MMR deficiency were identified as suspected Lynch syndrome. Recent studies estimated that colorectal cancer risk for relatives of suspected Lynch syndrome cases is lower than for relatives of those with MMR gene mutations, but higher than for relatives of those with tumor MMR deficiency resulting from methylation of the MLH1 gene promoter. The cause of tumor MMR deficiency in suspected Lynch syndrome cases is likely due to either unidentified germline MMR gene mutations, somatic cell mosaicism, or biallelic somatic

  16. A comparative assessment of GIS-based data mining models and a novel ensemble model in groundwater well potential mapping

    Science.gov (United States)

    Naghibi, Seyed Amir; Moghaddam, Davood Davoodi; Kalantar, Bahareh; Pradhan, Biswajeet; Kisi, Ozgur

    2017-05-01

    In recent years, application of ensemble models has been increased tremendously in various types of natural hazard assessment such as landslides and floods. However, application of this kind of robust models in groundwater potential mapping is relatively new. This study applied four data mining algorithms including AdaBoost, Bagging, generalized additive model (GAM), and Naive Bayes (NB) models to map groundwater potential. Then, a novel frequency ratio data mining ensemble model (FREM) was introduced and evaluated. For this purpose, eleven groundwater conditioning factors (GCFs), including altitude, slope aspect, slope angle, plan curvature, stream power index (SPI), river density, distance from rivers, topographic wetness index (TWI), land use, normalized difference vegetation index (NDVI), and lithology were mapped. About 281 well locations with high potential were selected. Wells were randomly partitioned into two classes for training the models (70% or 197) and validating them (30% or 84). AdaBoost, Bagging, GAM, and NB algorithms were employed to get groundwater potential maps (GPMs). The GPMs were categorized into potential classes using natural break method of classification scheme. In the next stage, frequency ratio (FR) value was calculated for the output of the four aforementioned models and were summed, and finally a GPM was produced using FREM. For validating the models, area under receiver operating characteristics (ROC) curve was calculated. The ROC curve for prediction dataset was 94.8, 93.5, 92.6, 92.0, and 84.4% for FREM, Bagging, AdaBoost, GAM, and NB models, respectively. The results indicated that FREM had the best performance among all the models. The better performance of the FREM model could be related to reduction of over fitting and possible errors. Other models such as AdaBoost, Bagging, GAM, and NB also produced acceptable performance in groundwater modelling. The GPMs produced in the current study may facilitate groundwater exploitation

  17. Determination of Morphological, Biometric and Biochemical Susceptibilities in Healthy Eurasier Dogs with Suspected Inherited Glaucoma

    Science.gov (United States)

    Goulle, Frédéric; Thomas, Philippe; Isard, Pierre-François; Azoulay, Thierry; Lafarge-Beurlet, Stéphanie; Woods, Mike; Lavillegrand, Sylvie; Ivkovic, Ivana; Neveux, Nathalie; Sahel, José-Alain; Picaud, Serge; Froger, Nicolas

    2014-01-01

    In both humans and dogs, the primary risk factor for glaucoma is high intraocular pressure (IOP), which may be caused by iridocorneal angle (ICA) abnormalities. Oxidative stress has also been implicated in retinal ganglion cell damage associated with glaucoma. A suspected inherited form of glaucoma was recently identified in Eurasier dogs (EDs), a breed for which pedigrees are readily available. Because of difficulties in assessing ICA morphology in dogs with advanced glaucoma, we selected a cohort of apparently healthy dogsfor the investigation of ICA morphological status, IOP and plasma concentrations of oxidative stress biomarkers. We aimed to establish correlations between these factors, to identify predictive markers of glaucoma in this dog breed. A cohort of 28 subjects, volunteered for inclusion by their owners, was selected by veterinary surgeons. These dogs were assigned to four groups: young males, young females (1–3 years old), adult males and adult females (4–8 years old). Ocular examination included ophthalmoscopy, tonometry, gonioscopy, biometry and ultrasound biomicroscopy (UBM), and the evaluation of oxidative stress biomarkers consisting of measurements of plasma glutathione peroxidase (GP) activity and taurine and metabolic precursor (methionine and cysteine) concentrations in plasma. The prevalence of pectinate ligament abnormalities was significantly higher in adult EDs than in young dogs. Moreover, in adult females, high IOP was significantly correlated with a short axial globe length, and a particularly large distance between Schwalbe's line and the anterior lens capsule. GP activity levels were significantly lower in EDs than in a randomized control group of dogs, and plasma taurine concentrations were higher. Hence, ICA abnormalities were associated with weaker antioxidant defenses in EDs, potentially counteracted by higher plasma taurine concentrations. This study suggests that EDs may constitute an appropriate canine model for the

  18. Determination of morphological, biometric and biochemical susceptibilities in healthy Eurasier dogs with suspected inherited glaucoma.

    Directory of Open Access Journals (Sweden)

    Thomas Boillot

    Full Text Available In both humans and dogs, the primary risk factor for glaucoma is high intraocular pressure (IOP, which may be caused by iridocorneal angle (ICA abnormalities. Oxidative stress has also been implicated in retinal ganglion cell damage associated with glaucoma. A suspected inherited form of glaucoma was recently identified in Eurasier dogs (EDs, a breed for which pedigrees are readily available. Because of difficulties in assessing ICA morphology in dogs with advanced glaucoma, we selected a cohort of apparently healthy dogsfor the investigation of ICA morphological status, IOP and plasma concentrations of oxidative stress biomarkers. We aimed to establish correlations between these factors, to identify predictive markers of glaucoma in this dog breed. A cohort of 28 subjects, volunteered for inclusion by their owners, was selected by veterinary surgeons. These dogs were assigned to four groups: young males, young females (1-3 years old, adult males and adult females (4-8 years old. Ocular examination included ophthalmoscopy, tonometry, gonioscopy, biometry and ultrasound biomicroscopy (UBM, and the evaluation of oxidative stress biomarkers consisting of measurements of plasma glutathione peroxidase (GP activity and taurine and metabolic precursor (methionine and cysteine concentrations in plasma. The prevalence of pectinate ligament abnormalities was significantly higher in adult EDs than in young dogs. Moreover, in adult females, high IOP was significantly correlated with a short axial globe length, and a particularly large distance between Schwalbe's line and the anterior lens capsule. GP activity levels were significantly lower in EDs than in a randomized control group of dogs, and plasma taurine concentrations were higher. Hence, ICA abnormalities were associated with weaker antioxidant defenses in EDs, potentially counteracted by higher plasma taurine concentrations. This study suggests that EDs may constitute an appropriate canine model for

  19. Treatment with epinephrine (adrenaline) in suspected anaphylaxis during anesthesia in Denmark.

    Science.gov (United States)

    Garvey, Lene H; Belhage, Bo; Krøigaard, Mogens; Husum, Bent; Malling, Hans-Jørgen; Mosbech, Holger

    2011-07-01

    Literature on the use of epinephrine in the treatment of anaphylaxis during anesthesia is very limited. The objective of this study was to investigate how often epinephrine is used in the treatment of suspected anaphylaxis during anesthesia in Denmark and whether timing of treatment is important. A retrospective study of 270 patients investigated at the Danish Anaesthesia Allergy Centre after referral due to suspected anaphylaxis during anesthesia was performed. Reactions had been graded by severity: C1, mild reactions; C2, moderate reactions; C3, anaphylactic shock with circulatory instability; C4, cardiac arrest. Use of epinephrine, dosage, route of administration, and time between onset of circulatory instability and epinephrine administration were noted. A total of 122 (45.2%) of referred patients had C3 or C4 reactions; of those, 101 (82.8%) received epinephrine. Route of administration was intravenous in 95 (94%) patients. Median time from onset of reported hypotension to treatment with epinephrine was 10 min (range, 1-70 min). Defining epinephrine treatment less than or equal to 10 min after onset of hypotension as early, and more than 10 min as late, infusion was needed in 12 of 60 patients (20%) treated early versus 12 of 35 patients (34%) treated late (odds ratio, 2.09) (95% confidence interval, 0.81-5.35). Anaphylaxis may be difficult to diagnose during anesthesia, and treatment with epinephrine can be delayed as a consequence. Anaphylaxis should be considered and treated in patients with circulatory instability during anesthesia of no apparent cause who do not respond to the usual treatments.

  20. Spinal diffusion tensor tractography for differentiation of intramedullary tumor-suspected lesions

    Energy Technology Data Exchange (ETDEWEB)

    Egger, K., E-mail: karl.egger@uniklinik-freiburg.de [Department of Neuroradiology, University Medical Center Freiburg, Breisacher Straße 64, 79106 Freiburg (Germany); Hohenhaus, M. [Department of Neurosurgery, University Medical Center Freiburg, Breisacher Straße 64, 79106 Freiburg (Germany); Van Velthoven, V. [Department of Neurosurgery, UZ Brussel, Laarbeeklaan 101, 1090 Brussel (Belgium); Heil, S.; Urbach, H. [Department of Neuroradiology, University Medical Center Freiburg, Breisacher Straße 64, 79106 Freiburg (Germany)

    2016-12-15

    Background and purpose: Primary MRI diagnosis of spinal intramedullary tumor-suspected lesions can be challenging and often requires spinal biopsy or resection with a substantial risk of neurological deficits. We evaluated whether Diffusion Tensor Imaging (DTI) tractography can facilitate the differential diagnosis. Materials and methods: Twenty-five consecutive patients with an intramedullary tumor-suspected lesion considered for spinal surgery were studied with a Diffusion-weighted multi-shot read out segmented EPI sequence (RESOLVE). White matter tracts (“streamlines”) were calculated using the FACT algorithm and visually co-registered to a T2-weighted 3D sequence. The fused images were assessed concerning spinal streamline appearance as normal, displaced or terminated. Definite diagnosis was verified by histological analysis or further clinical work-up. Results: All patients with normal appearing streamlines (n = 6) showed an acute inflammatory demyelinating pathology in the further clinical work-up. In 10 patients streamline displacing lesions were found from which 5 patients underwent a surgical treatment with histologically confirmed low-grade tumors like ependymomas and pilocytic astrocytomas. In nine patients streamlines were terminated, from which 6 patients received a histology proven diagnoses with a more heterogenous spectrum (3 cases of high grade tumor, 1 case of low grade tumor with intralesional hemorrhage and 2 cases with gliosis but no tumor cells). Conclusion: Using multi-shot DTI spinal tractography acute inflammatory lesions can be differentiated from other tumorous intramedullary lesions. The entity diagnosis of spinal tumors seems to be more challenging, primarily due to the variety of factors like invasivity, expansion or intralesional hemorrhage.

  1. Investigating suspected acute pulmonary embolism - what are hospital clinicians thinking?

    International Nuclear Information System (INIS)

    McQueen, A.S.; Worthy, S.; Keir, M.J.

    2008-01-01

    Aims: To assess local clinical knowledge of the appropriate investigation of suspected acute pulmonary embolism (PE) and this compare with the 2003 British Thoracic Society (BTS) guidelines as a national reference standard. Methods: A clinical questionnaire was produced based on the BTS guidelines. One hundred and eight-six participants completed the questionnaires at educational sessions for clinicians of all grades, within a single NHS Trust. The level of experience amongst participants ranged from final year medical students to consultant physicians. Results: The clinicians were divided into four groups based on seniority: Pre-registration, Junior, Middle, and Senior. Forty-six point eight percent of all the clinicians correctly identified three major risk factors for PE and 25.8% recognized the definition of the recommended clinical probability score from two alternatives. Statements regarding the sensitivity of isotope lung imaging and computed tomography pulmonary angiography (CTPA) received correct responses from 41.4 and 43% of participants, respectively, whilst 81.2% recognized that an indeterminate ventilation-perfusion scintigraphy (V/Q) study requires further imaging. The majority of clinicians correctly answered three clinical scenario questions regarding use of D-dimers and imaging (78, 85, and 57.5%). There was no statistically significant difference between the four groups for any of the eight questions. Conclusions: The recommended clinical probability score was unfamiliar to all four groups of clinicians in the present study, and the majority of doctors did not agree that a negative CTPA or isotope lung scintigraphy reliably excluded PE. However, questions based on clinical scenarios received considerably higher rates of correct responses. The results indicate that various aspects of the national guidelines on suspected acute pulmonary embolism are unfamiliar to many UK hospital clinicians. Further research is needed to identify methods to improve

  2. Exploring the speed and performance of molecular replacement with AMPLE using QUARK ab initio protein models

    Energy Technology Data Exchange (ETDEWEB)

    Keegan, Ronan M. [STFC Rutherford Appleton Laboratory, Didcot OX11 0FA (United Kingdom); Bibby, Jaclyn; Thomas, Jens [University of Liverpool, Liverpool L69 7ZB (United Kingdom); Xu, Dong [Sanford-Burnham Medical Research Institute, 10901 North Torrey Pines Road, La Jolla, CA 92037 (United States); Zhang, Yang [University of Michigan, Ann Arbor, MI 48109 (United States); Mayans, Olga [University of Liverpool, Liverpool L69 7ZB (United Kingdom); Winn, Martyn D. [Science and Technology Facilities Council Daresbury Laboratory, Warrington WA4 4AD (United Kingdom); Rigden, Daniel J., E-mail: drigden@liv.ac.uk [University of Liverpool, Liverpool L69 7ZB (United Kingdom); STFC Rutherford Appleton Laboratory, Didcot OX11 0FA (United Kingdom)

    2015-02-01

    Two ab initio modelling programs solve complementary sets of targets, enhancing the success of AMPLE with small proteins. AMPLE clusters and truncates ab initio protein structure predictions, producing search models for molecular replacement. Here, an interesting degree of complementarity is shown between targets solved using the different ab initio modelling programs QUARK and ROSETTA. Search models derived from either program collectively solve almost all of the all-helical targets in the test set. Initial solutions produced by Phaser after only 5 min perform surprisingly well, improving the prospects for in situ structure solution by AMPLE during synchrotron visits. Taken together, the results show the potential for AMPLE to run more quickly and successfully solve more targets than previously suspected.

  3. Separable potential approach in the folding model. Pt. 2

    International Nuclear Information System (INIS)

    Lee, C.L.; Robson, D.

    1982-01-01

    A microscopic folding formalism using a separable potential approach is applied to the elastic scattering of the n-α system. Starting with a separable nucleon-nucleon (NN) potential model, a sum of separable nucleon-nucleus potentials is obtained. A simple structure of the α-particle is assumed and the Tabakin, the Doleschall and the Strobel NN potentials are considered. These phenomenological interactions are of Yukawa or gaussian form with variable parameters for each partial wave. Spin-orbit and tensor forces are included. The resulting potentials developed from our folding calculations give approximately the same ssub(1/2) phase shifts for the n-α elastic scattering. However, in the psub(1/2) and psub(3/2) phase-shift analysis, an effective interaction derived from the NN potential is necessary to reproduce the resonances. One free energy independent parameter is introduced in our approximate G-matrix concept to give a good fit for the phase shifts. Single-nucleon knockout exchange (SNKE) is considered throughout. (orig.)

  4. Bile acid aspiration in suspected ventilator-associated pneumonia.

    Science.gov (United States)

    Wu, Yu-Chung; Hsu, Po-Kuei; Su, Kang-Cheng; Liu, Lung-Yu; Tsai, Cheng-Chien; Tsai, Shu-Ho; Hsu, Wen-Hu; Lee, Yu-Chin; Perng, Diahn-Warng

    2009-07-01

    The aims of this study were to measure the levels of bile acids in patients with suspected ventilator-associated pneumonia (VAP) and provide a possible pathway for neutrophilic inflammation to explain its proinflammatory effect on the airway. Bile acid levels were measured by spectrophotometric enzymatic assay, and liquid chromatography mass spectrometry was used to quantify the major bile acids. Alveolar cells were grown on modified air-liquid interface culture inserts, and bile acids were then employed to stimulate the cells. Reverse transcriptase polymerase chain reaction and Western blots were used to determine the involved gene expression and protein levels. The mean (+/- SE) concentration of total bile acids in tracheal aspirates was 6.2 +/- 2.1 and 1.1 +/- 0.4 mumol/L/g sputum, respectively, for patients with and without VAP (p VAP group (p aspiration may reduce the intensity of neutrophilic inflammation in intubated and mechanically ventilated patients in the ICU.

  5. Complementary roles of m-mode echocardiography and scintigraphy in the evaluation of adults wih suspected left-to-right shunts

    International Nuclear Information System (INIS)

    Botvinick, E.H.; Schiller, N.B.

    1980-01-01

    We sought to determine the relative clinical abilities and roles of echocardiography and scintigraphy in left-to-right shunt diagnosis. M-mode echocardiographic and scintigraphic studies were analyzed in 37 adults presenting diagnostic difficulties with suspected left-to-right shunts. An enlarged right ventricle on M-mode echocardiography was a sensitive (100%) but not specific (55%) indicator of atrial septal defect (ASD). M-mode lacked sensitivity for ventricular eptal defect (VSD) and patent ductus arteriosus (PDA). In a few studies, two-dimensional echocardiography provided additional specific and clinically important anatomic information. Scintigraphic analysis demonstrated complete diagnostic accuracy and excellent localizing and quantitative abilities in all patients studied. Because it is extremely sensitie to ASD, free of any exposure to radioactivity, entirely noninvasive and may by simply and visually analyzed, echocardiography is the study of choice in the preliminary evaluation of patients presenting, diagnostic difficulty with suspected ASD. Scintigraphy is the study of choice in the preliminary evaluation of patients presenting diagnostic difficulty with suspected VSD and PDA and is the logical response to the finding of echocardiographic right ventricular enlargement when the diagnosis remains in doubt

  6. Electrostatic potential map modelling with COSY Infinity

    International Nuclear Information System (INIS)

    Maloney, J.A.; Baartman, R.; Planche, T.; Saminathan, S.

    2016-01-01

    COSY Infinity (Makino and Berz, 2005) is a differential-algebra based simulation code which allows accurate calculation of transfer maps to arbitrary order. COSY’s existing internal procedures were modified to allow electrostatic elements to be specified using an array of field potential data from the midplane. Additionally, a new procedure was created allowing electrostatic elements and their fringe fields to be specified by an analytic function. This allows greater flexibility in accurately modelling electrostatic elements and their fringe fields. Applied examples of these new procedures are presented including the modelling of a shunted electrostatic multipole designed with OPERA, a spherical electrostatic bender, and the effects of different shaped apertures in an electrostatic beam line.

  7. Magnetic moments of octet baryons in a chiral potential model

    International Nuclear Information System (INIS)

    Barik, N.

    1986-01-01

    Incorporating the lowest-order pionic correction, the magnetic moments of the nucleon octet have been calculated in a chiral potential model. The potential, representing phenomenologically the nonperturbative gluon self-couplings, is chosen with equally mixed scalar and vector parts in a power-law form. The results are in reasonable agreement with experiment. (author)

  8. Stationary configurations of the Standard Model Higgs potential

    DEFF Research Database (Denmark)

    Iacobellis, Giuseppe; Masina, Isabella

    2016-01-01

    the stability of the SM electroweak minimum and ii) the value of the Higgs potential at a rising inflection point. We examine in detail and reappraise the experimental and theoretical uncertainties which plague their determination, finding that i) the stability of the SM is compatible with the present data...... at the 1.5σ level and ii) despite the large theoretical error plaguing the value of the Higgs potential at a rising inflection point, the application of such a configuration to models of primordial inflation displays a 3σ tension with the recent bounds on the tensor-to-scalar ratio of cosmological...

  9. The value of chest X-ray in the Scottish Referral Guidelines for suspected head and neck cancer in 2144 patients.

    Science.gov (United States)

    Fingland, P; Carswell, V; Tikka, T; Douglas, C M; Montgomery, J

    2018-04-30

    In Scotland, patients with suspected head and neck cancer are referred on the basis of the Scottish Referral Guidelines for Suspected Cancer, rather than the National Institute for Health and Care Excellence guidelines. A chest X-ray should be requested by the general practitioner at the same time as referral for persistent hoarseness. The evidence for this is level 4. This audit identified adherence to this recommendation and X-ray results. All 'urgent suspicion of cancer' referrals to the ENT department in the National Health Service Greater Glasgow and Clyde for 2015-2016 were audited. Persistent hoarseness for more than 3 weeks instigated referral in 318 patients (15.7 per cent). Chest X-ray was performed in 120 patients (38 per cent), which showed: no abnormality in 116 (96.7 per cent), features of infection in 2 (1.7 per cent) and something else in 2 patients (1.7 per cent). No chest X-ray altered the management of a patient. Performance of chest X-ray does not alter management and its removal from the Scottish Referral Guidelines for Suspected Cancer is recommended.

  10. The Shetland Islands scrapie monitoring and control programme: analysis of the clinical data collected from 772 scrapie suspects 1985-1997.

    Science.gov (United States)

    Cockcroft, P D; Clark, A M

    2006-02-01

    There were 574 scrapie positive suspects (histopathological scrapie lesions present) and 198 scrapie negative suspects (histopathological scrapie lesions absent). The greatest number of scrapie cases were recorded in sheep of 2, 3 and 4 years of age which represented 17%, 36% and 23% of the scrapie positive suspects, respectively. The sign sensitivities and specificities for the ten recorded signs were, respectively: pruritus (62%, 42%), ataxia (23%, 74%), hyperaesthesia (32%, 74%), wool loss (25%, 73%), fleece discolouration (29%, 85%), bruxism (23%, 69%), nibbling reflex (17%, 58%), head rubbing (47%, 78%), poll rubbing (25%, 83%). These single signs had poor discriminatory values with likelihood ratios close to one (range 0.89-1.21); combinations of the four signs, pruritus, wool loss, ataxia, hyperaesthesia and emaciation were more discriminatory (range 0.30-4.3). This study covered a time period when bovine spongiform encephalopathy (BSE) might have been introduced into the sheep population on the Shetland Islands via contaminated feed. No temporal changes could be detected in the age structure of the affected animals.

  11. Dog erythrocyte antigens (DEA) 1, 4, 7 and suspected naturally occurring anti-DEA 7 antibodies in Italian Corso dogs.

    Science.gov (United States)

    Spada, E; Proverbio, D; Priolo, V; Ippolito, D; Baggiani, L; Perego, R; Pennisi, M G

    2017-04-01

    We sought to determine the prevalence of dog erythrocyte antigen (DEA) 1, 4 and 7 and naturally occurring anti-DEA7 antibodies in Italian Corso dogs. In addition, we correlated DEAs with different epidemiologic variables, compared the prevalence of DEAs against other canine populations and assessed the risk of sensitisation and transfusion reactions (TRs) following unmatched transfusion. Blood samples from 100 Corso dogs were evaluated for DEA 1, 4, 7 and naturally occurring anti-DEA 7 antibodies. Seventy-one percent of samples were DEA 1-negative, 100% tested DEA 4-positive, and 95% tested DEA 7-negative. Suspected anti-DEA7 antibodies were found in 32% dogs. The DEA 1 and 7-negative phenotypes were significantly more common than in most canine populations. When a previously tested Italian canine population was considered as blood donors for Corso dogs, the risk of DEA 1 sensitisation using DEA 1 untyped blood was 29%, and of acute haemolytic TRs after a second untyped DEA 1-incompatible transfusion was 8%. The potential for delayed TRs between DEA 7-negative Corso dogs with suspected naturally occurring anti-DEA 7 antibodies receiving untyped DEA 7-positive blood was 11%. Conversely, when Corso dogs were blood donors for the same population, the risk of DEA 1 sensitisation was 17% and the risk of an acute haemolytic TR after a second DEA 1-incompatible blood transfusion was 3%. Corso dogs can be suitable blood donors. Additional studies are needed to clarify whether the high prevalence of naturally occurring anti-DEA 7 antibodies in this breed could increase their risk of delayed TRs when they are blood recipients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Cohort profile: prevalence of valvular heart disease in community patients with suspected heart failure in UK.

    Science.gov (United States)

    Marciniak, Anna; Glover, Keli; Sharma, Rajan

    2017-01-27

    The aim of this study was to evaluate the proportion of suspected heart failure patients with significant valvular heart disease. Early diagnosis of valve disease is essential as delay can limit treatment and negatively affect prognosis for undiagnosed patients. The prevalence of unsuspected valve disease in the community is uncertain. We prospectively evaluated 79 043 patients, between 2001 and 2011, who were referred to a community open access echocardiography service for suspected heart failure. All patients underwent a standard transthoracic echocardiogram according to British Society of Echocardiography guidelines. Of the total number, 29 682 patients (37.5%) were diagnosed with mild valve disease, 8983 patients (11.3%) had moderate valve disease and 2134 (2.7%) had severe valve disease. Of the total number of patients scanned, the prevalence of aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation was 10%, 8.4%, 1%, and 12.5% respectively. 18% had tricuspid regurgitation. 5% had disease involving one or more valves. Of patients with suspected heart failure in the primary care setting, a significant proportion have important valvular heart disease. These patients are at high risk of future cardiac events and will require onward referral for further evaluation. We recommend that readily available community echocardiography services should be provided for general practitioners as this will result in early detection of valve disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Imaging Algorithms for Evaluating Suspected Rotator Cuff Disease: Society of Radiologists in Ultrasound Consensus Conference Statement

    Science.gov (United States)

    Jacobson, Jon A.; Benson, Carol B.; Bancroft, Laura W.; Bedi, Asheesh; McShane, John M.; Miller, Theodore T.; Parker, Laurence; Smith, Jay; Steinbach, Lynne S.; Teefey, Sharlene A.; Thiele, Ralf G.; Tuite, Michael J.; Wise, James N.; Yamaguchi, Ken

    2013-01-01

    The Society of Radiologists in Ultrasound convened a panel of specialists from a variety of medical disciplines to reach a consensus about the recommended imaging evaluation of painful shoulders with clinically suspected rotator cuff disease. The panel met in Chicago, Ill, on October 18 and 19, 2011, and created this consensus statement regarding the roles of radiography, ultrasonography (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography. The consensus panel consisted of two co-moderators, a facilitator, a statistician and health care economist, and 10 physicians who have specialty expertise in shoulder pain evaluation and/or treatment. Of the 13 physicians on the panel, nine were radiologists who were chosen to represent a broad range of skill sets in diagnostic imaging, different practice types (private and academic), and different geographical regions of the United States. Five of the radiologists routinely performed musculoskeletal US as part of their practice and four did not. There was also one representative from each of the following clinical specialties: rheumatology, physical medicine and rehabilitation, orthopedic surgery, and nonoperative sports medicine. The goal of this conference was to construct several algorithms with which to guide the imaging evaluation of suspected rotator cuff disease in patients with a native rotator cuff, patients with a repaired rotator cuff, and patients who have undergone shoulder replacement. The panel hopes that these recommendations will lead to greater uniformity in rotator cuff imaging and more cost-effective care for patients suspected of having rotator cuff abnormality. © RSNA, 2013 PMID:23401583

  14. Utility of urine cytology in evaluating hematuria with sonographically suspected bladder lesion in patients older than 50 years

    Directory of Open Access Journals (Sweden)

    Hussam Eldin Helmy Mady

    2014-01-01

    Conclusion: Hematuria in patients older than 50 years with sonographically suspected bladder lesion mandates cystoscopy and biopsy. UC does not add more significant information in this group of patients.

  15. How to optimize tuberculosis case finding: explorations for Indonesia with a health system model

    Directory of Open Access Journals (Sweden)

    Mahendradhata Yodi

    2009-06-01

    Full Text Available Abstract Background A mathematical model was designed to explore the impact of three strategies for better tuberculosis case finding. Strategies included: (1 reducing the number of tuberculosis patients who do not seek care; (2 reducing diagnostic delay; and (3 engaging non-DOTS providers in the referral of tuberculosis suspects to DOTS services in the Indonesian health system context. The impact of these strategies on tuberculosis mortality and treatment outcome was estimated using a mathematical model of the Indonesian health system. Methods The model consists of multiple compartments representing logical movement of a respiratory symptomatic (tuberculosis suspect through the health system, including patient- and health system delays. Main outputs of the model are tuberculosis death rate and treatment outcome (i.e. full or partial cure. We quantified the model parameters for the Jogjakarta province context, using a two round Delphi survey with five Indonesian tuberculosis experts. Results The model validation shows that four critical model outputs (average duration of symptom onset to treatment, detection rate, cure rate, and death rate were reasonably close to existing available data, erring towards more optimistic outcomes than are actually reported. The model predicted that an intervention to reduce the proportion of tuberculosis patients who never seek care would have the biggest impact on tuberculosis death prevention, while an intervention resulting in more referrals of tuberculosis suspects to DOTS facilities would yield higher cure rates. This finding is similar for situations where the alternative sector is a more important health resource, such as in most other parts of Indonesia. Conclusion We used mathematical modeling to explore the impact of Indonesian health system interventions on tuberculosis treatment outcome and deaths. Because detailed data were not available regarding the current Indonesian population, we relied on expert

  16. ANAMNESIS AND CLINIC FINDINGS OF THE PATIENTS SUSPECTED OF HAVING ECTOPIC PREGNANCY

    Directory of Open Access Journals (Sweden)

    Stanoje Pesic

    2000-09-01

    Full Text Available An analysis has been done of a series of 573 patients suffering from extrauterinepregnancy, namely those found suspect upon entering the hospital. Thediagnosis of extra-uterine pregnancy was confirmed in 322 (56% patients. Theleading symptom of extra-uterine pregnancy is metrorrhagia (63,41%. As for theoperation time, 3 1% of them were immediately operated. The ultrasound techniqueadds to the diagnostic certainty. Our results show that carefully taken anamnesis inaddition to symptom recording and a careful clinic examination can make possiblethe extra-uterine pregnancy diagnosis.

  17. Development of global medium-energy nucleon-nucleus optical model potentials

    International Nuclear Information System (INIS)

    Madland, D.G.; Sierk, A.J.

    1997-01-01

    The authors report on the development of new global optical model potentials for nucleon-nucleus scattering at medium energies. Using both Schroedinger and Dirac scattering formalisms, the goal is to construct a physically realistic optical potential describing nucleon-nucleus elastic scattering observables for a projectile energy range of (perhaps) 20 meV to (perhaps) 2 GeV and a target mass range of 16 to 209, excluding regions of strong nuclear deformation. They use a phenomenological approach guided by conclusions from recent microscopic studies. The experimental database consists largely of proton-nucleus elastic differential cross sections, analyzing powers, spin-rotation functions, and total reaction cross sections, and neutron-nucleus total cross sections. They will use this database in a nonlinear least-squares adjustment of optical model parameters in both relativistic equivalent Schroedinger (including relativistic kinematics) and Dirac (second-order reduction) formalisms. Isospin will be introduced through the standard Lane model and a relativistic generalization of that model

  18. Fast optimization of statistical potentials for structurally constrained phylogenetic models

    Directory of Open Access Journals (Sweden)

    Rodrigue Nicolas

    2009-09-01

    Full Text Available Abstract Background Statistical approaches for protein design are relevant in the field of molecular evolutionary studies. In recent years, new, so-called structurally constrained (SC models of protein-coding sequence evolution have been proposed, which use statistical potentials to assess sequence-structure compatibility. In a previous work, we defined a statistical framework for optimizing knowledge-based potentials especially suited to SC models. Our method used the maximum likelihood principle and provided what we call the joint potentials. However, the method required numerical estimations by the use of computationally heavy Markov Chain Monte Carlo sampling algorithms. Results Here, we develop an alternative optimization procedure, based on a leave-one-out argument coupled to fast gradient descent algorithms. We assess that the leave-one-out potential yields very similar results to the joint approach developed previously, both in terms of the resulting potential parameters, and by Bayes factor evaluation in a phylogenetic context. On the other hand, the leave-one-out approach results in a considerable computational benefit (up to a 1,000 fold decrease in computational time for the optimization procedure. Conclusion Due to its computational speed, the optimization method we propose offers an attractive alternative for the design and empirical evaluation of alternative forms of potentials, using large data sets and high-dimensional parameterizations.

  19. Modeling the Potential for Vaccination to Diminish the Burden of Invasive Non-typhoidal Salmonella Disease in Young Children in Mali, West Africa.

    Directory of Open Access Journals (Sweden)

    Kristin Bornstein

    2017-02-01

    Full Text Available In sub-Saharan Africa, systematic surveillance of young children with suspected invasive bacterial disease (e.g., septicemia, meningitis has revealed non-typhoidal Salmonella (NTS to be a major pathogen exhibiting high case fatality (~20%. Where infant vaccination against Haemophilus influenzae type b (Hib and Streptococcus pneumoniae has been introduced to prevent invasive disease caused by these pathogens, as in Bamako, Mali, their burden has decreased markedly. In parallel, NTS has become the predominant invasive bacterial pathogen in children aged <5 years. While NTS is believed to be acquired orally via contaminated food/water, epidemiologic studies have failed to identify the reservoir of infection or vehicles of transmission. This has precluded targeting food chain interventions to diminish disease transmission but conversely has fostered the development of vaccines to prevent invasive NTS (iNTS disease. We developed a mathematical model to estimate the potential impact of NTS vaccination programs in Bamako.A Markov chain transmission model was developed utilizing age-specific Bamako demographic data and hospital surveillance data for iNTS disease in children aged <5 years and assuming vaccine coverage and efficacy similar to the existing, successfully implemented, Hib vaccine. Annual iNTS hospitalizations and deaths in children <5 years, with and without a Salmonella Enteritidis/Salmonella Typhimurium vaccine, were the model's outcomes of interest. Per the model, high coverage/high efficacy iNTS vaccination programs would drastically diminish iNTS disease except among infants age <8 weeks.The public health impact of NTS vaccination shifts as disease burden, vaccine coverage, and serovar distribution vary. Our model shows that implementing an iNTS vaccine through an analogous strategy to the Hib vaccination program in Bamako would markedly reduce cases and deaths due to iNTS among the pediatric population. The model can be adjusted for

  20. Suspected Lynch syndrome associated MSH6 variants: A functional assay to determine their pathogenicity.

    Directory of Open Access Journals (Sweden)

    Hellen Houlleberghs

    2017-05-01

    Full Text Available Lynch syndrome (LS is a hereditary cancer predisposition caused by inactivating mutations in DNA mismatch repair (MMR genes. Mutations in the MSH6 DNA MMR gene account for approximately 18% of LS cases. Many LS-associated sequence variants are nonsense and frameshift mutations that clearly abrogate MMR activity. However, missense mutations whose functional implications are unclear are also frequently seen in suspected-LS patients. To conclusively diagnose LS and enroll patients in appropriate surveillance programs to reduce morbidity as well as mortality, the functional consequences of these variants of uncertain clinical significance (VUS must be defined. We present an oligonucleotide-directed mutagenesis screen for the identification of pathogenic MSH6 VUS. In the screen, the MSH6 variant of interest is introduced into mouse embryonic stem cells by site-directed mutagenesis. Subsequent selection for MMR-deficient cells using the DNA damaging agent 6-thioguanine (6TG allows the identification of MMR abrogating VUS because solely MMR-deficient cells survive 6TG exposure. We demonstrate the efficacy of the genetic screen, investigate the phenotype of 26 MSH6 VUS and compare our screening results to clinical data from suspected-LS patients carrying these variant alleles.

  1. Hierarchy of model Kohn–Sham potentials for orbital-dependent functionals: A practical alternative to the optimized effective potential method

    International Nuclear Information System (INIS)

    Kohut, Sviataslau V.; Staroverov, Viktor N.; Ryabinkin, Ilya G.

    2014-01-01

    We describe a method for constructing a hierarchy of model potentials approximating the functional derivative of a given orbital-dependent exchange-correlation functional with respect to electron density. Each model is derived by assuming a particular relationship between the self-consistent solutions of Kohn–Sham (KS) and generalized Kohn–Sham (GKS) equations for the same functional. In the KS scheme, the functional is differentiated with respect to density, in the GKS scheme—with respect to orbitals. The lowest-level approximation is the orbital-averaged effective potential (OAEP) built with the GKS orbitals. The second-level approximation, termed the orbital-consistent effective potential (OCEP), is based on the assumption that the KS and GKS orbitals are the same. It has the form of the OAEP plus a correction term. The highest-level approximation is the density-consistent effective potential (DCEP), derived under the assumption that the KS and GKS electron densities are equal. The analytic expression for a DCEP is the OCEP formula augmented with kinetic-energy-density-dependent terms. In the case of exact-exchange functional, the OAEP is the Slater potential, the OCEP is roughly equivalent to the localized Hartree–Fock approximation and related models, and the DCEP is practically indistinguishable from the true optimized effective potential for exact exchange. All three levels of the proposed hierarchy require solutions of the GKS equations as input and have the same affordable computational cost

  2. Magnetic moments of octet baryons in a chiral potential model

    Energy Technology Data Exchange (ETDEWEB)

    Barik, N; Das, M

    1986-12-01

    Incorporating the lowest-order pionic correction, the magnetic moments of the nucleon octet have been calculated in a chiral potential model. The potential, representing phenomenologically the nonperturbative gluon self-couplings, is chosen with equally mixed scalar and vector parts in a power-law form. The results are in reasonable agreement with experiment. 32 refs., 2 tables.

  3. Overview of suspected adverse reactions to veterinary medicinal products reported in South Africa (March 2004 - February 2006 : report

    Directory of Open Access Journals (Sweden)

    V. Naidoo

    2006-06-01

    Full Text Available The Veterinary Pharmacovigilance and Medicines Information Centre is responsible for the monitoring of veterinary adverse drug reactions in South Africa. An overview of reports of suspected adverse drug reactions received by the centre during the period March 2004 to February 2006 is presented. A total of 21 reports was received in the 2-year period, continuing the decline in the number of reports to a lower figure than in any previous year. This is surprising considering the legal obligation of the veterinary professionals to report all adverse drug reactions. Once again the majority of reports involved suspected adverse reactions that occurred in dogs and cats. Most of the products implicated were stock remedies. Veterinarians predominantly administered these products.

  4. Modelling of solar energy potential in Nigeria using an artificial neural network model

    International Nuclear Information System (INIS)

    Fadare, D.A.

    2009-01-01

    In this study, an artificial neural network (ANN) based model for prediction of solar energy potential in Nigeria (lat. 4-14 o N, log. 2-15 o E) was developed. Standard multilayered, feed-forward, back-propagation neural networks with different architecture were designed using neural toolbox for MATLAB. Geographical and meteorological data of 195 cities in Nigeria for period of 10 years (1983-1993) from the NASA geo-satellite database were used for the training and testing the network. Meteorological and geographical data (latitude, longitude, altitude, month, mean sunshine duration, mean temperature, and relative humidity) were used as inputs to the network, while the solar radiation intensity was used as the output of the network. The results show that the correlation coefficients between the ANN predictions and actual mean monthly global solar radiation intensities for training and testing datasets were higher than 90%, thus suggesting a high reliability of the model for evaluation of solar radiation in locations where solar radiation data are not available. The predicted solar radiation values from the model were given in form of monthly maps. The monthly mean solar radiation potential in northern and southern regions ranged from 7.01-5.62 to 5.43-3.54 kW h/m 2 day, respectively. A graphical user interface (GUI) was developed for the application of the model. The model can be used easily for estimation of solar radiation for preliminary design of solar applications.

  5. Potentials for the Modified Cam-Clay model

    OpenAIRE

    Zouain , Nestor; Pontes , Ivaldo; Vaunat , Jean

    2009-01-01

    Abstract Energy and dissipation pseudo-potentials are employed to derive constitutive relationships, in the context of thermodynamic concepts, for the widely used Modified Cam-Clay (MCC) model for soil mechanics. A variational formulation of the MCC evolution equations is proposed in this paper. Since plastic collapse of MCC soils cannot be embedded in the classical limit analysis theory, finding the critical amplification of the load that produces plastic collapse is formulated in...

  6. Formation of potential antigens from radiographic contrast media

    International Nuclear Information System (INIS)

    Nilsson, R.; Ehrenberg, L.; Fedorcsak, I.

    1987-01-01

    The use of radiographic contrast media is occasionally accompanied by more or less serious adverse effects, evidently of complex etiology, following intravascular administration. Some of these reactions are suspected of having an allergic basis. The in vitro and in vivo formation of iodinated serum proteins following gamma irradiation in the presence of two commonly used radiographic contrast media is demonstrated. Non-toxic concentrations of ascorbate present during the irradiation is shown to prevent the formation of such iodo-proteins in vitro as well as in vivo. The amounts of potentially antigenic iodoprotein formed during radiographic procedures will certainly be very small, but this quantity may be sufficient to elicit a hypersensitivity reaction in cases when an individual has been previously sensitized to immunologically similar iodo-proteins, a mechanism that could account for certain rare and unpredictable reations. The radiation induced formation of iodo-proteins may also serve as a model for the formation of iodine containing antigens mediated by a free radical mechanism, i.e. in the metabolism of iodinated compounds like erythrosine, a widely used colouring agent for certain foods. (orig.)

  7. Improving the Yield of Histological Sampling in Patients With Suspected Colorectal Cancer During Colonoscopy by Introducing a Colonoscopy Quality Assurance Program.

    Science.gov (United States)

    Gado, Ahmed; Ebeid, Basel; Abdelmohsen, Aida; Axon, Anthony

    2011-08-01

    Masses discovered by clinical examination, imaging or endoscopic studies that are suspicious for malignancy typically require biopsy confirmation before treatment is initiated. Biopsy specimens may fail to yield a definitive diagnosis if the lesion is extensively ulcerated or otherwise necrotic and viable tumor tissue is not obtained on sampling. The diagnostic yield is improved when multiple biopsy samples (BSs) are taken. A colonoscopy quality-assurance program (CQAP) was instituted in 2003 in our institution. The aim of this study was to determine the effect of instituting a CQAP on the yield of histological sampling in patients with suspected colorectal cancer (CRC) during colonoscopy. Initial assessment of colonoscopy practice was performed in 2003. A total of five patients with suspected CRC during colonoscopy were documented in 2003. BSs confirmed CRC in three (60%) patients and were nondiagnostic in two (40%). A quality-improvement process was instituted which required a minimum six BSs with adequate size of the samples from any suspected CRC during colonoscopy. A total of 37 patients for the period 2004-2010 were prospectively assessed. The diagnosis of CRC was confirmed with histological examination of BSs obtained during colonoscopy in 63% of patients in 2004, 60% in 2005, 50% in 2006, 67% in 2007, 100% in 2008, 67% in 2009 and 100% in 2010. The yield of histological sampling increased significantly ( p quality assurance and improvement program increased the yield of histological sampling in patients with suspected CRC during colonoscopy.

  8. Low-Dose CT for Evaluation of Suspected Urolithiasis: Diagnostic Yield for Assessment of Alternative Diagnoses.

    Science.gov (United States)

    Weinrich, Julius Matthias; Bannas, Peter; Regier, Marc; Keller, Sarah; Kluth, Luis; Adam, Gerhard; Henes, Frank Oliver

    2018-03-01

    The purpose of this study is to assess the diagnostic yield of low-dose (LD) CT for alternative diagnoses in patients with suspected urolithiasis. In this retrospective study, we included 776 consecutive patients who underwent unenhanced abdominal CT for evaluation of suspected urolithiasis. All examinations were performed with an LD CT protocol; images were reconstructed using iterative reconstruction. The leading LD CT diagnosis was recorded for each patient and compared with the final clinical diagnosis, which served as the reference standard. The mean (± SD) effective dose of CT was 1.9 ± 0.6 mSv. The frequency of urolithiasis was 82.5% (640/776). LD CT reached a sensitivity of 94.1% (602/640), a specificity of 100.0% (136/136), and an accuracy of 95.1% (738/776) for the detection of urolithiasis. In 93 of 136 patients (68.4%) without urolithiasis, alternative diagnoses were established as the final clinical diagnoses. Alternative diagnoses were most commonly located in the genitourinary (n = 53) and gastrointestinal (n = 18) tracts. LD CT correctly provided alternative diagnoses for 57 patients (61.3%) and was false-negative for five patients (5.4%). The most common clinical alternative diagnoses were urinary tract infections (n = 22). Seven diagnoses missed at LD CT were located outside the FOV. For 43 of all 776 patients (5.5%), neither LD CT nor clinical workup could establish a final diagnosis. The sensitivity, specificity, and accuracy of LD CT for the detection of alternative diagnoses were 91.9% (57/62), 95.6% (43/45), and 93.5% (100/107), respectively. LD CT enables the diagnosis of most alternative diagnoses in the setting of suspected urolithiasis. The most frequent alternative diagnoses missed by LD CT are urinary tract infections or diagnoses located outside the FOV of the abdominopelvic CT scan.

  9. Alternative diagnoses based on CT angiography of the chest in patients with suspected pulmonary thromboembolism

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Eleci Vaz; Gazzana, Marcelo Basso; Seligman, Renato; Knorst, Marli Maria, E-mail: mknorst@gmail.com [Hospital de Clinicas de Porto Alegre, Porto Alegre, RS (Brazil); Guerra, Vinicius Andre [Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre, RS (Brazil). Faculdade de Medicina. Programa de Pos-Graduacao em Ciencias Pneumologicas; Sarmento, Muriel Bossle; Guazzelli, Pedro Arends; Hoffmeister, Mariana Costa [Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre (Brazil). Faculdade de Medicina

    2016-01-15

    Objective: To determine the prevalence of alternative diagnoses based on chest CT angiography (CTA) in patients with suspected pulmonary thromboembolism (PTE) who tested negative for PTE, as well as whether those alternative diagnoses had been considered prior to the CTA. Methods: This was a cross-sectional, retrospective study involving 191 adult patients undergoing CTA for suspected PTE between September of 2009 and May of 2012. Chest X-rays and CTAs were reviewed to determine whether the findings suggested an alternative diagnosis in the cases not diagnosed as PTE. Data on symptoms, risk factors, comorbidities, length of hospital stay, and mortality were collected. Results: On the basis of the CTA findings, PTE was diagnosed in 47 cases (24.6%). Among the 144 patients not diagnosed with PTE via CTA, the findings were abnormal in 120 (83.3%). Such findings were consistent with an alternative diagnosis that explained the symptoms in 75 patients (39.3%). Among those 75 cases, there were only 39 (20.4%) in which the same alterations had not been previously detected on chest X-rays. The most common alternative diagnosis, made solely on the basis of the CTA findings, was pneumonia (identified in 20 cases). Symptoms, risk factors, comorbidities, and the in-hospital mortality rate did not differ significantly between the patients with and without PTE. However, the median hospital stay was significantly longer in the patients with PTE than in those without (18.0 and 9.5 days, respectively; p = 0.001). Conclusions: Our results indicate that chest CTA is useful in cases of suspected PTE, because it can confirm the diagnosis and reveal findings consistent with an alternative diagnosis in a significant number of patients. (author)

  10. Head Injury Secondary to Suspected Child Maltreatment: Results of a Prospective Canadian National Surveillance Program

    Science.gov (United States)

    Bennett, Susan; Ward, Michelle; Moreau, Katherine; Fortin, Gilles; King, Jim; MacKay, Morag; Plint, Amy

    2011-01-01

    Objective: We sought to determine the incidence, clinical features, and demographic profile of head injury secondary to suspected child maltreatment (abuse or neglect) in Canada to help inform the development and evaluation of prevention programs for abusive head injuries. Methods: From March 1, 2005 to February 28, 2008, an average of 2,545…

  11. Suspected seminal vesiculitis in an Asian elephant (Elephas maximus).

    Science.gov (United States)

    Kilburn, Jennifer J; Velguth, Karen E; Backues, Kay A

    2011-09-01

    A 32-year-old male Asian elephant (Elephas maximus) underwent routine transrectal stimulation for semen collection as part of an artificial insemination program. The procedure consisted of a preinsemination semen collection followed by two consecutive days of semen collections for artificial insemination. The second day's sample contained large numbers of inflammatory cells, intracellular bacteria, and phagocytized sperm. Semen was submitted for culture and sensitivity. Culture revealed Acinetobacter lwoffii, Staphylococcus intermedius, Kocuria roseus, and an unidentified gram-positive organism. Empirical antibiotic therapy with trimethoprim sulfa was initiated and then changed to enrofloxacin based on sensitivity panel results for a total of 28 days of treatment. Diagnostic semen collections were performed during treatment and 2 wk posttreatment to determine the success of therapy. Posttreatment collections revealed resolution of the inflammation. The origin of the infection was suspected to be the seminal vesicles.

  12. A study on dynamic model of steady-state visual evoked potentials.

    Science.gov (United States)

    Zhang, Shangen; Han, Xu; Chen, Xiaogang; Wang, Yijun; Gao, Shangkai; Gao, Xiaorong

    2018-04-04

    Significant progress has been made in the past two decades to considerably improve the performance of steady-state visual evoked potential (SSVEP)-based brain-computer interface (BCI). However, there are still some unsolved problems that may help us to improve BCI performance, one of which is that our understanding of the dynamic process of SSVEP is still superficial, especially for the transient-state response. This study introduced an antiphase stimulation method (antiphase: phase 0/π), which can simultaneously separate and extract SSVEP and event-related potential (ERP) signals from EEG, and eliminate the interference of ERP to SSVEP. Based on the SSVEP signals obtained by the antiphase stimulation method, the envelope of SSVEP was extracted by the Hilbert transform, and the dynamic model of SSVEP was quantitatively studied by mathematical modeling. The step response of a second-order linear system was used to fit the envelope of SSVEP, and its characteristics were represented by four parameters with physical and physiological meanings: one was amplitude related, one was latency related and two were frequency related. This study attempted to use pre-stimulation paradigms to modulate the dynamic model parameters, and quantitatively analyze the results by applying the dynamic model to further explore the pre-stimulation methods that had the potential to improve BCI performance. The results showed that the dynamic model had good fitting effect with SSVEP under three pre-stimulation paradigms. The test results revealed that the parameters of SSVEP dynamic models could be modulated by the pre-stimulation baseline luminance, and the gray baseline luminance pre-stimulation obtained the highest performance. This study proposed a dynamic model which was helpful to understand and utilize the transient characteristics of SSVEP. This study also found that pre-stimulation could be used to adjust the parameters of SSVEP model, and had the potential to improve the performance

  13. Total quality management for addressing suspect parts at the Oak Ridge High Flux Isotope Reactor

    International Nuclear Information System (INIS)

    Hendrix, K.A.; Tulay, M.P.

    1993-01-01

    Martin Marietta Energy System (MMES) Research Reactors Division (RRD), operator of the High Flux Isotope Reactor (HFIR) recently embarked on an aggressive Program to address the issue of suspect Parts and to enhance their procurement process. Through the application of TQM process improvement, RRD has already achieved improved efficiency in specifying, procuring, and accepting replacement items for its largest research reactor. These process improvements have significantly decreased the risk of installing suspect parts in the HFIR safety systems. To date, a systematic plan has been implemented, which includes the following elements: Process assessment and procedure review; Procedural enhancements; On-site training and technology transfer; Enhanced receiving inspections; Performance supplier evaluations and source verifications integrated processes for utilizing commercial grade products in nuclear safety-related applications. This paper will describe the above elements, how a partnership between MMES and Gilbert/Commonwealth facilitated the execution of the plan, and how process enhancements were applied. We will also present measures for improved efficiency and productivity, that MMES intends to continually address with Quality Action Teams

  14. Evaluation of genotype-phenotype relationships in patients referred for endocrine assessment in suspected Pendred syndrome.

    Science.gov (United States)

    Soh, Lip Min; Druce, Maralyn; Grossman, Ashley B; Differ, Ann-Marie; Rajput, Liala; Bitner-Glindzicz, Maria; Korbonits, Márta

    2015-02-01

    Patients with Pendred syndrome have genotypic and phenotypic variability, leading to challenges in definitive diagnosis. Deaf children with enlarged vestibular aqueducts are often subjected to repeated investigations when tests for mutations in SLC26A4 are abnormal. This study provides genotype and phenotype information from patients with suspected Pendred syndrome referred to a single clinical endocrinology unit. A retrospective analysis of 50 patients with suspected Pendred syndrome to investigate the correlation between genetic, perchlorate discharge test (PDT) and endocrine status. Eight patients with monoallelic SLC26A4 mutations had normal PDT. Of the 33 patients with biallelic mutations, ten of 12 patients with >30% discharge developed hypothyroidism. In our cohort, c.626G>T and c.3-2A>G result in milder clinical presentations with lower median perchlorate discharge of 9.3% (interquartile range 4-15%) compared with 40% (interquartile range 21-60%) for the remaining mutations. Eight novel mutations were detected. All patients with PDT 30% have a high risk of developing goitre and hypothyroidism, and should have lifelong monitoring. © 2015 European Society of Endocrinology.

  15. Radioimmune imaging of bone marrow in patients with suspected bone metastases from primary breast cancer

    International Nuclear Information System (INIS)

    Duncker, C.M.; Carrio, I.; Berna, L.; Estorch, M.; Alonso, C.; Ojeda, B.; Blanco, R.; Germa, J.R.; Ortega, V.

    1990-01-01

    Radioimmune imaging of bone marrow was performed by technetium-99m- (99mTc) labeled antigranulocyte monoclonal antibody BW 250/183 (AGMoAb) scans in 32 patients with suspected bone metastases from primary breast cancer. AGMoAb scans showed bone marrow defects in 25/32 (78%) patients; bone invasion was subsequently confirmed in 23 (72%) patients. Conventional bone scans performed within the same week detected bone metastases in 17/32 (53%) patients (p less than 0.001). AGMoAb scans detected more sites indicating metastatic disease than bone scans in 12 of these 17 patients (71%). All patients with bone metastases in the axial skeleton had bone marrow defects at least at the sites of bone metastases. Of 15 patients with normal, or indicative of, benign disease bone scans, 8 patients (53%) presented with bone marrow defects in the AGMoAb scans. Bone invasion was confirmed in six of them. AGMoAb bone marrow scans provide a method for the early detection of bone metastatic invasion in patients with breast cancer and suspected bone metastases

  16. Validity of total leucocytes count and neutrophil count (differential leucocytes) in diagnosing suspected acute appendicitis

    International Nuclear Information System (INIS)

    Anwar, M.W.; Abid, I.

    2012-01-01

    Objective: To compare the diagnostic accuracy of Total Leucocytes Count (TLC) with Neutrophil count; Differential Leucocytes Count (DLC) in diagnosing cases of suspected acute appendicitis. Study design: Validation study. Place and duration of the study: Department of Surgery, Combined Military Hospital (CMH) Rawalpindi, from April 2008 to October 2008. Method: A total of 100 patients of Pain right iliac fossae who underwent appendicectomy were included. Detailed history of all the patients was taken for pain in right lower abdomen, its severity, its nature, relieving or provoking factors. Clinical examination was done in detail. Total and Differential Leucocytes Count was done. Every patient's appendix was examined grossly after appendicectomy for evidence of appendicitis. Diagnostic measures of TLC and DLC were calculated by standard formulas. Results: Sensitivity and specificity of TLC is 86.9% and 81.25% respectively and that of DLC is 82% and 68.75% respectively. Accuracy was 86% for TLC and 80% for DLC. Conclusion: TLC is more sensitive, specific and accurate test as compared to DLC and it should be used as diagnostic aid for suspected acute appendicitis cases. (author)

  17. Review of potential models for UF6 dispersion

    International Nuclear Information System (INIS)

    Sykes, R.I.; Lewellen, W.S.

    1992-07-01

    A survey of existing atmospheric dispersion models has been conducted to determine the most appropriate basis for the development of a model for predicting the consequences of an accidental UF 6 release. The model is required for safety analysis studies and should therefore be computationally efficient. The release of UF 6 involves a number of physical phenomena which make the situation more complicated than passive dispersion of a trace gas. The safety analysis must consider the density variations in the UF 6 cloud, which can be heavier or lighter than the ambient air. The release also involves rapid chemical reactions and associated heat release, which must be modeled. Other Department of Energy storage facilities require a dense gas prediction capability, so the model must be sufficiently general for use with a variety of release scenarios. The special problems associated with UF 6 make it unique, so there are very few models with existing capability for the problem. There are, however, a large number of dense gas dispersion models, some with relevant chemical reaction modeling, that could potentially form the basis of an advanced UF 6 model. We have examined a large selection of possible candidates, and selected 5 models for detailed consideration

  18. Management of a Dog with Poorly Regulated Diabetes Mellitus, Chronic Pancreatitis, and Suspected Atopy with Cyclosporine

    Directory of Open Access Journals (Sweden)

    Jörg M. Steiner

    2012-01-01

    Full Text Available A 3-year-and-9-months old male neutered Bichon Frise was presented for a second opinion for diabetes mellitus, weight loss, pruritus, and loss of hair. During further work-up, the dog was diagnosed with uncontrolled diabetes mellitus and concurrent diagnoses of pancreatitis and atopy were also suspected. Multiple adjustments of insulin therapy did not improve control of diabetes mellitus. Also, a variety of different treatments failed to improve pruritus. The dog was seen by a veterinary dermatologist who further suspected atopy and started treatment with cyclosporine. Pruritus improved and coincidentally serum Spec cPL and fructosamine concentrations normalized after therapy, suggesting the possibility that cyclosporine may have controlled pancreatic inflammation and improved control of diabetes mellitus. This case report would suggest that further research into autoimmunity in dogs with chronic pancreatitis is warranted. Also, a controlled study is needed and in progress before the use of cyclosporine in dogs with chronic pancreatitis or a subgroup thereof can be advocated.

  19. A phantom axon setup for validating models of action potential recordings.

    Science.gov (United States)

    Rossel, Olivier; Soulier, Fabien; Bernard, Serge; Guiraud, David; Cathébras, Guy

    2016-08-01

    Electrode designs and strategies for electroneurogram recordings are often tested first by computer simulations and then by animal models, but they are rarely implanted for long-term evaluation in humans. The models show that the amplitude of the potential at the surface of an axon is higher in front of the nodes of Ranvier than at the internodes; however, this has not been investigated through in vivo measurements. An original experimental method is presented to emulate a single fiber action potential in an infinite conductive volume, allowing the potential of an axon to be recorded at both the nodes of Ranvier and the internodes, for a wide range of electrode-to-fiber radial distances. The paper particularly investigates the differences in the action potential amplitude along the longitudinal axis of an axon. At a short radial distance, the action potential amplitude measured in front of a node of Ranvier is two times larger than in the middle of two nodes. Moreover, farther from the phantom axon, the measured action potential amplitude is almost constant along the longitudinal axis. The results of this new method confirm the computer simulations, with a correlation of 97.6 %.

  20. Unenhanced multidetector CT (CT KUB) in the initial imaging of suspected acute renal colic: evaluating a new service

    International Nuclear Information System (INIS)

    Chowdhury, F.U.; Kotwal, S.; Raghunathan, G.; Wah, T.M.; Joyce, A.; Irving, H.C.

    2007-01-01

    Aim: To evaluate a new imaging pathway for the investigation of patients presenting with suspected acute renal colic. Materials and methods: A retrospective review of 500 consecutive cases of suspected acute renal colic was undertaken to evaluate the initial results of a new imaging pathway introduced at our institution, which completely replaced the intravenous urogram (IVU) with unenhanced multidetector CT (CT KUB). Results: The positive rate for urolithiasis was 44% (221/500), the negative rate 46% (229/500) and the rate of other significant findings was 12% (59/500). Female patients had a low positive rate compared with male patients (27.5 versus 57.5%; p < 0.001). Urological intervention was required in 28% (61/221) and these patients had a larger average stone size (6.6 versus 3.7 mm; p < 0.001) and the stone was located more proximally. Out-of-hours imaging was performed in 37% (186/500), and these patients had a higher positive rate (52 versus 40%; p < 0.001). Other findings included a wide range of acute non-urological conditions. Conclusion: The feasibility of replacing the acute IVU with CT KUB in the initial assessment of suspected acute renal colic was demonstrated in the present study. The technique enables rapid diagnosis of urolithiasis, stratification of patients likely to proceed to urological intervention, and prompt diagnosis of a variety of other acute pathological conditions