Muscle-fiber conduction velocity and electromyography as diagnostic tools in patients with suspected inflammatory myopathy: a prospective study.

NARCIS (Netherlands)

Blijham, P.J.; Hengstman, G.J.D.; Laak, H.J. ter; Engelen, B.G.M. van; Zwarts, M.J.

2004-01-01

Combinations of different techniques can increase the diagnostic yield from neurophysiological examination of muscle. In 25 patients with suspected inflammatory myopathy, we prospectively performed needle electromyography (EMG) and measured muscle-fiber conduction velocity (MFCV) in a single muscle,

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

Science.gov (United States)

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

2018-04-16

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

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

Science.gov (United States)

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

2009-08-01

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

Diagnostic efficiency of DSM-IV criteria for obsessive compulsive personality disorder in patients with binge eating disorder.

Science.gov (United States)

Grilo, C M

2004-01-01

This study examined the diagnostic efficiency of the DSM-IV criteria for obsessive compulsive personality disorder (OCPD) in patients with binge eating disorder (BED). Two hundred and eleven consecutive adult patients with axis I diagnoses of BED were reliably assessed with semi-structured diagnostic interviews. Conditional probabilities-sensitivity, specificity, positive predictive power (PPP), and negative predictive power (NPP)-were calculated for each of the eight criteria for OCPD, using the 'best-estimate' OCPD diagnosis as the standard. The diagnostic efficiencies of the OCPD criteria were variable, with three criteria failing to have predictive value (PPPOCPD based on performance and call into question the utility of some criteria.

Prospective evaluation of three rapid diagnostic tests for diagnosis of human leptospirosis.

Directory of Open Access Journals (Sweden)

Marga G A Goris

Full Text Available BACKGROUND: Diagnosis of leptospirosis by the microscopic agglutination test (MAT or by culture is confined to specialized laboratories. Although ELISA techniques are more common, they still require laboratory facilities. Rapid Diagnostic Tests (RDTs can be used for easy point-of-care diagnosis. This study aims to evaluate the diagnostic performance of the RDTs LeptoTek Dri Dot, LeptoTek Lateral Flow, and Leptocheck-WB, prospectively. METHODOLOGY: During 2001 to 2012, one or two of the RDTs at the same time have been applied prior to routine diagnostics (MAT, ELISA and culture on serum specimens from participants sent in for leptospirosis diagnosis. The case definition was based on MAT, ELISA and culture results. Participants not fulfilling the case definition were considered not to have leptospirosis. The diagnostic accuracy was determined based on the 1(st submitted sample and paired samples, either in an overall analysis or stratified according to days post onset of illness. RESULTS: The overall sensitivity and specificity for the LeptoTek Dri Dot was 75% respectively 96%, for the LeptoTek Lateral Flow 78% respectively 95%, and for the Leptocheck-WB 78% respectively 98%. Based on the 1(st submitted sample the sensitivity was low (51% for LeptoTek Dri Dot, 69% for LeptoTek Lateral Flow, and 55% for Leptocheck-WB, but substantially increased when the results of paired samples were combined, although accompanied by a lower specificity (82% respectively 91% for LeptoTek Dri Dot, 86% respectively 84% for LeptoTek Lateral Flow, and 80% respectively 93% for Leptocheck-WB. CONCLUSIONS: All three tests present antibody tests contributing to the diagnosis of leptospirosis, thus supporting clinical suspicion and contributing to awareness. Since the overall sensitivity of the tested RDTs did not exceed 80%, one should be cautious to rely only on an RDT result, and confirmation by reference tests is strongly recommended.

Diagnostic accuracy of sub-mSv prospective ECG-triggering cardiac CT in young infant with complex congenital heart disease.

Science.gov (United States)

Gao, Wei; Zhong, Yu Min; Sun, Ai Min; Wang, Qian; Ouyang, Rong Zhen; Hu, Li Wei; Qiu, Han Sheng; Wang, Shi Yu; Li, Jian Ying

2016-06-01

To explore the clinical value and evaluate the diagnostic accuracy of sub-mSv low-dose prospective ECG-triggering cardiac CT (CCT) in young infants with complex congenital heart disease (CHD). A total of 102 consecutive infant patients (53 boys and 49 girls with mean age of 2.9 ± 2.4 m and weight less than 5 kg) with complex CHD were prospectively enrolled. Scans were performed on a 64-slice high definition CT scanner with low dose prospective ECG-triggering mode and reconstructed with 80 % adaptive statistical iterative reconstruction algorithm. All studies were performed during free breathing with sedation. The subjective image quality was evaluated by 5-point grading scale and interobserver variability was calculated. The objective image noise (standard deviation, SD) and contrast to noise ratio (CNR) was calculated. The effective radiation dose from the prospective ECG-triggering mode was recorded and compared with the virtual conventional retrospective ECG-gating mode. The detection rate for the origin of coronary artery was calculated. All patients also underwent echocardiography before CCT examination. 81 patients had surgery and their preoperative CCT and echocardiography findings were compared with the surgical results and sensitivity, specificity, positive and negative predictive values and accuracy were calculated for separate cardiovascular anomalies. Heart rates were 70-161 beats per minute (bpm) with mean value of 129.19 ± 14.52 bpm. The effective dose of 0.53 ± 0.15 mSv in the prospective ECG-triggering cardiac CT was lower than the calculated value in a conventional retrospective ECG-gating mode (2.00 ± 0.35 mSv) (p ECG-triggering CCT with sub-mSv effective dose provides excellent imaging quality and high diagnostic accuracy for young infants with complex CHD.

Follow-up of coronary artery bypass graft patency: diagnostic efficiency of high-pitch dual-source 256-slice MDCT findings.

Science.gov (United States)

Yuceler, Zeyneb; Kantarci, Mecit; Yuce, Ihsan; Kizrak, Yesim; Bayraktutan, Ummugulsum; Ogul, Hayri; Kiris, Adem; Celik, Omer; Pirimoglu, Berhan; Genc, Berhan; Gundogdu, Fuat

2014-01-01

Our aim was to evaluate the diagnostic accuracy of 256-slice, high-pitch mode multidetector computed tomography (MDCT) for coronary artery bypass graft (CABG) patency. Eighty-eight patients underwent 256-slice MDCT angiography to evaluate their graft patency after CABG surgery using a prospectively synchronized electrocardiogram in the high-pitch spiral acquisition mode. Effective radiation doses were calculated. We investigated the diagnostic accuracy of high-pitch, low-dose, prospective, electrocardiogram-triggering, dual-source MDCT for CABG patency compared with catheter coronary angiography imaging findings. A total of 215 grafts and 645 vessel segments were analyzed. All graft segments had diagnostic image quality. The proximal and middle graft segments had significantly (P < 0.05) better mean image quality scores (1.18 ± 0.4) than the distal segments (1.31 ± 0.5). Using catheter coronary angiography as the reference standard, high-pitch MDCT had the following sensitivity, specificity, positive predictive value, and negative predictive value of per-segment analysis for detecting graft patency: 97.1%, 99.6%, 94.4%, and 99.8%, respectively. In conclusion, MDCT can be used noninvasively with a lower radiation dose for the assessment of restenosis in CABG patients.

Validation and Diagnostic Efficiency of the Mini-SPIN in Spanish-Speaking Adolescents.

Directory of Open Access Journals (Sweden)

LuisJoaquín Garcia-Lopez

Full Text Available Social Anxiety Disorder (SAD is one of the most common mental disorders in adolescence. Many validated psychometric tools are available to diagnose individuals with SAD efficaciously. However, there is a demand for shortened self-report instruments that identify adolescents at risk of developing SAD. We validate the Mini-SPIN and its diagnostic efficiency in overcoming this problem in Spanish-speaking adolescents in Spain.The psychometric properties of the 3-item Mini-SPIN scale for adolescents were assessed in a community (study 1 and clinical sample (study 2.Study 1 consisted of 573 adolescents, and found the Mini-SPIN to have appropriate internal consistency and high construct validity. Study 2 consisted of 354 adolescents (147 participants diagnosed with SAD and 207 healthy controls. Data revealed that the Mini-SPIN has good internal consistency, high construct validity and adequate diagnostic efficiency.Our findings suggest that the Mini-SPIN has good psychometric properties on clinical and healthy control adolescents and general population, which indicates that it can be used as a screening tool in Spanish-speaking adolescents. Cut-off scores are provided.

Validation and Diagnostic Efficiency of the Mini-SPIN in Spanish-Speaking Adolescents.

Science.gov (United States)

Garcia-Lopez, LuisJoaquín; Moore, Harry T A

2015-01-01

Social Anxiety Disorder (SAD) is one of the most common mental disorders in adolescence. Many validated psychometric tools are available to diagnose individuals with SAD efficaciously. However, there is a demand for shortened self-report instruments that identify adolescents at risk of developing SAD. We validate the Mini-SPIN and its diagnostic efficiency in overcoming this problem in Spanish-speaking adolescents in Spain. The psychometric properties of the 3-item Mini-SPIN scale for adolescents were assessed in a community (study 1) and clinical sample (study 2). Study 1 consisted of 573 adolescents, and found the Mini-SPIN to have appropriate internal consistency and high construct validity. Study 2 consisted of 354 adolescents (147 participants diagnosed with SAD and 207 healthy controls). Data revealed that the Mini-SPIN has good internal consistency, high construct validity and adequate diagnostic efficiency. Our findings suggest that the Mini-SPIN has good psychometric properties on clinical and healthy control adolescents and general population, which indicates that it can be used as a screening tool in Spanish-speaking adolescents. Cut-off scores are provided.

Diagnostic Accuracy of the Aortic Dissection Detection Risk Score Plus D-Dimer for Acute Aortic Syndromes: The ADvISED Prospective Multicenter Study.

Science.gov (United States)

Nazerian, Peiman; Mueller, Christian; Soeiro, Alexandre de Matos; Leidel, Bernd A; Salvadeo, Sibilla Anna Teresa; Giachino, Francesca; Vanni, Simone; Grimm, Karin; Oliveira, Múcio Tavares; Pivetta, Emanuele; Lupia, Enrico; Grifoni, Stefano; Morello, Fulvio

2018-01-16

Acute aortic syndromes (AASs) are rare and severe cardiovascular emergencies with unspecific symptoms. For AASs, both misdiagnosis and overtesting are key concerns, and standardized diagnostic strategies may help physicians to balance these risks. D-dimer (DD) is highly sensitive for AAS but is inadequate as a stand-alone test. Integration of pretest probability assessment with DD testing is feasible, but the safety and efficiency of such a diagnostic strategy are currently unknown. In a multicenter prospective observational study involving 6 hospitals in 4 countries from 2014 to 2016, consecutive outpatients were eligible if they had ≥1 of the following: chest/abdominal/back pain, syncope, perfusion deficit, and if AAS was in the differential diagnosis. The tool for pretest probability assessment was the aortic dissection detection risk score (ADD-RS, 0-3) per current guidelines. DD was considered negative (DD-) if 1. Two hundred forty-one patients (13%) had AAS: 125 had type A aortic dissection, 53 had type B aortic dissection, 35 had intramural aortic hematoma, 18 had aortic rupture, and 10 had penetrating aortic ulcer. A positive DD test result had an overall sensitivity of 96.7% (95% confidence interval [CI], 93.6-98.6) and a specificity of 64% (95% CI, 61.6-66.4) for the diagnosis of AAS; 8 patients with AAS had DD-. In 294 patients with ADD-RS=0/DD-, 1 case of AAS was observed. This yielded a failure rate of 0.3% (95% CI, 0.1-1.9) and an efficiency of 15.9% (95% CI, 14.3-17.6) for the ADD-RS=0/DD- strategy. In 924 patients with ADD-RS ≤1/DD-, 3 cases of AAS were observed. This yielded a failure rate of 0.3% (95% CI, 0.1-1) and an efficiency of 49.9% (95% CI, 47.7-52.2) for the ADD-RS ≤1/DD- strategy. Integration of ADD-RS (either ADD-RS=0 or ADD-RS ≤1) with DD may be considered to standardize diagnostic rule out of AAS. URL: https://www.clinicaltrials.gov. Unique identifier: NCT02086136. © 2017 American Heart Association, Inc.

Diagnostic tests for Helicobacter pylori : A prospective evaluation of their accuracy, without selecting a single test as the gold standard

NARCIS (Netherlands)

Thijs, J C; van Zwet, A A; Thijs, W J; Oey, H B; Karrenbeld, A; Stellaard, F; Luijt, D S; Meyer, B C; Kleibeuker, J H

1996-01-01

OBJECTIVE: To assess the accuracy of six commonly used diagnostic tests for Helicobacter pylori in a prospective study without using any specific test as the gold standard (the patient was regarded as H. pylori-infected if two or more tests, whatever their nature, were positive). METHODS: In 105

A prospective audit of the use of diagnostic laparoscopy to establish the diagnosis of abdominal tuberculosis.

Science.gov (United States)

Islam, J; Clarke, D; Thomson, S R; Wilson, D; Dawood, H

2014-06-01

The incidence of abdominal tuberculosis is much higher in an HIV-positive cohort. The use of laparoscopy in the diagnostic work-up of suspected abdominal tuberculosis is underutilized and its use and efficacy in the context of HIV co-infection has never been examined. A prospective clinical audit of the use of diagnostic laparoscopy was conducted in patients with clinically suspected abdominal tuberculosis but histologically or microbiologically unconfirmed tuberculosis at any site. From January 2008 to June 2010, 81 patients underwent diagnostic laparoscopy; 34 were male and 47 were female, with a mean age of 33 years, and 77 % were HIV-positive. Fifty-five patients (68 %) had positive histology or culture for tuberculosis. In 15 patients (19 %), histology revealed non-specific inflammation, no pathology was found in one patient, and no specimen was taken from one patient. Eighty percent of peritoneal deposits and 77 % of lymph nodes were positive for tuberculosis, whereas 35 % of ascitic fluid cultures were positive. In nine patients (11 %) an alternative diagnosis was found; nine patients (11 %) had conversion to laparotomy. There was no procedure-related death. Nine patients (11 %) died during the 2-month follow-up period. Diagnostic laparoscopy avoids the morbidity and mortality of laparotomy in chronically ill patients, and reduces the rate of misdiagnosis of other abdominal conditions and unnecessary long-term therapy. Diagnostic laparoscopy and tissue sampling is a viable and reliable strategy in patients with suspected abdominal tuberculosis.

Protocol of a prospective study on the diagnostic value of transcranial duplex scanning of the substantia nigra in patients with parkinsonian symptoms

Directory of Open Access Journals (Sweden)

Wuisman Piet GWM

2007-09-01

Full Text Available Abstract Background Parkinson's disease (PD is the second most common neurodegenerative disorder. As there is no definitive diagnostic test, its diagnosis is based on clinical criteria. Recently transcranial duplex scanning (TCD of the substantia nigra in the brainstem has been proposed as an instrument to diagnose PD. We and others have found that TCD scanning of substantia nigra duplex is a relatively accurate diagnostic instrument in patients with parkinsonian symptoms. However, all studies on TCD so far have involved well-defined, later-stage PD patients, which will obviously lead to an overestimate of the diagnostic accuracy of TCD. We have therefore set out to conduct a prospective study testing the diagnostic accuracy of TCD in patients with a parkinsonism of unclear origin. Methods/Design We will enrol 250 consecutive patients, who are referred to neurology outpatient clinics of two teaching hospitals, for analysis of clinically unclear parkinsonism. Patients, whose parkinsonism is clearly diagnosable at the first visit, will be excluded from the study. All patients will undergo a TCD of the substantia nigra. As a surrogate gold standard we will use the consensus clinical diagnosis reached by two independent, blinded, movement disorder specialist neurologists after 2 years follow-up. At the time of TCD, patients will also undergo a SPECT scan of the brain. Discussion As this prospective trial enrols only patients with an early-stage parkinsonism, it will yield data on the diagnostic accuracy of TCD that is relevant to daily clinical practice: The neurologist needs a diagnostic tool that provides additional information in patients with a clinically indefinable parkinsonian syndrome. The above described observational longitudinal study was designed to explicitly study this aspect in the diagnostic process. Trial registration (ITRSCC NCT00368199

Coronary CT angiography using prospective ECG triggering. High diagnostic accuracy with low radiation dose

International Nuclear Information System (INIS)

Arnoldi, E.; Ramos-Duran, L.; Abro, J.A.; Costello, P.; Zwerner, P.L.; Schoepf, U.J.; Nikolaou, K.; Reiser, M.F.

2010-01-01

The purpose of this study was to evaluate the diagnostic performance of coronary CT angiography (coronary CTA) using prospective ECG triggering (PT) for the detection of significant coronary artery stenosis compared to invasive coronary angiography (ICA). A total of 20 patients underwent coronary CTA with PT using a 128-slice CT scanner (Definition trademark AS+, Siemens) and ICA. All coronary CTA studies were evaluated for significant coronary artery stenoses (≥50% luminal narrowing) by 2 observers in consensus using the AHA-15-segment model. Findings in CTA were compared to those in ICA. Coronary CTA using PT had 88% sensitivity in comparison to 100% with ICA, 95% to 88% specificity, 80% to 92% positive predictive value and 97% to 100% negative predictive value for diagnosing significant coronary artery stenosis on per segment per patient analysis, respectively. Mean effective radiation dose-equivalent of CTA was 2.6±1 mSv. Coronary CTA using PT enables non-invasive diagnosis of significant coronary artery stenosis with high diagnostic accuracy in comparison to ICA and is associated with comparably low radiation exposure. (orig.) [de

Fever of unknown origin: prospective comparison of diagnostic value of 18F-FDG PET and 111In-granulocyte scintigraphy

DEFF Research Database (Denmark)

Kjaer, Andreas; Lebech, Anne-Mette; Eigtved, Annika

2004-01-01

The diagnostic work-up in patients with fever of unknown origin (FUO) is often challenging and frequently includes nuclear medicine procedures. Whereas a role for leucocyte or granulocyte scintigraphy in FUO is generally accepted, a possible role of fluorine-18 fluorodeoxyglucose (FDG) positron...... emission tomography (PET) in these patients remains to be established. To study this, we compared prospectively, on a head-to-head basis, the diagnostic value of FDG-PET and indium-111 granulocyte scintigraphy in patients with FUO. Nineteen patients with FUO underwent both FDG-PET and (111)In......-granulocyte scintigraphy within 1 week. FDG-PET scans and granulocyte scintigrams were reviewed by different doctors who were blinded to the result of the other investigation. The diagnostic values of FDG-PET and granulocyte scintigraphy were evaluated with regard to identification of a focal infectious...

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.

Validation and Diagnostic Efficiency of the Mini-SPIN in Spanish-Speaking Adolescents

Science.gov (United States)

Garcia-Lopez, LuisJoaquín; Moore, Harry T. A.

2015-01-01

Objectives Social Anxiety Disorder (SAD) is one of the most common mental disorders in adolescence. Many validated psychometric tools are available to diagnose individuals with SAD efficaciously. However, there is a demand for shortened self-report instruments that identify adolescents at risk of developing SAD. We validate the Mini-SPIN and its diagnostic efficiency in overcoming this problem in Spanish-speaking adolescents in Spain. Methods The psychometric properties of the 3-item Mini-SPIN scale for adolescents were assessed in a community (study 1) and clinical sample (study 2). Results Study 1 consisted of 573 adolescents, and found the Mini-SPIN to have appropriate internal consistency and high construct validity. Study 2 consisted of 354 adolescents (147 participants diagnosed with SAD and 207 healthy controls). Data revealed that the Mini-SPIN has good internal consistency, high construct validity and adequate diagnostic efficiency. Conclusions Our findings suggest that the Mini-SPIN has good psychometric properties on clinical and healthy control adolescents and general population, which indicates that it can be used as a screening tool in Spanish-speaking adolescents. Cut-off scores are provided. PMID:26317695

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

Science.gov (United States)

2014-01-01

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

[Current status and clinical application prospect of Akabane's test].

Science.gov (United States)

Wang, Wenjie; Du, Yanjun

2016-06-12

The Akabane's test is one of the meridian diagnostic methods. Compared with the current meridian diagnostic methods, it has the advantages of convenience and efficiency, but it also has several disadvantages such as the accuracy is difficult to control, the outcome interpretation is limited, etc. In this paper, the influence factors of Akabane's test were analyzed one by one, especially proposed personal opinion on outcome interpretation, which could ascertain the location and nature of disease, leading to disease syndrome. With accurate syndrome, the treatment plan could be established. The application prospect of Akabane's test was initially explored, and it was proposed that wearable automation equipment could be one of the development directions.

A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder.

Science.gov (United States)

Mazurek, Micah O; Lu, Frances; Symecko, Heather; Butter, Eric; Bing, Nicole M; Hundley, Rachel J; Poulsen, Marie; Kanne, Stephen M; Macklin, Eric A; Handen, Benjamin L

2017-09-01

The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children referred for autism diagnostic evaluations. Concordance and discordance were assessed using a consistent diagnostic battery. DSM-5 criteria demonstrated excellent overall specificity and good sensitivity relative to DSM-IV criteria. Sensitivity and specificity were strongest for children meeting DSM-IV criteria for autistic disorder, but poor for those meeting criteria for Asperger's disorder and pervasive developmental disorder. Higher IQ, older age, female sex, and less pronounced ASD symptoms were associated with greater discordance.

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

Science.gov (United States)

Matthai, Smita Mary; Kini, Usha

2003-02-01

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

Short-term diagnostic stability among re-admitted psychiatric in ...

African Journals Online (AJOL)

Results: The commonest diagnoses at admission were schizophrenia spectrum disorders (47.4%) and bipolar spectrum disorders (30.7%). Overall diagnostic stability as measured by prospective consistency in this study was 72.8%.The most stable diagnostic category was Major Depressive Disorder (100% prospective ...

Computer Vision Malaria Diagnostic Systems—Progress and Prospects

Directory of Open Access Journals (Sweden)

Joseph Joel Pollak

2017-08-01

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

Diagnostic information system dynamics in the evaluation of machine learning algorithms for the supervision of energy efficiency of district heating-supplied buildings

International Nuclear Information System (INIS)

Kiluk, Sebastian

2017-01-01

Highlights: • Energy efficiency classification sustainability benefits from knowledge prediction. • Diagnostic classification can be validated with its dynamics and current data. • Diagnostic classification dynamics provides novelty extraction for knowledge update. • Data mining comparison can be performed with knowledge dynamics and uncertainty. • Diagnostic information refinement benefits form comparing classifiers dynamics. - Abstract: Modern ways of exploring the diagnostic knowledge provided by data mining and machine learning raise some concern about the ways of evaluating the quality of output knowledge, usually represented by information systems. Especially in district heating, the stationarity of efficiency models, and thus the relevance of diagnostic classification system, cannot be ensured due to the impact of social, economic or technological changes, which are hard to identify or predict. Therefore, data mining and machine learning have become an attractive strategy for automatically and continuously absorbing such dynamics. This paper presents a new method of evaluation and comparison of diagnostic information systems gathered algorithmically in district heating efficiency supervision based on exploring the evolution of information system and analyzing its dynamic features. The process of data mining and knowledge discovery was applied to the data acquired from district heating substations’ energy meters to provide the automated discovery of diagnostic knowledge base necessary for the efficiency supervision of district heating-supplied buildings. The implemented algorithm consists of several steps of processing the billing data, including preparation, segmentation, aggregation and knowledge discovery stage, where classes of abstract models representing energy efficiency constitute an information system representing diagnostic knowledge about the energy efficiency of buildings favorably operating under similar climate conditions and

Evaluation of diagnostic efficiency of intelligence program for automatic diagnosis of circumferential profiles of myocardial short axial SPECT

International Nuclear Information System (INIS)

Bunko, Hisashi; Tada, Akira; Nakajima, Kenichi; Taki, Junichi; Kojima, Kazuhiko.

1984-01-01

Quantitative diagnosis using circumferential profile (CFP) is widely employed for Tl-201 myocardial imaging. However, its diagnostic efficiency is susceptible to the number and composition of the confirmed normal (CN) group. Intelligence program for CFP data file and automatic diagnosis (CAD), which was previously developed by us, was modified for creating universal data file (d-base) and evaluated its diagnostic efficiency for myocardial short axial images according to the number of CNs. CAD consists of following 3 major functions: (1) CFP data filing to d-base, (2) modification and correction of file data, and (3) automatic diagnosis of CFP. When function (1) or (2) is completed, new diagnostic criteria (mean-2 sd) are generated automatically using CN data in the d-base at that time. Because of this function, diagnostic criteria are changeable according to the number of CNs. Sensitivity (TP) and specificity (TN) of CAD program for Tl-201 7-pinhole images of 16 normals and 17 ischemic heart diseases (IHDs) were 100%, 44% (CN = 4), 88%, 94% (CN = 8 or 16) and 88%, 100% (CN = 12), respectively. Diagnostic efficiency reached plateau in more than 8 CNs. Although number of patients were limited (8 CNs and 6 IHDs), results of CAD for short axial SPECT showed consistent tendency with 7-pinhole images. In conclusion, intelligence program is necessary for automatic diagnosis using quantitative criteria under the clinical condition of daily increasing informations. Automatic diagnosis of CFP using CAD program is simple, effective and useful for interpretation of Tl-201 myocardial short axial images. CAD program is applicable to any quantitative distribution study using CFPs. (author)

Improved Efficiency of Miscible CO2 Floods and Enhanced Prospects for CO2 Flooding Heterogeneous Reservoirs

Energy Technology Data Exchange (ETDEWEB)

Grigg, Reid B.; Schechter, David S.

1999-10-15

The goal of this project is to improve the efficiency of miscible CO2 floods and enhance the prospects for flooding heterogeneous reservoirs. This report provides results of the second year of the three-year project that will be exploring three principles: (1) Fluid and matrix interactions (understanding the problems). (2) Conformance control/sweep efficiency (solving the problems. 3) Reservoir simulation for improved oil recovery (predicting results).

Energy efficiency and human activity: Past trends, future prospects

International Nuclear Information System (INIS)

Schipper, L.; Meyers, S.; Howarth, R.B.; Steiner, R.

1992-01-01

This book, sponsored by the Stockholm Environmental Institute (SEI), presents a detailed analysis of changes in world energy use over the past twenty years. It considers the future prospects of energy demand, and discusses ways of restraining growth in consumption in order to meet environmental and economic development goals. Based on a decade of research by the authors and their colleagues at Lawrence Berkeley Laboratory in collaboration with the SEI, it presents information on energy use and the forces shaping it in the industrial, developing, and formerly planned economies. Looking separately at industry, passenger travel, freight transport, and the residential and service sectors, the authors describe the impact on energy use of growth in activity, structural change, and change in energy intensities, and discuss the role of energy prices and energy conservation policies in the industrial countries and the former Soviet Union. The book presents an overview of the potential for improving energy efficiency, and discusses the policies that could help realize the potential. While calling for strong action by governments and the private sector, the authors stress the importance of considering the full range of factors that will shape realization of the energy efficiency potential around the world

Factor structure and diagnostic efficiency of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for avoidant personality disorder in Hispanic men and women with substance use disorders.

Science.gov (United States)

Becker, Daniel F; Añez, Luis Miguel; Paris, Manuel; Bedregal, Luis; Grilo, Carlos M

2009-01-01

This study examined the internal consistency, factor structure, and diagnostic efficiency of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria for avoidant personality disorder (AVPD) and the extent to which these metrics may be affected by sex. Subjects were 130 monolingual Hispanic adults (90 men, 40 women) who had been admitted to a specialty clinic that provides psychiatric and substance abuse services to Spanish-speaking patients. All were reliably assessed with the Spanish-Language Version of the Diagnostic Interview for DSM-IV Personality Disorders. The AVPD diagnosis was determined by the best-estimate method. After evaluating internal consistency of the AVPD criterion set, an exploratory factor analysis was performed using principal components extraction. Afterward, diagnostic efficiency indices were calculated for all AVPD criteria. Subsequent analyses examined men and women separately. For the overall group, internal consistency of AVPD criteria was good. Exploratory factor analysis revealed a 1-factor solution (accounting for 70% of the variance), supporting the unidimensionality of the AVPD criterion set. The best inclusion criterion was "reluctance to take risks," whereas "interpersonally inhibited" was the best exclusion criterion and the best predictor overall. When men and women were examined separately, similar results were obtained for both internal consistency and factor structure, with slight variations noted between sexes in the patterning of diagnostic efficiency indices. These psychometric findings, which were similar for men and women, support the construct validity of the DSM-IV criteria for AVPD and may also have implications for the treatment of this particular clinical population.

Pre-diagnostic metabolite concentrations and prostate cancer risk in 1077 cases and 1077 matched controls in the European Prospective Investigation into Cancer and Nutrition.

NARCIS (Netherlands)

Schmidt, Julie A; Fensom, Georgina K; Rinaldi, Sabina; Scalbert, Augustin; Appleby, Paul N; Achaintre, David; Gicquiau, Audrey; Gunter, Marc J; Ferrari, Pietro; Kaaks, Rudolf; Kühn, Tilman; Floegel, Anna; Boeing, Heiner; Trichopoulou, Antonia; Lagiou, Pagona; Anifantis, Eleutherios; Agnoli, Claudia; Palli, Domenico; Trevisan, Morena; Tumino, Rosario; Bueno-de-Mesquita, H Bas; Agudo, Antonio; Larrañaga, Nerea; Redondo-Sánchez, Daniel; Barricarte, Aurelio; Huerta, José Maria; Quirós, J Ramón; Wareham, Nick; Khaw, Kay-Tee; Perez-Cornago, Aurora; Johansson, Mattias; Cross, Amanda J; Tsilidis, Konstantinos K; Riboli, Elio; Key, Timothy J; Travis, Ruth C

2017-01-01

Little is known about how pre-diagnostic metabolites in blood relate to risk of prostate cancer. We aimed to investigate the prospective association between plasma metabolite concentrations and risk of prostate cancer overall, and by time to diagnosis and tumour characteristics, and risk of death

Two-Year Diagnostic Stability in Early-Onset First-Episode Psychosis

Science.gov (United States)

Castro-Fornieles, Josefina; Baeza, Immaculada; de la Serna, Elena; Gonzalez-Pinto, Ana; Parellada, Mara; Graell, Montserrat; Moreno, Dolores; Otero, Soraya; Arango, Celso

2011-01-01

Background: Only one study has used a prospective method to analyze the diagnostic stability of first psychotic episodes in children and adolescents. The Child and Adolescent First-Episode Psychosis Study (CAFEPS) is a 2-year, prospective longitudinal study of early-onset first episodes of psychosis (EO-FEP). Aim: To describe diagnostic stability…

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

International Nuclear Information System (INIS)

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

1995-01-01

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

Improved Efficiency of Miscible CO2 Floods and Enhanced Prospects for CO2 Flooding Heterogeneous Reservoirs; ANNUAL

International Nuclear Information System (INIS)

Grigg, Reid B.; Schechter, David S.

1999-01-01

The goal of this project is to improve the efficiency of miscible CO2 floods and enhance the prospects for flooding heterogeneous reservoirs. This report provides results of the second year of the three-year project that will be exploring three principles: (1) Fluid and matrix interactions (understanding the problems). (2) Conformance control/sweep efficiency (solving the problems. 3) Reservoir simulation for improved oil recovery (predicting results)

Step-and-shoot prospectively ECG-gated vs. retrospectively ECG-gated with tube current modulation coronary CT angiography using 128-slice MDCT patients with chest pain: diagnostic performance and radiation dose

International Nuclear Information System (INIS)

Kim, Jeong Su; Choo, Ki Seok; Jeong, Dong Wook

2011-01-01

Background With increasing awareness for radiation exposure, the study of diagnostic accuracy of coronary CT angiography (CCTA) with low radiation dose techniques is mandatory to both radiologist and clinician. Purpose To compare diagnostic performance and effective radiation dose between step-and-shoot prospectively ECG-gated and retrospectively ECG-gated with tube current modulation (TCM) CCTA using 128-slice multidetector computed tomography (MDCT). Material and Methods We retrospectively evaluated 60 patients who underwent CCTA with either of two different low-dose techniques using 128-slice MDCT (23 patients for step-and shoot-prospectively ECG-gated and 37 patients for retrospectively ECG-gated with TCM CCTA) followed by conventional coronary angiography. All coronary arteries and all segments thereof, except anatomical variants or small size (< 1.5 mm) ones, were included in analysis. Results In per-segment analysis, sensitivity, specificity, positive predictive value, and negative predictive value were 91/96%, 95/94%, 75/73%, and 98/99% for step-and-shoot prospectively ECG-gated and retrospectively ECG gated with TCM CCTA, respectively, relative to conventional coronary angiography. Effective radiation dose were 1.75 ± 0.83 mSv, 4.91 ± 1.71 mSv in the step-and-shoot prospectively ECG-gated and retrospectively ECG-gated with TCM CCTA groups, respectively. Conclusion The two low-radiation dose CCTA techniques using 128-slice MDCT yields comparable diagnostic performance for coronary artery disease in symptomatic patients with low heart rates

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

Science.gov (United States)

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

2013-02-15

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

The Development of System for Management of Enterprise: Diagnostic and Anticipative Approaches

Directory of Open Access Journals (Sweden)

Pawlowski Grzegorz

2017-03-01

Full Text Available The article is aimed at formation of theoretical and methodical foundations for development of a system for management of enterprise in line with the diagnostic and anticipative approaches. It has been determined that the diagnostic approach is based on the process of identification, analysis and assessment of the enterprise’s status (subject to restrictions on access to information resources to address the problematic moments and weaknesses of enterprise and/or use chances of functioning modalities and strong positions of enterprise to ensure its development and forming a perspective. At the same time, it has been determined that the anticipative approach is directed to an early warning and response to financial crisis, signaling to directors of enterprises on hazards, risks, and additional chances to increase efficiency and effectiveness of financial-economic activity by means of continuous monitoring of changes, arising in the environment of functioning. Prospect for further research will be developing a diagnostic system, taking into consideration the diagnostics in the enterprise’s management system and the theoretical-methodological foundations for development of system for management of enterprise.

Diagnostic and prognostic stratification in the emergency department using urinary biomarkers of nephron damage: a multicenter prospective cohort study.

Science.gov (United States)

Nickolas, Thomas L; Schmidt-Ott, Kai M; Canetta, Pietro; Forster, Catherine; Singer, Eugenia; Sise, Meghan; Elger, Antje; Maarouf, Omar; Sola-Del Valle, David Antonio; O'Rourke, Matthew; Sherman, Evan; Lee, Peter; Geara, Abdallah; Imus, Philip; Guddati, Achuta; Polland, Allison; Rahman, Wasiq; Elitok, Saban; Malik, Nasir; Giglio, James; El-Sayegh, Suzanne; Devarajan, Prasad; Hebbar, Sudarshan; Saggi, Subodh J; Hahn, Barry; Kettritz, Ralph; Luft, Friedrich C; Barasch, Jonathan

2012-01-17

This study aimed to determine the diagnostic and prognostic value of urinary biomarkers of intrinsic acute kidney injury (AKI) when patients were triaged in the emergency department. Intrinsic AKI is associated with nephron injury and results in poor clinical outcomes. Several urinary biomarkers have been proposed to detect and measure intrinsic AKI. In a multicenter prospective cohort study, 5 urinary biomarkers (urinary neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, urinary liver-type fatty acid binding protein, urinary interleukin-18, and cystatin C) were measured in 1,635 unselected emergency department patients at the time of hospital admission. We determined whether the biomarkers diagnosed intrinsic AKI and predicted adverse outcomes during hospitalization. All biomarkers were elevated in intrinsic AKI, but urinary neutrophil gelatinase-associated lipocalin was most useful (81% specificity, 68% sensitivity at a 104-ng/ml cutoff) and predictive of the severity and duration of AKI. Intrinsic AKI was strongly associated with adverse in-hospital outcomes. Urinary neutrophil gelatinase-associated lipocalin and urinary kidney injury molecule 1 predicted a composite outcome of dialysis initiation or death during hospitalization, and both improved the net risk classification compared with conventional assessments. These biomarkers also identified a substantial subpopulation with low serum creatinine at hospital admission, but who were at risk of adverse events. Urinary biomarkers of nephron damage enable prospective diagnostic and prognostic stratification in the emergency department. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Image quality, radiation dose, and diagnostic accuracy of prospectively ECG-triggered high-pitch coronary CT angiography at 70 kVp in a clinical setting: comparison with invasive coronary angiography

Energy Technology Data Exchange (ETDEWEB)

Zhang, Long Jiang; Qi, Li; Zhou, Chang Sheng; Zhao, Yan E.; Li, Xie; Lu, Guang Ming [Jinling Hospital, Medical School of Nanjing University, Department of Medical Imaging, Nanjing, Jiangsu (China); Wang, Yining; Cao, Jian; Jin, Zhengyu [Peking Union Medical College Hospital, Department of Radiology, Beijing (China); Schoepf, U.J. [Jinling Hospital, Medical School of Nanjing University, Department of Medical Imaging, Nanjing, Jiangsu (China); Medical University of South Carolina, Division of Cardiovascular Imaging, Charleston, SC (United States); Meinel, Felix G. [Medical University of South Carolina, Division of Cardiovascular Imaging, Charleston, SC (United States); Ludwig-Maximilians-University Hospital, Institute for Clinical Radiology, Munich (Germany); Bayer, Richard R. [Medical University of South Carolina, Division of Cardiovascular Imaging, Charleston, SC (United States); Gong, Jian Bin [Jinling Hospital, Medical School of Nanjing University, Department of Cardiology, Nanjing, Jiangsu (China)

2016-03-15

To investigate image quality, radiation dose, and diagnostic performance of prospectively ECG-triggered high-pitch coronary CT angiography (CCTA) at 70 kVp compared to invasive coronary angiography (ICA) as reference standard. Forty-three patients underwent prospectively ECG-triggered high-pitch CCTA at 70 kVp using 30 cc (11 g iodine) contrast medium and ICA. Subjective and objective image quality was evaluated for each CCTA study. CCTA performance for diagnosing ≥50 % stenosis was assessed. Results were stratified according to heart rate (HR), body mass index (BMI), Agatston score, and image quality. At CCTA, 94.3 % (500/530) of coronary segments were of diagnostic quality. Using ICA as reference standard, sensitivity and accuracy were 100 % and 93.0 % on a per-patient basis. Per-vessel and per-segment performances were 92.2 % and 89.5 %; 79.5 % and 88.3 %, respectively. No differences were found in diagnostic accuracy between different HR, BMI, and calcification subgroups (all P > 0.05) on a per-patient basis. However, low image quality reduced diagnostic accuracy on a per-patient, per-vessel and per-segment basis (all P < 0.05). The mean effective radiation dose was 0.2 ± 0.0 mSv. Our presented protocol results in an effective radiation dose of 0.2 mSv and high diagnostic accuracy for stenosis detection in a selected, non-obese population. (orig.)

Meta-analysis: diagnostic accuracy of coronary CT angiography with prospective ECG gating based on step-and-shoot, Flash and volume modes for detection of coronary artery disease

Energy Technology Data Exchange (ETDEWEB)

Yang, Linfeng; Zhou, Tao; Zhang, Ruijie; Peng, Zhaohui; Ding, Juan; Wang, Sen; Li, Min; Sun, Gang [Jinan Military General Hospital, Department of Medical Imaging, Jinan, Shandong Province (China); Xu, Lin [Jinan Military General Hospital, Department of Medical Cardiology, Jinan, Shandong Province (China)

2014-10-15

To investigate the diagnostic performance of coronary computed tomographic angiography (CCTA) with prospective electrocardiograph (ECG) gating based on step-and-shoot (SAS), Flash and volume imaging modes. We searched the electronic databases PubMed for all published studies regarding CCTA. We used an exact binomial rendition of the bivariate mixed-effects regression model developed for synthesis of diagnostic data. A total of 21,852 segments, 4,851 vessels and 1,375 patients were identified using database searches. Patient-level pooled sensitivity was 0.99 (95 % confidence interval [CI], 0.98-1.00); specificity was 0.88 (CI, 0.85-0.91). The results showed that the sensitivity and specificity for detection of significant stenosis did not differ in the three protocols (P = 0.24). No heterogeneity was found at the patient level for sensitivity (Q = 26.23; P = 0.12; I {sup 2} = 27.56 % [CI, 0.00-67.02 %]) and specificity (Q = 19.54; P = 0.42; I {sup 2} = 2.78 % [CI, 0.00-66.26 %]). CCTA with prospective ECG gating has similar high diagnostic value to rule out CAD in all three presented modes. (orig.)

Blood culture-negative endocarditis: Improving the diagnostic yield using new diagnostic tools.

Science.gov (United States)

Fournier, Pierre-Edouard; Gouriet, Frédérique; Casalta, Jean-Paul; Lepidi, Hubert; Chaudet, Hervé; Thuny, Franck; Collart, Frédéric; Habib, Gilbert; Raoult, Didier

2017-11-01

Blood culture-negative endocarditis (BCNE) may represent up to 70% of all endocarditis cases, depending on series. From 2001 to 2009, we implemented in our laboratory a multimodal diagnostic strategy for BCNE that included systematized testing of blood, and when available, valvular biopsy specimens using serological, broad range molecular, and histopathological assays. A causative microorganism was identified in 62.7% of patients.In this study from January 2010 to December 2015, in an effort to increase the number of identified causative microorganisms, we prospectively added to our diagnostic protocol specific real-time (RT) polymerase chain reaction (PCR) assays targeting various endocarditis agents, and applied them to all patients with BCNE admitted to the 4 public hospitals in Marseille, France.A total of 283 patients with BCNE were included in the study. Of these, 177 were classified as having definite endocarditis. Using our new multimodal diagnostic strategy, we identified an etiology in 138 patients (78.0% of cases). Of these, 3 were not infective (2.2%) and 1 was diagnosed as having Mycobacterium bovis BCG endocarditis. By adding specific PCR assays from blood and valvular biopsies, which exhibited a significantly greater sensitivity (P < 10) than other methods, causative agents, mostly enterococci, streptococci, and zoonotic microorganisms, were identified in an additional 27 patients (14 from valves only, 11 from blood only, and 2 from both). Finally, in another 107 patients, a pathogen was detected using serology in 37, valve culture in 8, broad spectrum PCR from valvular biopsies and blood in 19 and 2, respectively, immunohistochemistry from valves in 3, and a combination of several assays in 38.By adding specific RT-PCR assays to our systematic PCR testing of patients with BCNE, we increased the diagnostic efficiency by 24.3%, mostly by detecting enterococci and streptococci that had not been detected by other diagnostic methods, but also agents

Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management.

Science.gov (United States)

Kuupiel, Desmond; Bawontuo, Vitalis; Mashamba-Thompson, Tivani P

2017-11-29

Access to point-of-care (POC) diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs) and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings.

Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management

Directory of Open Access Journals (Sweden)

Desmond Kuupiel

2017-11-01

Full Text Available Access to point-of-care (POC diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings.

Qualitative study of sexual functioning in couples with erectile dysfunction: prospective evaluation of the thermography diagnostic system.

Science.gov (United States)

Ng, Wan Kee; Ng, Yin Kwee; Tan, Yung Khan

2009-01-01

To evaluate the prospective use of the thermography diagnostic system in assessing sexual function in patients with erectile dysfunction (ED). Thermographs were taken on 14 subjects in a clinical trial conducted at Tan Tock Seng Hospital. After a thorough clinical interview with a standardized questionnaire, patients were scanned for baseline temperature profile before being given an oral dose of sildenafil 100 mg. Subjects were scanned again in the same setting an hour later. If so desired, subjects were given visual stimulation and were allowed minimum direct stimulation, excluding the penis, to elicit erection. Temperature profiles were analyzed using the thermography analysis software in the VarioCAM camera. Three representative cases are presented to illustrate the potential for using the Infrared thermography (IR) diagnostic system in differentiating psychogenic ED. IR was able to capture a significant difference in blood flow to the corpus cavernosum. Subjects with psychogenic ED have higher surface temperatures (34.3 degrees C +/- 0.71 in the flaccid state and 35.3 degrees C +/- 0.2 during erection) compared to subjects with organic ED (33.64 degrees C +/- 0.4 in flaccid and 33.55 degrees C +/- 0.91 during erection). The difference in surface temperature between flaccid and erected states in subjects with organic ED was not significant. The proposed diagnostic test based on IR has tremendous clinical potential in differentiating psychogenic ED from organic ED. IR could potentially be a portable, noninvasive and convenient adjunct in the diagnosis and management of ED.

Diagnostics of the Enterprise Export Potential

Directory of Open Access Journals (Sweden)

Skrynkovskyy Ruslan M.

2016-11-01

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

Comparison of the diagnostic accuracy of PET/MRI to PET/CT-acquired FDG brain exams for seizure focus detection: a prospective study

Energy Technology Data Exchange (ETDEWEB)

Paldino, Michael J.; Jones, Jeremy Y.; Mahmood, Nadia; Sher, Andrew; Hayatghaibi, Shireen; Seghers, Victor [Texas Children' s Hospital, Department of Radiology, Houston, TX (United States); Yang, Erica [SimonMed Imaging, Department of Radiology, Scottsdale, AZ (United States); Zhang, Wei [Texas Children' s Hospital, Outcomes and Impact Service, Houston, TX (United States); Krishnamurthy, Ramkumar [Nationwide Children' s Hospital, Department of Radiology, Columbus, OH (United States)

2017-10-15

There is great interest in positron emission tomography (PET)/magnetic resonance (MR) as a clinical tool due to its capacity to provide diverse diagnostic information in a single exam. The goal of this exam is to compare the diagnostic accuracy of PET/MR-acquired [F-18]2-fluoro-2-deoxyglucose (FDG) brain exams to that of PET/CT with respect to identifying seizure foci in children with localization-related epilepsy. Institutional Review Board approval and informed consent were obtained for this Health Insurance Portability and Accountability Act-compliant, prospective study. All patients referred for clinical FDG-PET/CT exams of the brain at our institution for a diagnosis of localization-related epilepsy were prospectively recruited to undergo an additional FDG-PET acquisition on a tandem PET/MR system. Attenuation-corrected FDG images acquired at PET/MR and PET/CT were interpreted independently by five expert readers. Readers were blinded to the scanner used for acquisition and attenuation correction as well as all other clinical and imaging data. A Likert scale scoring system (1-5) was used to assess image quality. The locale of seizure origin determined at multidisciplinary epilepsy surgery work rounds was considered the reference standard. Non-inferiority testing for paired data was used to compare the diagnostic accuracy of PET/MR to that of PET/CT. The final study population comprised 35 patients referred for a diagnosis of localization-related epilepsy (age range: 2-19 years; median: 11 years; 21 males, 14 females). Image quality did not differ significantly between the two modalities. The accuracy of PET/MR was not inferior to that of PET/CT for localization of a seizure focus (P=0.017). The diagnostic accuracy of FDG-PET images acquired on a PET/MR scanner and generated using MR-based attenuation correction was not inferior to that of PET images processed by traditional CT-based correction. (orig.)

Comparison of the diagnostic accuracy of PET/MRI to PET/CT-acquired FDG brain exams for seizure focus detection: a prospective study

International Nuclear Information System (INIS)

Paldino, Michael J.; Jones, Jeremy Y.; Mahmood, Nadia; Sher, Andrew; Hayatghaibi, Shireen; Seghers, Victor; Yang, Erica; Zhang, Wei; Krishnamurthy, Ramkumar

2017-01-01

There is great interest in positron emission tomography (PET)/magnetic resonance (MR) as a clinical tool due to its capacity to provide diverse diagnostic information in a single exam. The goal of this exam is to compare the diagnostic accuracy of PET/MR-acquired [F-18]2-fluoro-2-deoxyglucose (FDG) brain exams to that of PET/CT with respect to identifying seizure foci in children with localization-related epilepsy. Institutional Review Board approval and informed consent were obtained for this Health Insurance Portability and Accountability Act-compliant, prospective study. All patients referred for clinical FDG-PET/CT exams of the brain at our institution for a diagnosis of localization-related epilepsy were prospectively recruited to undergo an additional FDG-PET acquisition on a tandem PET/MR system. Attenuation-corrected FDG images acquired at PET/MR and PET/CT were interpreted independently by five expert readers. Readers were blinded to the scanner used for acquisition and attenuation correction as well as all other clinical and imaging data. A Likert scale scoring system (1-5) was used to assess image quality. The locale of seizure origin determined at multidisciplinary epilepsy surgery work rounds was considered the reference standard. Non-inferiority testing for paired data was used to compare the diagnostic accuracy of PET/MR to that of PET/CT. The final study population comprised 35 patients referred for a diagnosis of localization-related epilepsy (age range: 2-19 years; median: 11 years; 21 males, 14 females). Image quality did not differ significantly between the two modalities. The accuracy of PET/MR was not inferior to that of PET/CT for localization of a seizure focus (P=0.017). The diagnostic accuracy of FDG-PET images acquired on a PET/MR scanner and generated using MR-based attenuation correction was not inferior to that of PET images processed by traditional CT-based correction. (orig.)

Summary and Prospect.

Science.gov (United States)

Wei, Zhengde; Chen, Xueli; Zhang, Xiaochu

2017-01-01

In this chapter, the main content is to summarize the similarities and differences between substance and non-substance addictions in several aspects, involving definition, mechanisms, diagnosis and treatment. We try to display the complete picture of addictions in a brief but comprehensive way. Mechanism includes molecule and neural circuit, genetics, neuroimaging and cognitive psychology; diagnosis includes diagnostic criterion, diagnostic scales, biochemical diagnosis and new diagnostic techniques; treatment includes drug therapy, physical therapy, traditional Chinese medical therapy, nutrition support therapy, psychotherapy and cognitive-behavioral therapy. This chapter also covers some prospect which will induct future studies on addiction. We aim at providing the researchers and graduate students with better understanding of substance and non-substance addictions.

The Effectiveness and Efficiency of Inpatient Rehabilitation Services in Thailand: A Prospective Multicenter Study

Directory of Open Access Journals (Sweden)

Vilai Kuptniratsaikul

2016-01-01

Full Text Available Objective To investigate the effectiveness and efficiency of inpatient rehabilitation. Methods A total of 2,081 patients across 14 hospitals were recruited in this prospective, multicenter cohort study. Data on the diagnoses, types of admission, length of stay (LOS, and functional ability score based on a modified Barthel index (BI at admission (BIa and at discharge (BId were collected. Effectiveness was defined as the difference of BI (ΔBI and efficiency as ΔBI divided by LOS. Results The majority of patients were diagnosed with spinal cord injury and stroke (41.8% and 37.5%, respectively. The mean age was 52.4 ± 18.6 years with a mean LOS of 23.9 ± 19.9 days, BIa of 9.4 ± 6.1, and BId of 12.3 ± 5.7. The overall effectiveness and efficiency were 2.9 ± 3.4 and 0.16 ± 0.30 scores/day, respectively; stroke rehabilitation provided the most effective and efficient BI improvement compared with rehabilitation for other diseases. Most patients (54.5% received intensive functional rehabilitation, which was the most effective and efficient program (4.4 ± 3.6 and 0.23 ± 0.32 scores/day, respectively; the efficiency of the intensive program was not different among various diseases (P = 0.726. Conclusion Stroke rehabilitation had the highest efficiency compared with rehabilitation for other neurological diseases. The most efficient type of admission was intensive rehabilitation, regardless of the disease being treated.

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

Science.gov (United States)

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

2018-01-01

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

Hand trauma: A prospective observational study reporting diagnostic concordance in emergency hand trauma which supports centralised service improvements.

Science.gov (United States)

Miranda, B H; Spilsbury, Z P; Rosala-Hallas, A; Cerovac, S

2016-10-01

Hand injuries are common, contributing up to 30% of accident and emergency (A&E) attendances. The aim of this study was to prospectively analyse the pathological demographics of hand injuries in a level 1 trauma centre with a Hand Trauma Unit and direct A&E links, and compare clinical and intra-operative findings. The null hypothesis was that there would be no differences between clinical and intra-operative findings (100% diagnostic concordance). Data were prospectively collected for referrals during 2012. Referral diagnosis, additional pathologies found on clinical assessment and intra-operative findings were documented on a live database accessible from both the Hand Unit and associated operating theatres. Odds ratios were calculated using SAS. Injuries (1526) were identified in 1308 patients included in the study. Diagnostic concordance between Hand Unit clinical examination and intra-operative findings was 92.5% ± 2.85% (mean ± SEM); this was lower for flexor tendon injuries (56.3%) because a greater number of additional pathologies were found intra-operatively (2.25 ± 0.10). This 'trend' was noted across multiple referral pathologies including phalangeal fractures (1.28 ± 0.02; 82.9%), lacerations (1.33 ± 0.04; 79.1%), extensor tendon injuries (1.30 ± 0.05; 87.8%) and dislocations (1.18 ± 0.05; 87.8%). Odds ratio analysis indicated a relationship between primary referral diagnoses that were more or less likely to be associated with additional injuries (p management of hand trauma. Our findings, coupled with the presented relevant literature reports, lead us to advocate that A&E departments should move towards a system wherein links to specialist hand trauma services are in place; we hereby present useful data for hospitals implementing such services. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

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

2018-01-01

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

Diagnostic stability of autism spectrum disorder in toddlers prospectively identified in a community-based setting: Behavioural characteristics and predictors of change over time.

Science.gov (United States)

Barbaro, Josephine; Dissanayake, Cheryl

2017-10-01

Autism spectrum disorder diagnoses in toddlers have been established as accurate and stable across time in high-risk siblings and clinic-referred samples. Few studies have investigated diagnostic stability in children prospective identified in community-based settings. Furthermore, there is a dearth of evidence on the individual behaviours that predict diagnostic change over time. The stability and change of autism spectrum disorder diagnoses were investigated from 24 to 48 months in 77 children drawn from the Social Attention and Communication Study. Diagnostic stability was high, with 88.3% overall stability and 85.5% autism spectrum disorder stability. The behavioural markers at 24 months that contributed to diagnostic shift off the autism spectrum by 48 months included better eye contact, more directed vocalisations, the integration of gaze and directed vocalisations/gestures and higher non-verbal developmental quotient. These four variables correctly predicted 88.7% of children into the autism spectrum disorder-stable and autism spectrum disorder-crossover groups overall, with excellent prediction for the stable group (96.2%) and modest prediction for the crossover group (44.4%). Furthermore, non-verbal developmental quotient at 24 months accounted for the significant improvement across time in 'Social Affect' scores on the Autism Diagnostic Observation Schedule for both groups and was the only unique predictor of diagnostic crossover. These findings contribute to the body of evidence on the feasibility of diagnoses at earlier ages to facilitate children's access to interventions to promote positive developmental outcomes.

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

Science.gov (United States)

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

2015-10-01

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

Applications of GPR in archaeological prospecting and cultural heritage diagnostics: Research Perspectives in COST Action TU1208

Science.gov (United States)

Pajewski, Lara; Benedetto, Andrea; Schettini, Giuseppe; Soldovieri, Francesco

2013-04-01

Ground Penetrating Radar (GPR) is a safe, non-destructive and non-invasive imaging technique that can be effectively used for advanced inspection of composite structures and for diagnostics affecting the whole life-cycle of civil engineering works. GPR can also be successfully employed in archaeological prospecting and cultural heritage diagnostics. In many Countries, where the archeological patrimony is an outstanding value (as Egypt, Israel, Greece, Central and South America), GPR is usually employed both as a diagnostic tool for the preventive detection of archeological structures and as the most advanced instrument able to prospect geometry and shape of underground valuable sites. However many uncertainties persist, because of several difficulties and ambiguities due to the complexity of the image processing in heterogeneous environment. It is possible to identify three main areas, in GPR field, that have to be addressed in order to promote the use of this technology in archaeological prospecting and cultural heritage diagnostics. These are: a) increase of the system sensitivity to enable the usability in a wider range of conditions, archeological sites are often located in impervious and critical environments; b) research novel data processing algorithms/analysis tools for the interpretation of GPR results; c) contribute to the development of new standards and guidelines and to training of end users, that will also help to increase the awareness of operators. It is also important to further investigate and promote a combined use of GPR with other non-invasive advanced techniques, typically used in the archeological investigation. In this framework, the COST Action TU1208 "Civil Engineering Applications of Ground Penetrating Radar", proposed by a research team of "Roma Tre" University, Rome, Italy, has been approved in November 2012 and is going to start in April 2013. It is a 4-years ambitious project already involving 17 European Countries (AT, BE, CH, CZ, DE

Comparison of clinical judgment and diagnostic ultrasonography in the diagnosis of acute appendicitis

DEFF Research Database (Denmark)

Jahn, H; Mathiesen, F K; Neckelmann, K

1997-01-01

, and diagnostic aids are desirable to reduce the negative appendicectomy rate. Diagnostic US performed poorly as a routine procedure. Application of an up to date scoring system might be of some help to patients with a high or low probability of acute appendicitis, but any conclusion about its clinical......OBJECTIVE: To evaluate the diagnostic accuracy of clinical judgment and diagnostic ultrasonography (US) used routinely and to create a scoring system to aid diagnosis. DESIGN: Prospective, double-blind study. SETTING: University hospital, Denmark. SUBJECTS: 222 Consecutive patients suspected...... of having acute appendicitis admitted between 0800 and midnight from June 1990 to June 1992. INTERVENTIONS: 148 Patients (67%) underwent appendicectomy and the remaining 74 patients were observed. 193 Patients (87%) had a diagnostic US examination. 21 Predictive variables were collected prospectively...

CFTR mutations spectrum and the efficiency of molecular diagnostics in Polish cystic fibrosis patients.

Directory of Open Access Journals (Sweden)

Ewa Ziętkiewicz

Full Text Available Cystic fibrosis (CF is caused by mutations in the cystic fibrosis transmembrane regulator gene (CFTR. In light of the strong allelic heterogeneity and regional specificity of the mutation spectrum, the strategy of molecular diagnostics and counseling in CF requires genetic tests to reflect the frequency profile characteristic for a given population. The goal of the study was to provide an updated comprehensive estimation of the distribution of CFTR mutations in Polish CF patients and to assess the effectiveness of INNOLiPA_CFTR tests in Polish population. The analyzed cohort consisted of 738 patients with the clinically confirmed CF diagnosis, prescreened for molecular defects using INNOLiPA_CFTR panels from Innogenetics. A combined efficiency of INNOLiPA CFTR_19 and CFTR_17_TnUpdate tests was 75.5%; both mutations were detected in 68.2%, and one mutation in 14.8% of the affected individuals. The group composed of all the patients with only one or with no mutation detected (109 and 126 individuals, respectively was analyzed further using a mutation screening approach, i.e. SSCP/HD (single strand conformational polymorphism/heteroduplex analysis of PCR products followed by sequencing of the coding sequence. As a result, 53 more mutations were found in 97 patients. The overall efficiency of the CF allele detection was 82.5% (7.0% increase compared to INNOLiPA tests alone. The distribution of the most frequent mutations in Poland was assessed. Most of the mutations repetitively found in Polish patients had been previously described in other European populations. The most frequent mutated allele, F508del, represented 54.5% of Polish CF chromosomes. Another eight mutations had frequencies over 1%, 24 had frequencies between 1 and 0.1%; c.2052-2053insA and c.3468+2_3468+3insT were the most frequent non-INNOLiPA mutations. Mutation distribution described herein is also relevant to the Polish diaspora. Our study also demonstrates that the reported

Diagnostic efficiency of demographically corrected Wechsler Adult Intelligence Scale-III and Wechsler Memory Scale-III indices in moderate to severe traumatic brain injury and lower education levels.

Science.gov (United States)

Walker, Alexandra J; Batchelor, Jennifer; Shores, E Arthur; Jones, Mike

2009-11-01

Despite the sensitivity of neuropsychological tests to educational level, improved diagnostic accuracy for demographically corrected scores has yet to be established. Diagnostic efficiency statistics of Wechsler Adult Intelligence Scale-III (WAIS-III) and Wechsler Memory Scale-III (WMS-III) indices that were corrected for education, sex, and age (demographically corrected) were compared with age corrected indices in individuals aged 16 to 75 years with moderate to severe traumatic brain injury (TBI) and 12 years or less education. TBI participants (n = 100) were consecutive referrals to an outpatient rehabilitation service and met careful selection criteria. Controls (n = 100) were obtained from the WAIS-III/WMS-III standardization sample. Demographically corrected indices did not provide higher diagnostic efficiency than age corrected indices and this result was supported by reanalysis of the TBI group against a larger and unmatched control group. Processing Speed Index provided comparable diagnostic accuracy to that of combined indices. Demographically corrected indices were associated with higher cut-scores to maximize overall classification, reflecting the upward adjustment of those scores in a lower education sample. This suggests that, in clinical practice, the test results of individuals with limited education may be more accurately interpreted with the application of demographic corrections. Diagnostic efficiency statistics are presented, and future research directions are discussed.

Diagnostic Efficiency in Digital Pathology: A Comparison of Optical Versus Digital Assessment in 510 Surgical Pathology Cases.

Science.gov (United States)

Mills, Anne M; Gradecki, Sarah E; Horton, Bethany J; Blackwell, Rebecca; Moskaluk, Christopher A; Mandell, James W; Mills, Stacey E; Cathro, Helen P

2018-01-01

Prior work has shown that digital images and microscopic slides can be interpreted with comparable diagnostic accuracy. Although accuracy has been well-validated, the interpretative time for digital images has scarcely been studied and concerns about efficiency remain a major barrier to adoption. We investigated the efficiency of digital pathology when compared with glass slide interpretation in the diagnosis of surgical pathology biopsy and resection specimens. Slides were pulled from 510 surgical pathology cases from 5 organ systems (gastrointestinal, gynecologic, liver, bladder, and brain). Original diagnoses were independently confirmed by 2 validating pathologists. Diagnostic slides were scanned using the Philips IntelliSite Pathology Solution. Each case was assessed independently on digital and optical by 3 reading pathologists, with a ≥6 week washout period between modalities. Reading pathologists recorded assessment times for each modality; digital times included time to load the case. Diagnostic accuracy was determined based on whether a rendered diagnosis differed significantly from the original diagnosis. Statistical analysis was performed to assess for differences in interpretative times across modalities. All 3 reading pathologists showed comparable diagnostic accuracy across optical and digital modalities (mean major discordance rates with original diagnosis: 4.8% vs. 4.4%, respectively). Mean assessment times ranged from 1.2 to 9.1 seconds slower on digital versus optical. The slowest reader showed a significant learning effect during the course of the study so that digital assessment times decreased over time and were comparable with optical times by the end of the series. Organ site and specimen type did not significantly influence differences in interpretative times. In summary, digital image reading times compare favorably relative to glass slides across a variety of organ systems and specimen types. Mean increase in assessment time is 4

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

Science.gov (United States)

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

2015-08-01

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

A Primer on Receiver Operating Characteristic Analysis and Diagnostic Efficiency Statistics for Pediatric Psychology: We Are Ready to ROC

Science.gov (United States)

2014-01-01

Objective To offer a practical demonstration of receiver operating characteristic (ROC) analyses, diagnostic efficiency statistics, and their application to clinical decision making using a popular parent checklist to assess for potential mood disorder. Method Secondary analyses of data from 589 families seeking outpatient mental health services, completing the Child Behavior Checklist and semi-structured diagnostic interviews. Results Internalizing Problems raw scores discriminated mood disorders significantly better than did age- and gender-normed T scores, or an Affective Problems score. Internalizing scores 30 had a diagnostic likelihood ratio of 7.4. Conclusions This study illustrates a series of steps in defining a clinical problem, operationalizing it, selecting a valid study design, and using ROC analyses to generate statistics that support clinical decisions. The ROC framework offers important advantages for clinical interpretation. Appendices include sample scripts using SPSS and R to check assumptions and conduct ROC analyses. PMID:23965298

Efficient Probabilistic Diagnostics for Electrical Power Systems

Science.gov (United States)

Mengshoel, Ole J.; Chavira, Mark; Cascio, Keith; Poll, Scott; Darwiche, Adnan; Uckun, Serdar

2008-01-01

We consider in this work the probabilistic approach to model-based diagnosis when applied to electrical power systems (EPSs). Our probabilistic approach is formally well-founded, as it based on Bayesian networks and arithmetic circuits. We investigate the diagnostic task known as fault isolation, and pay special attention to meeting two of the main challenges . model development and real-time reasoning . often associated with real-world application of model-based diagnosis technologies. To address the challenge of model development, we develop a systematic approach to representing electrical power systems as Bayesian networks, supported by an easy-to-use speci.cation language. To address the real-time reasoning challenge, we compile Bayesian networks into arithmetic circuits. Arithmetic circuit evaluation supports real-time diagnosis by being predictable and fast. In essence, we introduce a high-level EPS speci.cation language from which Bayesian networks that can diagnose multiple simultaneous failures are auto-generated, and we illustrate the feasibility of using arithmetic circuits, compiled from Bayesian networks, for real-time diagnosis on real-world EPSs of interest to NASA. The experimental system is a real-world EPS, namely the Advanced Diagnostic and Prognostic Testbed (ADAPT) located at the NASA Ames Research Center. In experiments with the ADAPT Bayesian network, which currently contains 503 discrete nodes and 579 edges, we .nd high diagnostic accuracy in scenarios where one to three faults, both in components and sensors, were inserted. The time taken to compute the most probable explanation using arithmetic circuits has a small mean of 0.2625 milliseconds and standard deviation of 0.2028 milliseconds. In experiments with data from ADAPT we also show that arithmetic circuit evaluation substantially outperforms joint tree propagation and variable elimination, two alternative algorithms for diagnosis using Bayesian network inference.

Quantum Dots for Molecular Diagnostics of Tumors

OpenAIRE

Zdobnova, T.A.; Lebedenko, E.N.; Deyev, S.М.

2011-01-01

Semiconductor quantum dots (QDs) are a new class of fluorophores with unique physical and chemical properties, which allow to appreciably expand the possibilities for the current methods of fluorescent imaging and optical diagnostics. Here we discuss the prospects of QD application for molecular diagnostics of tumors ranging from cancer-specific marker detection on microplates to non-invasive tumor imaging in vivo. We also point out the essential problems that require resolution in order to c...

Patterns of anaphylaxis after diagnostic workup

DEFF Research Database (Denmark)

Oropeza, Athamaica Ruiz; Bindslev-Jensen, Carsten; Broesby-Olsen, Sigurd

2017-01-01

BACKGROUND: Most published studies on anaphylaxis are retrospective or register based. Data on subsequent diagnostic work-up are sparse. We aimed to characterize patients seen with suspected anaphylaxis at the emergency care setting (ECS), after subsequent diagnostic work-up at our Allergy Center...... (AC). METHODS: Prospective study including patients from the ECS, Odense University Hospital, during May 2013-April 2014. Possible anaphylaxis cases were daily identified based on a broad search profile including history and symptoms in patient records, diagnostic codes and pharmacological treatments....... At the AC, all patients were evaluated according to international guidelines. RESULTS: Among 226 patients with suspected anaphylaxis, the diagnosis was confirmed in 124 (54.9%) after diagnostic work-up; 118 of the 124 fulfilled WAO/EAACI criteria of anaphylaxis at the ECS, while 6 were found among 46...

Diagnostics of trophoblast disease and the control of therapeutic efficiency based on definition of chorionic gonadotrapin and trophoblastic beta1-glycoprotein

International Nuclear Information System (INIS)

Yugrinova, L.G.; Olefirenko, G.A.; Dotsenko, Yu.S.

1982-01-01

A comparative estimation of markers of trophoblast disease, chorionic gonadotropin (CG) and trophoblastic beta 1 -glycoprotein defined by different methods is given. It is found that diagnostics and control of therapeutic efficiency for patients having trophoblast disease based on CG definition are possible. In 86% of cases the clinical diagnosis was confirmed by the immunoradioautography, and in 33% - by the immunodiffusion method. The dependence of marker detection frequency on the therapeutic efficiency is found

Diagnostic planning in JT-60 project

International Nuclear Information System (INIS)

Matoba, Tohru; Suzuki, Yasuo; Funahashi, Akimasa; Itagaki, Tokiyoshi

1977-08-01

The diagnostic plans of JT-60 were made along with design of the main machine. Basic requirements of the diagnostic program are (1) multiple measurement of respective plasma parameters, (2) efficient usage of the discharge, (3) capable data acquisition system, (4) high reliability of the diagnostic equipments, and (5) systematic development of new diagnostic techniques. Dimensions of the diagnostic ports were determined in detailed design of the vacuum vessel, anticipating the possible diagnostic methods. The proposed diagnostic systems and the plans are shown in table and figures respectively. Problems in the diagnostics are also described. (auth.)

Modern diagnostic capabilities for vasospastic angina diagnostics (intracoronary provocative testing

Directory of Open Access Journals (Sweden)

А. А. Обединский

2017-04-01

Full Text Available This review is devoted to a topical problem of modern cardiology – techniques of diagnosing vasospastic angina. The results of retrospective and prospective studies on the efficacy and safety of vasospastic angina diagnostics are reviewed. The literature on the prevalence, progression and treatment of this pathology is discussed.Received 13 January 2017. Accepted 6 February 2017.Financing: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest.

A diagnostic methodology for refrigerating systems; Methodologie de diagnostic des installations frigorifiques

Energy Technology Data Exchange (ETDEWEB)

Vrinat, G. [Association Francaise du Froid (AFF), 75 - Paris (France)

1997-12-31

A diagnostic methodology for refrigerating machines, equipment and plants has been defined and evaluated for EDF, the French national power utility and ADEME, the French Agency for Energy Conservation, in the framework of energy conservation objectives: the diagnostic method should enable to identify malfunctions, assess the cost efficiency of the equipment, identify limiting factors, and consider corrective measures

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

Science.gov (United States)

Sohrabi, Mehdi; Parsi, Masoumeh; Sina, Sedigheh

2018-05-17

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

Location of core diagnostic information across various sequences in brain MRI and implications for efficiency of MRI scanner utilization.

Science.gov (United States)

Sharma, Aseem; Chatterjee, Arindam; Goyal, Manu; Parsons, Matthew S; Bartel, Seth

2015-04-01

Targeting redundancy within MRI can improve its cost-effective utilization. We sought to quantify potential redundancy in our brain MRI protocols. In this retrospective review, we aggregated 207 consecutive adults who underwent brain MRI and reviewed their medical records to document clinical indication, core diagnostic information provided by MRI, and its clinical impact. Contributory imaging abnormalities constituted positive core diagnostic information whereas absence of imaging abnormalities constituted negative core diagnostic information. The senior author selected core sequences deemed sufficient for extraction of core diagnostic information. For validating core sequences selection, four readers assessed the relative ease of extracting core diagnostic information from the core sequences. Potential redundancy was calculated by comparing the average number of core sequences to the average number of sequences obtained. Scanning had been performed using 9.4±2.8 sequences over 37.3±12.3 minutes. Core diagnostic information was deemed extractable from 2.1±1.1 core sequences, with an assumed scanning time of 8.6±4.8 minutes, reflecting a potential redundancy of 74.5%±19.1%. Potential redundancy was least in scans obtained for treatment planning (14.9%±25.7%) and highest in scans obtained for follow-up of benign diseases (81.4%±12.6%). In 97.4% of cases, all four readers considered core diagnostic information to be either easily extractable from core sequences or the ease to be equivalent to that from the entire study. With only one MRI lacking clinical impact (0.48%), overutilization did not seem to contribute to potential redundancy. High potential redundancy that can be targeted for more efficient scanner utilization exists in brain MRI protocols.

The Oil Security Metrics Model: A Tool for Evaluating the Prospective Oil Security Benefits of DOE's Energy Efficiency and Renewable Energy R&D Programs

Energy Technology Data Exchange (ETDEWEB)

Greene, David L [ORNL; Leiby, Paul Newsome [ORNL

2006-05-01

Energy technology R&D is a cornerstone of U.S. energy policy. Understanding the potential for energy technology R&D to solve the nation's energy problems is critical to formulating a successful R&D program. In light of this, the U.S. Congress requested the National Research Council (NRC) to undertake both retrospective and prospective assessments of the Department of Energy's (DOE's) Energy Efficiency and Fossil Energy Research programs (NRC, 2001; NRC, 2005). ("The Congress continued to express its interest in R&D benefits assessment by providing funds for the NRC to build on the retrospective methodology to develop a methodology for assessing prospective benefits." NRC, 2005, p. ES-2) In 2004, the NRC Committee on Prospective Benefits of DOE's Energy Efficiency and Fossil Energy R&D Programs published a report recommending a new framework and principles for prospective benefits assessment. The Committee explicitly deferred the issue of estimating security benefits to future work. Recognizing the need for a rigorous framework for assessing the energy security benefits of its R&D programs, the DOE's Office of Energy Efficiency and Renewable Energy (EERE) developed a framework and approach for defining energy security metrics for R&D programs to use in gauging the energy security benefits of their programs (Lee, 2005). This report describes methods for estimating the prospective oil security benefits of EERE's R&D programs that are consistent with the methodologies of the NRC (2005) Committee and that build on Lee's (2005) framework. Its objective is to define and implement a method that makes use of the NRC's typology of prospective benefits and methodological framework, satisfies the NRC's criteria for prospective benefits evaluation, and permits measurement of that portion of the prospective energy security benefits of EERE's R&D portfolio related to oil. While the Oil Security Metrics (OSM) methodology described

Prospects for energy efficiency improvement and reduction of emissions and life cycle costs for natural gas vehicles

Science.gov (United States)

Kozlov, A. V.; Terenchenko, A. S.; Luksho, V. A.; Karpukhin, K. E.

2017-01-01

This work is devoted to the experimental investigation of the possibilities to reduce greenhouse gas emissions and to increase energy efficiency of engines that use natural gas as the main fuel and the analysis of economic efficiency of use of dual fuel engines in vehicles compared to conventional diesel. The results of experimental investigation of a 190 kW dual-fuel engine are presented; it is shown that quantitative and qualitative working process control may ensure thermal efficiency at the same level as that of the diesel engine and in certain conditions 5...8% higher. The prospects for reduction of greenhouse gas emissions have been assessed. The technical and economic evaluation of use of dual fuel engines in heavy-duty vehicles has been performed, taking into account the total life cycle. It is shown that it is possible to reduce life cycle costs by two times.

Multicountry Prospective Clinical Evaluation of Two Enzyme-Linked Immunosorbent Assays and Two Rapid Diagnostic Tests for Diagnosing Dengue Fever

Science.gov (United States)

Dauner, Allison L.; Valks, Andrea; Forshey, Brett M.; Long, Kanya C.; Thaisomboonsuk, Butsaya; Sierra, Gloria; Picos, Victor; Talmage, Sara; Morrison, Amy C.; Halsey, Eric S.; Comach, Guillermo; Yasuda, Chadwick; Loeffelholz, Michael; Jarman, Richard G.; Fernandez, Stefan; An, Ung Sam; Kochel, Tadeusz J.; Jasper, Louis E.; Wu, Shuenn-Jue L.

2015-01-01

We evaluated four dengue diagnostic devices from Alere, including the SD Bioline Dengue Duo (nonstructural [NS] 1 Ag and IgG/IgM), the Panbio Dengue Duo Cassette (IgM/IgG) rapid diagnostic tests (RDTs), and the Panbio dengue IgM and IgG capture enzyme-linked immunosorbent assays (ELISAs) in a prospective, controlled, multicenter study in Peru, Venezuela, Cambodia, and the United States, using samples from 1,021 febrile individuals. Archived, well-characterized samples from an additional 135 febrile individuals from Thailand were also used. Reference testing was performed on all samples using an algorithm involving virus isolation, in-house IgM and IgG capture ELISAs, and plaque reduction neutralization tests (PRNT) to determine the infection status of the individual. The primary endpoints were the clinical sensitivities and specificities of these devices. The SD Bioline Dengue Duo had an overall sensitivity of 87.3% (95% confidence interval [CI], 84.1 to 90.2%) and specificity of 86.8% (95% CI, 83.9 to 89.3%) during the first 14 days post-symptom onset (p.s.o.). The Panbio Dengue Duo Cassette demonstrated a sensitivity of 92.1% (87.8 to 95.2%) and specificity of 62.2% (54.5 to 69.5%) during days 4 to 14 p.s.o. The Panbio IgM capture ELISA had a sensitivity of 87.6% (82.7 to 91.4%) and specificity of 88.1% (82.2 to 92.6%) during days 4 to 14 p.s.o. Finally, the Panbio IgG capture ELISA had a sensitivity of 69.6% (62.1 to 76.4%) and a specificity of 88.4% (82.6 to 92.8%) during days 4 to 14 p.s.o. for identification of secondary dengue infections. This multicountry prospective study resulted in reliable real-world performance data that will facilitate data-driven laboratory test choices for managing patient care during dengue outbreaks. PMID:25588659

Mild cognitive impairment and prospective memory: translating the evidence into neuropsychological practice.

Science.gov (United States)

Kinsella, Glynda J; Pike, Kerryn E; Cavuoto, Marina G; Lee, Stephen D

2018-04-30

There has been a recent rapid development of research characterizing prospective memory performance in mild cognitive impairment (MCI) in older age. However, this body of literature remains largely separated from routine clinical practice in neuropsychology. Furthermore, there is emerging evidence of effective interventions to improve prospective memory performance. Therefore, our objective in this article was to offer a clinical neuropsychological perspective on the existing research in order to facilitate the translation of the evidence-base into clinical practice. By conducting a critical review of the existing research related to prospective memory and MCI, we highlight how this data can be introduced into clinical practice, either within diagnostic assessment or clinical management. Prospective memory is impaired in older adults with MCI, with a pattern of performance that helps with differential diagnosis from healthy aging. Clinical neuropsychologists are encouraged to add prospective memory assessment to their toolbox for diagnostic evaluation of clients with MCI. Preliminary findings of prospective memory interventions in MCI are promising, but more work is required to determine how different approaches translate to increasing independence in everyday life.

Indications for computed tomography (CT-) diagnostics in proximal humeral fractures

DEFF Research Database (Denmark)

Bahrs, Christian; Rolauffs, Bernd; Südkamp, Norbert P

2009-01-01

diagnostics depending on the fractured parts. METHODS: In a prospective diagnostic study in two level 1 trauma centers, 44 patients with proximal humeral fractures were diagnosed with conventional X-rays (22 AP + axillary views, 22 AP + scapular Y-views) and CT (multi-planar reconstruction (MPR) and maximum...... diagnostic methods was assessed according to the number of fractured parts (Bonferroni-Holm adjustment). RESULTS: There was significantly more overlap of the fractured region on the scapular Y-views (mean 71.5%, range 45-90%) than on axillary views (mean 56.2%, range 10.5-100%). CT-diagnostics allowed...... a significantly better assessment of the relevant structures than conventional diagnostics (p diagnostics of the fracture...

Time efficiency and diagnostic accuracy of new automated myocardial perfusion analysis software in 320-row CT cardiac imaging

Energy Technology Data Exchange (ETDEWEB)

Rief, Matthias; Stenzei, Fabian; Kranz, Anisha; Schlattmann, Peter; Dewey, Marc [Dept. of Radiology, Charite - Universiteitsmedizin Berlin, Berlin (Greece)

2013-01-15

We aimed to evaluate the time efficiency and diagnostic accuracy of automated myocardial computed tomography perfusion (CTP) image analysis software. 320-row CTP was performed in 30 patients, and analyses were conducted independently by three different blinded readers by the use of two recent software releases (version 4.6 and novel version 4.71GR001, Toshiba, Tokyo, Japan). Analysis times were compared, and automated epi- and endocardial contour detection was subjectively rated in five categories (excellent, good, fair, poor and very poor). As semi-quantitative perfusion parameters, myocardial attenuation and transmural perfusion ratio (TPR) were calculated for each myocardial segment and agreement was tested by using the intraclass correlation coefficient (ICC). Conventional coronary angiography served as reference standard. The analysis time was significantly reduced with the novel automated software version as compared with the former release (Reader 1: 43:08 ± 11:39 min vs. 09:47 ± 04:51 min, Reader 2: 42:07 ± 06:44 min vs. 09:42 ± 02:50 min and Reader 3: 21:38 ± 3:44 min vs. 07:34 ± 02:12 min; p < 0.001 for all). Epi- and endocardial contour detection for the novel software was rated to be significantly better (p < 0.001) than with the former software. ICCs demonstrated strong agreement (≥ 0.75) for myocardial attenuation in 93% and for TPR in 82%. Diagnostic accuracy for the two software versions was not significantly different (p 0.169) as compared with conventional coronary angiography. The novel automated CTP analysis software offers enhanced time efficiency with an improvement by a factor of about four, while maintaining diagnostic accuracy.

Lifestyle influences on the association between pre-diagnostic hormone replacement therapy and breast cancer prognosis - results from The Danish 'Diet, Cancer and Health' prospective cohort

DEFF Research Database (Denmark)

Holm, Marianne; Olsen, Anja; Kroman, Niels

2014-01-01

OBJECTIVES: The association between pre-diagnostic hormone replacement therapy (HRT) and breast cancer specific mortality as well as potential influences from other lifestyle factors on the association was investigated. STUDY DESIGN: Female participants from the prospective cohort "Diet, Cancer......, and Health" diagnosed with breast cancer (BC) were identified and their pre-diagnostic HRT use evaluated for association with tumour biology and breast cancer outcome in multivariate analysis. MAIN OUTCOME MEASURE: Breast cancer specific mortality. RESULTS: Of the 1212 patients originally considered 1064...... were included. Of these, 105 women died from breast cancer during a median follow-up of 6.3 years (range 0.2-14.3 years). In multivariate analyses women who used HRT at enrolment into the cohort study had 47% lower risk of dying from breast cancer as compared to women who had previously or never used...

Insights into cerumen and application in diagnostics: past, present and future prospective.

Science.gov (United States)

Shokry, Engy; Filho, Nelson Roberto Antoniosi

2017-10-15

Cerumen or earwax is an emerging bio-fluid in clinical diagnosis that has been very little exploited during the past decades in spite of its high diagnostic potential. It is highly abundant in diagnostic biomarkers such as genetic material, lipids, proteins, chemical elements, internal and external metabolites ( e.g. hormones, volatile organic compounds, amino acids, xenobiotics etc. ) reaching earwax from the blood circulation. Thus, it is able to reflect not only physiology, pathophysiology of the human body but can also detect recent and long term exposure to environmental pollutants, without the need of invasive blood tests and in the same time overcoming many disadvantages faced by using other diagnostic biological fluids. This review discusses the biology, functions, chemistry of earwax, past and current approaches for the study of its chemical composition, emphasizing how a detected variation in its composition can offer information of high clinical value, which can be useful in diagnosis of many diseases such as metabolic disorders and tumours as well as in forensic applications. It also presents details about techniques of sample collection, storage, and analysis. Moreover, it highlights concerns about the use of earwax for diagnostic purposes, which should be addressed to make earwax diagnostics a reality in the future.

An efficient diagnostic technique for distribution systems based on under fault voltages and currents

Energy Technology Data Exchange (ETDEWEB)

Campoccia, A.; Di Silvestre, M.L.; Incontrera, I.; Riva Sanseverino, E. [Dipartimento di Ingegneria Elettrica elettronica e delle Telecomunicazioni, Universita degli Studi di Palermo, viale delle Scienze, 90128 Palermo (Italy); Spoto, G. [Centro per la Ricerca Elettronica in Sicilia, Monreale, Via Regione Siciliana 49, 90046 Palermo (Italy)

2010-10-15

Service continuity is one of the major aspects in the definition of the quality of the electrical energy, for this reason the research in the field of faults diagnostic for distribution systems is spreading ever more. Moreover the increasing interest around modern distribution systems automation for management purposes gives faults diagnostics more tools to detect outages precisely and in short times. In this paper, the applicability of an efficient fault location and characterization methodology within a centralized monitoring system is discussed. The methodology, appropriate for any kind of fault, is based on the use of the analytical model of the network lines and uses the fundamental components rms values taken from the transient measures of line currents and voltages at the MV/LV substations. The fault location and identification algorithm, proposed by the authors and suitably restated, has been implemented on a microprocessor-based device that can be installed at each MV/LV substation. The speed and precision of the algorithm have been tested against the errors deriving from the fundamental extraction within the prescribed fault clearing times and against the inherent precision of the electronic device used for computation. The tests have been carried out using Matlab Simulink for simulating the faulted system. (author)

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

Directory of Open Access Journals (Sweden)

Fabrice Rannou

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

Diagnostic Hearing Assessment in Schools: Validity and Time Efficiency of Automated Audiometry.

Science.gov (United States)

Mahomed-Asmail, Faheema; Swanepoel, De Wet; Eikelboom, Robert H

2016-01-01

Poor follow-up compliance from school-based hearing screening typically undermines the efficacy of school-based hearing screening programs. Onsite diagnostic audiometry with automation may reduce false positives and ensure directed referrals. To investigate the validity and time efficiency of automated diagnostic air- and bone-conduction audiometry for children in a natural school environment following hearing screening. A within-subject repeated measures design was employed to compare air- and bone-conduction pure-tone thresholds (0.5-4 kHz), measured by manual and automated pure-tone audiometry. Sixty-two children, 25 males and 37 females, with an average age of 8 yr (standard deviation [SD] = 0.92; range = 6-10 yr) were recruited for this study. The participants included 30 children who failed on a hearing screening and 32 children who passed a hearing screening. Threshold comparisons were made for air- and bone-conduction thresholds across ears tested with manual and automated audiometry. To avoid a floor effect thresholds of 15 dB HL were excluded in analyses. The Wilcoxon signed ranked test was used to compare threshold correspondence for manual and automated thresholds and the paired samples t-test was used to compare test time. Statistical significance was set as p ≤ 0.05. 85.7% of air-conduction thresholds and 44.6% of bone-conduction thresholds corresponded within the normal range (15 dB HL) for manual and automated audiometry. Both manual and automated audiometry air- and bone-conduction thresholds exceeded 15 dB HL in 9.9% and 34.0% of thresholds, respectively. For these thresholds, average absolute differences for air- and bone-conduction thresholds were 6.3 (SD = 8.3) and 2.2 dB (SD = 3.6) and they corresponded within 10 dB across frequencies in 87.7% and 100.0%, respectively. There was no significant difference between manual and automated air- and bone-conduction across frequencies for these thresholds. Using onsite automated diagnostic audiometry

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

International Nuclear Information System (INIS)

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

2005-01-01

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

Efficient production and diagnostics of MeV proton beams from a cryogenic hydrogen ribbon

International Nuclear Information System (INIS)

Velyhan, A.; Giuffrida, L.; Scuderi, V.; Lastovicka, T.; Margarone, D.; Perin, J.P.; Chatain, D.; Garcia, S.; Bonnay, P.; Dostal, J.; Ullschmied, J.; Dudzak, R.; Krousky, E.; Cykhardt, J.; Prokupek, J.; Pfeifer, M.; Rosinski, M.; Krasa, J.; Brabcova, K.; Napoli, M. De

2017-01-01

A solid hydrogen thin ribbon, produced by the cryogenic system ELISE (Experiments on Laser Interaction with Solid hydrogEn) target delivery system, was experimentally used at the PALS kJ-laser facility to generate intense proton beams with energies in the MeV range. This sophisticated target system operating at cryogenic temperature (∼ 10 K) continuously producing a 62 μm thick target was combined with a 600 J sub-nanosecond laser pulse to generate a collimated proton stream. The accelerated proton beams were fully characterized by a number of diagnostics. High conversion efficiency of laser to energetic protons is of great interest for future potential applications in non-conventional proton therapy and fast ignition for inertial confinement fusion.

An Efficient Method of Vibration Diagnostics For Rotating Machinery Using a Decision Tree

Directory of Open Access Journals (Sweden)

Bo Suk Yang

2000-01-01

Full Text Available This paper describes an efficient method to automatize vibration diagnosis for rotating machinery using a decision tree, which is applicable to vibration diagnosis expert system. Decision tree is a widely known formalism for expressing classification knowledge and has been used successfully in many diverse areas such as character recognition, medical diagnosis, and expert systems, etc. In order to build a decision tree for vibration diagnosis, we have to define classes and attributes. A set of cases based on past experiences is also needed. This training set is inducted using a result-cause matrix newly developed in the present work instead of using a conventionally implemented cause-result matrix. This method was applied to diagnostics for various cases taken from published work. It is found that the present method predicts causes of the abnormal vibration for test cases with high reliability.

Effect of age on the diagnostic efficiency of HbA1c for diabetes in a Chinese middle-aged and elderly population: The Shanghai Changfeng Study.

Science.gov (United States)

Wu, Li; Lin, Huandong; Gao, Jian; Li, Xiaoming; Xia, Mingfeng; Wang, Dan; Aleteng, Qiqige; Ma, Hui; Pan, Baishen; Gao, Xin

2017-01-01

Glycated hemoglobin A1c (HbA1c) ≥6.5% (or 48mmol/mol) has been recommended as a new diagnostic criterion for diabetes; however, limited literature is available regarding the effect of age on the HbA1c for diagnosing diabetes and the causes for this age effect remain unknown. In this study, we investigated whether and why age affects the diagnostic efficiency of HbA1c for diabetes in a community-based Chinese population. In total, 4325 participants without previously known diabetes were enrolled in this study. Participants were stratified by age. Receiver operating characteristic curve (ROC) was plotted for each age group and the area under the curve (AUC) represented the diagnostic efficiency of HbA1c for diabetes defined by the plasma glucose criteria. The area under the ROC curve in each one-year age group was defined as AUCage. Multiple regression analyses were performed to identify factors inducing the association between age and AUCage based on the changes in the β and P values of age. The current threshold of HbA1c (≥6.5% or 48mmol/mol) showed low sensitivity (35.6%) and high specificity (98.9%) in diagnosing diabetes. ROC curve analyses showed that the diagnostic efficiency of HbA1c in the ≥75 years age group was significantly lower than that in the 45-54 years age group (AUC: 0.755 vs. 0.878; PHbA1c was negatively correlated with age (r = -0.557, P = 0.001). When adjusting the red blood cell (RBC) count in the multiple regression model, the negative association between age and AUCage disappeared, with the regression coefficient of age reversed to 0.001 and the P value increased to 0.856. The diagnostic efficiency of HbA1c for diabetes decreased with aging, and this age effect was induced by the decreasing RBC count with age. HbA1c is unsuitable for diagnosing diabetes in elderly individuals because of their physiologically decreased RBC count.

The application actualities and prospects of geophysical methods to uranium prospecting

International Nuclear Information System (INIS)

Liu Qingcheng

2010-01-01

Basic principles of geophysical methods to uranium prospect are briefly introduced, and the effects as well as problems in using those methods are analysed respectively. Combining with the increasing demand of uranium resources for Chinese nuclear power development and the higher requirements of geophysical techniques, the developing directions and the thoughts of geophysical techniques in uranium prospecting were proposed. A new pattern with producing, teaching and researching together is brought forward to develop advancing uranium prospecting key technologies and to break through technological bottlenecks depending on independent innovation. Integrated geophysical methods for prospecting uranium deposits are suggested. The method includes geophysical techniques as follows: gravity, magnetic, seismic, radioactive, remote sensing, and geochemical method in some proving grounds. Based on the experimental research, new uranium deposits prospecting models with efficient integrated geophysical methods can be established. (authors)

USSR energy efficiency and prospects

International Nuclear Information System (INIS)

Sinyak, Y.

1991-06-01

The U.S.S.R. is the largest energy producer and the second largest energy consumer in the world. Its share of global energy use reached above 17% in 1988. The soviet energy system is characterized by low efficiency and high per capita energy consumption, although there are some reasons justifying the greater U.S.S.R. energy use per unit of product output than in other industrialized countries. The present energy-savings potential is approximately equal to one-half of the domestic energy consumption. Improvements in energy efficiency at all levels of the national economy are now considered to be the primary goal of national energy policy for the next couple of decades. Being endowed with abundant natural gas resources, the U.S.S.R. will count on this energy source in the future to improve its energy efficiency, reduce expenses and cope with air pollution. After 2005-2010, stabilized primary energy consumption may be reached or there may even be a decline of total energy use. The U.S.S.R. could reduce CO 2 emissions by 20% by 2030 but with substantial negative impacts on GNP growth. Required improvements in the Soviet energy system depend on changes in energy management, including reduction of the role of centralized planning, decentralization and privatization of energy-producing facilities, energy-price reforms, reshaping of investment patterns, reduction in military expenditures, etc. (author)

The interpretation of tokamak magnetic diagnostics: Status and prospects

International Nuclear Information System (INIS)

Braams, B.J.

1985-09-01

The analytical theory and the computational methods that are available for the determination of MHD equilibrium characteristics from magnetic measurements on axisymmetric systems are reviewed and developed. The interpretation of these measurements relies to a large extent on two classes of integral relations due to L.E. Zakharov and V.D. Shafranov. Following and extending their work we provide an inventory of useful integral relations, including the contributions due to pressure anisotropy and plasma rotation. Effective methods to evaluate the required integrals from imperfect measurements are considered. A full equilibrium analysis of the magnetic diagnostics implies a determination of the current profile, consistent with the equations of MHD equilibrium, aiming at an optimal fit between the corresponding calculated magnetic field and the measured data. Published approaches to this problem are evaluated, and a novel fast algorithm is proposed. Instead of the full equilibrium analysis several more limited problems are often considered, for which faster methods are available. The determination of only the plasma boundary requires the solution of a Cauchy problem, or similar, for an elliptic equation. The published approaches are compared. Analytical theory provides approximations that are suitable for the rapid estimation of characteristic parameters, related to the plasma current, position, shape of the cross-section, pressure and internal inductance. Very efficient algorithms may be obtained when this theory is employed in conjunction with the method of function parametrization. These algorithms are well suited to real-time control of the plasma. Appendices present a discussion of the boundary conditions for the MHD equilibrium problem, a compendium of analytical solutions to the homogeneous equilibrium equation, and a re-examination of the possibility of determining the current distribution from knowledge of only the shape of the flux surfaces. (orig.)

Novel Treponema pallidum Recombinant Antigens for Syphilis Diagnostics: Current Status and Future Prospects

Directory of Open Access Journals (Sweden)

Aleksey Kubanov

2017-01-01

Full Text Available The recombinant protein technology considerably promoted the development of rapid and accurate treponema-specific laboratory diagnostics of syphilis infection. For the last ten years, the immunodominant recombinant inner membrane lipoproteins are proved to be sensitive and specific antigens for syphilis screening. However, the development of an enlarged T. pallidum antigen panel for diagnostics of early and late syphilis and differentiation of syphilis stages or cured syphilis remains as actual goal of multidisciplinary expertise. Current review revealed novel recombinant antigens: surface-exposed proteins, adhesins, and periplasmic and flagellar proteins, which are promising candidates for the improved syphilis serological diagnostics. The opportunities and limitations of diagnostic usage of these antigens are discussed and the criteria for selection of optimal antigens panel summarized.

Novel Treponema pallidum Recombinant Antigens for Syphilis Diagnostics: Current Status and Future Prospects.

Science.gov (United States)

Kubanov, Aleksey; Runina, Anastassia; Deryabin, Dmitry

2017-01-01

The recombinant protein technology considerably promoted the development of rapid and accurate treponema-specific laboratory diagnostics of syphilis infection. For the last ten years, the immunodominant recombinant inner membrane lipoproteins are proved to be sensitive and specific antigens for syphilis screening. However, the development of an enlarged T. pallidum antigen panel for diagnostics of early and late syphilis and differentiation of syphilis stages or cured syphilis remains as actual goal of multidisciplinary expertise. Current review revealed novel recombinant antigens: surface-exposed proteins, adhesins, and periplasmic and flagellar proteins, which are promising candidates for the improved syphilis serological diagnostics. The opportunities and limitations of diagnostic usage of these antigens are discussed and the criteria for selection of optimal antigens panel summarized.

Quantum Dots for Molecular Diagnostics of Tumors

Science.gov (United States)

Zdobnova, T.A.; Lebedenko, E.N.; Deyev, S.М.

2011-01-01

Semiconductor quantum dots (QDs) are a new class of fluorophores with unique physical and chemical properties, which allow to appreciably expand the possibilities for the current methods of fluorescent imaging and optical diagnostics. Here we discuss the prospects of QD application for molecular diagnostics of tumors ranging from cancer-specific marker detection on microplates to non-invasive tumor imagingin vivo. We also point out the essential problems that require resolution in order to clinically promote QD, and we indicate innovative approaches to oncology which are implementable using QD. PMID:22649672

Acute abdomen. Diagnostic radiology according to principal signs

International Nuclear Information System (INIS)

Krestin, G.P.

1994-01-01

The acute abdomen is a frequent and very often dangerous syndrome which requires sophisticated diagnostic evaluation. A decisive factor determining the following case history is efficient and exact diagnosis, calling for experienced clinical and diagnostic experts for efficient application of available methods, and correct interpretation of findings. The book offers: 1. Practice-oriented diagnostic strategies, based on 13 principal signs and constellations derived from clinical experience, presented in each chapter as a combination of - suitable differential diagnostic procedures and methods,- exhaustive description of the clinical signs and diagnostic findings specific of the various symptoms,- algorithmic presentations. 2. A special chapter on the pediatric acute abdomen. 3. The most important findings shown in more than 250 original pictures. 4. A graphical design and presentation of the information which permits quick access to the important content. (orig./CB) [de

Influenza-like syndrome in homosexual men: a prospective diagnostic study

NARCIS (Netherlands)

de Wolf, F.; Lange, J. M.; Bakker, M.; Tjong-A-Hung, S.; Hooykaas, C.; Coutinho, R.; van der Noordaa, J.; Goudsmit, J.

1988-01-01

In the course of a prospective study of the prevalence and incidence of infection with the human immunodeficiency virus (HIV) and risk factors for the acquired immune deficiency syndrome among 961 homosexual men, 97 initially HIV antibody seronegative men reported a febrile period lasting at least

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

African Journals Online (AJOL)

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

Procalcitonin in cerebrospinal fluid in meningitis : a prospective diagnostic study

NARCIS (Netherlands)

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

2016-01-01

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

Effect of age on the diagnostic efficiency of HbA1c for diabetes in a Chinese middle-aged and elderly population: The Shanghai Changfeng Study.

Directory of Open Access Journals (Sweden)

Li Wu

Full Text Available Glycated hemoglobin A1c (HbA1c ≥6.5% (or 48mmol/mol has been recommended as a new diagnostic criterion for diabetes; however, limited literature is available regarding the effect of age on the HbA1c for diagnosing diabetes and the causes for this age effect remain unknown. In this study, we investigated whether and why age affects the diagnostic efficiency of HbA1c for diabetes in a community-based Chinese population.In total, 4325 participants without previously known diabetes were enrolled in this study. Participants were stratified by age. Receiver operating characteristic curve (ROC was plotted for each age group and the area under the curve (AUC represented the diagnostic efficiency of HbA1c for diabetes defined by the plasma glucose criteria. The area under the ROC curve in each one-year age group was defined as AUCage. Multiple regression analyses were performed to identify factors inducing the association between age and AUCage based on the changes in the β and P values of age.The current threshold of HbA1c (≥6.5% or 48mmol/mol showed low sensitivity (35.6% and high specificity (98.9% in diagnosing diabetes. ROC curve analyses showed that the diagnostic efficiency of HbA1c in the ≥75 years age group was significantly lower than that in the 45-54 years age group (AUC: 0.755 vs. 0.878; P<0.001. Pearson correlation analysis showed that the AUCage of HbA1c was negatively correlated with age (r = -0.557, P = 0.001. When adjusting the red blood cell (RBC count in the multiple regression model, the negative association between age and AUCage disappeared, with the regression coefficient of age reversed to 0.001 and the P value increased to 0.856.The diagnostic efficiency of HbA1c for diabetes decreased with aging, and this age effect was induced by the decreasing RBC count with age. HbA1c is unsuitable for diagnosing diabetes in elderly individuals because of their physiologically decreased RBC count.

A Prospective Study to Compare the Diagnostic Value of Serum Procalcitonin and Crp in Early Onset Sepsis

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Suresh Kumar Verma

2017-10-01

Full Text Available Introduction: Neonatal sepsis is the most common cause of death in newborns in developing countries. Prompt diagnosis is the critical determinant in its outcome. As manifestations are often vague, clinically it is difficult to differentiate sepsis from non-infective conditions. Timely diagnosis is important as delay in initiation of antimicrobials can prove fatal. On the other hand empirical use of antibiotics not only increases the risk of antibiotic resistance but also delays the diagnosis of true condition. Procalcitonin (PCT has been well evaluated in late onset sepsis but data pertaining to Early Onset Sepsis (EOS are still lacking. We compared the diagnostic value of PCT and CRP (C-Reactive Protein in EOS. Aim: To compare the diagnostic value of serum PCT and CRP in early onset sepsis. Materials and Methods: It was a prospective observational study conducted in Neonatal Intensive Care Unit of the Department of Paediatrics, Dr.S.N. Medical College, Jodhpur, India. All neonates delivered in hospitals attached to this medical college or referred here within 7 days of life and having ≥2 perinatal risk factors for sepsis or displaying clinical sepsis were included in the study. All enrolled neonates were subjected to sepsis screen, PCT levels and blood culture at birth or admission which ever was the earliest. PCT levels ≥ 0.5 ng/ml and CRP levels above 8mg/l were considered positive for EOS. Results: Sensitivity and negative predictive value of PCT were higher than CRP (90.12% vs. 50.62% and 93.33% vs. 79.06% respectively. Also it had a higher positive predictive value of 40.56% than CRP where it was 37.61%. CRP was more specific (68.95% vs. 51.4% with overall higher diagnostic accuracy (0.64 vs. 0.61 in comparison to PCT. Conclusion: PCT is more sensitive and has a higher negative predictive value than CRP in early onset sepsis. Higher positive predictive value and specificity of CRP suggest that, PCT should not be used alone rather

Incremental diagnostic value of targeted biopsy using mpMRI-TRUS fusion versus 14-fragments prostatic biopsy. A prospective controlled study

International Nuclear Information System (INIS)

Mariotti, Guilherme C.; Falsarella, Priscila M.; Garcia, Rodrigo G.; Queiroz, Marcos R.G.; Lemos, Gustavo C.; Baroni, Ronaldo H.

2018-01-01

To compare the incremental diagnostic value of targeted biopsy using real-time multiparametric magnetic resonance imaging and transrectal ultrasound (mpMRI-TRUS) fusion to conventional 14-cores biopsy. Uni-institutional, institutional review board (IRB) approved prospective blinded study comparing TRUS-guided random and targeted biopsy using mpMRI-TRUS fusion, in 100 consecutive men. We included men with clinical-laboratorial suspicious for prostate cancer and Likert score ≥ 3 mp-MRI. Patients previously diagnosed with prostate cancer were excluded. All patients were submitted to 14-cores TRUS-guided biopsy (mpMRI data operator-blinded), followed by targeted biopsy using mpMRI-TRUS fusion. There was an overall increase in cancer detection rate, from 56% with random technique to 62% combining targeted biopsy using mpMRI-TRUS fusion; incremental diagnosis was even more relevant for clinically significant lesions (Gleason ≥ 7), diagnosing 10% more clinically significant lesions with fusion biopsy technique. Diagnosis upgrade occurred in 5 patients that would have negative results in random biopsies and had clinically significant tumours with the combined technique, and in 5 patients who had the diagnosis of significant tumours after fusion biopsy and clinically insignificant tumours in random biopsies(p=0.0010). Targeted biopsy using mpMRI-TRUS fusion has incremental diagnostic value in comparison to conventional random biopsy, better detecting clinically significant prostate cancers. (orig.)

Incremental diagnostic value of targeted biopsy using mpMRI-TRUS fusion versus 14-fragments prostatic biopsy. A prospective controlled study

Energy Technology Data Exchange (ETDEWEB)

Mariotti, Guilherme C.; Falsarella, Priscila M.; Garcia, Rodrigo G.; Queiroz, Marcos R.G. [Hospital Israelita Albert Einstein, Department of Interventional Radiology, Sao Paulo (Brazil); Lemos, Gustavo C. [Hospital Israelita Albert Einstein, Department of Urology, Sao Paulo (Brazil); Baroni, Ronaldo H. [Hospital Israelita Albert Einstein, Department of Radiology, Sao Paulo (Brazil)

2018-01-15

To compare the incremental diagnostic value of targeted biopsy using real-time multiparametric magnetic resonance imaging and transrectal ultrasound (mpMRI-TRUS) fusion to conventional 14-cores biopsy. Uni-institutional, institutional review board (IRB) approved prospective blinded study comparing TRUS-guided random and targeted biopsy using mpMRI-TRUS fusion, in 100 consecutive men. We included men with clinical-laboratorial suspicious for prostate cancer and Likert score ≥ 3 mp-MRI. Patients previously diagnosed with prostate cancer were excluded. All patients were submitted to 14-cores TRUS-guided biopsy (mpMRI data operator-blinded), followed by targeted biopsy using mpMRI-TRUS fusion. There was an overall increase in cancer detection rate, from 56% with random technique to 62% combining targeted biopsy using mpMRI-TRUS fusion; incremental diagnosis was even more relevant for clinically significant lesions (Gleason ≥ 7), diagnosing 10% more clinically significant lesions with fusion biopsy technique. Diagnosis upgrade occurred in 5 patients that would have negative results in random biopsies and had clinically significant tumours with the combined technique, and in 5 patients who had the diagnosis of significant tumours after fusion biopsy and clinically insignificant tumours in random biopsies(p=0.0010). Targeted biopsy using mpMRI-TRUS fusion has incremental diagnostic value in comparison to conventional random biopsy, better detecting clinically significant prostate cancers. (orig.)

DADOS-Prospective: an open source application for Web-based prospective data collection

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Nguyen Lam

2006-11-01

Full Text Available Abstract Background Randomized, prospective trials involving multi-institutional collaboration have become a central part of clinical and translational research. However, data management and coordination of multi-center studies is a complex process that involves developing systems for data collection and quality control, tracking data queries and resolutions, as well as developing communication procedures. We describe DADOS-Prospective, an open-source Web-based application for collecting and managing prospective data on human subjects for clinical and translational trials. DADOS-Prospective not only permits users to create new clinical research forms (CRF and supports electronic signatures, but also offers the advantage of containing, in a single environment, raw research data in downloadable spreadsheet format, source documentation and regulatory files stored in PDF format, and audit trails. Results Feedback from formal and field usability tests was used to guide the design and development of DADOS-Prospective. To date, DADOS-Prospective has been implemented in five prospective clinical studies at our institution. Four of these studies are still in the CRF creation phase and one study has been entirely launched. Conclusion DADOS-Prospective has significant advantages over existing Web-based data collecting programs. At our institution, it has been demonstrated to be an efficient tool for prospective clinical studies.

Can and should value-based pricing be applied to molecular diagnostics?

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Garau, Martina; Towse, Adrian; Garrison, Louis; Housman, Laura; Ossa, Diego

2013-01-01

Current pricing and reimbursement systems for diagnostics are not efficient. Prices for diagnostics are often driven by administrative practices and expected production cost. The purpose of the paper is to discuss how a value-based pricing framework being used to ensure efficient use and price of medicines could also be applied to diagnostics. Diagnostics not only facilitates health gain and cost savings, but also information to guide patients' decisions on interventions and their future 'behaviors'. For value assessment processes we recommend a two-part approach. Companion diagnostics introduced at the launch of the drug should be assessed through new drug assessment processes considering a broad range of value elements and a balanced analysis of diagnostic impacts. A separate diagnostic-dedicated committee using value-based pricing principles should review other diagnostics lying outside the companion diagnostics-and-drug 'at-launch' situation.

Diagnostic value of inflammatory markers (complete blood count ...

African Journals Online (AJOL)

Objective The aim of the study was to evaluate the diagnostic value of inflammatory markers [complete blood cell count (CBC), erythrocyte sedimentation rate (ESR),. C-reactive protein (CRP)] for the differentiation of acute appendicitis from nonspecific abdominal pain in children. Patients and methods In this prospective ...

Diagnostic value of inflammatory markers (complete blood count ...

African Journals Online (AJOL)

Objective The aim of the study was to evaluate the diagnostic value of inflammatory markers [complete blood cell count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)] for the differentiation of acute appendicitis from nonspecific abdominal pain in children. Patients and methods In this prospective ...

Diagnostic development

International Nuclear Information System (INIS)

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

1978-01-01

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

β-trace protein as a diagnostic marker for perilymphatic fluid fistula: a prospective controlled pilot study to test a sample collection technique.

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Bachmann-Harildstad, Gregor; Stenklev, Niels Christian; Myrvoll, Elin; Jablonski, Greg; Klingenberg, Olav

2011-01-01

The diagnosis of perilymphatic fluid (PLF) fistula is still challenging. Perilymphatic fluid fistula is one possible complication after stapedotomy or cochlear implant surgery. We have performed a prospective diagnostic pilot study to further investigate β-trace protein (β-TP) as a marker for PLF fistula. In this pilot study, we tested the sensitivity of the β-TP marker using a simple method for sample collection from the tympanic cavity. Prospective controlled diagnostic study. Two-center tertiary referral hospitals. A total of 35 adult patients undergoing ear surgery were included. Subjects were divided into 2 groups: 1) 19 patients undergoing stapedotomy were investigated for PLF fistula in samples obtained from the tympanic cavity and 2) 16 patients undergoing myringoplasty were investigated for PLF fistula in samples from the tympanic cavity. This group served as the control. Mean age +/- SD at surgery was 49.9 +/- 8.0 years in the study group and 39.69 +/- 15.47 years in the control group. β-Trace protein (prostaglandin D synthase) in tympanic cavity samples and serum samples was analyzed. The samples were collected by gradually filling the tympanic cavity with 100 to 200 μl sodium chloride and by immediately collecting a volume of 60 to 100 μl in a mucus specimen set container. The concentration of β-TP was quantified using laser nephelometry. The median β-TP in the study group was 0.8 mg/L (range, 0.05-4.5 mg/L). In the control group, the median β-TP value was 0.16 mg/L (range, 0.01-0.36 mg/L). Thirty-five percent of the values in the study group were below the highest value in the negative control group. The β-TP values of the tympanic cavity samples were significantly higher in the study group than in controls (p = 0.0001). The serum values were 0.55 +/- 0.18 and 0.53 +/- 0.11 mg/L, respectively. It may be feasible to test for PLF fistula using β-TP in samples from the tympanic cavity. Our results, however, suggest a relative low diagnostic

On improving of efficiency of plasma diagnostics with the help of computer

International Nuclear Information System (INIS)

Temko, S.W.; Temko, K.W.; Kuz'min, S.K.

1994-01-01

The cloud of weakly ionized plasma contaminated by impurities is considered. Impurities are the large-size particles, resulting under influence of adhesion and coagulation. Impurities cause decrease conduction and increase of radiation energy losses. To precipitate impurities one can use ultrasonic coagulation. However, under the acting ultrasonics the turbulence arises and instabilities, disturbing the plasma state, can develop. To stabilize plasma state and to deposit impurities on the walls of gas-discharge camera one needs both the data on diagnostics and the results of calculations as well as the system of situation adaptive controlling. The situations are time-dependent plasma states. The control system is formed from the distributed microprocessors network and from controlling computer. Microprocessors are installed on diagnostic installations, on energy sources and on ultrasonic signals supplies. To improve reliability and refusal-stability of the control system an apparatus, program and time excessivenesses are used. An effective methods of diagnostics can be SHF-methods and laser diagnostics. To find optical calculating data the authors apply statistical thermodynamics of spatial clusters, which was proposed by the authors earlier. Computer compares under the given program the diagnostic data with the results of calculations and produces control responses both on power sources and on generators of ultrasonic signals

Structured diagnostic imaging in patients with multiple trauma

International Nuclear Information System (INIS)

Linsenmaier, U.; Rieger, J.; Rock, C.; Pfeifer, K.J.; Reiser, M.; Kanz, K.G.

2002-01-01

Purpose. Development of a concept for structured diagnostic imaging in patients with multiple trauma.Material and methods. Evaluation of data from a prospective trial with over 2400 documented patients with multiple trauma. All diagnostic and therapeutic steps, primary and secondary death and the 90 days lethality were documented.Structured diagnostic imaging of multiple injured patients requires the integration of an experienced radiologist in an interdisciplinary trauma team consisting of anesthesia, radiology and trauma surgery. Radiology itself deserves standardized concepts for equipment, personnel and logistics to perform diagnostic imaging for a 24-h-coverage with constant quality.Results. This paper describes criteria for initiation of a shock room or emergency room treatment, strategies for documentation and interdisciplinary algorithms for the early clinical care coordinating diagnostic imaging and therapeutic procedures following standardized guidelines. Diagnostic imaging consists of basic diagnosis, radiological ABC-rule, radiological follow-up and structured organ diagnosis using CT. Radiological trauma scoring allows improved quality control of diagnosis and therapy of multiple injured patients.Conclusion. Structured diagnostic imaging of multiple injured patients leads to a standardization of diagnosis and therapy and ensures constant process quality. (orig.) [de

Optimizing MRI Logistics: Prospective Analysis of Performance, Efficiency, and Patient Throughput.

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Beker, Kevin; Garces-Descovich, Alejandro; Mangosing, Jason; Cabral-Goncalves, Ines; Hallett, Donna; Mortele, Koenraad J

2017-10-01

The objective of this study is to optimize MRI logistics through evaluation of MRI workflow and analysis of performance, efficiency, and patient throughput in a tertiary care academic center. For 2 weeks, workflow data from two outpatient MRI scanners were prospectively collected and stratified by value added to the process (i.e., value-added time, business value-added time, or non-value-added time). Two separate time cycles were measured: the actual MRI process cycle as well as the complete length of patient stay in the department. In addition, the impact and frequency of delays across all observations were measured. A total of 305 MRI examinations were evaluated, including body (34.1%), neurologic (28.9%), musculoskeletal (21.0%), and breast examinations (16.1%). The MRI process cycle lasted a mean of 50.97 ± 24.4 (SD) minutes per examination; the mean non-value-added time was 13.21 ± 18.77 minutes (25.87% of the total process cycle time). The mean length-of-stay cycle was 83.51 ± 33.63 minutes; the mean non-value-added time was 24.33 ± 24.84 minutes (29.14% of the total patient stay). The delay with the highest frequency (5.57%) was IV or port placement, which had a mean delay of 22.82 minutes. The delay with the greatest impact on time was MRI arthrography for which joint injection of contrast medium was necessary but was not accounted for in the schedule (mean delay, 42.2 minutes; frequency, 1.64%). Of 305 patients, 34 (11.15%) did not arrive at or before their scheduled time. Non-value-added time represents approximately one-third of the total MRI process cycle and patient length of stay. Identifying specific delays may expedite the application of targeted improvement strategies, potentially increasing revenue, efficiency, and overall patient satisfaction.

Analysis of Vibration Diagnostics Methods for Induction Motors

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A. P. Kalinov

2012-01-01

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

Etiology of mental retardation in children referred to a tertiary care center: a prospective study

NARCIS (Netherlands)

van Karnebeek, Clara D. M.; Scheper, Frederike Y.; Abeling, Nico G.; Alders, Marielle; Barth, Peter G.; Hoovers, Jan M. N.; Koevoets, Cindy; Wanders, Ronald J. A.; Hennekam, Raoul C. M.

2005-01-01

A prospective assessment following a step-wise protocol in 281 patients with unexplained cognitive delay was used to assess diagnostic possibilities. Diagnostic procedures were complex and required a multidisciplinary approach. One third of diagnoses was established based on clinical history and

[Diagnostic laparoscopy in acute abdomen].

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Keller, R; Kleemann, M; Hildebrand, P; Roblick, U J; Bruch, H-P

2006-11-01

Acute abdomen is not a disease in itself but a description of a complex of symptoms combined with severe abdominal pain developed within a time frame of less than 24 h. All strategies for the management of acute abdomen underline the need for an interdisciplinary approach to diagnosis and therapy. This requires focused and intelligent use of efficient diagnostic procedures. Diagnostic laparoscopy may be a key to solving the diagnostic dilemma of unspecific acute abdomen. Furthermore, it allows not only direct inspection of the abdominal cavity but also surgical intervention, if needed. In particular the rate of negative laparotomies can be reduced.

Analysis the prospects of use of mobile X-ray diagnostic apparatus of the C-arm type

International Nuclear Information System (INIS)

Blinov, N.N.; Mazurov, A.I.

2000-01-01

The efficiency of using the mobile X-ray apparatus with the C-arm multi-positional support, equipped with a medium-frequency generator and roentgen image amplifier with a digital channel, and device for obtaining hard copies in the diagnostic, surgical and therapeutic practice, is shown and the basis requirements, imposed in various areas on the apparatus of this type (traumatology, orthopedics, hospital wards studies, X-ray endoscopy, X-ray operational units, intervention roentgenology, angiography), are formulated. The technical characteristics are presented and the operation of the national surgical mobile apparatus RTS-612 is described. The experience in the apparatus operation showed, that x-ray surgical complexes, meeting the requirements of the modern public health in the area of traumatology, orthopedics, cardiosurgery, endoscopy, urology and other areas, wherein the X-ray control during the operation is accomplished, may be created on its basis [ru

Diagnostic accuracy of metronome-paced tachypnea to detect dynamic hyperinflation

NARCIS (Netherlands)

Lahaije, A.J.M.C.; Willems, L.M.; Hees, H.W. van; Dekhuijzen, P.N.R.; Helvoort, H.A.C. van; Heijdra, Y.F.

2013-01-01

INTRODUCTION: This prospective study was carried out to investigate if metronome-paced tachypnea (MPT) can serve as an accurate diagnostic tool to identify patients with chronic obstructive pulmonary disease (COPD) who are susceptible to develop dynamic hyperinflation during exercise. Commonly, this

Diagnosing asthma in general practice with portable exhaled nitric oxide measurement – results of a prospective diagnostic study

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Laux Gunter

2009-03-01

Full Text Available Abstract Background To evaluate the sensitivity, specificity and predictive values of fractional exhaled nitric oxide (FENO for the diagnosis of asthma in general practice. Methods Prospective diagnostic study with 160 patients attending 10 general practices for the first time with complaints suspicious of obstructive airway disease (OAD. Patients were referred to a lung function laboratory for diagnostic investigation. The index test was FENO measured with a portable FENO analyser based on electrochemical sensor. The reference standard was the Tiffeneau ratio (FEV1/VC as received by spirometric manoeuvre and/or results of bronchial provocation. Bronchial provocation with methacholine was performed to determine bronchial hyper-responsiveness (BHR in the event of inconclusive spirometric results. Results 88 (55% were female; their average age was 43.9 years. 75 (46.9% patients had asthma, 25 (15.6% had COPD, 8 (5.0% had an overlap of COPD and asthma, and 52 (32.5% had no OAD. At a cut-off level of 46 parts per billion (ppb (n = 30; 18.8%, sensitivity was 32% (95%CI 23–43%, specificity 93% (95%CI 85–97%, positive predictive value (PPV 80% (95%CI 63–91%, negative predictive value (NPV 61% (95%CI 52–69% when compared with a 20% fall in FEV1 from the baseline value (PC20 after inhaling methacholine concentration ≤ 16 mg/ml. At 76 ppb (n = 11; 6.9% specificity was 100% (95%CI 96–100% and PPV was 100% (95%CI 72–100. At a cut-off level of 12 ppb (n = 34; 21.3%, sensitivity was 90% (95%CI 79–95%, specificity 25% (95%CI 17–34%, PPV 40% (95%CI 32–50, NPV 81% (95%CI 64–91% when compared with a 20% fall of FEV1 after inhaling methacholine concentration ≤ 4 mg/ml. Three patients with unsuspicious spirometric results have to be tested with FENO to save one bronchial provocation test. Conclusion Asthma could be ruled in with FENO > 46 ppb. Mild and moderate to severe asthma could be ruled out with FENO ≤ 12 ppb. FENO measurement with

Prospective Chemistry Teachers' Misconceptions about Colligative Properties: Boiling Point Elevation and Freezing Point Depression

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Pinarbasi, Tacettin; Sozbilir, Mustafa; Canpolat, Nurtac

2009-01-01

This study aimed at identifying prospective chemistry teachers' misconceptions of colligative properties. In order to fulfill this aim, a diagnostic test composed of four open-ended questions was used. The test was administered to seventy-eight prospective chemistry teachers just before qualifying to teaching in secondary schools. Nine different…

Diagnostic accuracy of triage tests to exclude pulmonary embolism

NARCIS (Netherlands)

Mac Gillavry, M. R.; Lijmer, J. G.; Sanson, B. J.; Büller, H. R.; Brandjes, D. P.

2001-01-01

We performed a study in 403 prospectively included patients with suspected pulmonary embolism to compare the accuracy of a combination of the SimpliRED D-dimer assay and an intuitive clinical probability estimate with either one alone. Based on a conjoint diagnostic refer, ence standard, including

When Less Is More: How Fewer Diagnostic Criteria Can Indicate Greater Severity

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Cooper, Luke D.; Balsis, Steve

2009-01-01

For diagnosing many mental disorders, the current "Diagnostic and Statistical Manual of Mental Disorders" ("DSM") system weights each diagnostic criterion equally--each criterion counts the same toward meeting the diagnostic threshold. Research on the diagnostic efficiency of criteria, however, reveals that some diagnostic criteria are more useful…

Diagnostic accuracy of cerebrospinal fluid protein markers for sporadic Creutzfeldt-Jakob disease in Canada: a 6-year prospective study

Science.gov (United States)

2011-01-01

Background To better characterize the value of cerebrospinal fluid (CSF) proteins as diagnostic markers in a clinical population of subacute encephalopathy patients with relatively low prevalence of sporadic Creutzfeldt-Jakob disease (sCJD), we studied the diagnostic accuracies of several such markers (14-3-3, tau and S100B) in 1000 prospectively and sequentially recruited Canadian patients with clinically suspected sCJD. Methods The study included 127 patients with autopsy-confirmed sCJD (prevalence = 12.7%) and 873 with probable non-CJD diagnoses. Standard statistical measures of diagnostic accuracy were employed, including sensitivity (Se), specificity (Sp), predictive values (PVs), likelihood ratios (LRs), and Receiver Operating Characteristic (ROC) analysis. Results At optimal cutoff thresholds (empirically selected for 14-3-3, assayed by immunoblot; 976 pg/mL for tau and 2.5 ng/mL for S100B, both assayed by ELISA), Se and Sp respectively were 0.88 (95% CI, 0.81-0.93) and 0.72 (0.69-0.75) for 14-3-3; 0.91 (0.84-0.95) and 0.88 (0.85-0.90) for tau; and 0.87 (0.80-0.92) and 0.87 (0.84-0.89) for S100B. The observed differences in Sp between 14-3-3 and either of the other 2 markers were statistically significant. Positive LRs were 3.1 (2.8-3.6) for 14-3-3; 7.4 (6.9-7.8) for tau; and 6.6 (6.1-7.1) for S100B. Negative LRs were 0.16 (0.10-0.26) for 14-3-3; 0.10 (0.06-0.20) for tau; and 0.15 (0.09-0.20) for S100B. Estimates of areas under ROC curves were 0.947 (0.931-0.961) for tau and 0.908 (0.888-0.926) for S100B. Use of interval LRs (iLRs) significantly enhanced accuracy for patient subsets [e.g., 41/120 (34.2%) of tested sCJD patients displayed tau levels > 10,000 pg/mL, with an iLR of 56.4 (22.8-140.0)], as did combining tau and S100B [e.g., for tau > 976 pg/mL and S100B > 2.5 ng/mL, positive LR = 18.0 (12.9-25.0) and negative LR = 0.02 (0.01-0.09)]. Conclusions CSF 14-3-3, tau and S100B proteins are useful diagnostic markers of sCJD even in a low

Evaluation of the Program Effectiveness of Research Competence Development in Prospective Elementary School Teachers

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Khan, Natalya N.; Kolumbayeva, Sholpan Zh.; Karsybayeva, Raissa K.; Nabuova, Roza A.; Kurmanbekova, Manshuk B.; Syzdykbayeva, Aigul Dzh.

2016-01-01

To develop research competence in prospective teachers, a system of methods for diagnostics and formation of this competence in prospective elementary school teachers in the training process is designed. To diagnose the research competence, a series of techniques were used that allow subtle evaluation of each competence research component:…

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

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

2016-01-01

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

Are endometrial nerve fibres unique to endometriosis? A prospective case-control study of endometrial biopsy as a diagnostic test for endometriosis in women with pelvic pain.

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Ellett, Lenore; Readman, Emma; Newman, Marsali; McIlwaine, Kate; Villegas, Rocio; Jagasia, Nisha; Maher, Peter

2015-12-01

Can the presence of endometrial nerve fibres be used as a diagnostic test for endometriosis in women with pelvic pain? Endometrial fine nerve fibres were seen in the endometrium of women both with and without endometriosis, making their detection a poor diagnostic tool for endometriosis. Laparoscopy and biopsy are currently the gold standard for making a diagnosis of endometriosis. It has been reported that small density nerve fibres in the functional layer of the endometrium are unique to women with endometriosis and hence nerve fibre detection could function as a less invasive diagnostic test of endometriosis. However, it may be that other painful conditions of the pelvis are also associated with these nerve fibres. We therefore focused this prospective study on women with pelvic pain to examine the efficacy of endometrial nerve fibre detection as a diagnostic test for endometriosis. This prospective case-control study conducted between July 2009 and July 2013 included 44 women with pelvic pain undergoing laparoscopic examination for the diagnosis of endometriosis. Immunohistochemical nerve fibre detection in endometrial curettings and biopsies using anti-protein gene product 9.5 was compared with surgical diagnosis. Paired endometrial biopsies and curettings were taken from patients with (n = 22, study group) and without (n = 22, control group) endometriosis. Tissue was analysed by immunohistochemistry and nerve fibres were counted whenever they were present in the functional layer of the endometrium. Fine nerve fibres were present in the eutopic endometrium of patients both with and without endometriosis. The presence of nerve fibres in curettings was not effective for either diagnosing or excluding endometriosis; sensitivity and specificity were 31.8 and 45.5% respectively, positive predictive value was 36.8% and negative predictive value was 40.0%. Few endometrial biopsy specimens were found to have nerve fibres present; sensitivity and specificity for

TECHNICAL DIAGNOSTICS AT RUP “BMZ”

Directory of Open Access Journals (Sweden)

A. A. Kuzembajev

2004-01-01

Full Text Available The review of technical diagnostics and crack detection at RUP “BMZ” is given in the article and there are reflected the functions and tasks of the Laboratory of Technical Diagnostics and Crack detection (LTDandC. The examples of determination of the equipment failure by methods of vibration diagnostics, applied in LTDandC, are given and the efficiency of using of the system of technical servicing of the equipment according to “state” is shown. The idea of transfer from the repairs system “according to schedule” to repairs “according to state” using new information technologies such as vibrating monitoring and vibrating diagnostics is briefly reflected in the article.

Diagnosing Chronic Pancreatitis Comparison and Evaluation of Different Diagnostic Tools

NARCIS (Netherlands)

Issa, Yama; van Santvoort, Hjalmar C.; van Dieren, Susan; Besselink, Marc G.; Boermeester, Marja A.; Ahmed Ali, Usama

2017-01-01

Objectives: This study aims to compare theM-ANNHEIM, Buchler, and Luneburg diagnostic tools for chronic pancreatitis (CP). Methods: A cross-sectional analysis of the development of CP was performed in a prospectively collected multicenter cohort including 669 patients after a first episode of acute

Reliability and diagnostic of modular systems

Directory of Open Access Journals (Sweden)

J. Kohlas

2014-01-01

Full Text Available Reliability and diagnostic are in general two problems discussed separately. Yet the two problems are in fact closely related to each other. Here, this relation is considered in the simple case of modular systems. We show, how the computation of reliability and diagnostic can efficiently be done within the same Bayesian network induced by the modularity of the structure function of the system.

Hazard and efficiency of X-ray diagnostic investigations

International Nuclear Information System (INIS)

1984-01-01

This symposium deals with the hazards and efficiency of biomedical X-ray examinations. The first articles are devoted to the effects of radiation on the human body. Special attention is paid to low dose irradiation. Later on the efficiency and necessity of X-ray examinations are discussed. Reference is made to the diagnosis of colon- and mammacarcinoma. (Auth.)

An eight-year prospective controlled study about the safety and diagnostic value of cardiac and non-cardiac 1.5-T MRI in patients with a conventional pacemaker or a conventional implantable cardioverter defibrillator.

Science.gov (United States)

Lupo, Pierpaolo; Cappato, Riccardo; Di Leo, Giovanni; Secchi, Francesco; Papini, Giacomo D E; Foresti, Sara; Ali, Hussam; De Ambroggi, Guido M G; Sorgente, Antonio; Epicoco, Gianluca; Cannaò, Paola M; Sardanelli, Francesco

2018-06-01

To investigate safety and diagnostic value of 1.5-T MRI in carriers of conventional pacemaker (cPM) or conventional implantable defibrillator (cICD). We prospectively compared cPM/cICD-carriers undergoing MRI (study group, SG), excluding those device-dependent or implanted cPM/cICD-carriers undergoing chest x-ray, CT or follow-up (reference group, RG). 142 MRI (55 cardiac) were performed in 120 patients with cPM (n=71) or cICD (n=71). In the RG 98 measurements were performed in 95 patients with cPM (n=40) or cICD (n=58). No adverse events were observed. No MRI prolonged/interrupted. All cPM/cICD were correctly reprogrammed after MRI without malfunctions. One temporary communication failure was observed in one cPM-carrier. Immediately after MRI, 12/14 device interrogation parameters did not change significantly (clinically negligible changes of battery voltage and cICD charging time), without significant variations for SG versus RG. Three-12 months after MRI, 9/11 device interrogation parameters did not change significantly (clinically negligible changes of battery impedance/voltage). Non-significant changes of three markers of myocardial necrosis. Non-cardiac MRI: 82/87 diagnostic without artefacts; 4/87 diagnostic with artefacts; 1/87 partially diagnostic. Cardiac MRI: in cPM-carriers, 14/15 diagnostic with artefacts, 1/15 partially diagnostic; in cICD-carriers, 9/40 diagnostic with artefacts, 22 partially diagnostic, nine non-diagnostic. A favourable risk-benefit ratio of 1.5-T MRI in cPM/cICD carriers was reported. • Cooperation between radiologists and cardiac electrophysiologists allowed safe 1.5-T MRI in cPM/cICD-carriers. • No adverse events for 142 MRI in 71 cPM-carriers and 71 cICD-carriers. • Ninety-nine per cent (86/87) of non-cardiac MRI in cPM/cICD-carriers were diagnostic. • All cPM-carrier cardiac MRIs had artefacts, 14 examinations diagnostic, 1 partially diagnostic. • Twenty-three per cent (9/40) of cardiac MRI in cICD-carriers were non-diagnostic.

ISHM-oriented adaptive fault diagnostics for avionics based on a distributed intelligent agent system

Science.gov (United States)

Xu, Jiuping; Zhong, Zhengqiang; Xu, Lei

2015-10-01

In this paper, an integrated system health management-oriented adaptive fault diagnostics and model for avionics is proposed. With avionics becoming increasingly complicated, precise and comprehensive avionics fault diagnostics has become an extremely complicated task. For the proposed fault diagnostic system, specific approaches, such as the artificial immune system, the intelligent agents system and the Dempster-Shafer evidence theory, are used to conduct deep fault avionics diagnostics. Through this proposed fault diagnostic system, efficient and accurate diagnostics can be achieved. A numerical example is conducted to apply the proposed hybrid diagnostics to a set of radar transmitters on an avionics system and to illustrate that the proposed system and model have the ability to achieve efficient and accurate fault diagnostics. By analyzing the diagnostic system's feasibility and pragmatics, the advantages of this system are demonstrated.

Background review for diagnostic test development for Zika virus infection.

Science.gov (United States)

Charrel, Rémi N; Leparc-Goffart, Isabelle; Pas, Suzan; de Lamballerie, Xavier; Koopmans, Marion; Reusken, Chantal

2016-08-01

To review the state of knowledge about diagnostic testing for Zika virus infection and identify areas of research needed to address the current gaps in knowledge. We made a non-systematic review of the published literature about Zika virus and supplemented this with information from commercial diagnostic test kits and personal communications with researchers in European preparedness networks. The review covered current knowledge about the geographical spread, pathogen characteristics, life cycle and infection kinetics of the virus. The available molecular and serological tests and biosafety issues are described and discussed in the context of the current outbreak strain. We identified the following areas of research to address current knowledge gaps: (i) an urgent assessment of the laboratory capacity and capability of countries to detect Zika virus; (ii) rapid and extensive field validation of the available molecular and serological tests in areas with and without Zika virus transmission, with a focus on pregnant women; (iii) monitoring the genomic diversity of circulating Zika virus strains; (iv) prospective studies into the virus infection kinetics, focusing on diagnostic sampling (specimen types, combinations and timings); and (v) developing external quality assessments for molecular and serological testing, including differential diagnosis for similar viruses and symptom clusters. The availability of reagents for diagnostic development (virus strains and antigens, quantified viral ribonucleic acid) needs to be facilitated. An international laboratory response is needed, including preparation of protocols for prospective studies to address the most pressing information needs.

Pre-diagnostic alcohol consumption and breast cancer recurrence and mortality

DEFF Research Database (Denmark)

Holm, Marianne; Olsen, Anja; Christensen, Jane

2013-01-01

The association between pre-diagnostic alcohol consumption and breast cancer recurrence and breast cancer specific mortality was investigated in 1,052 women diagnosed with early breast cancer in a prospective cohort of 29,875 women. Known clinical, lifestyle and socioeconomic risk factors were...... evaluated and adjusted for in multivariate analysis. We found a modest but significant association between pre-diagnostic alcohol consumption and breast cancer recurrence with a median follow-up of six years after date of diagnosis, both when using baseline measures of alcohol intake (HR, 1.65; 95% CI, 1...

Diagnostic Accuracy of Copeptin in the Differential Diagnosis of the Polyuria-polydipsia Syndrome: A Prospective Multicenter Study.

Science.gov (United States)

Timper, Katharina; Fenske, Wiebke; Kühn, Felix; Frech, Nica; Arici, Birsen; Rutishauser, Jonas; Kopp, Peter; Allolio, Bruno; Stettler, Christoph; Müller, Beat; Katan, Mira; Christ-Crain, Mirjam

2015-06-01

The polyuria-polydipsia syndrome comprises primary polydipsia (PP) and central and nephrogenic diabetes insipidus (DI). Correctly discriminating these entities is mandatory, given that inadequate treatment causes serious complications. The diagnostic "gold standard" is the water deprivation test with assessment of arginine vasopressin (AVP) activity. However, test interpretation and AVP measurement are challenging. The objective was to evaluate the accuracy of copeptin, a stable peptide stoichiometrically cosecreted with AVP, in the differential diagnosis of polyuria-polydipsia syndrome. This was a prospective multicenter observational cohort study from four Swiss or German tertiary referral centers of adults >18 years old with the history of polyuria and polydipsia. A standardized combined water deprivation/3% saline infusion test was performed and terminated when serum sodium exceeded 147 mmol/L. Circulating copeptin and AVP levels were measured regularly throughout the test. Final diagnosis was based on the water deprivation/saline infusion test results, clinical information, and the treatment response. Fifty-five patients were enrolled (11 with complete central DI, 16 with partial central DI, 18 with PP, and 10 with nephrogenic DI). Without prior thirsting, a single baseline copeptin level >21.4 pmol/L differentiated nephrogenic DI from other etiologies with a 100% sensitivity and specificity, rendering a water deprivation testing unnecessary in such cases. A stimulated copeptin >4.9 pmol/L (at sodium levels >147 mmol/L) differentiated between patients with PP and patients with partial central DI with a 94.0% specificity and a 94.4% sensitivity. A stimulated AVP >1.8 pg/mL differentiated between the same categories with a 93.0% specificity and a 83.0% sensitivity. This study was limited by incorporation bias from including AVP levels as a diagnostic criterion. Copeptin is a promising new tool in the differential diagnosis of the polyuria-polydipsia syndrome

Ultrasonography as a better diagnostic efficiency in rib fracture

OpenAIRE

UZUN, Metin; BEKSAÇ, Burak; KARATAŞ, Adnan; KÜÇÜKDURMAZ, Fatih; KIRCALI, Bahar ANAYURDU; TETİK, Cihangir

2013-01-01

In this study, our aim was to demonstrate the need of use of ultrasonography in rib fractures in order not to face medicolegal problems. One hundred patients admitted to our emergency service with mild to moderate blunt thorax trauma were included in our study prospectively. The inclusion criteria were pain upon palpation of ribs, deep inspiration, coughing but no any other pathologies like a pneumothorax, hemothorax. All patients are evaluated with ultrasonography (USG) and direct X-rays. X-...

Diagnostic efficiency of abattoir meat inspection service in Ethiopia to detect carcasses infected with Mycobacterium bovis: implications for public health.

Science.gov (United States)

Biffa, Demelash; Bogale, Asseged; Skjerve, Eystein

2010-08-06

Bovine Tuberculosis (BTB) is a widespread and endemic disease of cattle in Ethiopia posing a significant threat to public health. Regular surveillance by skin test, bacteriology and molecular methods is not feasible due to lack of resource. Thus, routine abattoir (RA) inspection will continue to play a key role for national surveillance. We evaluated efficiency of RA inspection for diagnosis of Mycobacterium bovis infection and discussed its public health implications in light of a high risk of human exposure. The study was conducted in five abattoirs: Addis Ababa, Adama, Hawassa, Yabello and Melge-Wondo abattoirs. The efficiency of routine abattoir (RA) inspection was validated in comparison to detailed abattoir (DA) inspection, followed by culture and microscopy (CM) and region of difference (RD) deletion analysis. Diagnostic accuracies (with corresponding measures of statistical uncertainty) were determined by computing test property statistics (sensitivity and specificity) and likelihood estimations using web-based SISA diagnostic statistics software. Post-test probability of detecting TB infected carcasses was estimated using nomograms. Agreement between RA and DA inspections was measured using kappa statistics. The study was conducted and reported in accordance with standards for reporting of diagnostic accuracy (STARD) requirements. Both routine and detailed meat inspection protocols were performed on a subpopulation of 3322 cattle selected randomly from among 78,269 cattle slaughtered during the study period. Three hundred thirty seven carcasses identified through detailed meat inspection protocols were subjected to culture and microscopy; of the 337, a subset of 105 specimens for culture and microscopy were subjected to further molecular testing. There was a substantial agreement between RA and DA inspections in Addis Ababa (Kappa = 0.7) and Melge-Wondo abattoirs (Kappa = 0.67). In Adama, Hawassa and Yabello abattoirs, the agreement was however poor (Kappa

Aircraft gas turbine engine vibration diagnostics

OpenAIRE

Stanislav Fábry; Marek Češkovič

2017-01-01

In the Czech and Slovak aviation are in service elderly aircrafts, usually produced in former Soviet Union. Their power units can be operated in more efficient way, in case of using additional diagnostic methods that allow evaluating their health. Vibration diagnostics is one of the methods indicating changes of rotational machine dynamics. Ground tests of aircraft gas turbine engines allow vibration recording and analysis. Results contribute to airworthiness evaluation and making corrections...

Status and prospects of new clinical methods of cancer diagnostics and treatment based on particle and ion beams available at JINR

International Nuclear Information System (INIS)

Savchenko, O.V.

1996-01-01

Brief history of radiation therapy is given. New radiation sources providing better distribution of the radiation doses in a patient's body are shown to increase the efficiency of the radiation therapy. Grounds for using heavy nuclear particles to treat malignant tumours and the first clinical tests of these particles at some physics research centres in different countries of the world are considered. A many-room complex of radiation treatment with JINR phasotron beams at the Laboratory of Nuclear Problems is described. The first results of treating cancer patients with proton beams in this complex are given. The prospects for radiation therapy and diagnosis with heavy nuclear beams from other basic facilities of JINR are presented. The necessity of building a radiological hospital and a regional treatment and diagnosis centre in Dubna is discussed, which will allow the fastest and most efficient application of new nuclear physics techniques and designs to medicine. 68 refs., 17 figs., 6 tabs

Clinico-pathological study to evaluate oral lichen planus for the establishment of clinical and histopathological diagnostic criteria.

Science.gov (United States)

Hiremath, Santhosh; Kale, Alka D; Hallikerimath, Seema

2015-01-01

Lichen planus and lichenoid lesions affecting the oral cavity show similar clinico-pathological features creating a diagnostic dilemma. Hence, the aim of the present study was to establish a clinical and histopathological correlation in the diagnosis of oral lichen planus, based on the modified WHO diagnostic criteria of oral lichen planus and oral lichenoid lesions proposed by Van der Meij and Van der Waal in 2003. In the present study, 100 cases of oral lichen planus were clinically and histopathologically analyzed. Out of the 100 cases, 50 were prospective and 50 were retrospective cases. Prospective cases were collected based on the clinical diagnosis of oral lichen planus and oral lichenoid lesion. Retrospective cases were collected based on the histopathological diagnosis of oral lichen planus. Both the clinical and histopathological analyses were performed based on a proposal for a set of modified diagnostic criteria of oral lichen planus and oral lichenoid lesion. A final diagnosis of oral lichen planus was made only after the correlation of the clinical diagnosis with the histopathological diagnosis. The interobserver agreement among three observers for both prospective and retrospective cases in the final diagnosis of oral lichen planus was found to be "good" to "very good" indicating high reproducibility. However, the final diagnoses of true oral lichen planus after clinico-pathological correlation in prospective and retrospective study groups appeared to be 38.0% and 54.0% respectively. The results of the present study revealed mild to moderate clinico-pathological correlation in the final diagnosis of oral lichen planus for the prospective and retrospective study groups respectively.

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

International Nuclear Information System (INIS)

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

2000-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2000-11-01

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

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

Science.gov (United States)

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

2001-01-01

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

Cable Diagnostic Focused Initiative

Energy Technology Data Exchange (ETDEWEB)

Hartlein, R.A.; Hampton, R.N.

2010-12-30

This report summarizes an extensive effort made to understand how to effectively use the various diagnostic technologies to establish the condition of medium voltage underground cable circuits. These circuits make up an extensive portion of the electric delivery infrastructure in the United States. Much of this infrastructure is old and experiencing unacceptable failure rates. By deploying efficient diagnostic testing programs, electric utilities can replace or repair circuits that are about to fail, providing an optimal approach to improving electric system reliability. This is an intrinsically complex topic. Underground cable systems are not homogeneous. Cable circuits often contain multiple branches with different cable designs and a range of insulation materials. In addition, each insulation material ages differently as a function of time, temperature and operating environment. To complicate matters further, there are a wide variety of diagnostic technologies available for assessing the condition of cable circuits with a diversity of claims about the effectiveness of each approach. As a result, the benefits of deploying cable diagnostic testing programs have been difficult to establish, leading many utilities to avoid the their use altogether. This project was designed to help address these issues. The information provided is the result of a collaborative effort between Georgia Tech NEETRAC staff, Georgia Tech academic faculty, electric utility industry participants, as well as cable system diagnostic testing service providers and test equipment providers. Report topics include: •How cable systems age and fail, •The various technologies available for detecting potential failure sites, •The advantages and disadvantages of different diagnostic technologies, •Different approaches for utilities to employ cable system diagnostics. The primary deliverables of this project are this report, a Cable Diagnostic Handbook (a subset of this report) and an online

Juggling Efficiency

DEFF Research Database (Denmark)

Andersen, Rikke Sand; Vedsted, Peter

2015-01-01

on institutional logics, we illustrate how a logic of efficiency organise and give shape to healthcare seeking practices as they manifest in local clinical settings. Overall, patient concerns are reconfigured to fit the local clinical setting and healthcare professionals and patients are required to juggle...... efficiency in order to deal with uncertainties and meet more complex or unpredictable needs. Lastly, building on the empirical case of cancer diagnostics, we discuss the implications of the pervasiveness of the logic of efficiency in the clinical setting and argue that provision of medical care in today......'s primary care settings requires careful balancing of increasing demands of efficiency, greater complexity of biomedical knowledge and consideration for individual patient needs....

MR imaging of silicone breast implants: evaluation of prospective and retrospective interpretations and interobserver agreement.

Science.gov (United States)

Quinn, S F; Neubauer, N M; Sheley, R C; Demlow, T A; Szumowski, J

1996-01-01

MR imaging was used to evaluate the integrity of silicone breast implants in 54 women with 108 implants. MR images were interpreted by relatively inexperienced readers who tried to reproduce the experiences reported in the literature. The study examines the interobserver agreement using different diagnostic signs and the influence of experience on interpretation errors. Prospective and retrospective interpretations were compared with surgical findings at the time of explanation. Diagnostic indicators, including the linguine sign, the inverted tear drop sign, the C sign, water droplets mixed with silicone, and extracapsular globules of silicone, were evaluated for diagnostic efficacy and interobserver agreement. The prospective sensitivity and specificity were 87% and 78%, respectively. With the retrospective interpretations, the sensitivity and specificity increased to 93% and 92%, respectively. Most of the prospective false-positive interpretations were due to misinterpreting radial folds as signs of implant rupture. Six implants interpreted retrospectively as false positives had gross amounts of silicone around the implants at surgery but there were no obvious rents in the implant shells. There was fair to excellent interobserver agreement with the individual diagnostic signs except for extracapsular globules of silicone. All of the signs had specificities of greater than 90%. The sensitivities of the individual signs were less than the overall retrospective sensitivity. With experience, the sensitivity improved from 87% to 93% and the specificity improved from 78% to 92%. This study helps substantiate the use of diagnostic signs used by other authors to detect silicone loss from breast implants by MR imaging; however, questions remain as to the clinical role of MR imaging in evaluating implants for silicone loss.

Quantitative optical diagnostics in pathology recognition and monitoring of tissue reaction to PDT

Science.gov (United States)

Kirillin, Mikhail; Shakhova, Maria; Meller, Alina; Sapunov, Dmitry; Agrba, Pavel; Khilov, Alexander; Pasukhin, Mikhail; Kondratieva, Olga; Chikalova, Ksenia; Motovilova, Tatiana; Sergeeva, Ekaterina; Turchin, Ilya; Shakhova, Natalia

2017-07-01

Optical coherence tomography (OCT) is currently actively introduced into clinical practice. Besides diagnostics, it can be efficiently employed for treatment monitoring allowing for timely correction of the treatment procedure. In monitoring of photodynamic therapy (PDT) traditionally employed fluorescence imaging (FI) can benefit from complementary use of OCT. Additional diagnostic efficiency can be derived from numerical processing of optical diagnostics data providing more information compared to visual evaluation. In this paper we report on application of OCT together with numerical processing for clinical diagnostic in gynecology and otolaryngology, for monitoring of PDT in otolaryngology and on OCT and FI applications in clinical and aesthetic dermatology. Image numerical processing and quantification provides increase in diagnostic accuracy. Keywords: optical coherence tomography, fluorescence imaging, photod

The diagnostic value of 18F-FDG-PET/CT and MRI in suspected vertebral osteomyelitis - a prospective study.

Science.gov (United States)

Kouijzer, Ilse J E; Scheper, Henk; de Rooy, Jacky W J; Bloem, Johan L; Janssen, Marcel J R; van den Hoven, Leon; Hosman, Allard J F; Visser, Leo G; Oyen, Wim J G; Bleeker-Rovers, Chantal P; de Geus-Oei, Lioe-Fee

2018-05-01

The aim of this study was to determine the diagnostic value of 18 F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) and magnetic resonance imaging (MRI) in diagnosing vertebral osteomyelitis. From November 2015 until December 2016, 32 patients with suspected vertebral osteomyelitis were prospectively included. All patients underwent both 18 F-FDG-PET/CT and MRI within 48 h. All images were independently reevaluated by two radiologists and two nuclear medicine physicians who were blinded to each others' image interpretation. 18 F-FDG-PET/CT and MRI were compared to the clinical diagnosis according to international guidelines. For 18 F-FDG-PET/CT, sensitivity, specificity, PPV, and NPV in diagnosing vertebral osteomyelitis were 100%, 83.3%, 90.9%, and 100%, respectively. For MRI, sensitivity, specificity, PPV, and NPV were 100%, 91.7%, 95.2%, and 100%, respectively. MRI detected more epidural/spinal abscesses. An important advantage of 18 F-FDG-PET/CT is the detection of metastatic infection (16 patients, 50.0%). 18 F-FDG-PET/CT and MRI are both necessary techniques in diagnosing vertebral osteomyelitis. An important advantage of 18 F-FDG-PET/CT is the visualization of metastatic infection, especially in patients with bacteremia. MRI is more sensitive in detection of small epidural abscesses.

Diagnostic radiology on multiple injured patients: interdisciplinary management

International Nuclear Information System (INIS)

Linsenmaier, U.; Pfeifer, K.J.; Kanz, K.G.; Mutschler, W.

2001-01-01

The presence of a radiologist within the admitting area of an emergency department and his capability as a member of the trauma team have a major impact on the role of diagnostic radiology in trauma care. The knowledge of clinical decision criteria, algorithms, and standards of patient care are essential for the acceptance within a trauma team. We present an interdisciplinary management concept of diagnostic radiology for trauma patients, which comprises basic diagnosis, organ diagnosis, radiological ABC, and algorithms of early clinical care. It is the result of a prospective study comprising over 2000 documented multiple injured patients. The radiologist on a trauma team should support trauma surgery and anesthesia in diagnostic and clinical work-up. The radiological ABC provides a structured approach for diagnostic imaging in all steps of the early clinical care of the multiple injured patient. Radiological ABC requires a reevaluation in cases of equivocal findings or difficulties in the clinical course. Direct communication of radiological findings with the trauma team enables quick clinical decisions. In addition, the radiologist can priority-oriented influence the therapy by using interventional procedures. The clinical radiologist is an active member of the interdisciplinary trauma team, not only providing diagnostic imaging but also participating in clinical decisions. (orig.) [de

The rapid evolution of molecular genetic diagnostics in neuromuscular diseases.

Science.gov (United States)

Volk, Alexander E; Kubisch, Christian

2017-10-01

The development of massively parallel sequencing (MPS) has revolutionized molecular genetic diagnostics in monogenic disorders. The present review gives a brief overview of different MPS-based approaches used in clinical diagnostics of neuromuscular disorders (NMDs) and highlights their advantages and limitations. MPS-based approaches like gene panel sequencing, (whole) exome sequencing, (whole) genome sequencing, and RNA sequencing have been used to identify the genetic cause in NMDs. Although gene panel sequencing has evolved as a standard test for heterogeneous diseases, it is still debated, mainly because of financial issues and unsolved problems of variant interpretation, whether genome sequencing (and to a lesser extent also exome sequencing) of single patients can already be regarded as routine diagnostics. However, it has been shown that the inclusion of parents and additional family members often leads to a substantial increase in the diagnostic yield in exome-wide/genome-wide MPS approaches. In addition, MPS-based RNA sequencing just enters the research and diagnostic scene. Next-generation sequencing increasingly enables the detection of the genetic cause in highly heterogeneous diseases like NMDs in an efficient and affordable way. Gene panel sequencing and family-based exome sequencing have been proven as potent and cost-efficient diagnostic tools. Although clinical validation and interpretation of genome sequencing is still challenging, diagnostic RNA sequencing represents a promising tool to bypass some hurdles of diagnostics using genomic DNA.

Capital Market Theories: Market Efficiency Versus Investor Prospects

OpenAIRE

Kathleen Hodnett; Heng-Hsing Hsieh

2012-01-01

This paper reviews the development of capital market theories based on the assumption of capital market efficiency, which includes the efficient market hypothesis (EMH), modern portfolio theory (MPT), the capital asset pricing model (CAPM), the implications of MPT in asset allocation decisions, criticisms regarding the market portfolio and the development of the arbitrage pricing theory (APT). An alternative school of thought proposes that investors are irrational and that their trading behav...

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

NARCIS (Netherlands)

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

1998-01-01

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

The diagnosis of urinary tract infections in young children (DUTY: protocol for a diagnostic and prospective observational study to derive and validate a clinical algorithm for the diagnosis of UTI in children presenting to primary care with an acute illness

Directory of Open Access Journals (Sweden)

Downing Harriet

2012-07-01

Full Text Available Abstract Background Urinary tract infection (UTI is common in children, and may cause serious illness and recurrent symptoms. However, obtaining a urine sample from young children in primary care is challenging and not feasible for large numbers. Evidence regarding the predictive value of symptoms, signs and urinalysis for UTI in young children is urgently needed to help primary care clinicians better identify children who should be investigated for UTI. This paper describes the protocol for the Diagnosis of Urinary Tract infection in Young children (DUTY study. The overall study aim is to derive and validate a cost-effective clinical algorithm for the diagnosis of UTI in children presenting to primary care acutely unwell. Methods/design DUTY is a multicentre, diagnostic and prospective observational study aiming to recruit at least 7,000 children aged before their fifth birthday, being assessed in primary care for any acute, non-traumatic, illness of ≤ 28 days duration. Urine samples will be obtained from eligible consented children, and data collected on medical history and presenting symptoms and signs. Urine samples will be dipstick tested in general practice and sent for microbiological analysis. All children with culture positive urines and a random sample of children with urine culture results in other, non-positive categories will be followed up to record symptom duration and healthcare resource use. A diagnostic algorithm will be constructed and validated and an economic evaluation conducted. The primary outcome will be a validated diagnostic algorithm using a reference standard of a pure/predominant growth of at least >103, but usually >105 CFU/mL of one, but no more than two uropathogens. We will use logistic regression to identify the clinical predictors (i.e. demographic, medical history, presenting signs and symptoms and urine dipstick analysis results most strongly associated with a positive urine culture result. We will

The diagnosis of urinary tract infections in young children (DUTY): protocol for a diagnostic and prospective observational study to derive and validate a clinical algorithm for the diagnosis of UTI in children presenting to primary care with an acute illness.

Science.gov (United States)

Downing, Harriet; Thomas-Jones, Emma; Gal, Micaela; Waldron, Cherry-Ann; Sterne, Jonathan; Hollingworth, William; Hood, Kerenza; Delaney, Brendan; Little, Paul; Howe, Robin; Wootton, Mandy; Macgowan, Alastair; Butler, Christopher C; Hay, Alastair D

2012-07-19

Urinary tract infection (UTI) is common in children, and may cause serious illness and recurrent symptoms. However, obtaining a urine sample from young children in primary care is challenging and not feasible for large numbers. Evidence regarding the predictive value of symptoms, signs and urinalysis for UTI in young children is urgently needed to help primary care clinicians better identify children who should be investigated for UTI. This paper describes the protocol for the Diagnosis of Urinary Tract infection in Young children (DUTY) study. The overall study aim is to derive and validate a cost-effective clinical algorithm for the diagnosis of UTI in children presenting to primary care acutely unwell. DUTY is a multicentre, diagnostic and prospective observational study aiming to recruit at least 7,000 children aged before their fifth birthday, being assessed in primary care for any acute, non-traumatic, illness of ≤ 28 days duration. Urine samples will be obtained from eligible consented children, and data collected on medical history and presenting symptoms and signs. Urine samples will be dipstick tested in general practice and sent for microbiological analysis. All children with culture positive urines and a random sample of children with urine culture results in other, non-positive categories will be followed up to record symptom duration and healthcare resource use. A diagnostic algorithm will be constructed and validated and an economic evaluation conducted.The primary outcome will be a validated diagnostic algorithm using a reference standard of a pure/predominant growth of at least >103, but usually >105 CFU/mL of one, but no more than two uropathogens.We will use logistic regression to identify the clinical predictors (i.e. demographic, medical history, presenting signs and symptoms and urine dipstick analysis results) most strongly associated with a positive urine culture result. We will then use economic evaluation to compare the cost

Alternative diagnostic strategies for coronary artery disease in women: demonstration of the usefulness and efficiency of probability analysis

International Nuclear Information System (INIS)

Melin, J.A.; Wijns, W.; Vanbutsele, R.J.; Robert, A.; De Coster, P.; Brasseur, L.A.; Beckers, C.; Detry, J.M.

1985-01-01

Alternative strategies using conditional probability analysis for the diagnosis of coronary artery disease (CAD) were examined in 93 infarct-free women presenting with chest pain. Another group of 42 consecutive female patients was prospectively analyzed. For this latter group, the physician had access to the pretest and posttest probability of CAD before coronary angiography. These 135 women all underwent stress electrocardiographic, thallium scintigraphic, and coronary angiographic examination. The pretest and posttest probabilities of coronary disease were derived from a computerized Bayesian algorithm. Probability estimates were calculated by the four following hypothetical strategies: SO, in which history, including risk factors, was considered; S1, in which history and stress electrocardiographic results were considered; S2, in which history and stress electrocardiographic and stress thallium scintigraphic results were considered; and S3, in which history and stress electrocardiographic results were used, but in which stress scintigraphic results were considered only if the poststress probability of CAD was between 10% and 90%, i.e., if a sufficient level of diagnostic certainty could not be obtained with the electrocardiographic results alone. The strategies were compared with respect to accuracy with the coronary angiogram as the standard. For both groups of women, S2 and S3 were found to be the most accurate in predicting the presence or absence of coronary disease (p less than .05). However, it was found with use of S3 that more than one-third of the thallium scintigrams could have been avoided without loss of accuracy. It was also found that diagnostic catheterization performed to exclude CAD as a diagnosis could have been avoided in half of the patients without loss of accuracy.(ABSTRACT TRUNCATED AT 250 WORDS)

Prospective evaluation of the diagnostic value of sensitive KIT D816V mutation analysis of blood in adults with suspected systemic mastocytosis

DEFF Research Database (Denmark)

Kielsgaard Kristensen, Thomas; Vestergaard, H; Bindslev-Jensen, C

2017-01-01

BACKGROUND: Sensitive KIT D816V mutation analysis of blood has been proposed to guide bone marrow (BM) investigation in suspected systemic mastocytosis (SM). The aim of this prospective study was for the first time to compare the D816V status of the "screening blood sample" used to guide BM biopsy...... in suspected SM to the outcome of the subsequent BM investigation. METHODS: Fifty-eight adult patients with suspected SM were included. The outcome of sensitive KIT D816V analysis of blood was compared to the result of the BM investigation. RESULTS: Screening blood samples from 44 of 58 patients tested D816V...... patients did not fulfill any diagnostic SM criteria (excluding tryptase criterion). Of the 48 SM patients, 90% tested D816V-positive. Thirteen SM patients presented with Hymenoptera venom-induced anaphylaxis, no skin lesions, and baseline serum tryptase ≤20 ng/mL. Of these, 92% tested D816V...

A study on the test of efficiency of the diagnostic X-ray equipment according to their rectifications

International Nuclear Information System (INIS)

Seon, Jong Ryul

1997-01-01

For the efficient management of the diagnostic x-ray equipment, a nation-wide inspection of hospitals was performed by an inspection institute in Taejon in the first half of 1997. Among those hospitals inspected, 28 equipments(machines) which were over 500 mA were randomly selected according to their characteristics : 7 condenser type x-ray equipments, 7 three control phase of full wave rectification of type remote control x-ray equipments, 7 single phase of full wave rectification type for general radiography equipments, and 7 single phase of full wave rectification type of R/F equipments. We obtained the following results by conducting the experiment based on the efficiency of the equipments mentioned above. 1) When te equipments are analyzed, 2 out of 7 single phase of full wave rectification type of general radiography equipments(28.6%), 3 out of 7 single phase of full wave rectification type of R/F equipments(42.9%), 5 out of 7 three phase of full wave rectification type remote of control x-ray equipments(71.4%), and 4 out of 7 condenser type of x-ray equipments(57.1%) showed suitability. It proves the superiority of the three phase of full wave rectification type of remote control x-ray equipments. 2) From the overall analysis, only about 50% of the equipments(suitability of 14 out of 28) maintain the efficient management. Therefore, maintenance management of equipments is more necessary. If the efficiency of the x-ray equipment is uniformly maintained and managed to prevent the breakdown(trouble) beforehand especially through the continuous inspection of tube voltage, tube current, exposure time, and collimator, the financial loss and exposure dose to the patient, as well as the workers engaged in radiation, can be reduced for better medical service

Hydrothermal Synthesis of VO2 Polymorphs: Advantages, Challenges and Prospects for the Application of Energy Efficient Smart Windows.

Science.gov (United States)

Li, Ming; Magdassi, Shlomo; Gao, Yanfeng; Long, Yi

2017-09-01

Vanadium dioxide (VO 2 ) is a widely studied inorganic phase change material, which has a reversible phase transition from semiconducting monoclinic to metallic rutile phase at a critical temperature of τ c ≈ 68 °C. The abrupt decrease of infrared transmittance in the metallic phase makes VO 2 a potential candidate for thermochromic energy efficient windows to cut down building energy consumption. However, there are three long-standing issues that hindered its application in energy efficient windows: high τ c , low luminous transmittance (T lum ), and undesirable solar modulation ability (ΔT sol ). Many approaches, including nano-thermochromism, porous films, biomimetic surface reconstruction, gridded structures, antireflective overcoatings, etc, have been proposed to tackle these issues. The first approach-nano-thermochromism-which is to integrate VO 2 nanoparticles in a transparent matrix, outperforms the rest; while the thermochromic performance is determined by particle size, stoichiometry, and crystallinity. A hydrothermal method is the most common method to fabricate high-quality VO 2 nanoparticles, and has its own advantages of large-scale synthesis and precise phase control of VO 2 . This Review focuses on hydrothermal synthesis, physical properties of VO 2 polymorphs, and their transformation to thermochromic VO 2 (M), and discusses the advantages, challenges, and prospects of VO 2 (M) in energy-efficient smart windows application. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Synchrotron radiation from magnetic undulators as a prospective diagnostic tool

International Nuclear Information System (INIS)

Barbini, R.; Ciocci, F.; Dattoli, G.; Torre, A.; Ginnessi, L.

1989-01-01

The brightness of the radiation emitted by an ultrarelativistic e-beam passing through a magnetic undulator is sensitive to the beam quality (namely, energy spread and emittances) and to the undulator characteristics (i.e., possible random errors both in intensity and direction of magnetization, etc.) The spectrum distortion induced by the above effects and the possibility of using the undulator radiation as a diagnostic tool is discussed. Finally the importance of near-field effects when the radiation is detectedunfocussed off-axis and how they can combine with the effects induced by the beam emittances to produced a larger on-axis inhomogeneous broadening

Optical diagnostics of intermittent flows

DEFF Research Database (Denmark)

Okulov, V.L.; Naumov, I.V.; Sørensen, Jens Nørkær

2007-01-01

The efficiency of combined use of different optical techniques for flow diagnostics is demonstrated with the practically important case of intense swirling flows. It is shown that, when applied separately, commonly used optical measuring techniques, such as laser Doppler anemometry and particle...... is for the first time applied for diagnostics of the flow pattern in a closed cylinder with a rotating end face with the aim of studying the changeover from the steady axisymmetric to unsteady asymmetric flow over a wide range of flow parameters. It is found that such a transition is notable for azimuthal...

TV Broadcast Efficiency in 5G Networks from Subscriber Prospective

KAUST Repository

Lau, Chun Pong

2015-12-06

The flexibility of radio access network facilitated by 5G networks opens the gateway of deploying dynamic strategies for broadcasting TV channels in an efficient way. Currently, spectrum efficiency and bandwidth efficiency are the two common metrics measuring the efficiency of a system. These metrics assess the net bitrate for a unit of spectrum bandwidth. However, there is a lack of measurement, quantifying the effectiveness of a broadcasting strategy from the user perspective. In this paper, we introduce a novel measurement approach, called broadcast efficiency which considers the mobile user as a main reference. Broadcast efficiency is calculated as the number of served audiences per unit of radio resource. From numerical analysis, we show that broadcasting unpopular TV channels dramatically decreases the broadcast efficiency. This finding is evaluated by employing multiple distributions on the size of audience among TV channels. Furthermore, by conducting a real-life simulation, we discover that a high broadcast efficiency may result in a low percentage of served audiences if the audiences of TV channels are quite evenly distributed.

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

Science.gov (United States)

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

2017-01-01

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

Prospectively ECG-triggered sequential dual-source coronary CT angiography in patients with atrial fibrillation: comparison with retrospectively ECG-gated helical CT

Energy Technology Data Exchange (ETDEWEB)

Xu, Lei; Yang, Lin; Zhang, Zhaoqi [Capital Medical University, Department of Radiology, Beijing Anzhen Hospital, Beijing (China); Wang, Yining; Jin, Zhengyu [Chinese Academy of Medical Sciences, Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Zhang, Longjiang; Lu, Guangming [Nanjing University, Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing, Jiangsu (China)

2013-07-15

To investigate the feasibility of applying prospectively ECG-triggered sequential coronary CT angiography (CCTA) to patients with atrial fibrillation (AF) and evaluate the image quality and radiation dose compared with a retrospectively ECG-gated helical protocol. 100 patients with persistent AF were enrolled. Fifty patients were randomly assigned to a prospective protocol and the other patients to a retrospective protocol using a second-generation dual-source CT (DS-CT). Image quality was evaluated using a four-point grading scale (1 = excellent, 2 = good, 3 = moderate, 4 = poor) by two reviewers on a per-segment basis. The coronary artery segments were considered non-diagnostic with a quality score of 4. The radiation dose was evaluated. Diagnostic segment rate in the prospective group was 99.4 % (642/646 segments), while that in the retrospective group was 96.5 % (604/626 segments) (P < 0.001). Effective dose was 4.29 {+-} 1.86 and 11.95 {+-} 5.34 mSv for each of the two protocols (P < 0.001), which was a 64 % reduction in the radiation dose for prospective sequential imaging compared with retrospective helical imaging. In AF patients, prospectively ECG-triggered sequential CCTA is feasible using second-generation DS-CT and can decrease >60 % radiation exposure compared with retrospectively ECG-gated helical imaging while improving diagnostic image quality. (orig.)

[Usher syndrome: clinical features, diagnostic options, and therapeutic prospects].

Science.gov (United States)

Seeliger, M W; Fischer, M D; Pfister, M

2009-06-01

Usher syndrome denotes a clinically and genetically heterogeneous combination of retinitis pigmentosa and sensorineural deafness. The division into subtypes I, II, and III is based on the degree of hearing loss: Type I is characterized by deafness from birth together with ataxia and retarded motor development, type II by a stationary deafness of a moderate degree, and type III by a progressive deafness with adult onset. In Germany, Usher syndrome currently bears particular relevance because in January 2009 a new compulsory screening of auditory function in newborn infants was introduced. Consequently, it can be expected that a higher number of patients with Usher syndrome will be identified in early childhood and referred to ophthalmologists. The focus of this work is to introduce the typical clinical picture of Usher syndrome, summarize diagnostic options, and give an overview of therapeutic strategies.

PROspective Multicenter Imaging Study for Evaluation of chest pain: rationale and design of the PROMISE trial.

Science.gov (United States)

Douglas, Pamela S; Hoffmann, Udo; Lee, Kerry L; Mark, Daniel B; Al-Khalidi, Hussein R; Anstrom, Kevin; Dolor, Rowena J; Kosinski, Andrzej; Krucoff, Mitchell W; Mudrick, Daniel W; Patel, Manesh R; Picard, Michael H; Udelson, James E; Velazquez, Eric J; Cooper, Lawton

2014-06-01

Suspected coronary artery disease (CAD) is one of the most common, potentially life-threatening diagnostic problems clinicians encounter. However, no large outcome-based randomized trials have been performed to guide the selection of diagnostic strategies for these patients. The PROMISE study is a prospective, randomized trial comparing the effectiveness of 2 initial diagnostic strategies in patients with symptoms suspicious for CAD. Patients are randomized to either (1) functional testing (exercise electrocardiogram, stress nuclear imaging, or stress echocardiogram) or (2) anatomical testing with ≥64-slice multidetector coronary computed tomographic angiography. Tests are interpreted locally in real time by subspecialty certified physicians, and all subsequent care decisions are made by the clinical care team. Sites are provided results of central core laboratory quality and completeness assessment. All subjects are followed up for ≥1 year. The primary end point is the time to occurrence of the composite of death, myocardial infarction, major procedural complications (stroke, major bleeding, anaphylaxis, and renal failure), or hospitalization for unstable angina. More than 10,000 symptomatic subjects were randomized in 3.2 years at 193 US and Canadian cardiology, radiology, primary care, urgent care, and anesthesiology sites. Multispecialty community practice enrollment into a large pragmatic trial of diagnostic testing strategies is both feasible and efficient. The PROMISE trial will compare the clinical effectiveness of an initial strategy of functional testing against an initial strategy of anatomical testing in symptomatic patients with suspected CAD. Quality of life, resource use, cost-effectiveness, and radiation exposure will be assessed. Copyright © 2014 Mosby, Inc. All rights reserved.

Neurogenetics in Argentina: diagnostic yield in a personalized research based clinic.

Science.gov (United States)

Rodríguez-Quiroga, Sergio Alejandro; Cordoba, Marta; González-Morón, Dolores; Medina, Nancy; Vega, Patricia; Dusefante, Cecilia Vazquez; Arakaki, Tomoko; Garretto, Nélida Susana; Kauffman, Marcelo Andres

2015-01-01

As a whole neurogenetic diseases are a common group of neurological disorders. However, the recognitionand molecular diagnosis of these disorders is not always straightforward. Besides, there is a paucity of informationregarding the diagnostic yield that specialized neurogenetic clinics could obtain. We performed a prospective,observational, analytical study of the patients seen in a neurogenetic clinic at a tertiary medicalcentre to assess the diagnostic yield of a comprehensive diagnostic evaluation that included a personalizedclinical assessment along with traditional and next-generation sequencing diagnostic tests. We included a cohortof 387 patients from May 2008 to June 2014. For sub-group analysis we selected a sample of patientswhose main complaint was the presence of progressive ataxia, to whom we applied a systematic moleculardiagnostic algorithm. Overall, a diagnostic mutation was identified in 27·4% of our cohort. However, if weonly considered those patients where a molecular test could be performed, the success rate rises to 45%. Weobtained diagnostic yields of 23·5 and 57·5% in the global group of ataxic patients and in the subset of ataxicpatients with a positive family history, respectively. Thus, about a third of patients evaluated in a neurogeneticclinic could be successfully diagnosed.

Diagnostic imaging of shoulder impingement

International Nuclear Information System (INIS)

Merl, T.; Weinhardt, H.; Oettl, G.; Lenz, M.; Riel, K.A.

1996-01-01

Magnetic resonance imaging is a method that has been advancing in the last few years to the modality of choice for diagnostic evaluation of the bone joints, as the method is capable of imaging not only the ossous but also the soft tissue components of the joint. MRI likewise has become an accepted method for diagnostic evaluation of syndromes of the shoulder, with high diagnostic accuracy in detecting rotator cuff lesions, or as an efficient MRI arthrography for evaluation of the instability or lesions of the labrocapsular complex. In the evaluation of early stages of shoulder impingement, the conventional MRI technique as a static technique yields indirect signs which in many cases do not provide the diagnostic certainty required in order to do justice to the functional nature of the syndrome. In these cases, functional MRI for imaging of the arm in abducted position and in rotational movement may offer a chance to early detect impingement and thus identify patients who will profit from treatment at an early stage [de

Current state and prospects of the phytosynthesized colloidal gold nanoparticles and their applications in cancer theranostics.

Science.gov (United States)

Ovais, Muhammad; Raza, Abida; Naz, Shagufta; Islam, Nazar Ul; Khalil, Ali Talha; Ali, Shaukat; Khan, Muhammad Adeeb; Shinwari, Zabta Khan

2017-05-01

The design, development, and biomedical applications of phytochemical-based green synthesis of biocompatible colloidal gold nanoparticles (AuNPs) are becoming an emerging field due to several advantages (safer, eco-friendly, simple, fast, energy efficient, low-cost, and less toxic) over conventional chemical synthetic procedures. Biosynthesized colloidal gold nanoparticles are remarkably attractive in several biomedical applications including cancer theranostics due to small size, unusual physico-chemical properties, facile surface modification, high biocompatibility, and numerous other advantages. Of late, several researchers have investigated the biosynthesis and prospective applications (diagnostics, imaging, drug delivery, and cancer therapeutics) of AuNPs in health care and medicine. However, not a single review article is available in the literature that demonstrates the anti-cancer potential of biosynthesized colloidal AuNPs with detailed mechanistic study. In the present review article, we for the first time discuss the biointerface of colloidal AuNPs, plants, and cancer mainly (i) comprehensive mechanistic aspects of phytochemical-based synthesis of AuNPs; (ii) proposed anti-cancer mechanisms along with biomedical applications in diagnostics, imaging, and drug delivery; and (iii) key challenges for biogenic AuNPs as future cancer nanomedicine.

The efficacy of diagnostic battery in Pott′s disease: A prospective study

Directory of Open Access Journals (Sweden)

Manoj Kumar

2014-01-01

Full Text Available Background: The diagnosis of Pott′s disease is mostly based on clinicoradiological observations substantiated by the bacterial culture, staining and histopathology. Since, no single technique is enough to conclude Pott′s disease in diagnosis, the present study was undertaken to correlate the clinicoradiological, microbiological, histopathological and molecular method to evaluate the effectiveness in diagnosis of Pott′s disease. Materials and Methods: 62 clinicoradiologically suspected cases of Pott′s disease were included in this study. The specimens for diagnostic work up were collected either during surgery or by computed tomography guided fine needle aspiration. All these specimens were tested for tuberculosis (TB through Ziehl-Neelsen (ZN microscopy, BACTEC culture, histopathology and polymerase chain reaction (PCR. The final diagnosis was established by the results of performed tests and clinicoradiological improvement of cases at the end of 6 months on anti tubercular treatment. Results: Out of 62 cases, 7 were excluded from this study as these were turned out to be neoplastic lesions on histopathology. Amongst remaining 55 cases, the TB was diagnosed in 39 (71% on histopathology, 37 (67.5% on PCR, 27 (49% on BACTEC culture and 20 (36.3% on ZN microscopy. Ultimately 45 cases were tested as positive and 10 were detected as negative for TB in combination of ZN microscopy, BACTEC culture and histopathology. PCR was positive in 37 of 45 cases and 10/55 cases remained negative. On clinical analysis of these 10 cases, it was noted that these were cases of relapse/poor compliance. The combination of PCR and histopathology was also shown positive for TB in 45 cases. Hence, the PCR showed a fair positive agreement (Κc = 0.63 against the combined results of all performed traditional methods. Conclusions: The combination of PCR and histopathology is a rapid and efficient tool for diagnosis of Pott′s disease.

Informativeness of Diagnostic Marker Values and the Impact of Data Grouping.

Science.gov (United States)

Ma, Hua; Bandos, Andriy I; Gur, David

2018-01-01

Assessing performance of diagnostic markers is a necessary step for their use in decision making regarding various conditions of interest in diagnostic medicine and other fields. Globally useful markers could, however, have ranges of values that are " diagnostically non-informative" . This paper demonstrates that the presence of marker values from diagnostically non-informative ranges could lead to a loss in statistical efficiency during nonparametric evaluation and shows that grouping non-informative values provides a natural resolution to this problem. These points are theoretically proven and an extensive simulation study is conducted to illustrate the possible benefits of using grouped marker values in a number of practically reasonable scenarios. The results contradict the common conjecture regarding the detrimental effect of grouped marker values during performance assessments. Specifically, contrary to the common assumption that grouped marker values lead to bias, grouping non-informative values does not introduce bias and could substantially reduce sampling variability. The proven concept that grouped marker values could be statistically beneficial without detrimental consequences implies that in practice, tied values do not always require resolution whereas the use of continuous diagnostic results without addressing diagnostically non-informative ranges could be statistically detrimental. Based on these findings, more efficient methods for evaluating diagnostic markers could be developed.

IMPLEMENTATION OF TURNOUTS TECHNICAL DIAGNOSTICS SYSTEMS

Directory of Open Access Journals (Sweden)

S. YU. Buryak

2015-06-01

Full Text Available Purpose. In the paper it is necessary to: 1 find out the causes of turnouts faults to determine diagnostic features failures; 2 consider the requirements structure, purpose components of turnouts, work and technology of their maintenance to determine the construction of the economic activities related to system to the turnout’s maintenance; 3 substantiate the possibility, necessity and prospects of automated diagnostics turnout’s implementation; 4 elaborate a prototype of an automated hardware and software system for the turnouts control parameters and perform diagnostics on them. Methodology. In the paper possible turnouts faults were presented and manifestations and influence on its work were shown. According to the current technology works the process analyze of turnouts’ maintenance was conducted, were defined the basic performed operations during the examination of appearance, parameters and check the repair or replacement of parts and assemblies. Based on the analysis of reasons of turnouts malfunctioning and their fixes were systematized types of damages and ways to deal with them, an information scheme of troubleshooting were created, opportunities and limits of automating the process of diagnostics were identified and compared with the existing method of turnouts maintenance. A diagnostics system block diagram was created, an algorithm of its work was developed and established main basic principles of operation. Software and hardware to determine the turnout’s state considering diagnostic performance of points in use were applied. Findings. During the experiment was created a method of automated turnout’s diagnostics with AC electric drives, managed centrally. The results of automated hardware and software system make it possible to control turnout’s parameters and perform diagnostics on them. Originality. Authors created the method of turnout’s state determination by current curve and its spectral composition in the

Efficiency of a Malaria Reactive Test-and-Treat Program in Southern Zambia: A Prospective, Observational Study.

Science.gov (United States)

Deutsch-Feldman, Molly; Hamapumbu, Harry; Lubinda, Jailos; Musonda, Michael; Katowa, Ben; Searle, Kelly M; Kobayashi, Tamaki; Shields, Timothy M; Stevenson, Jennifer C; Thuma, Philip E; Moss, William J; For The Southern Africa International Centers Of Excellence For Malaria Research

2018-05-01

To improve malaria surveillance and achieve elimination, the Zambian National Malaria Elimination Program implemented a reactive test-and-treat program in Southern Province in 2013 in which individuals with rapid diagnostic test (RDT)-confirmed malaria are followed-up at their home within 1 week of diagnosis. Individuals present at the index case household and those residing within 140 m of the index case are tested with an RDT and treated with artemether-lumefantrine if positive. This study evaluated the efficiency of this reactive test-and-treat strategy by characterizing infected individuals missed by the RDT and the current screening radius. The radius was expanded to 250 m, and a quantitative polymerase chain reaction (qPCR) test was performed on dried blood spot specimens. From January 2015 through March 2016, 145 index cases were identified at health centers and health posts. A total of 3,333 individuals residing in 525 households were screened. Excluding index cases, the parasite prevalence was 1.1% by RDT (33 positives of 3,016 participants) and 2.4% by qPCR (73 positives of 3,016 participants). Of the qPCR-positive cases, 62% of 73 individuals tested negative by RDT. Approximately half of the infected individuals resided within the index case household (58% of RDT-positive individuals and 48% of qPCR-positive individuals). The low sensitivity of the RDT and the high proportion of secondary cases within the index case household decreased the efficiency of this reactive test-and-treat strategy. Reactive focal drug administration in index case households would be a more efficient approach to treating infected individuals associated with a symptomatic case.

Detection of residual disease after neoadjuvant chemoradiotherapy for oesophageal cancer (preSANO): a prospective multicentre, diagnostic cohort study.

Science.gov (United States)

Noordman, Bo Jan; Spaander, Manon C W; Valkema, Roelf; Wijnhoven, Bas P L; van Berge Henegouwen, Mark I; Shapiro, Joël; Biermann, Katharina; van der Gaast, Ate; van Hillegersberg, Richard; Hulshof, Maarten C C M; Krishnadath, Kausilia K; Lagarde, Sjoerd M; Nieuwenhuijzen, Grard A P; Oostenbrug, Liekele E; Siersema, Peter D; Schoon, Erik J; Sosef, Meindert N; Steyerberg, Ewout W; van Lanschot, J Jan B

2018-05-31

After neoadjuvant chemoradiotherapy for oesophageal cancer, roughly half of the patients with squamous cell carcinoma and a quarter of those with adenocarcinoma have a pathological complete response of the primary tumour before surgery. Thus, the necessity of standard oesophagectomy after neoadjuvant chemoradiotherapy should be reconsidered for patients who respond sufficiently to neoadjuvant treatment. In this study, we aimed to establish the accuracy of detection of residual disease after neoadjuvant chemoradiotherapy with different diagnostic approaches, and the optimal combination of diagnostic techniques for clinical response evaluations. The preSANO trial was a prospective, multicentre, diagnostic cohort study at six centres in the Netherlands. Eligible patients were aged 18 years or older, had histologically proven, resectable, squamous cell carcinoma or adenocarcinoma of the oesophagus or oesophagogastric junction, and were eligible for potential curative therapy with neoadjuvant chemoradiotherapy (five weekly cycles of carboplatin [area under the curve 2 mg/mL per min] plus paclitaxel [50 mg/m 2 of body-surface area] combined with 41·4 Gy radiotherapy in 23 fractions) followed by oesophagectomy. 4-6 weeks after completion of neoadjuvant chemoradiotherapy, patients had oesophagogastroduodenoscopy with biopsies and endoscopic ultrasonography with measurement of maximum tumour thickness. Patients with histologically proven locoregional residual disease or no-pass during endoscopy and without distant metastases underwent immediate surgical resection. In the remaining patients a second clinical response evaluation was done (PET-CT, oesophagogastroduodenoscopy with biopsies, endoscopic ultrasonography with measurement of maximum tumour thickness, and fine-needle aspiration of suspicious lymph nodes), followed by surgery 12-14 weeks after completion of neoadjuvant chemoradiotherapy. The primary endpoint was the correlation between clinical response during

Frontline diagnostic evaluation of patients suspected of angina by coronary computed tomography reduces downstream resource utilization when compared to conventional ischemia testing

DEFF Research Database (Denmark)

Nielsen, L. H.; Markenvard, John; Jensen, Jesper Møller

2011-01-01

It has been proposed that the increasing use of coronary computed tomographic angiography (CTA) may introduce additional unnecessary diagnostic procedures. However, no previous study has assessed the impact on downstream test utilization of conventional diagnostic testing relative to CTA in patie...... prospective trials are needed in order to define the most cost-effective diagnostic use of CTA relative to conventional ischemia testing....

Single and Combined Diagnostic Value of Clinical Features and Laboratory Tests in Acute Appendicitis

NARCIS (Netherlands)

Laméris, Wytze; van Randen, Adrienne; Go, Peter M. N. Y. H.; Bouma, Wim H.; Donkervoort, Sandra C.; Bossuyt, Patrick M. M.; Stoker, Jaap; Boermeester, Marja A.

2009-01-01

Objectives: The objective was to evaluate the diagnostic accuracy of clinical features and laboratory test results in detecting acute appendicitis. Methods: Clinical features and laboratory test results were prospectively recorded in a consecutive series of 1,101 patients presenting with abdominal

Efficient Integration, Validation and Troubleshooting in Multimodal Distributed Diagnostic Schemes, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — In general, development and validation of diagnostic models for complex safety critical systems are time and cost intensive jobs. The proposed Phase-II effort will...

Should the diagnostic and therapeutic protocols for adrenal incidentalomas be changed?

Science.gov (United States)

Mateo-Gavira, Isabel; Vilchez-López, Francisco Javier; Larrán-Escandón, Laura; Ojeda-Schuldt, María Belén; Tinoco, Cristina López; Aguilar-Diosdado, Manuel

2015-01-01

The prevalence of adrenal incidentalomas is increasing with the aging of the population and the use of high resolution imaging technics. Current protocols propose a comprehensive monitoring of their functional and morphological state, but with no conclusive clinical evidence that endorses it. Retrospective study of 96 patients diagnosed with adrenal incidentaloma between 2008 and 2012. We evaluated clinical, functional and imaging at baseline and during follow-up. Initially, 9 cases were surgically removed: 4 due to hyperfunction (2 Cushing syndromes and 2 pheochromocytomas) and 5 due to size larger than 4cm. During follow-up one case of pheochromocytoma was diagnosed and another grew more than 1cm, needing surgery. In 98.86% of nonfunctional and benign lesions, there was no functional and/or morphological changes in the final evaluation. The results of our study challenge the validity of current diagnostic-therapeutic protocols of incidentalomas, which should be reassessed in prospective studies taking into account efficiency characteristics. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Implant-buccal plate distance as diagnostic parameter: a prospective cohort study on implant placement in fresh extraction sockets.

Science.gov (United States)

Capelli, Matteo; Testori, Tiziano; Galli, Fabio; Zuffetti, Francesco; Motroni, Alessandro; Weinstein, Roberto; Del Fabbro, Massimo

2013-12-01

The aim of this study is to investigate contour changes around immediate implants in fresh extraction sockets when different grafting procedures are performed, based on the distance between the external implant collar and the bony surface on the buccal plate (I-BP). A secondary aim is to assess the esthetic outcome via the implant esthetic score (IAS). This prospective cohort study was performed in three centers. Suitable patients to undergo implant placement in fresh extraction sockets were selected. Periodontal biotype, horizontal and vertical peri-implant bone defects, and dehiscences were assessed. Depending on I-BP, two types of grafting procedures were performed. In group A (I-BP sockets. No implant failed during the observation period. The mean follow-up was 25 months (range: 12 to 37 months). After 1 year of loading, group A showed a slight decrease in mean buccal volume, whereas group B had an increase in volume (P = 0.02). IAS was higher for group B than group A. When implants are placed immediately after tooth extraction, I-BP may represent a useful diagnostic parameter in choosing the most appropriate grafting procedure (IG versus IEG). In clinical cases in which the distance between implant surface and the buccal plate is <4 mm, the combination of internal and external grafting (IEG) is recommended to maintain the volume and the contour of the ridge and achieve a successful esthetic outcome.

Nano structures for Medical Diagnostics Md

International Nuclear Information System (INIS)

Bellah, M.; Iqbal, S.M.; Bellah, M.; Iqbal, S.M.; Christensen, S.M.; Iqbal, S.M.; Iqbal, S.M.

2012-01-01

Nano technology is the art of manipulating materials on atomic or molecular scales especially to build nano scale structures and devices. The field is expanding quickly, and a lot of work is ongoing in the design, characterization, synthesis, and application of materials, structures, devices, and systems by controlling shape and size at nanometer scale. In the last few years, much work has been focused on the use of nano structures toward problems of biology and medicine. In this paper, we focus on the application of various nano structures and nano devices in clinical diagnostics and detection of important biological molecules. The discussion starts by introducing some basic techniques of micro-/nano scale fabrication that have enabled reproducible production of nano structures. The prospects, benefits, and limitations of using these novel techniques in the fields of bio detection and medical diagnostics are then discussed. Finally, the challenges of mass production and acceptance of nano technology by the medical community are considered.

Combined use of aortic dissection detection risk score and D-dimer in the diagnostic workup of suspected acute aortic dissection.

Science.gov (United States)

Nazerian, Peiman; Morello, Fulvio; Vanni, Simone; Bono, Alessia; Castelli, Matteo; Forno, Daniela; Gigli, Chiara; Soardo, Flavia; Carbone, Federica; Lupia, Enrico; Grifoni, Stefano

2014-07-15

Acute aortic dissection (AD) represents a diagnostic conundrum. Validated algorithms are particularly needed to identify patients where AD could be ruled out without aortic imaging. We evaluated the diagnostic accuracy of a strategy combining the aortic dissection detection (ADD) risk score with D-dimer, a sensitive biomarker of AD. Patients from two clinical centers with suspected AD were prospectively enrolled in a registry, from January 2008 to March 2013. The ADD risk score was calculated by retrospective blinded chart review. For D-dimer, a cutoff of 500 ng/ml was applied. AD was diagnosed in 233 of 1035 (22.5%) patients. The ADD risk score was 0 in 322 (31.1%), 1 in 508 (49.1%) and >1 in 205 (19.8%) patients. The sensitivity and the failure rate of D-dimer were 100% and 0% in patients with ADD score 0, versus 97.5% (95% CI 91.4-99.6%) and 4.2% (95% CI 0.7-12.5%) in patients with ADD risk score >1. In patients with ADD risk score ≤ 1, the sensitivity and the failure rate of D-dimer were 98.7% (95% CI 95.3-99.8%) and 0.8% (95% CI 0.1-2.6%). The diagnostic efficiency of D-dimer in patients with ADD risk score 0 and ≤ 1 was 8.9% (95% CI 7.2-10.7%) and 23.6% (95% CI 21.1-26.2%) respectively. In a large cohort of patients with suspected AD, the presence of ADD risk score 0 or ≤ 1 combined with a negative D-dimer accurately and efficiently ruled out AD. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

ROLE OF DIAGNOSTIC LAPAROSCOPY IN EVALUATION AND TREATMENT OF CHRONIC ABDOMINAL PAIN IN CHILDREN.

Science.gov (United States)

Talat, Nabila; Afzal, Muhammad; Ahmad, Sarfraz; Rasool, Naima; Wasti, Arsalan Raza; Saleem, Muhammad

2016-01-01

Chronic abdominal Pain in children is a very common cause of hospital admission. Many of them are discharged without a diagnosis even after battery of investigations. Laparoscopy plays a significant role in diagnosis and management of many causes of acute and chronic abdominal pain. The purpose of this study was to determine the efficacy of laparoscopy as an efficient diagnostic and management tool in children with chronic abdominal pain. A descriptive, prospective case series was collected in the department of Paediatric surgery Mayo's Hospital Lahore, over the period of 5 years between Jan 2007-Dec 2013. The data of consecutive 50 patients, who were admitted in the department with the diagnosis of chronic abdominal pain, was recorded. All patients who had 2-3 admissions in hospital for last 2 months and failed to establish a definitive diagnosis after clinical examination and base line investigations underwent laparoscopy. The details of associated symptoms, finding of laparoscopy, laparoscopic procedures done, definitive diagnosis, histopathology, complications and relief of symptoms were collected and analysed and results were evaluated using SPSS-17. Out of 50 patients studies, 27/50 (54%) were male, 23/50 (46%) were female. Age ranged from 2-12 years, with the mean age of 7.24 year. Tuberculosis abdomen, adhesions, mesenteric lymphadenitis, appendicitis and cholecystitis were the final diagnosis. Five abdomens were found normal on laparoscopy. Complete pain relief was achieved in 30/50 (60%), reduced intensity of pain was gained in 12/50 (24%) cases while 16% (8/50) still complained of pain. Laparoscopy is an efficient diagnostic and treatment tool in children with chronic unexplained abdominal pain. It avoids serial examinations; prolong admission, battery of investigations and unnecessary surgeries.

Diagnostic and economic evaluation of new biomarkers for Alzheimer’s disease: the research protocol of a prospective cohort study

Directory of Open Access Journals (Sweden)

Handels Ron LH

2012-08-01

Full Text Available Abstract Background New research criteria for the diagnosis of Alzheimer’s disease (AD have recently been developed to enable an early diagnosis of AD pathophysiology by relying on emerging biomarkers. To enable efficient allocation of health care resources, evidence is needed to support decision makers on the adoption of emerging biomarkers in clinical practice. The research goals are to 1 assess the diagnostic test accuracy of current clinical diagnostic work-up and emerging biomarkers in MRI, PET and CSF, 2 perform a cost-consequence analysis and 3 assess long-term cost-effectiveness by an economic model. Methods/design In a cohort design 241 consecutive patients suspected of having a primary neurodegenerative disease are approached in four academic memory clinics and followed for two years. Clinical data and data on quality of life, costs and emerging biomarkers are gathered. Diagnostic test accuracy is determined by relating the clinical practice and new research criteria diagnoses to a reference diagnosis. The clinical practice diagnosis at baseline is reflected by a consensus procedure among experts using clinical information only (no biomarkers. The diagnosis based on the new research criteria is reflected by decision rules that combine clinical and biomarker information. The reference diagnosis is determined by a consensus procedure among experts based on clinical information on the course of symptoms over a two-year time period. A decision analytic model is built combining available evidence from different resources among which (accuracy results from the study, literature and expert opinion to assess long-term cost-effectiveness of the emerging biomarkers. Discussion Several other multi-centre trials study the relative value of new biomarkers for early evaluation of AD and related disorders. The uniqueness of this study is the assessment of resource utilization and quality of life to enable an economic evaluation. The study results

64-slice spiral CT coronary angiography with prospective electrocardiogram-gating: an initial study

International Nuclear Information System (INIS)

Yuan Xuchun; Wang Xianzhu; Liao Wenling; Chen Qin; Deng Huiyi

2008-01-01

Objective: To evaluate the feasibility of prospective electrocardiogram (ECG)-gating computed tomography coronary angiography (CTCA). Methods: Sixty patients with suspected or known coronary artery disease underwent 64-slice CTCA using prospective ECG-gating. Multi-planar reconstruction ( MPR), curved-planar reconstruction (CPR), maximum intensity projection (MIP) and volume rendering (VR) were used to demonstrate the coronary arteries. The image quality and radiation dose was evaluated. Results: The mean effective radiation dose was (2.7±0.2) mSv. 93.3% (720/772) segments of all coronary arteries were of diagnostic image quality, 44.2% (341/772)was classified as excellent and 49.1% (379/772)was good. Non-diagnostic coronary segments were found in 6.7% (52/772) of all coronary arteries. There were 5(8.3%) cases with severe coronary stenosis(>75%) or occlusion, 17 (28.4%) cases with moderate stenosis (50%-75%), 18 (30.0%) cases with mild stenosis (<50% )or irregular lumen, 20(33.3%) cases with normal coronary, artery. Conclusion: With a low radiation dose, prospective electrocardiogram (ECG)-gated coronary 64-MSCT angiography has a good potential for the detection of coronary stenosis, especially for excluding coronary artery disease. (authors)

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

International Nuclear Information System (INIS)

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

1997-01-01

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

New method of leak detecting in diagnostic of gas pipeline system

International Nuclear Information System (INIS)

Kalinowski, K.; Dabrowski, A.; Sobkiewicz, D.; Oracz, H.

2007-01-01

This report describes new directions in gas transmission pipelines diagnostics as well as new methods and equipment used to detect leaks. It was also shown that efficient and functional diagnostics system is the necessary condition to keep the exploitation of transmission systems safe. (author)

Improved description of the migraine aura by a diagnostic aura diary

DEFF Research Database (Denmark)

Russell, M B; Iversen, Helle Klingenberg; Olesen, J

1994-01-01

We present a diagnostic aura diary for prospective recordings of migraine with aura. Three questionnaires are supplemented with sheets for drawings and plottings of visual and sensory auras. Twenty patients recorded 54 attacks of migraine with aura and 2 attacks of migraine aura without headache...... head pain, headache and aura symptoms were contralateral in 90% and ipsilateral in 10%....

Prospective evaluation of EUS-guided fine needle biopsy in pancreatic mass lesions

DEFF Research Database (Denmark)

Larsen, M H; Fristrup, C W; Detlefsen, S

2018-01-01

Background and study aim : Due to the scarcity of specific data on endoscopic ultrasound (EUS)-guided fine-needle biopsies (SharkCore) FNB in the evaluation of pancreatic lesions, we performed a prospective study of the diagnostic performance of EUS SharkCore FNB in patients with pancreatic lesions...

Fundamental and future prospects of printed ambipolar fluorene-type polymer light-emitting transistors for improved external quantum efficiency, mobility, and emission pattern

Science.gov (United States)

Kajii, Hirotake

2018-05-01

In this review, we focus on the improved external quantum efficiency, field-effect mobility, and emission pattern of top-gate-type polymer light-emitting transistors (PLETs) based on ambipolar fluorene-type polymers. A low-temperature, high-efficiency, printable red phosphorescent PLET based on poly(alkylfluorene) with modified alkyl side chains fabricated by a film transfer process is demonstrated. Device fabrication based on oriented films leads to an improved EL intensity owing to the increase in field-effect mobility. There are three factors that affect the transport of carriers, i.e., the energy level, threshold voltage, and mobility of each layer for heterostructure PLETs, which result in various emission patterns such as the line-shaped, multicolor and in-plane emission pattern in the full-channel area between source and drain electrodes. Fundamentals and future prospects in heterostructure devices are discussed and reviewed.

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.

[Quality management and strategic consequences of assessing documentation and coding under the German Diagnostic Related Groups system].

Science.gov (United States)

Schnabel, M; Mann, D; Efe, T; Schrappe, M; V Garrel, T; Gotzen, L; Schaeg, M

2004-10-01

The introduction of the German Diagnostic Related Groups (D-DRG) system requires redesigning administrative patient management strategies. Wrong coding leads to inaccurate grouping and endangers the reimbursement of treatment costs. This situation emphasizes the roles of documentation and coding as factors of economical success. The aims of this study were to assess the quantity and quality of initial documentation and coding (ICD-10 and OPS-301) and find operative strategies to improve efficiency and strategic means to ensure optimal documentation and coding quality. In a prospective study, documentation and coding quality were evaluated in a standardized way by weekly assessment. Clinical data from 1385 inpatients were processed for initial correctness and quality of documentation and coding. Principal diagnoses were found to be accurate in 82.7% of cases, inexact in 7.1%, and wrong in 10.1%. Effects on financial returns occurred in 16%. Based on these findings, an optimized, interdisciplinary, and multiprofessional workflow on medical documentation, coding, and data control was developed. Workflow incorporating regular assessment of documentation and coding quality is required by the DRG system to ensure efficient accounting of hospital services. Interdisciplinary and multiprofessional cooperation is recognized to be an important factor in establishing an efficient workflow in medical documentation and coding.

Injury of the posterior ligamentous complex of the thoracolumbar spine: a prospective evaluation of the diagnostic accuracy of magnetic resonance imaging.

Science.gov (United States)

Vaccaro, Alexander R; Rihn, Jeffrey A; Saravanja, Davor; Anderson, David G; Hilibrand, Alan S; Albert, Todd J; Fehlings, Michael G; Morrison, William; Flanders, Adam E; France, John C; Arnold, Paul; Anderson, Paul A; Friel, Brian; Malfair, David; Street, John; Kwon, Brian; Paquette, Scott; Boyd, Michael; Dvorak, Marcel F S; Fisher, Charles

2009-11-01

Prospective diagnostic imaging study. To determine the accuracy of magnetic resonance imaging (MRI) in diagnosing injury of the posterior ligamentous complex (PLC) in patients with thoracolumbar trauma. Treatment decisions in thoracolumbar injury patients are currently based on the status of the PLC. It is, therefore, important to understand the accuracy of MRI in diagnosing varying degrees of PLC injury. Prior studies report that MRI is up to 100% sensitive for diagnosing PCL injury. Patients with an acute injury from T1 to L3 who required posterior surgery were prospectively studied. A musculoskeletal radiologist, based on the preoperative MRI findings, characterized each of the 6 components of the PLC as intact, incompletely disrupted, or disrupted. During the surgical procedure, the surgeon identified each component of the PLC as intact, incompletely disrupted, or disrupted. The radiologist's interpretation and surgical findings were compared. Forty-two patients with 62 levels of injury were studied. There were 33 males (78.6%) and 9 females (21.4%), and the average age was 35.7 years. According to the kappa score, there was a moderate level of agreement between the radiologist's interpretation and the intraoperative findings for all PLC components except the thoracolumbar fascia, for which there was slight agreement. The sensitivity for the various PLC components ranged from 79% (left facet capsule) to 90% (interspinous ligament). The specificity ranged from 53% (thoracolumbar fascia) to 65% (ligamentum flavum). There was less agreement between the radiologist and surgeon for the patients with less severe neurologic compromise, i.e., those patients with an AIS grade of either D or E. The sensitivity and specificity of MRI for diagnosing injury of the PLC are lower than previously reported in the literature. The integrity of the PLC as determined by MRI should not be used in isolation to determine treatment.

Process management and controlling in diagnostic radiology

International Nuclear Information System (INIS)

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

2002-01-01

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

Dose reduction using prospective electrocardiograph-triggered axial coronary scan on the 64-slice spiral CT

International Nuclear Information System (INIS)

Wang Yanyan; Wu Guogeng; Zhou Cheng; Gao Jianhua; Jiao Sheng; Cao Huizhi

2008-01-01

Objective: To compare radiation dose and image quality between prospective electrocardiograph (ECG)-triggered axial scan and retrospective ECG-gated helical scan in coronary 64-slice CT angiography (CTA). Methods: Seventy-seven consecutive patients [group A. Average body mass index (BMI): 24.6, heart rate 0.05). Conclusion: Prospective ECG-triggered axial scan in 64-slice coronary CTA can significantly reduce radiation exposure and the image quality can fulfill clinical diagnostic needs. (authors)

Aircraft gas turbine engine vibration diagnostics

Directory of Open Access Journals (Sweden)

Stanislav Fábry

2017-11-01

Full Text Available In the Czech and Slovak aviation are in service elderly aircrafts, usually produced in former Soviet Union. Their power units can be operated in more efficient way, in case of using additional diagnostic methods that allow evaluating their health. Vibration diagnostics is one of the methods indicating changes of rotational machine dynamics. Ground tests of aircraft gas turbine engines allow vibration recording and analysis. Results contribute to airworthiness evaluation and making corrections, if needed. Vibration sensors distribution, signal recording and processing are introduced in a paper. Recorded and re-calculated vibration parameters are used in role of health indicators.

The diagnostic contribution of the frontal lumbar spine radiograph in community referred low back pain - A prospective study of 1030 patients

Energy Technology Data Exchange (ETDEWEB)

Khoo, L.A.L. E-mail: lisanne.khoo@stgeorges.nhs.uk; Heron, C.; Patel, U.; Given-Wilson, R.; Grundy, A.; Khaw, K.T.; Dundas, D

2003-08-01

AIM: The diagnostic contribution of the anteroposterior (AP) view was studied to assess whether this view could be omitted safely, thus reducing the radiation burden received by patients undergoing lumbar spine radiography. MATERIALS AND METHODS: Prospective analysis of 1030 consecutive referrals for lumbar spine radiography from general practice. RESULTS: In the majority of cases (90.5%) the AP view was non-contributory. In 4.2% the diagnosis was strengthened and it was altered in 4.6%. However, in the latter group only 1.3% of the total were considered significant alterations. These were cases of possible, but not definite, pars defects and sacroiliitis. Specific important conditions such as infection, malignancy and benign tumours were not missed on the lateral view alone, in our study population. The radiation burden is reduced by 75% by omitting the AP view. CONCLUSION: A single lateral view is an adequate examination, with the proviso that sacroiliac joint disease is not assessed on this view and some pars defects and facet joint degenerative changes may be overlooked. The radiation protection gains are considerable. A single lateral lumbar view is now our routine practice unless sacroiliitis is a specific clinical concern.

Development of gyrotrons for plasma diagnostics (invited)

International Nuclear Information System (INIS)

Woskoboinikow, P.

1986-01-01

Recent advances in high-frequency (>100 GHz) gyrotron technology are reviewed and application to millimeter/submillimeter wave plasma diagnostics is discussed. Gyrotrons have useful capabilities of high-power (>1 kW), long pulse/cw operation, narrow linewidth (<100 kHz), and good spatial mode quality with efficient (--90%) mode converters. These capabilities could be used to significantly improve collective Thomson scattering diagnostics for the study of instabilities, plasma waves, turbulence, and thermal ion fluctuations. Imaging applications with many detector arrays of plasma density, field direction, and microinstabilities may be possible with gyrotons. In a high-field compact ignition tokamak experiment a possible millimeter wave diagnostics window could be exploited by a gyrotron to measure a number of parameters, including alpha particle density and velocity distribution

Improving early cycle economic evaluation of diagnostic technologies.

Science.gov (United States)

Steuten, Lotte M G; Ramsey, Scott D

2014-08-01

The rapidly increasing range and expense of new diagnostics, compels consideration of a different, more proactive approach to health economic evaluation of diagnostic technologies. Early cycle economic evaluation is a decision analytic approach to evaluate technologies in development so as to increase the return on investment as well as patient and societal impact. This paper describes examples of 'early cycle economic evaluations' as applied to diagnostic technologies and highlights challenges in its real-time application. It shows that especially in the field of diagnostics, with rapid technological developments and a changing regulatory climate, early cycle economic evaluation can have a guiding role to improve the efficiency of the diagnostics innovation process. In the next five years the attention will move beyond the methodological and analytic challenges of early cycle economic evaluation towards the challenge of effectively applying it to improve diagnostic research and development and patient value. Future work in this area should therefore be 'strong on principles and soft on metrics', that is, the metrics that resonate most clearly with the various decision makers in this field.

Accuracy of FDG-PET-CT in the Diagnostic Work-up of Vascular Prosthetic Graft Infection

NARCIS (Netherlands)

Bruggink, J. L. M.; Glaudemans, A. W. J. M.; Saleem, B. R.; Meerwaldt, R.; Alkefaji, H.; Prins, T. R.; Start, R. H. J. A.; Zeebregts, C. J.

Objectives: To investigate the diagnostic accuracy of fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) compared with computed tomography (CT) scanning and added value of fused FDG-PET CT in diagnosing vascular prosthetic graft infection. Design: Prospective cohort study with

Prospective study of radioimmunoassay for antibodies against neutrophil cytoplasm in diagnosis of systemic vasculitis

International Nuclear Information System (INIS)

Savage, C.O.S.; Winearls, C.G.; Jones, S.; Marshall, P.D.; Lockwood, C.M.

1987-01-01

The diagnosis and management of Wegener's granulomatosis and microscopic polyarteritis are complicated by the lack of specific diagnostic tests. The diagnostic performance of a solid-phase radioimmunoassay, which detects the autoantibodies against neutrophil cytoplasm present in these disorders, was assessed in a prospective study of patients with suspected vasculitis and/or rapidly progressive nephritis. The assay had a sensitivity and specificity of 96% when carried out in combination with a specific inhibition stage and indirect immunofluorescence staining of alcohol-fixed normal neutrophils. (author)

Energy Efficiency Market Report 2013: Market Trends and Medium-Term Prospects

Energy Technology Data Exchange (ETDEWEB)

NONE

2013-07-01

Energy efficiency has been referred to as a ''hidden fuel'', one that extends energy supplies, increases energy security, lowers carbon emissions and generally supports sustainable economic growth. Yet it is hiding in plain sight: in 2011, investments in the energy efficiency market globally were at a similar scale to those in renewable energy or fossil-fuel power generation. The Energy Efficiency Market Report provides a practical basis for understanding energy efficiency market activities, a review of the methodological and practical challenges associated with measuring the market and its components, and statistical analysis of energy efficiency and its impact on energy demand. It also highlights a specific technology sector in which there is significant energy efficiency market activity, in this instance appliances and ICT. The report presents a selection of country case studies that illustrate current energy efficiency markets in specific sectors, and how they may evolve in the medium term. The energy efficiency market is diffuse, varied and involves all energy-consuming sectors of the economy. A comprehensive overview of market activity is complicated by the challenges associated with quantifying the components of the market and the paucity of comparable reported data. This report underscores how vital high-quality and timely energy efficiency data is to understanding this market.

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.

Mercaptoacetyltriglycine diuretic renography and output efficiency measurement in renal transplant patients

International Nuclear Information System (INIS)

Spicer, S.T.; Chi, Ka-Kit; Larcos, G.; Farlow, D.C.; Choong, K.K.L.; Gruenewald, S.M.; Nankivell, B.J.; Chapman, J.R.

1999-01-01

Suspected urinary tract obstruction following renal transplantation presents a diagnostic dilemma. The purposes of this study were: (1) to establish a normal range of measurement of output efficiency (OE) in the renal transplant population, and (2) to assess prospectively the usefulness of OE in the setting of allograft obstruction. Twenty-two renal transplant patients with stable renal function and no evidence of hydronephrosis on serial ultrasound examination had a diuretic mercaptoacetyltriglycine scan with calculation of OE. Three renal transplant patients with confirmed graft obstruction were also studied. Standard qualitative and quantitative parameters as well as OE were calculated. The mean OE for the 22 normal renal transplant patients was 86.3%±3.7% (range: 77%-91%). OE values in the three obstructed patients were 59%, 68% and 75% respectively. It is concluded that OE should normally exceed 77% in renal graft recipients. OE is a promising means of diagnosing functional obstruction in these patients. (orig.)

Time-Efficiency Analysis Comparing Digital and Conventional Workflows for Implant Crowns: A Prospective Clinical Crossover Trial.

Science.gov (United States)

Joda, Tim; Brägger, Urs

2015-01-01

To compare time-efficiency in the production of implant crowns using a digital workflow versus the conventional pathway. This prospective clinical study used a crossover design that included 20 study participants receiving single-tooth replacements in posterior sites. Each patient received a customized titanium abutment plus a computer-aided design/computer-assisted manufacture (CAD/CAM) zirconia suprastructure (for those in the test group, using digital workflow) and a standardized titanium abutment plus a porcelain-fused-to-metal crown (for those in the control group, using a conventional pathway). The start of the implant prosthetic treatment was established as the baseline. Time-efficiency analysis was defined as the primary outcome, and was measured for every single clinical and laboratory work step in minutes. Statistical analysis was calculated with the Wilcoxon rank sum test. All crowns could be provided within two clinical appointments, independent of the manufacturing process. The mean total production time, as the sum of clinical plus laboratory work steps, was significantly different. The mean ± standard deviation (SD) time was 185.4 ± 17.9 minutes for the digital workflow process and 223.0 ± 26.2 minutes for the conventional pathway (P = .0001). Therefore, digital processing for overall treatment was 16% faster. Detailed analysis for the clinical treatment revealed a significantly reduced mean ± SD chair time of 27.3 ± 3.4 minutes for the test group compared with 33.2 ± 4.9 minutes for the control group (P = .0001). Similar results were found for the mean laboratory work time, with a significant decrease of 158.1 ± 17.2 minutes for the test group vs 189.8 ± 25.3 minutes for the control group (P = .0001). Only a few studies have investigated efficiency parameters of digital workflows compared with conventional pathways in implant dental medicine. This investigation shows that the digital workflow seems to be more time-efficient than the

Value of intensive diagnostic microbiological investigation in low- and high-risk patients with community-acquired pneumonia

NARCIS (Netherlands)

van der Eerden, M. M.; Vlaspolder, F.; de Graaff, C. S.; Groot, T.; Jansen, H. M.; Boersma, W. G.

2005-01-01

In a prospective study to evaluate the diagnostic yield of different microbiological tests in hospitalised patients with community-acquired pneumonia, material for microbiological investigation was obtained from 262 patients. Clinical samples consisted of the following: sputum for Gram staining,

Diagnostic imaging in undergraduate medical education: an expanding role

International Nuclear Information System (INIS)

Miles, K.A.

2005-01-01

Radiologists have been involved in anatomy instruction for medical students for decades. However, recent technical advances in radiology, such as multiplanar imaging, 'virtual endoscopy', functional and molecular imaging, and spectroscopy, offer new ways in which to use imaging for teaching basic sciences to medical students. The broad dissemination of picture archiving and communications systems is making such images readily available to medical schools, providing new opportunities for the incorporation of diagnostic imaging into the undergraduate medical curriculum. Current reforms in the medical curriculum and the establishment of new medical schools in the UK further underline the prospects for an expanding role for imaging in medical education. This article reviews the methods by which diagnostic imaging can be used to support the learning of anatomy and other basic sciences

Abdominal symptoms in general practice: frequency, cancer suspicions raised, and actions taken by GPs in six European countries. Cohort study with prospective registration of cancer.

NARCIS (Netherlands)

Holtedahl, K.; Vedsted, P.; Borgquist, L.; Donker, G.A.; Buntinx, F.; Weller, D.; Braaten, T.; Hjertholm, P.; Mansson, J.; Strandberg, E.L.; Campbell, C.; Ellegaard, L.; Parajuli, R.

2017-01-01

Background: Abdominal symptoms are diagnostically challenging to general practitioners (GPs): although common, they may indicate cancer. In a prospective cohort of patients, we examined abdominal symptom frequency, initial diagnostic suspicion, and actions of GPs in response to abdominal

Diagnostic Performance of Ultra-Low-Dose Computed Tomography for Detecting Asbestos-Related Pleuropulmonary Diseases: Prospective Study in a Screening Setting.

Directory of Open Access Journals (Sweden)

Marysa Schaal

Full Text Available To evaluate the diagnostic performance of Ultra-Low-Dose Chest CT (ULD CT for the detection of any asbestos-related lesions (primary endpoint and specific asbestos-related abnormalities, i.e. non-calcified and calcified pleural plaques, diffuse pleural thickening, asbestosis and significant lung nodules (secondary endpoints.55 male patients (55.7±8.1 years old with occupational asbestos exposure for at least 15 years and where CT screening was indicated were prospectively included. They all underwent a standard unenhanced chest CT (120kV, automated tube current modulation, considered as the reference, and an ULD CT (135kV, 10mA, both with iterative reconstruction. Two chest radiologists independently and blindly read the examinations, following a detailed protocol. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy and error rate of ULD CT were calculated using the exact method of Pearson with a confidence interval of 95%.Radiation dose was 17.9±1.2mGy.cm (0.25mSv for the ULD-CT versus 288.8 ±151mGy.cm (4mSv; p <2.2e-16. Prevalence of abnormalities was 20%. The ULD CT's diagnostic performance in joint reading was high for the primary endpoint (sensitivity = 90.9%, specificity = 100%, positive predictive value = 100%, negative predictive value = 97.8%, high for lung nodules, diffuse pleural thickening and calcified pleural plaques (sensitivity, specificity, PPV and NPV = 100% and fair for asbestosis (sensitivity = 75%, specificity = 100%, PPV = 00%, NPV = 98.1%. Intra-reader accuracy between the ULD CT and the reference CT for the primary endpoint was 98% for the senior and 100% for the junior radiologist. Inter-reader agreement for the primary endpoint was almost perfect (Cohen's Kappa of 0.81.ULD CT in the screening of asbestos exposure related diseases has 90.9% sensitivity and 100% specificity, and could therefore be proposed as a first line examination.

Peripheral occlusive vascular disease: Diagnostic performance of MRA and DSA

International Nuclear Information System (INIS)

Krug, B.; Kugel, H.; Harnischmacher, U.; Heindel, W.; Altenburg, A.; Fischbach, R.; Schmidt, R.

1995-01-01

In 59 patients with arterial flow disturbances 2-D inflow sequence of the abdominal and lower leg arteries were prospectively obtained on a 1.5 T MR-imager and were compared with additional DSA examinations. Supplementary Phase Contraste RSE ('Rapid Sequential Excitation') sequences were carried out in 29 patients. MRA and DSA angiograms were evaluated in random order by 4 readers using a questionnaire. The assessment of image quality were evaluated by variance analysis. Diagnostic performance of MRA and DSA was assessed by comparison of the readers' diagnostic assessments with reference diagnoses established by a radiologist and a vascular surgeon with full knowledge of all data concerning a patient. Image quality of inflow MRA was considered inferior to i.a. DSA (p [de

Role of diagnostic laproscopy in evaluation and treatment of chronic abdominal pain in children

International Nuclear Information System (INIS)

Talat, N.; Afzal, M.; Ahmad, S.; Rasool, N.; Wasti, A.R.; Saleem, M.

2016-01-01

Background: Chronic abdominal Pain in children is a very common cause of hospital admission. Many of them are discharged without a diagnosis even after battery of investigations. Laparoscopy plays a significant role in diagnosis and management of many causes of acute and chronic abdominal pain. The purpose of this study was to determine the efficacy of laparoscopy as an efficient diagnostic and management tool in children with chronic abdominal pain. Methods: A descriptive, prospective case series was collected in the department of Paediatric surgery Mayo Hospital Lahore, over the period of 5 years between Jan 2007- Dec 2013. The data of consecutive 50 patients, who were admitted in the department with the diagnosis of chronic abdominal pain, was recorded. All patients who had 2-3 admissions in hospital for last 2 months and failed to establish a definitive diagnosis after clinical examination and base line investigations underwent laparoscopy. The details of associated symptoms, finding of laparoscopy, laparoscopic procedures done, definitive diagnosis, histopathology, complications and relief of symptoms were collected and analysed and results were evaluated using SPSS17. Results: Out of 50 patients studies, 27/50 (54 percentage) were male, 23/50 (46 percentage) were female. Age ranged from 2-12 years, with the mean age of 7.24 year. Tuberculosis abdomen, adhesions, mesenteric lymphadenitis, appendicitis and cholecystitis were the final diagnosis. Five abdomens were found normal on laparoscopy. Complete pain relief was achieved in 30/50 (60 percentage), reduced intensity of pain was gained in 12/50 (24 percentage) cases while 16 percentage (8/50) still complained of pain. Conclusions: Laparoscopy is an efficient diagnostic and treatment tool in children with chronic unexplained abdominal pain. It avoids serial examinations; prolong admission, battery of investigations and unnecessary surgeries. (author)

Energy efficiency: potentials and profits

International Nuclear Information System (INIS)

Sigaud, J.B.

2011-01-01

In this work, Jean-Marie Bouchereau (ADEME) has presented a review of the energy efficiency profits in France during the last 20 years and the prospects from now to 2020. Then, Geoffrey Woodward (TOTAL) and Sebastien Huchette (AXENS) have recalled the stakes involved in the energy efficiency of the upstream and downstream sectors respectively and presented examples of advances approaches illustrated by concrete cases of applications. (O.M.)

Multi-method automated diagnostics of rotating machines

Science.gov (United States)

Kostyukov, A. V.; Boychenko, S. N.; Shchelkanov, A. V.; Burda, E. A.

2017-08-01

The automated machinery diagnostics and monitoring systems utilized within the petrochemical plants are an integral part of the measures taken to ensure safety and, as a consequence, the efficiency of these industrial facilities. Such systems are often limited in their functionality due to the specifics of the diagnostic techniques adopted. As the diagnostic techniques applied in each system are limited, and machinery defects can have different physical nature, it becomes necessary to combine several diagnostics and monitoring systems to control various machinery components. Such an approach is inconvenient, since it requires additional measures to bring the diagnostic results in a single view of the technical condition of production assets. In this case, we mean by a production facility a bonded complex of a process unit, a drive, a power source and lines. A failure of any of these components will cause an outage of the production asset, which is unacceptable. The purpose of the study is to test a combined use of vibration diagnostics and partial discharge techniques within the diagnostic systems of enterprises for automated control of the technical condition of rotating machinery during maintenance and at production facilities. The described solutions allow you to control the condition of mechanical and electrical components of rotating machines. It is shown that the functionality of the diagnostics systems can be expanded with minimal changes in technological chains of repair and operation of rotating machinery. Automation of such systems reduces the influence of the human factor on the quality of repair and diagnostics of the machinery.

The diagnostic adaptive behavior scale: evaluating its diagnostic sensitivity and specificity.

Science.gov (United States)

Balboni, Giulia; Tassé, Marc J; Schalock, Robert L; Borthwick-Duffy, Sharon A; Spreat, Scott; Thissen, David; Widaman, Keith F; Zhang, Dalun; Navas, Patricia

2014-11-01

The Diagnostic Adaptive Behavior Scale (DABS) was constructed with items across three domains--conceptual, social, and practical adaptive skills--and normed on a representative sample of American individuals from 4 to 21 years of age. The DABS was developed to focus its assessment around the decision point for determining the presence or absence of significant limitations of adaptive behavior for the diagnosis of Intellectual Disability (ID). The purpose of this study, which was composed of 125 individuals with and 933 without an ID-related diagnosis, was to determine the ability of the DABS to correctly identify the individuals with and without ID (i.e., sensitivity and specificity). The results indicate that the DABS sensitivity coefficients ranged from 81% to 98%, specificity coefficients ranged from 89% to 91%, and that the Area Under the Receiver Operating Characteristic Curve were excellent or good. These results indicate that the DABS has very good levels of diagnostic efficiency. Copyright © 2014. Published by Elsevier Ltd.

Electromagnetic navigation diagnostic bronchoscopy for small peripheral lung lesions.

Science.gov (United States)

Makris, D; Scherpereel, A; Leroy, S; Bouchindhomme, B; Faivre, J-B; Remy, J; Ramon, P; Marquette, C-H

2007-06-01

The present study prospectively evaluated the diagnostic yield and safety of electromagnetic navigation-guided bronchoscopy biopsy, for small peripheral lung lesions in patients where standard techniques were nondiagnostic. The study was conducted in a tertiary medical centre on 40 consecutive patients considered unsuitable for straightforward surgery or computed tomography (CT)-guided transthoracic needle aspiration biopsy, due to comorbidities. The lung lesion diameter was mean+/-sem 23.5+/-1.5 mm and the depth from the visceral-costal pleura was 14.9+/-2 mm. Navigation was facilitated by an electromagnetic tracking system which could detect a position sensor incorporated into a flexible catheter advanced through a bronchoscope. Information obtained during bronchoscopy was superimposed on previously acquired CT data. Divergence between CT data and data obtained during bronchoscopy was calculated by the system's software as a measure of navigational accuracy. All but one of the target lesions was reached and the overall diagnostic yield was 62.5% (25-40). Diagnostic yield was significantly affected by CT-to-body divergence; yield was 77.2% when estimated divergence was drainage was required in one case. Electromagnetic navigation-guided bronchoscopy has the potential to improve the diagnostic yield of transbronchial biopsies without additional fluoroscopic guidance, and may be useful in the early diagnosis of lung cancer, particularly in nonoperable patients.

Study of methodology diversification in diagnostics

International Nuclear Information System (INIS)

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

1999-03-01

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

Point-of-care diagnostics for niche applications.

Science.gov (United States)

Cummins, Brian M; Ligler, Frances S; Walker, Glenn M

2016-01-01

Point-of-care or point-of-use diagnostics are analytical devices that provide clinically relevant information without the need for a core clinical laboratory. In this review we define point-of-care diagnostics as portable versions of assays performed in a traditional clinical chemistry laboratory. This review discusses five areas relevant to human and animal health where increased attention could produce significant impact: veterinary medicine, space travel, sports medicine, emergency medicine, and operating room efficiency. For each of these areas, clinical need, available commercial products, and ongoing research into new devices are highlighted. Copyright © 2016 Elsevier Inc. All rights reserved.

Prospective Comparison of the Diagnostic Accuracy of MR Imaging versus CT for Acute Appendicitis.

Science.gov (United States)

Repplinger, Michael D; Pickhardt, Perry J; Robbins, Jessica B; Kitchin, Douglas R; Ziemlewicz, Tim J; Hetzel, Scott J; Golden, Sean K; Harringa, John B; Reeder, Scott B

2018-04-24

Purpose To compare the accuracy of magnetic resonance (MR) imaging with that of computed tomography (CT) for the diagnosis of acute appendicitis in emergency department (ED) patients. Materials and Methods This was an institutional review board-approved, prospective, observational study of ED patients at an academic medical center (February 2012 to August 2014). Eligible patients were nonpregnant and 12- year-old or older patients in whom a CT study had been ordered for evaluation for appendicitis. After informed consent was obtained, CT and MR imaging (with non-contrast material-enhanced, diffusion-weighted, and intravenous contrast-enhanced sequences) were performed in tandem, and the images were subsequently retrospectively interpreted in random order by three abdominal radiologists who were blinded to the patients' clinical outcomes. Likelihood of appendicitis was rated on a five-point scale for both CT and MR imaging. A composite reference standard of surgical and histopathologic results and clinical follow-up was used, arbitrated by an expert panel of three investigators. Test characteristics were calculated and reported as point estimates with 95% confidence intervals (CIs). Results Analysis included images of 198 patients (114 women [58%]; mean age, 31.6 years ± 14.2 [range, 12-81 years]; prevalence of appendicitis, 32.3%). The sensitivity and specificity were 96.9% (95% CI: 88.2%, 99.5%) and 81.3% (95% CI: 73.5%, 87.3%) for MR imaging and 98.4% (95% CI: 90.5%, 99.9%) and 89.6% (95% CI: 82.8%, 94.0%) for CT, respectively, when a cutoff point of 3 or higher was used. The positive and negative likelihood ratios were 5.2 (95% CI: 3.7, 7.7) and 0.04 (95% CI: 0, 0.11) for MR imaging and 9.4 (95% CI: 5.9, 16.4) and 0.02 (95% CI: 0.00, 0.06) for CT, respectively. Receiver operating characteristic curve analysis demonstrated that the optimal cutoff point to maximize accuracy was 4 or higher, at which point there was no difference between MR imaging and CT

An efficient and comprehensive strategy for genetic diagnostics of polycystic kidney disease.

Directory of Open Access Journals (Sweden)

Tobias Eisenberger

Full Text Available Renal cysts are clinically and genetically heterogeneous conditions. Autosomal dominant polycystic kidney disease (ADPKD is the most frequent life-threatening genetic disease and mainly caused by mutations in PKD1. The presence of six PKD1 pseudogenes and tremendous allelic heterogeneity make molecular genetic testing challenging requiring laborious locus-specific amplification. Increasing evidence suggests a major role for PKD1 in early and severe cases of ADPKD and some patients with a recessive form. Furthermore it is becoming obvious that clinical manifestations can be mimicked by mutations in a number of other genes with the necessity for broader genetic testing. We established and validated a sequence capture based NGS testing approach for all genes known for cystic and polycystic kidney disease including PKD1. Thereby, we demonstrate that the applied standard mapping algorithm specifically aligns reads to the PKD1 locus and overcomes the complication of unspecific capture of pseudogenes. Employing careful and experienced assessment of NGS data, the method is shown to be very specific and equally sensitive as established methods. An additional advantage over conventional Sanger sequencing is the detection of copy number variations (CNVs. Sophisticated bioinformatic read simulation increased the high analytical depth of the validation study and further demonstrated the strength of the approach. We further raise some awareness of limitations and pitfalls of common NGS workflows when applied in complex regions like PKD1 demonstrating that quality of NGS needs more than high coverage of the target region. By this, we propose a time- and cost-efficient diagnostic strategy for comprehensive molecular genetic testing of polycystic kidney disease which is highly automatable and will be of particular value when therapeutic options for PKD emerge and genetic testing is needed for larger numbers of patients.

An efficient and comprehensive strategy for genetic diagnostics of polycystic kidney disease.

Science.gov (United States)

Eisenberger, Tobias; Decker, Christian; Hiersche, Milan; Hamann, Ruben C; Decker, Eva; Neuber, Steffen; Frank, Valeska; Bolz, Hanno J; Fehrenbach, Henry; Pape, Lars; Toenshoff, Burkhard; Mache, Christoph; Latta, Kay; Bergmann, Carsten

2015-01-01

Renal cysts are clinically and genetically heterogeneous conditions. Autosomal dominant polycystic kidney disease (ADPKD) is the most frequent life-threatening genetic disease and mainly caused by mutations in PKD1. The presence of six PKD1 pseudogenes and tremendous allelic heterogeneity make molecular genetic testing challenging requiring laborious locus-specific amplification. Increasing evidence suggests a major role for PKD1 in early and severe cases of ADPKD and some patients with a recessive form. Furthermore it is becoming obvious that clinical manifestations can be mimicked by mutations in a number of other genes with the necessity for broader genetic testing. We established and validated a sequence capture based NGS testing approach for all genes known for cystic and polycystic kidney disease including PKD1. Thereby, we demonstrate that the applied standard mapping algorithm specifically aligns reads to the PKD1 locus and overcomes the complication of unspecific capture of pseudogenes. Employing careful and experienced assessment of NGS data, the method is shown to be very specific and equally sensitive as established methods. An additional advantage over conventional Sanger sequencing is the detection of copy number variations (CNVs). Sophisticated bioinformatic read simulation increased the high analytical depth of the validation study and further demonstrated the strength of the approach. We further raise some awareness of limitations and pitfalls of common NGS workflows when applied in complex regions like PKD1 demonstrating that quality of NGS needs more than high coverage of the target region. By this, we propose a time- and cost-efficient diagnostic strategy for comprehensive molecular genetic testing of polycystic kidney disease which is highly automatable and will be of particular value when therapeutic options for PKD emerge and genetic testing is needed for larger numbers of patients.

Prospective and retrospective ECG-gating for CT coronary angiography perform similarly accurate at low heart rates

Energy Technology Data Exchange (ETDEWEB)

Stolzmann, Paul, E-mail: paul.stolzmann@usz.ch [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Goetti, Robert; Baumueller, Stephan [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Plass, Andre; Falk, Volkmar [Clinic for Cardiovascular Surgery, University Hospital Zurich (Switzerland); Scheffel, Hans; Feuchtner, Gudrun; Marincek, Borut [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Alkadhi, Hatem [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Leschka, Sebastian [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

2011-07-15

Objective: To compare, in patients with suspicion of coronary artery disease (CAD) and low heart rates, image quality, diagnostic performance, and radiation dose values of prospectively and retrospectively electrocardiography (ECG)-gated dual-source computed tomography coronary angiography (CTCA) for the diagnosis of significant coronary stenoses. Materials and methods: Two-hundred consecutive patients with heart rates {<=}70 bpm were retrospectively enrolled; 100 patients undergoing prospectively ECG-gated CTCA (group 1) and 100 patients undergoing retrospectively-gated CTCA (group 2). Coronary artery segments were assessed for image quality and significant luminal diameter narrowing. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and accuracy of both CTCA groups were determined using conventional catheter angiography (CCA) as reference standard. Radiation dose values were calculated. Results: Both groups were comparable regarding gender, body weight, cardiovascular risk profile, severity of CAD, mean heart rate, heart rate variability, and Agatston score (all p > 0.05). There was no significant difference in the rate of non-assessable coronary segments between group 1 (1.6%, 24/1404) and group 2 (1.4%, 19/1385; p = 0.77); non-diagnostic image quality was significantly (p < 0.001) more often attributed to stair step artifacts in group 1. Segment-based sensitivity, specificity, PPV, NPV, and accuracy were 98%, 98%, 88%, 100%, and 100% among group 1; 96%, 99%, 90%, 100%, and 98% among group 2, respectively. Parameters of diagnostic performance were similar (all p > 0.05). Mean effective radiation dose of prospectively ECG-gated CTCA (2.2 {+-} 0.4 mSv) was significantly (p < 0.0001) smaller than that of retrospectively ECG-gated CTCA (8.1 {+-} 0.6 mSv). Conclusion: Prospectively ECG-gated CTCA yields similar image quality, performs as accurately as retrospectively ECG-gated CTCA in patients having heart rates {<=}70 bpm

Diagnostic reasoning strategies and diagnostic success.

Science.gov (United States)

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

2003-08-01

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

Diagnostics carried by a light multipurpose deployer for vacuum vessel interventions

Energy Technology Data Exchange (ETDEWEB)

Houry, M., E-mail: Michael.houry@cea.fr [CEA-IRFM, F-13108 Saint-Paul-Lez-Durance (France); Gargiulo, L.; Balorin, C.; Bruno, V.; Keller, D.; Roche, H. [CEA-IRFM, F-13108 Saint-Paul-Lez-Durance (France); Kammerer, N.; Measson, Y. [CEA, LIST, F-92265 Fontenay-aux-Roses (France); Carrel, F.; Schoepff, V. [CEA, LIST, F-91191 Gif-sur-Yvette (France)

2011-10-15

ITER will greatly rely on remote-handling operations to accomplish its scientific missions. Robotic systems will also be required to operate inside vacuum vessels in order to limit or replace human access, to intervene quickly between experimental sessions for in-vessel inspections and measurements, and to preserve the machine conditioning and thus improve machine availability. In this prospect, a multipurpose carrier prototype called Articulated Inspection Arm (AIA) was developed by CEA laboratories within the European work program. With an embedded camera, it successfully demonstrated close inspection feasibility inside Tore Supra tokamak. The AIA robot was designed for mini-invasive operations with interchangeable diagnostics to be plugged at its head. This covers various applications for the safety, the operation and the scientific mission (in-vessel inspection, plasma diagnostics calibrations or inner components analysis and treatments). This paper presents recent analysis and results obtain with diagnostics developed by CEA for in-vessel remote-handling intervention.

Diagnostics carried by a light multipurpose deployer for vacuum vessel interventions

International Nuclear Information System (INIS)

Houry, M.; Gargiulo, L.; Balorin, C.; Bruno, V.; Keller, D.; Roche, H.; Kammerer, N.; Measson, Y.; Carrel, F.; Schoepff, V.

2011-01-01

ITER will greatly rely on remote-handling operations to accomplish its scientific missions. Robotic systems will also be required to operate inside vacuum vessels in order to limit or replace human access, to intervene quickly between experimental sessions for in-vessel inspections and measurements, and to preserve the machine conditioning and thus improve machine availability. In this prospect, a multipurpose carrier prototype called Articulated Inspection Arm (AIA) was developed by CEA laboratories within the European work program. With an embedded camera, it successfully demonstrated close inspection feasibility inside Tore Supra tokamak. The AIA robot was designed for mini-invasive operations with interchangeable diagnostics to be plugged at its head. This covers various applications for the safety, the operation and the scientific mission (in-vessel inspection, plasma diagnostics calibrations or inner components analysis and treatments). This paper presents recent analysis and results obtain with diagnostics developed by CEA for in-vessel remote-handling intervention.

Prospective Teachers’ Tendencies to Utilize From the Facilities of Contemporary Educational Technology

OpenAIRE

Gizem SAYGILI; Teoman İsmail KESERCİOĞLU

2015-01-01

In terms of effectiveness and efficiency, it is important to determine the views of prospective teachers related to taking advantage of the facilities of contemporary educational technology. This study which aims to identify prospective teachers’ attitudes towards computer-assisted learning was conducted with 140 prospective teachers (86 female, 54 male) who have been attending pedagogical formation education at Süleyman Demirel University in the 2013 academic year. In this study, in eight di...

Efficacy of the multidisciplinary tumor board conference in gynecologic oncology: A prospective study.

Science.gov (United States)

Lee, Banghyun; Kim, Kidong; Choi, Jin Young; Suh, Dong Hoon; No, Jae Hong; Lee, Ho-Young; Eom, Keun-Yong; Kim, Haeryoung; Hwang, Sung Il; Lee, Hak Jong; Kim, Yong Beom

2017-12-01

Evidence has shown that multidisciplinary tumor board conferences (MTBCs) improve patient management for various cancer types. However, few retrospective studies have investigated MTBC efficacy for patients with gynecologic cancers. Here, we prospectively aimed to evaluate how MTBCs influence patient management in gynecologic oncology. This prospective study included 85 consecutive cases that were presented at gynecologic oncology MTBCs in our tertiary university hospital between January 2015 and April 2016. The primary endpoint was treatment plan change rate, which included both major and minor changes. Major changes were defined as exchange, addition, or subtraction of treatment modality. Minor changes included all other, such as intramodality changes or treatment time changes. The secondary endpoints were the change rates of diagnosis, diagnostic work-up, and radiological and pathological findings.The treatment plan change rate, irrespective of changes in diagnostic work-up, was 27.1%, which included 10.6% major and 16.5% minor changes. Among the treatment plan changes, changes in the treatment plan change rate alone were noted in 16.5% of cases, and changes in diagnosis and radiological findings occurred in 7.1% and 3.5% of cases, respectively. Diagnosis and radiological findings, irrespective of changes in diagnostic work-up, were also changed in 9.4% and 10.6% of cases, respectively. However, there were no changes in pathological findings. Moreover, there was a change of diagnostic method for further work-up in 23.5% of cases. The implementation rate of MTBC-determined treatment changes was 91.8%. Gynecologic oncology MTBCs resulted in considerable changes in treatment plans. Diagnosis, diagnostic work-up, and radiological findings were influenced by MTBCs. The data emphasize the importance of adopting a multidisciplinary team approach for gynecologic cancer management.

The Diagnostic and Prognostic Value of a Dual-Tasking Paradigm in a Memory Clinic

DEFF Research Database (Denmark)

Nielsen, Malene Schjnning; Simonsen, Anja Hviid; Siersma, Volkert

2018-01-01

-tasking paradigm, such as the Timed Up and Go-Dual Task (TUG-DT), may be useful in the diagnostic assessment of mild cognitive impairment (MCI). OBJECTIVE: To investigate the diagnostic and prognostic ability of a dual-tasking paradigm in patients with MCI or mild Alzheimer's disease (AD) and to evaluate...... the association between the dual-tasking paradigm and cerebrospinal fluid (CSF) AD biomarkers. METHODS: The study is a prospective cohort study conducted in a clinical setting in two memory clinics. Eighty-six patients were included (28 MCI, 17 AD, 41 healthy controls (HC)). The ability to perform dual...

Tailored approaches in drug development and diagnostics : from molecular design to biological model systems

NARCIS (Netherlands)

Sahlgren, C.M.; Meinander, A.; Zhang, H.; Cheng, F.; Preis, Maren; Xu, C.; Salminen, T.A.; Toivola, D.M.; Abankwa, D.; Rosling, A.; Karaman, D.Ş.; Salo-Ahen, O.M.H.; Österbacka, R.; Eriksson, J.E.; Willför, S.; Petre, I.; Peltonen, J.; Leino, R.; Johnson, M.; Rosenholm, J.; Sandler, N.

2017-01-01

Approaches to increase the efficiency in developing drugs and diagnostics tools, including new drug delivery and diagnostic technologies, are needed for improved diagnosis and treatment of major diseases and health problems such as cancer, inflammatory diseases, chronic wounds, and antibiotic

The accuracy of postoperative, non-invasive Air-Test to diagnose atelectasis in healthy patients after surgery: a prospective, diagnostic pilot study.

Science.gov (United States)

Ferrando, Carlos; Romero, Carolina; Tusman, Gerardo; Suarez-Sipmann, Fernando; Canet, Jaume; Dosdá, Rosa; Valls, Paola; Villena, Abigail; Serralta, Ferran; Jurado, Ana; Carrizo, Juan; Navarro, Jose; Parrilla, Cristina; Romero, Jose E; Pozo, Natividad; Soro, Marina; Villar, Jesús; Belda, Francisco Javier

2017-05-29

To assess the diagnostic accuracy of peripheral capillary oxygen saturation (SpO 2 ) while breathing room air for 5 min (the 'Air-Test') in detecting postoperative atelectasis. Prospective cohort study. Diagnostic accuracy was assessed by measuring the agreement between the index test and the reference standard CT scan images. Postanaesthetic care unit in a tertiary hospital in Spain. Three hundred and fifty patients from 12 January to 7 February 2015; 170 patients scheduled for surgery under general anaesthesia who were admitted into the postsurgical unit were included. The Air-Test was performed in conscious extubated patients after a 30 min stabilisation period during which they received supplemental oxygen therapy via a venturi mask. The Air-Test was defined as positive when SpO 2 was ≤96% and negative when SpO 2 was ≥97%. Arterial blood gases were measured in all patients at the end of the Air-Test. In the subsequent 25 min, the presence of atelectasis was evaluated by performing a CT scan in 59 randomly selected patients. The primary study outcome was assessment of the accuracy of the Air-Test for detecting postoperative atelectasis compared with the reference standard. The secondary outcome was the incidence of positive Air-Test results. The Air-Test diagnosed postoperative atelectasis with an area under the receiver operating characteristic curve of 0.90 (95% CI 0.82 to 0.98) with a sensitivity of 82.6% and a specificity of 87.8%. The presence of atelectasis was confirmed by CT scans in all patients (30/30) with positive and in 5 patients (17%) with negative Air-Test results. Based on the Air-Test, postoperative atelectasis was present in 36% of the patients (62 out of 170). The Air-Test may represent an accurate, simple, inexpensive and non-invasive method for diagnosing postoperative atelectasis. NCT02650037. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is

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

Science.gov (United States)

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

2014-03-01

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

Large-scale, high-definition Ground Penetrating Radar prospection in archaeology

Science.gov (United States)

Trinks, I.; Kucera, M.; Hinterleitner, A.; Löcker, K.; Nau, E.; Neubauer, W.; Zitz, T.

2012-04-01

The future demands on professional archaeological prospection will be its ability to cover large areas in a time and cost efficient manner with very high spatial resolution and accuracy. The objective of the 2010 in Vienna established Ludwig Boltzmann Institute for Archaeological Prospection and Virtual Archaeology (LBI ArchPro) in collaboration with its eight European partner organisations is the advancement of state-of-the-art archaeological sciences. The application and specific further development of remote sensing, geophysical prospection and virtual reality applications, as well as of novel integrated interpretation approaches dedicated to non-invasive spatial archaeology combining near-surface prospection methods with advanced computer science is crucial for modern archaeology. Within the institute's research programme different areas for distinct case studies in Austria, Germany, Norway, Sweden and the UK have been selected as basis for the development and testing of new concepts for efficient and universally applicable tools for spatial, non-invasive archaeology. In terms of geophysical prospection the investigation of entire archaeological landscapes for the exploration and protection of Europe's buried cultural heritage requires new measurement devices, which are fast, accurate and precise. Therefore the further development of motorized, multichannel survey systems and advanced navigation solutions is required. The use of motorized measurement devices for archaeological prospection implicates several technological and methodological challenges. Latest multichannel Ground Penetrating Radar (GPR) arrays mounted in front off, or towed behind motorized survey vehicles permit large-scale GPR prospection surveys with unprecedented spatial resolution. In particular the motorized 16 channel 400 MHz MALÅ Imaging Radar Array (MIRA) used by the LBI ArchPro in combination with latest automatic data positioning and navigation solutions permits the reliable high

Minimizing the disruptive effects of prospective memory in simulated air traffic control.

Science.gov (United States)

Loft, Shayne; Smith, Rebekah E; Remington, Roger W

2013-09-01

Prospective memory refers to remembering to perform an intended action in the future. Failures of prospective memory can occur in air traffic control. In two experiments, we examined the utility of external aids for facilitating air traffic management in a simulated air traffic control task with prospective memory requirements. Participants accepted and handed-off aircraft and detected aircraft conflicts. The prospective memory task involved remembering to deviate from a routine operating procedure when accepting target aircraft. External aids that contained details of the prospective memory task appeared and flashed when target aircraft needed acceptance. In Experiment 1, external aids presented either adjacent or nonadjacent to each of the 20 target aircraft presented over the 40-min test phase reduced prospective memory error by 11% compared with a condition without external aids. In Experiment 2, only a single target aircraft was presented a significant time (39-42 min) after presentation of the prospective memory instruction, and the external aids reduced prospective memory error by 34%. In both experiments, costs to the efficiency of nonprospective memory air traffic management (nontarget aircraft acceptance response time, conflict detection response time) were reduced by nonadjacent aids compared with no aids or adjacent aids. In contrast, in both experiments, the efficiency of the prospective memory air traffic management (target aircraft acceptance response time) was facilitated by adjacent aids compared with nonadjacent aids. Together, these findings have potential implications for the design of automated alerting systems to maximize multitask performance in work settings where operators monitor and control demanding perceptual displays. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Biomedical microanalysis--putting it to work now in diagnostic pathology

International Nuclear Information System (INIS)

Abraham, J.L.

1980-01-01

Based on a review of seven years' experience with microanalysis in human pathology, the emphasis of this keynote paper is that currently available microanalytic instrumentation and methodology are of great use diagnostically. The appropriate diagnostic questions which must be posed for microanalysis center around those seeking the cause of the disease (etiologic diagnosis). The preventive and forensic aspects of etiologic diagnosis are stressed. Pathologists analyse not only tissues but also material samples. The backscattered electron (BSE) image with compositional contrast has been essential in making efficient diagnostic use of microanalysis in the scanning electron microscope (SEM). From the 454 specimens seen in the four years 1976-1979, examples are presented to illustrate several aspects of microanalysis: e.g., documentation of the identity and source of toxic dust in lungs; identification of particulate materials in liver, kidney, salivary glands, lymph nodes, etc.; problems of contamination of specimens; use of high vs low magnification analysis; relative volume of tissue sampled using thick (5 micrometer) vs thin (100nm) sections; time required for analysis; and use of fresh frozen, cryo-sectioned tissue for analysis of soluble materials. For practical diagnostic microanalysis, SEM with BSE and x-ray microanalysis of 5 micrometer thick tissue sections at present seems to be the most efficient procedure

Development of in situ cleaning techniques for diagnostic mirrors in ITER

International Nuclear Information System (INIS)

Litnovsky, A.; Laengner, M.; Matveeva, M.; Schulz, Ch.; Marot, L.; Voitsenya, V.S.; Philipps, V.; Biel, W.; Samm, U.

2011-01-01

Mirrors will be used in all optical and laser-based diagnostic systems of ITER. In the severe environment, the optical characteristics of mirrors will be degraded, hampering the entire performance of the respective diagnostics. A minute impurity deposition of 20 nm of carbon on the mirror is sufficient to decrease the mirror reflectivity by tens of percent outlining the necessity of the mirror cleaning in ITER. The results of R and D on plasma cleaning of molybdenum diagnostic mirrors are reported. The mirrors contaminated with amorphous carbon films in the laboratory conditions and in the tokamaks were cleaned in steady-state hydrogenic plasmas. The maximum cleaning efficiency of 4.2 nm/min was reached for the laboratory and soft tokamak hydrocarbon films, whereas for the hard tokamak films the carbidization of mirrors drastically decreased the cleaning efficiency down to 0.016 nm/min. This implies the necessity of sputtering cleaning of contaminated mirrors as the only reliable tool to remove the deposits by plasma cleaning. An overview of R and D program on mirror cleaning is provided along with plans for further studies and the recommendations for ITER mirror-based diagnostics.

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

OpenAIRE

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

2009-01-01

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

Convergence diagnostics for Eigenvalue problems with linear regression model

International Nuclear Information System (INIS)

Shi, Bo; Petrovic, Bojan

2011-01-01

Although the Monte Carlo method has been extensively used for criticality/Eigenvalue problems, a reliable, robust, and efficient convergence diagnostics method is still desired. Most methods are based on integral parameters (multiplication factor, entropy) and either condense the local distribution information into a single value (e.g., entropy) or even disregard it. We propose to employ the detailed cycle-by-cycle local flux evolution obtained by using mesh tally mechanism to assess the source and flux convergence. By applying a linear regression model to each individual mesh in a mesh tally for convergence diagnostics, a global convergence criterion can be obtained. We exemplify this method on two problems and obtain promising diagnostics results. (author)

Clinical applications of SONIALVISION 100 digital diagnostic table system

International Nuclear Information System (INIS)

Shiomi, Takeshi; Shimizu, Tatsuya; Iinuma, Masao; Takemoto, Hajime; Tanaka, Shuji

2003-01-01

This report refers to the clinical applications of our newly developed SONIALVISION 100 fully digitalized X-ray diagnostic table system. The main design concept of the SONIALVISION 100 system is the improvement of workflow in various clinical fields. The development of digital imaging technologies has come to allow fully digitalized X-ray diagnostic table systems to be widely utilized in various clinical applications, including interventional radiology (IVR) and examinations using contrast medium. This report mainly refers to the clinical applications of the Shimadzu SONIALVISION 100 digitalized X-ray diagnostic table system, also presenting some typical image data demonstrating the high efficiency, made available through the use of this new system, in high-speed spot imaging and digital tomography. (author)

Algorithmic acquisition of diagnostic patterns in district heating billing system

International Nuclear Information System (INIS)

Kiluk, Sebastian

2012-01-01

An application of algorithmic exploration of billing data is examined for fault detection, diagnosis (FDD) based on evaluation of present state and detection of unexpected changes in energy efficiency of buildings. Large data sets from district heating (DH) billing systems are used for construction of feature space, diagnostic rules and classification of the buildings according to their energy efficiency properties. The algorithmic approach automates discovering knowledge about common, thus accepted changes in buildings’ properties, in equipment and in habitants’ behavior reflecting progress in technology and life style. In this article implementation of Data Mining and Knowledge Discovery (DMKD) method in supervision system with exemplary results based on real data is presented. Crucial steps of data processing influencing diagnostic results are described in details.

BRIEF REPORT: Beyond Clinical Experience: Features of Data Collection and Interpretation That Contribute to Diagnostic Accuracy

Science.gov (United States)

Nendaz, Mathieu R; Gut, Anne M; Perrier, Arnaud; Louis-Simonet, Martine; Blondon-Choa, Katherine; Herrmann, François R; Junod, Alain F; Vu, Nu V

2006-01-01

BACKGROUND Clinical experience, features of data collection process, or both, affect diagnostic accuracy, but their respective role is unclear. OBJECTIVE, DESIGN Prospective, observational study, to determine the respective contribution of clinical experience and data collection features to diagnostic accuracy. METHODS Six Internists, 6 second year internal medicine residents, and 6 senior medical students worked up the same 7 cases with a standardized patient. Each encounter was audiotaped and immediately assessed by the subjects who indicated the reasons underlying their data collection. We analyzed the encounters according to diagnostic accuracy, information collected, organ systems explored, diagnoses evaluated, and final decisions made, and we determined predictors of diagnostic accuracy by logistic regression models. RESULTS Several features significantly predicted diagnostic accuracy after correction for clinical experience: early exploration of correct diagnosis (odds ratio [OR] 24.35) or of relevant diagnostic hypotheses (OR 2.22) to frame clinical data collection, larger number of diagnostic hypotheses evaluated (OR 1.08), and collection of relevant clinical data (OR 1.19). CONCLUSION Some features of data collection and interpretation are related to diagnostic accuracy beyond clinical experience and should be explicitly included in clinical training and modeled by clinical teachers. Thoroughness in data collection should not be considered a privileged way to diagnostic success. PMID:17105525

Check valve diagnostics utilizing acoustic and magnetic technologies

International Nuclear Information System (INIS)

Agostinelli, A.

1991-01-01

The potential hazards associated with check valve failures make it necessary to detect check valve problems before they cause significant damage. In the nuclear industry, check valve failures are known to have resulted in damaging water hammer conditions, overpressurization of low pressure systems, steam binding of auxiliary feedwater pumps, and other serious component damage in power plant environments. Similar problems exist in fossil power and various process industries, but the resources dedicated to valve maintenance issues are greatly reduced. However, the trend toward plant life extension, predictive maintenance, and maximum operating efficiency will raise the general awareness of check valve maintenance in commercial (non-nuclear) applications. Although this paper includes specific references to the nuclear industry, the check valve problem conditions and diagnostic techniques apply across all power and process plant environments. The ability to accurately diagnose check valve conditions using non-intrusive, predictive maintenance testing methods allows for a more cost-efficient, productive maintenance program. One particular diagnostic system, called Quickcheck trademark, assists utilities in addressing these concerns. This article presents actual field test data and analysis that demonstrate the power of check valve diagnostics. Prior to presenting the field data, a brief overview of the system is overviewed

'Doctor Google' ending the diagnostic odyssey in lysosomal storage disorders: parents using internet search engines as an efficient diagnostic strategy in rare diseases.

Science.gov (United States)

Bouwman, Machtelt G; Teunissen, Quirine G A; Wijburg, Frits A; Linthorst, Gabor E

2010-08-01

The expansion of the internet has resulted in widespread availability of medical information for both patients and physicians. People increasingly spend time on the internet searching for an explanation, diagnosis or treatment for their symptoms. Regarding rare diseases, the use of the internet may be an important tool in the diagnostic process. The authors present two cases in which concerned parents made a correct diagnosis of a lysosomal storage disorder in their child by searching the internet after a long doctor's delay. These cases illustrate the utility of publicly available internet search engines in diagnosing rare disorders and in addition illustrate the lengthy diagnostic odyssey which is common in these disorders.

Xpert MTB/RIF Ultra for detection of Mycobacterium tuberculosis and rifampicin resistance: a prospective multicentre diagnostic accuracy study.

Science.gov (United States)

Dorman, Susan E; Schumacher, Samuel G; Alland, David; Nabeta, Pamela; Armstrong, Derek T; King, Bonnie; Hall, Sandra L; Chakravorty, Soumitesh; Cirillo, Daniela M; Tukvadze, Nestani; Bablishvili, Nino; Stevens, Wendy; Scott, Lesley; Rodrigues, Camilla; Kazi, Mubin I; Joloba, Moses; Nakiyingi, Lydia; Nicol, Mark P; Ghebrekristos, Yonas; Anyango, Irene; Murithi, Wilfred; Dietze, Reynaldo; Lyrio Peres, Renata; Skrahina, Alena; Auchynka, Vera; Chopra, Kamal Kishore; Hanif, Mahmud; Liu, Xin; Yuan, Xing; Boehme, Catharina C; Ellner, Jerrold J; Denkinger, Claudia M

2018-01-01

The Xpert MTB/RIF assay is an automated molecular test that has improved the detection of tuberculosis and rifampicin resistance, but its sensitivity is inadequate in patients with paucibacillary disease or HIV. Xpert MTB/RIF Ultra (Xpert Ultra) was developed to overcome this limitation. We compared the diagnostic performance of Xpert Ultra with that of Xpert for detection of tuberculosis and rifampicin resistance. In this prospective, multicentre, diagnostic accuracy study, we recruited adults with pulmonary tuberculosis symptoms presenting at primary health-care centres and hospitals in eight countries (South Africa, Uganda, Kenya, India, China, Georgia, Belarus, and Brazil). Participants were allocated to the case detection group if no drugs had been taken for tuberculosis in the past 6 months or to the multidrug-resistance risk group if drugs for tuberculosis had been taken in the past 6 months, but drug resistance was suspected. Demographic information, medical history, chest imaging results, and HIV test results were recorded at enrolment, and each participant gave at least three sputum specimen on 2 separate days. Xpert and Xpert Ultra diagnostic performance in the same sputum specimen was compared with culture tests and drug susceptibility testing as reference standards. The primary objectives were to estimate and compare the sensitivity of Xpert Ultra test with that of Xpert for detection of smear-negative tuberculosis and rifampicin resistance and to estimate and compare Xpert Ultra and Xpert specificities for detection of rifampicin resistance. Study participants in the case detection group were included in all analyses, whereas participants in the multidrug-resistance risk group were only included in analyses of rifampicin-resistance detection. Between Feb 18, and Dec 24, 2016, we enrolled 2368 participants for sputum sampling. 248 participants were excluded from the analysis, and 1753 participants were distributed to the case detection group (n=1439

Course of Subthreshold Bipolar Disorder in Youth: Diagnostic Progression from Bipolar Disorder Not Otherwise Specified

Science.gov (United States)

Axelson, David A.; Birmaher, Boris; Strober, Michael A.; Goldstein, Benjamin I.; Ha, Wonho; Gill, Mary Kay; Goldstein, Tina R.; Yen, Shirley; Hower, Heather; Hunt, Jeffrey I.; Liao, Fangzi; Iyengar, Satish; Dickstein, Daniel; Kim, Eunice; Ryan, Neal D.; Frankel, Erica; Keller, Martin B.

2011-01-01

Objective: To determine the rate of diagnostic conversion from an operationalized diagnosis of bipolar disorder not otherwise specified (BP-NOS) to bipolar I disorder (BP-I) or bipolar II disorder (BP-II) in youth over prospective follow-up and to identify factors associated with conversion. Method: Subjects were 140 children and adolescents…

Diagnostic value of full-mouth radiography in dogs

International Nuclear Information System (INIS)

Verstraete, F.J.M.; Kass, P.H.; Terpak, C.H.

1998-01-01

Objective-To determine the diagnostic value of full-mouth radiography in dogs.Sample Population-Prospective series of 226 dogs referred for dental treatment without previous full-mouth radiographic views being available. Procedure-In a prospective nested case-control analysis of multiple outcomes in a hospital cohort of dogs presented for dental treatment, full-mouth radiographic views were obtained prior to oral examination and charting. After treatment, clinical and radiographic findings were compared, with reference to presenting problems, main clinical findings, additional information obtained from the radiographs, and unexpected radiographic findings. The importance of the radiographic findings in therapeutic decision-making was assessed. Results-The main clinical findings were radiographically confirmed in all dogs. Selected presenting problems and main clinical findings yielded significantly increased odds ratios for a variety of other conditions, either expected or unexpected. Radiographs of teeth without clinical lesions yielded incidental or clinically important findings in 41.7 and 27.8% of dogs, respectively, and were considered of no clinical value in 30.5%. Radiographs of teeth with clinical lesions merely confirmed the findings in 24.3% of dogs, yielded additional or clinically essential information in 50.0 and 22.6%, respectively, and were considered of no value in 3.1%. Older dogs derived more benefit from full-mouth radiography than did younger dogs. Incidental findings were more common in larger dogs. Clinical Relevance-Diagnostic yield of full-mouth radiography in new canine patients referred for dental treatment is high, and the routine use of such radiographs is justifiable

Efficient diagnostic methods for nuclear power plant monitoring

International Nuclear Information System (INIS)

Sunder, R.

1997-01-01

There are systems for operational monitoring of vibrations, valves, solid-borne sound, leaks, and embrittlement. The paper focuses on vibration monitoring of pressurized components and systems in PWRs and BWRs. Other than with conventional systems, the task is not to globally monitor the vibration level, but the frequency-selective information is used as a sensitive information source, the level of vibrations being of secondary significance. The essential feature therefore is the comprehensive and selective scanning of individual frequency components in the recorded vibration spectra, which in some cases can be less than a millesimal millimeter. Upon identification of the various vibration components - from so-called baseline analyses using correlation methods - vibration analysis is done by only one step, comparing a defined reference state with the actual vibration state of the monitored system component. In the event of detected deviations, information on the causes of vibrations - essentially component-related structural resonances - will give the relevant cause-effect relationship. The paper uses some practical examples to illustrate that reliable diagnoses are achieved by the above-mentioned frequency-selective technique. It is important, however, to carry out a sufficiently reliable statistical verification of diagnostic data by means of vibration trending. This is ensured with the digital systems and their high data acquisition rates. (orig./CB) [de

Diagnostic accuracy of organ electrodermal diagnostics | Szopinski ...

African Journals Online (AJOL)

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

[Rationale for a diagnostic approach in non-Graves' orbital inflammation--Report of 61 patients].

Science.gov (United States)

Gavard-Perret, A; Lagier, J; Delmas, J; Delas, J; Adenis, J-P; Robert, P-Y

2015-12-01

Orbital inflammatory syndromes include a wide variety of inflammatory intraorbital processes which are very different in terms of clinical presentation and prognosis. We currently prefer to differentiate so-called "specific" inflammations, for which an etiology is able to be identified, from idiopathic orbital inflammatory syndromes (IOIS), for which the etiology remains unknown and the histology is nonspecific. To propose an efficient diagnostic approach for clinicians managing patients with non-Graves' orbital inflammations. This is a retrospective and prospective study concerning 61 patients managed by the medical team for non-Graves' orbital inflammations between May, 1999 and May, 2013 in the ophthalmology departments of Nice and Limoges university hospitals in France. Seventeen specific inflammations, 19 orbital lymphomas and 25 idiopathic orbital inflammatory syndromes were included. Patients were divided into two groups. Thirty-six patients (group 1) underwent primary biopsy, while for the other 25 (group 2), therapy was begun empirically without biopsy. We could therefore compare both approaches in terms of diagnostic efficiency and time until identification of a specific etiology. Our statistical results show that an approach without primary biopsy leads to a number of specific diagnoses statistically much lower than that obtained by the approach with primary biopsy. Also, the risk of missing a specific inflammation (with as a consequence an inappropriate treatment and a risk of functional sequelae as well as a fatal risk of missing a lymphoproliferative pathology) is very clearly higher in the case of not performing primary biopsy. Finally, the average time elapsed between the initial consultation with the ophthalmologist and a specific diagnosis was one month in the case of the first approach, while this delay was almost three times higher with the second approach, with a mean of 2.91 months (P<0.01). Our study shows that biopsy should be the mainstay

EpCAM-based flow cytometry in cerebrospinal fluid greatly improves diagnostic accuracy of leptomeningeal metastases from epithelial tumors

NARCIS (Netherlands)

Milojkovic Kerklaan, B.; Pluim, Dick; Bol, Mijke; Hofland, Ingrid; Westerga, Johan; van Tinteren, Harm; Beijnen, Jos H; Boogerd, Willem; Schellens, Jan H M; Brandsma, Dieta

BACKGROUND: Moderate diagnostic accuracy of MRI and initial cerebrospinal fluid (CSF) cytology analysis results in at least 10%-15% false negative diagnoses of leptomeningeal metastases (LM) of solid tumors, thus postponing start of therapy. The aim of this prospective clinical study was to

Hospitalization for Failure to Thrive: A Prospective Descriptive Report.

Science.gov (United States)

Larson-Nath, Catherine; St Clair, Nicole; Goday, Praveen

2018-02-01

Failure to thrive (FTT) is a common symptom leading to hospitalization of children. Most literature describing this population is from 30 years ago. Since that time the hospitalized population has become more medically complex. We aimed to describe children hospitalized for FTT in a tertiary care pediatric hospital. We prospectively collected demographic, anthropometric, evaluation, and outcome data for 92 consecutive children admitted with FTT. The majority of children grew with behavioral interventions alone (primary nonorganic FTT) and had negative evaluation (n = 63). Children with primary organic FTT had longer hospital stays (7 vs 4 days; P < .001) and lower daily weight gain (35 vs 58 g/d; P < .001). Laboratory, radiological, and endoscopic evaluation rarely led to a diagnostic etiology of FTT in hospitalized children. We conclude that children hospitalized with FTT should be observed for weight gain prior to pursuing diagnostic investigation.

The diagnostic efficiency of ultrasound guided imaging algorithm in evaluation of patients with hematuria

Energy Technology Data Exchange (ETDEWEB)

Unsal, Alparslan, E-mail: alparslanunsal@yahoo.com [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Caliskan, Eda Kazak [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Erol, Haluk [Adnan Menderes University, Faculty of Medicine, Department of Urology, 09100 Aydin (Turkey); Karaman, Can Zafer [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey)

2011-07-15

Purpose: To assess the efficiency of the following imaging algorithm, including intravenous urography (IVU) or computed tomography urography (CTU) based on ultrasonographic (US) selection, in the radiological management of hematuria. Materials and methods: One hundred and forty-one patients with hematuria were prospectively evaluated. Group 1 included 106 cases with normal or nearly normal US result and then they were examined with IVU. Group 2 was composed of the remaining 35 cases which had any urinary tract abnormality, and they were directed to CTU. Radiological results were compared with clinical diagnosis. Results: Ultrasonography and IVU results of 97 cases were congruent in group 1. Eight simple cysts were detected with US and 1 non-obstructing ureter stone was detected with IVU in remaining 9 patients. The only discordant case in clinical comparison was found to have urinary bladder cancer on conventional cystoscopy. Ultrasonography and CTU results were congruent in 30 cases. Additional lesions were detected with CTU (3 ureter stones, 1 ureter TCC, 1 advanced RCC) in remaining 5 patients. Ultrasonography + CTU combination results were all concordant with clinical diagnosis. Except 1 case, radio-clinical agreement was achieved. Conclusion: Cross-sectional imaging modalities are preferred in evaluation of hematuria. CTU is the method of choice; however the limitations preclude using CTU as first line or screening test. Ultrasonography is now being accepted as a first line imaging modality with the increased sensitivity in mass detection compared to IVU. The US guided imaging algorithm can be used effectively in radiological approach to hematuria.

Dynamic Visualization of SNS Diagnostics Summary Report and System Status

CERN Document Server

Blokland, Willem; Long, Cary D; Murphy, Darryl J; Purcell, John D; Sundaram, Madhan

2005-01-01

The Spallation Neutron Source (SNS) accelerator systems will deliver a 1.0 GeV, 1.4 MW proton beam to a liquid mercury target for neutron scattering research. The accelerator complex consists of a 1 GeV linear accelerator, an accumulator ring and associated transport lines. The SNS diagnostics platform is PC-based running Embedded Windows XP and LabVIEW. The diagnostics instruments communicate with the control system using the Channel Access (CA) protocol of the Experimental Physics and Industrial Control System (EPICS). This paper describes the Diagnostics Group's approach to collecting data from the instruments, processing it, and presenting live in a summarized way over the web. Effectively, adding a supervisory level to the diagnostics instruments. One application of this data mining is the "Diagnostics Status Page" that summarizes the insert-able devices, transport efficiencies, and the mode of the accelerator in a compact webpage. The displays on the webpage change automatically to show the latest and/o...

Prostate Stem Cell Antigen: A Prospective Therapeutic and Diagnostic Target

Science.gov (United States)

Raff, Adam B.; Gray, Andrew; Kast, W. Martin

2009-01-01

The development of novel clinical tools to combat cancer is an intense field of research and recent efforts have been directed at the identification of proteins that may provide diagnostic, prognostic and/or therapeutic applications due to their restricted expression. To date, a number of protein candidates have emerged as potential clinical tools in the treatment of prostate cancer. Discovered over ten year ago, prostate stem cell antigen (PSCA) is a cell surface antigen that belongs to the Ly-6/Thy-1 family of glycosylphosphatidylinositol-anchored proteins. PSCA is highly overexpressed in human prostate cancer, with limited expression in normal tissues, making it an ideal target for both diagnosis and therapy. Several studies have now clearly correlated the expression of PSCA with relevant clinical benchmarks, such as Gleason score and metastasis, while others have demonstrated the efficacy of PSCA targeting in treatment through various modalities. The purpose of this review is to present the current body of knowledge about PSCA and its potential role in the treatment of human prostate cancer. PMID:18838214

Feasibility of prospectively ECG-triggered high-pitch coronary CT angiography with 30 mL iodinated contrast agent at 70 kVp: initial experience

Energy Technology Data Exchange (ETDEWEB)

Zhang, Long Jiang; Qi, Li; Tang, Chun Xiang; Zhou, Chang Sheng; Ji, Xue Man; Lu, Guang Ming [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Wang, Jing [Medical School of Nanjing University, Department of Cardiology, Jinling Hospital, Nanjing, Jiangsu (China); Spearman, James V.; De Cecco, Carlo Nicola; Meinel, Felix G. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Schoepf, U.J. [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States)

2014-07-15

To evaluate the feasibility, image quality and radiation dose of prospectively ECG-triggered high-pitch coronary CT angiography (CCTA) with 30 mL contrast agent at 70 kVp. Fifty-eight patients with suspected coronary artery disease, a body mass index (BMI) of less than 25 kg/m{sup 2}, sinus rhythm and a heart rate (HR) of less than 70 beats per minute (bpm) were prospectively enrolled in this study. Thirty mL of 370 mg I/mL iodinated contrast agent was administrated at a flow rate of 5 mL/s. All patients underwent prospectively ECG-triggered high-pitch CCTA on a second-generation dual-source CT system at 70 kVp using automated tube current modulation. Fifty-six patients (96.6 %) had diagnostic CCTA images and two patients (3.4 %) had one vessel with poor image quality each rated as non-diagnostic. No significant effects of HR, HR variability and BMI on CCTA image quality were observed (all P > 0.05). Effective dose was 0.17 ± 0.02 mSv and the size-specific dose estimate was 1.03 ± 0.13 mGy. Prospectively ECG-triggered high-pitch CCTA at 70 kVp with 30 mL of contrast agent can provide diagnostic image quality at a radiation dose of less than 0.2 mSv in patients with a BMI of less than 25 kg/m{sup 2} and an HR of less than 70 bpm. (orig.)

Prospective ECG triggering reduces prosthetic heart valve-induced artefacts compared with retrospective ECG gating on 256-slice CT

NARCIS (Netherlands)

Symersky, P.; Habets, J.; Westers, P.; Mol, de B.A.J.M.; Prokop, M.; Budde, R.P.J.

2012-01-01

Objectives Multidetector computed tomography (MDCT) has diagnostic value for the evaluation of prosthetic heart valve (PHV) dysfunction but it is hampered by artefacts. We hypothesised that image acquisition using prospective triggering instead of retrospective gating would reduce artefacts related

Prospective comparative study of spiral computer tomography and magnetic resonance imaging for detection of hepatocellular carcinoma

NARCIS (Netherlands)

Stoker, J.; Romijn, M. G.; de Man, R. A.; Brouwer, J. T.; Weverling, G. J.; van Muiswinkel, J. M.; Zondervan, P. E.; Laméris, J. S.; Ijzermans, J. N. M.

2002-01-01

Background: Hepatocellular carcinoma (HCC) is often detected at a relatively late stage when tumour size prohibits curative surgery. Screening to detect HCC at an early stage is performed for patients at risk. Aim: The aim of this study was to compare prospectively the diagnostic accuracy and

Comparison of diagnostic performance for perinatal and paediatric post-mortem imaging: CT versus MRI

International Nuclear Information System (INIS)

Arthurs, Owen J.; Jacques, Thomas S.; Sebire, Neil J.; Guy, Anna; Chong, W.K.; Gunny, Roxanna; Saunders, Dawn; Olsen, Oystein E.; Thayyil, Sudhin; Wade, Angie; Jones, Rod; Norman, Wendy; Taylor, Andrew M.; Scott, Rosemary; Robertson, Nicola J.; Owens, Catherine M.; Offiah, Amaka C.; Chitty, Lyn S.

2016-01-01

To compare the diagnostic yield of whole-body post-mortem computed tomography (PMCT) imaging to post-mortem magnetic resonance (PMMR) imaging in a prospective study of fetuses and children. We compared PMCT and PMMR to conventional autopsy as the gold standard for the detection of (a) major pathological abnormalities related to the cause of death and (b) all diagnostic findings in five different body organ systems. Eighty two cases (53 fetuses and 29 children) underwent PMCT and PMMR prior to autopsy, at which 55 major abnormalities were identified. Significantly more PMCT than PMMR examinations were non-diagnostic (18/82 vs. 4/82; 21.9 % vs. 4.9 %, diff 17.1 % (95 % CI 6.7, 27.6; p < 0.05)). PMMR gave an accurate diagnosis in 24/55 (43.64 %; 95 % CI 31.37, 56.73 %) compared to 18/55 PMCT (32.73 %; 95 % CI 21.81, 45.90). PMCT was particularly poor in fetuses <24 weeks, with 28.6 % (8.1, 46.4 %) more non-diagnostic scans. Where both PMCT and PMMR were diagnostic, PMMR gave slightly higher diagnostic accuracy than PMCT (62.8 % vs. 59.4 %). Unenhanced PMCT has limited value in detection of major pathology primarily because of poor-quality, non-diagnostic fetal images. On this basis, PMMR should be the modality of choice for non-invasive PM imaging in fetuses and children. (orig.)

Prospective Evaluation of the Energy and CO₂ Emissions Impact of China’s 2010 – 2013 Efficiency Standards for Products

Energy Technology Data Exchange (ETDEWEB)

Khanna, Nina [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Technologies Area. China Energy Group; Zhou, Nan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Technologies Area. China Energy Group; Fridley, David [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Technologies Area. China Energy Group; McNeil, Michael [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). International Energy Studies Group

2016-07-01

Since China introduced its first mandatory minimum energy performance standards (MEPS) for eight major household products in 1989, its MEPS program has expanded significantly to cover nearly 60 residential, industrial and commercial products. In June of 2012, the pace of standards development for new and revised standards was further accelerated with the launch of the national “100 Energy Efficiency Standards.” Initiatives. An unprecedented 21 MEPS were adopted by China from 2012 to 2013, compared to only 7 MEPS adopted from 2010 to 2011. The Chinese MEPS program now covers 15 products in the residential sector, 15 types of commercial and office equipment, 14 types of industrial equipment and 13 lighting products, making it one of the most comprehensive MEPS program in the world. This study provides an updated prospective evaluation of the potential energy and CO₂ impact of 23 of the 28 MEPS adopted by China from 2010 to 2013. This study updates a previous analysis (Zhou et al. 2011) by quantifying the additional potential energy and CO₂ reductions from the newest standards that have been adopted since 2010. The most recent actual and projected sales, usage, and efficiency data were collected for 14 product categories covered under 23 MEPS adopted between 2010 and 2013. Three scenarios are then used to quantify the energy and CO₂ reduction potential of the one-time implementation of these 23 MEPS, including a baseline counterfactual scenario, the actual MEPS scenario and a best available technologies efficiency scenario. The setting of the baseline efficiency is crucial to determining the savings potential of the new and revised MEPS and international best available technology efficiency levels, as it reflects the market average in the absence of MEPS. For this study, the average baseline is based on either the reported 2010 market-average efficiency if sales-weighted efficiency data is available for new product MEPS and

Diagnostic Yield of Microscopic Colitis in Open Access Endoscopy Center.

Science.gov (United States)

Ellingson, Derek; Miick, Ronald; Chang, Faye; Hillard, Robert; Choudhary, Abhishek; Ashraf, Imran; Bechtold, Matthew; Diaz-Arias, Alberto

2011-08-01

The diagnostic yield in open access endoscopy has been evaluated which generally support the effectiveness and efficiency of open access endoscopy. With a few exceptions, diagnostic yield studies have not been performed in open access endoscopy for more specific conditions. Therefore, we conducted a study to determine the efficiency of open access endoscopy in the detection of microscopic colitis as compared to traditional referral via a gastroenterologist. A retrospective search of the pathology database at the University of Missouri for specimens from a local open access endoscopy center was conducted via SNOMED code using the terms: "microscopic", "lymphocytic", "collagenous", "spirochetosis", "focal active colitis", "melanosis coli" and "histopathologic" in the diagnosis line for the time period between January 1, 2004 and May 25, 2006. Specimens and colonoscopy reports were reviewed by a single pathologist. Of 266 consecutive patients with chronic diarrhea and normal colonoscopies, the number of patients with microscopic disease are as follows: Lymphocytic colitis (n = 12, 4.5%), collagenous colitis (n = 17, 6.4%), focal active colitis (n = 15, 5.6%), and spirochetosis (n = 2, 0.4%). The diagnostic yield of microscopic colitis in this study of an open access endoscopy center does not differ significantly from that seen in major medical centers. In terms of diagnostic yield, open access endoscopy appears to be as effective in diagnosing microscopic colitis.

Automation of diagnostic genetic testing: mutation detection by cyclic minisequencing.

Science.gov (United States)

Alagrund, Katariina; Orpana, Arto K

2014-01-01

The rising role of nucleic acid testing in clinical decision making is creating a need for efficient and automated diagnostic nucleic acid test platforms. Clinical use of nucleic acid testing sets demands for shorter turnaround times (TATs), lower production costs and robust, reliable methods that can easily adopt new test panels and is able to run rare tests in random access principle. Here we present a novel home-brew laboratory automation platform for diagnostic mutation testing. This platform is based on the cyclic minisequecing (cMS) and two color near-infrared (NIR) detection. Pipetting is automated using Tecan Freedom EVO pipetting robots and all assays are performed in 384-well micro plate format. The automation platform includes a data processing system, controlling all procedures, and automated patient result reporting to the hospital information system. We have found automated cMS a reliable, inexpensive and robust method for nucleic acid testing for a wide variety of diagnostic tests. The platform is currently in clinical use for over 80 mutations or polymorphisms. Additionally to tests performed from blood samples, the system performs also epigenetic test for the methylation of the MGMT gene promoter, and companion diagnostic tests for analysis of KRAS and BRAF gene mutations from formalin fixed and paraffin embedded tumor samples. Automation of genetic test reporting is found reliable and efficient decreasing the work load of academic personnel.

76 FR 65518 - Prospective Grant of Exclusive License: The Development of a Companion Diagnostic Kit for...

Science.gov (United States)

2011-10-21

... contemplated exclusive license should be directed to: Patrick P. McCue, Ph.D., Licensing and Patenting Manager... has been demonstrated for biliary tract, kidney, lung, and stomach cancers. The prospective exclusive...

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

Science.gov (United States)

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

2017-01-01

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

Sensitivity and Specificity of a Prototype Rapid Diagnostic Test for the Detection of Trypanosoma brucei gambiense Infection: A Multi-centric Prospective Study.

Science.gov (United States)

Bisser, Sylvie; Lumbala, Crispin; Nguertoum, Etienne; Kande, Victor; Flevaud, Laurence; Vatunga, Gedeao; Boelaert, Marleen; Büscher, Philippe; Josenando, Theophile; Bessell, Paul R; Biéler, Sylvain; Ndung'u, Joseph M

2016-04-01

A major challenge in the control of human African trypanosomiasis (HAT) is lack of reliable diagnostic tests that are rapid and easy to use in remote areas where the disease occurs. In Trypanosoma brucei gambiense HAT, the Card Agglutination Test for Trypanosomiasis (CATT) has been the reference screening test since 1978, usually on whole blood, but also in a 1/8 dilution (CATT 1/8) to enhance specificity. However, the CATT is not available in a single format, requires a cold chain for storage, and uses equipment that requires electricity. A solution to these challenges has been provided by rapid diagnostic tests (RDT), which have recently become available. A prototype immunochromatographic test, the SD BIOLINE HAT, based on two native trypanosomal antigens (VSG LiTat 1.3 and VSG LiTat 1.5) has been developed. We carried out a non-inferiority study comparing this prototype to the CATT 1/8 in field settings. The prototype SD BIOLINE HAT, the CATT Whole Blood and CATT 1/8 were systematically applied on fresh blood samples obtained from 14,818 subjects, who were prospectively enrolled through active and passive screening in clinical studies in three endemic countries of central Africa: Angola, the Democratic Republic of the Congo and the Central African Republic. One hundred and forty nine HAT cases were confirmed by parasitology. The sensitivity and specificity of the prototype SD BIOLINE HAT was 89.26% (95% confidence interval (CI) = 83.27-93.28) and 94.58% (95% CI = 94.20-94.94) respectively. The sensitivity and specificity of the CATT on whole blood were 93.96% (95% CI = 88.92-96.79) and 95.91% (95% CI = 95.58-96.22), and of the CATT 1/8 were 89.26% (95% CI = 83.27-93.28) and 98.88% (95% CI = 98.70-99.04) respectively. After further optimization, the prototype SD BIOLINE HAT could become an alternative to current screening methods in primary healthcare settings in remote, resource-limited regions where HAT typically occurs.

Advantages of digital imaging for radiological diagnostic

International Nuclear Information System (INIS)

Trapero, M. A.; Gonzalez, S.; Albillos, J. C.; Martel, J.; Rebollo, M.

2006-01-01

The advantages and limitations of radiological digital images in comparison with analogic ones are analyzed. We discuss three main topics: acquisition, post-procedure manipulation, and visualization, archive and communication. Digital acquisition with computed radiology systems present a global sensitivity very close to conventional film for diagnostic purposes. However, flat panel digital systems seems to achieve some advantages in particular clinical situations. A critical issue is the radiation dose-reduction that can be accomplished without reducing image quality nor diagnostic exactitude. The post-procedure manipulation allows, particularly in multiplanar modalities like CT or MR, to extract all implicit diagnostic information in the images: Main procedures are multiplanar and three-dimensional reformations, dynamic acquisitions, functional studies and image fusion. The use of PACS for visualization, archive and communication of images, improves the effectiveness and the efficiency of the workflow, allows a more comfortable diagnosis for the radiologist and gives way to improvements in the communication of images, allowing tele consulting and the tele radiology. (Author) 6 refs

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

Science.gov (United States)

Saglam, Murat

2015-01-01

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

Indications, applications and future prospects of diagnostic examinations in clinical cardiology

International Nuclear Information System (INIS)

Sugishita, Yasuro; Koseki, Susumu; Matsuda, Mitsuo

1982-01-01

Nowadays there are various kinds of diagnostic examinations in the field of clinical cardiology. In this field, information concerning structure, dimension (hypertrophy and dilatation) and cardiac function is essentially imporant. For the diagnosis of valvular and congenital heart diseases and of cardiomyopathy, ultrasonic examinations are more useful; for ischemic heart disease, nuclear medicine is superior. Angiocardiography provides us much information but it is invasive. A combination of an exercise-test with the examinations mentioned above is useful for the detection of left ventricular and coronary reserves. The determinants of left ventricular reserve, being related to the prognosis of the patients, can be analyzed by exercise echocardiography. Exercise echocardiography can reveal instantaneous changes in myocardial ischemia during exercise. Regional and global left ventricular performances revealed by exercise radionuclide angiocardiography can lead us to a new interpretation of an exercise ECG. (author)

USING THE INFORMATION OF ON-BOARD DIAGNOSTIC SYSTEMS IN DETERMINING THE TECHNICAL STATE OF THE LOCOMOTIVE

Directory of Open Access Journals (Sweden)

B. Ye. Bodnar

2008-12-01

Full Text Available The issues of increase of efficiency of information processing by оn-board systems of diagnostics of locomotives are considered. The examples of information processing by the on-board system of diagnostics of electric locomotives DE1 are presented. The suggestions on improvement of systematization and processing of information by on-board systems of diagnostics are given.

MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer - A multicenter prospective comparative study

DEFF Research Database (Denmark)

Antonsen, Sofie Leisby; Jensen, Lisa Neerup; Loft, Annika

2012-01-01

OBJECTIVES: The aim of this prospective multicenter study was to evaluate and compare the diagnostic performance of PET/CT, MRI and transvaginal two-dimensional ultrasound (2DUS) in the preoperative assessment of endometrial cancer (EC). METHODS: 318 consecutive women with EC were included when...

Diagnostics

DEFF Research Database (Denmark)

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

2007-01-01

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

Diagnostic Impact and Cost-effectiveness of Whole-Exome Sequencing for Ambulant Children With Suspected Monogenic Conditions.

Science.gov (United States)

Tan, Tiong Yang; Dillon, Oliver James; Stark, Zornitza; Schofield, Deborah; Alam, Khurshid; Shrestha, Rupendra; Chong, Belinda; Phelan, Dean; Brett, Gemma R; Creed, Emma; Jarmolowicz, Anna; Yap, Patrick; Walsh, Maie; Downie, Lilian; Amor, David J; Savarirayan, Ravi; McGillivray, George; Yeung, Alison; Peters, Heidi; Robertson, Susan J; Robinson, Aaron J; Macciocca, Ivan; Sadedin, Simon; Bell, Katrina; Oshlack, Alicia; Georgeson, Peter; Thorne, Natalie; Gaff, Clara; White, Susan M

2017-09-01

Optimal use of whole-exome sequencing (WES) in the pediatric setting requires an understanding of who should be considered for testing and when it should be performed to maximize clinical utility and cost-effectiveness. To investigate the impact of WES in sequencing-naive children suspected of having a monogenic disorder and evaluate its cost-effectiveness if WES had been available at different time points in their diagnostic trajectory. This prospective study was part of the Melbourne Genomics Health Alliance demonstration project. At the ambulatory outpatient clinics of the Victorian Clinical Genetics Services at the Royal Children's Hospital, Melbourne, Australia, children older than 2 years suspected of having a monogenic disorder were prospectively recruited from May 1 through November 30, 2015, by clinical geneticists after referral from general and subspecialist pediatricians. All children had nondiagnostic microarrays and no prior single-gene or panel sequencing. All children underwent singleton WES with targeted phenotype-driven analysis. The study examined the clinical utility of a molecular diagnosis and the cost-effectiveness of alternative diagnostic trajectories, depending on timing of WES. Of 61 children originally assessed, 44 (21 [48%] male and 23 [52%] female) aged 2 to 18 years (mean age at initial presentation, 28 months; range, 0-121 months) were recruited, and a diagnosis was achieved in 23 (52%) by singleton WES. The diagnoses were unexpected in 8 of 23 (35%), and clinical management was altered in 6 of 23 (26%). The mean duration of the diagnostic odyssey was 6 years, with each child having a mean of 19 tests and 4 clinical genetics and 4 nongenetics specialist consultations, and 26 (59%) underwent a procedure while under general anesthetic for diagnostic purposes. Economic analyses of the diagnostic trajectory identified that WES performed at initial tertiary presentation resulted in an incremental cost savings of A$9020 (US$6838) per

One-stop endoscopic hernia surgery: efficient and satisfactory.

Science.gov (United States)

Voorbrood, C E H; Burgmans, J P J; Clevers, G J; Davids, P H P; Verleisdonk, E J M M; Schouten, N; van Dalen, T

2015-06-01

One-stop surgery offers patients diagnostic work-up and subsequent surgical treatment on the same day. In the present study, patient satisfaction and efficiency from an institutional perspective were evaluated in patients who were referred for one-stop endoscopic inguinal hernia repair. In a high-volume inguinal hernia clinic, all consecutive patients referred for one-stop surgical treatment, were registered prospectively. An instructed secretary screened patients for eligibility for the one-stop option when the appointment was made. Totally extraperitoneal hernia repair under general anaesthesia was the preferred operative technique. Patient's satisfaction, successful day surgery and institutional efficiency were evaluated. Between January 2010 and January 2012 a total of 349 patients (17 % of all patients in the hernia clinic) were referred for one-stop hernia repair. Mean age was 47.5 years and 96.3 % were males. Three hundred thirty-six patients underwent hernia surgery on the same day (96.3 %). In thirteen patients (3.7 %) no operative repair was done on the day of presentation due to an incorrect diagnosis (n = 7), a watchful waiting policy for asymptomatic hernia (n = 3), rescheduling due to a large scrotal hernia, and there were two "no shows". Following hernia repair 97 % of the patients were discharged on the same day, while ten patients required hospitalization. Based on the questionnaires the main satisfaction score among patients was 9.0 (8.89-9.17 95 % CI) on a scale ranging from 0 to 10. One-stop hernia surgery is feasible and satisfactory from an institutional as well as from a patient's perspective.

Cerebral angiography with prospective ECG triggering preliminary study of dual-source CT

International Nuclear Information System (INIS)

Xue Yuejun; Qian Nong; Shao Yanhui; Pan Changjie; Rong Weiliang; Xu Yiqun

2012-01-01

Objective: To study the image quality and radiation dose in dual-source CT cerebral angiography with prospective ECG-triggered sequence mode (step-and-shoot, SAS). Methods: A total of forty-three patients with clinically suspected cerebral vascular disease underwent cerebral CT angiography with prospective ECG-triggering (step-and-shoot, SAS). Data acquisition was at 60% R-R interval of the ECG presentation mode. The post-processing included maximum intensity projection (MIP), multiplanar reformation (MPR) and volume rendering (VR). The CTA image quality, radiation dose and rates of excellent images were evaluated. Results: The CTA image quality score was 4.72 ± 0.50 and 97.7% (42/43) patients had excellent CTA images. The average effective dose of SAS-CTA was (0.22 ± 0.01)mSv, which was lower by 76.31% than that of DE-CTA. Conclusions: Prospective ECG-triggering sequence could be used in cerebral angiography with a significant reduction in radiation dose and diagnostic image quality. (authors)

The characteristic calibration of the plastic scintillation detector for neutron diagnostic

CERN Document Server

Chen Hong Su

2002-01-01

The author presents the characteristic of the plastic scintillation detector used for pulse neutron diagnostic. The detection efficiency and sensitivity of the detector to DT neutron have been calibrated by the K-400 accelerator and by the pulse neutron tube, separately. The detection efficiency from the experiment is in agreement with that from calculation in the range of experimental errors

Eco-development and energy efficient technologies in Russia: prospects and reality

Science.gov (United States)

Kurakova, Oksana

2017-10-01

The article highlights the concept of eco-standards in Russia, and discusses new technologies that allow to build energy-efficient houses in the form of countryside real estate. Special attention is given to the principle of heat production based on the use of individual facilities, power centers mini thermal power plants, as well as to ways to reduce water consumption at home. Presents analysis of the advantages projects “built-to-suit” for the introduction of the energy efficient technologies. Justified idea and principles of “green construction” in Russia in the real estate market. Conclusion about the effectiveness of the use, opportunities and development of energy efficient technologies.

Applications of 'edge-on' illuminated porous plate detectors for diagnostic X-ray imaging

CERN Document Server

Shikhaliev, P M

2002-01-01

Scanning X-ray imaging systems for non-invasive diagnostics have several advantages over conventional imaging systems using area detectors. They significantly reduce the detected scatter radiation, cover large areas and potentially provide high spatial resolution. Applications of one-dimensional gaseous detectors and 'edge-on' illuminated silicon strip detectors for scanning imaging systems are currently under intensive investigation. The purpose of this work is to investigate 'edge-on' illuminated Porous Plate (PP) detectors for applications in diagnostic X-ray imaging. MicroChannel Plate (MCP), which is a common type of PP, has previously been investigated as a detector in surface-on illumination mode for medical X-ray imaging. However, its detection efficiency was too low for medical imaging applications. In the present study, the PP are used in the 'edge-on' illumination mode. Furthermore, the structural parameters of different PP types are optimized to improve the detection efficiency in the diagnostic X...

Oecophylla smaragdina food conversion efficiency: prospects for ant farming

DEFF Research Database (Denmark)

Offenberg, Hans Joachim

2011-01-01

can be combined with the use of the ants in biological control programmes in tropical plantations where pest insects are converted into ant biomass. To assess the cost-benefits of ant farming based on artificial feeding, food consumption and food conversion efficiency (ECI) of Oecophylla smaragdina......Oecophylla ants are sold at high prices on several commercial markets as a human delicacy, as pet food or as traditional medicine. Currently markets are supplied by ants collected from the wild; however, an increasing interest in ant farming exists as all harvest is easily sold and as ant farming...... selling prices these efficiencies led to rates of return from 1.52 to 4.56, respectively, if: (i) protein is supplied from commercial products; or (ii) alternatively supplied from free sources such as insects and kitchen waste. These results suggest that Oecophylla ant farming may become highly profitable...

Application of diagnostic system for diesel engines in nuclear power plant

International Nuclear Information System (INIS)

Yoshinaga, Takeshi

2004-01-01

The diagnostic system for diesel engines makes a diagnosis of secular change and abnormal indications of diesel engines (DG) by combination of characteristic analysis of engine, lubricating oil, fuel oil, and cooling water. The principles of diagnostic system for DG, results of confirmation of the efficiency and the maintenance plan for DG in the Japan Atomic Power Company are described. DG in the company is classified to a safety device in order to supply the power source to the Emergency Core Cooling System etc., when the power source in the plant is lost, for example, at lightning struck. Characteristics of DG, outline of the diagnostic system for DG, diagnostic technologies such as engine signature analysis, chemical analysis of samples, temperature measurement, degradation mode of DG, and training in the company are stated. (S.Y.)

A prospective study of shoulder pain in primary care: Prevalence of imaged pathology and response to guided diagnostic blocks

Directory of Open Access Journals (Sweden)

McNair Peter J

2011-05-01

Full Text Available Abstract Background The prevalence of imaged pathology in primary care has received little attention and the relevance of identified pathology to symptoms remains unclear. This paper reports the prevalence of imaged pathology and the association between pathology and response to diagnostic blocks into the subacromial bursa (SAB, acromioclavicular joint (ACJ and glenohumeral joint (GHJ. Methods Consecutive patients with shoulder pain recruited from primary care underwent standardised x-ray, diagnostic ultrasound scan and diagnostic injections of local anaesthetic into the SAB and ACJ. Subjects who reported less than 80% reduction in pain following either of these injections were referred for a magnetic resonance arthrogram (MRA and GHJ diagnostic block. Differences in proportions of positive and negative imaging findings in the anaesthetic response groups were assessed using Fishers test and odds ratios were calculated a for positive anaesthetic response (PAR to diagnostic blocks. Results In the 208 subjects recruited, the rotator cuff and SAB displayed the highest prevalence of pathology on both ultrasound (50% and 31% respectively and MRA (65% and 76% respectively. The prevalence of PAR following SAB injection was 34% and ACJ injection 14%. Of the 59% reporting a negative anaesthetic response (NAR for both of these injections, 16% demonstrated a PAR to GHJ injection. A full thickness tear of supraspinatus on ultrasound was associated with PAR to SAB injection (OR 5.02; p p p p ≤ 0.05. Conclusions Rotator cuff and SAB pathology were the most common findings on ultrasound and MRA. Evidence of a full thickness supraspinatus tear was associated with symptoms arising from the subacromial region, and a biceps tendon sheath effusion and an intact rotator cuff were associated with an intra-articular GHJ pain source. When combined with clinical information, these results may help guide diagnostic decision making in primary care.

Teacher's Psycho-Diagnostic Activities in School Educational System

Science.gov (United States)

Minakhmetova, Albina Z.; Pyanova, Ekaterina N.; Akhmetshina, Enze M.

2016-01-01

The urgency of the problem stated in the article stems from the fact that in modern conditions the study of the psycho-diagnostic component of the teacher's activities is relevant in practical terms, since the functions of these activities affect the efficiency of pedagogical activity and the educational process itself, including the effectiveness…

The role of cue detection for prospective memory development across the lifespan.

Science.gov (United States)

Hering, Alexandra; Wild-Wall, Nele; Gajewski, Patrick D; Falkenstein, Michael; Kliegel, Matthias; Zinke, Katharina

2016-12-01

Behavioral findings suggest an inverted U-shaped pattern of prospective memory development across the lifespan. A key mechanism underlying this development is the ability to detect cues. We examined the influence of cue detection on prospective memory, combining behavioral and electrophysiological measures, in three age groups: adolescents (12-14 years), young (19-28 years), and old adults (66-77 years). Cue detection was manipulated by varying the distinctiveness (i.e., how easy it was to detect the cue based on color) of the prospective memory cue in a semantic judgment ongoing task. Behavioral results supported the pattern of an inverted U-shape with a pronounced prospective memory decrease in old adults. Adolescents and young adults showed a prospective memory specific modulation (larger amplitudes for the cues compared to other trials) already for the N1 component. No such specific modulation was evident in old adults for the early N1 component but only at the later P3b component. Adolescents showed differential modulations of the amplitude also for irrelevant information at the P3b, suggesting less efficient processing. In terms of conceptual implications, present findings underline the importance of cue detection for prospective remembering and reveal different developmental trajectories for cue detection. Our findings suggest that cue detection is not a unitary process but consists of multiple stages corresponding to several ERP components that differentially contribute to prospective memory performance across the lifespan. In adolescents resource allocation for detecting cues seemed successful initially but less efficient at later stages; whereas we found the opposite pattern for old adults. Copyright © 2016 Elsevier Ltd. All rights reserved.

Diagnostic value of alpha-fetoprotein in liver cancer

International Nuclear Information System (INIS)

Pervez, T.; Anwar, S.M.

2001-01-01

Objective: To determine diagnostic value of alpha-fetoproteins (alpha-FP) in liver cancer. Design: Prospective study. Place and duration of study: Department of clinical oncology services Hospital Lahore, during the period from February 1998 to February 2001. Subjects and Methods: Among 200 persons studied, 100 presented with liver mass, jaundice and other symptoms directing toward liver pathology, later confirmed histopathologically, as suffering from hepatocellular carcinoma (HCC) while the other 100 healthy subject came to the department for blood donation and were HBs Ag pasitive on blood screening. All these subjects under went blood test for alpha-FP. This tumor marker was analyzed by using enzyme immunoassay-based kit. Results: The alpha-FP positivity was statistically evaluated. In HCC this test was statistically significant with p value of <0.001. In this study sensitivity of alpha-FP was 72% specificity 89%, positive predictive value 86.7% and negative predictive value of 76.1%. Conclusion: This study showed that alpha-FP was a useful diagnostic tool in the diagnosis of HCC. (author)

Advantages of the nested case-control design in diagnostic research

Directory of Open Access Journals (Sweden)

Hoes Arno W

2008-07-01

Full Text Available Abstract Background Despite its benefits, it is uncommon to apply the nested case-control design in diagnostic research. We aim to show advantages of this design for diagnostic accuracy studies. Methods We used data from a full cross-sectional diagnostic study comprising a cohort of 1295 consecutive patients who were selected on their suspicion of having deep vein thrombosis (DVT. We draw nested case-control samples from the full study population with case:control ratios of 1:1, 1:2, 1:3 and 1:4 (per ratio 100 samples were taken. We calculated diagnostic accuracy estimates for two tests that are used to detect DVT in clinical practice. Results Estimates of diagnostic accuracy in the nested case-control samples were very similar to those in the full study population. For example, for each case:control ratio, the positive predictive value of the D-dimer test was 0.30 in the full study population and 0.30 in the nested case-control samples (median of the 100 samples. As expected, variability of the estimates decreased with increasing sample size. Conclusion Our findings support the view that the nested case-control study is a valid and efficient design for diagnostic studies and should also be (reappraised in current guidelines on diagnostic accuracy research.

Diagnostics Challenges for FACET-II

Energy Technology Data Exchange (ETDEWEB)

Clarke, Christine

2015-10-07

FACET-II is a prospective user facility at SLAC National Accelerator Laboratory. The facility will focus on high-energy, high-brightness beams and their interaction with plasma and lasers. The accelerator is designed for high-energy-density electron beams with peak currents of approximately 50 kA (potentially 100 kA) that are focused down to below 10x10 micron transverse spot size at an energy of 10 GeV. Subsequent phases of the facility will provide positron beams above 10 kA peak current to the experiment station. Experiments will require well characterised beams; however, the high peak current of the electron beam can lead to material failure in wirescanners, optical transition radiation screens and other instruments critical for measurement or delivery. The radiation environment and space constraints also put additional pressure on diagnostic design.

Computer System For Diagnostics of Mobile Machinery Transmission

Directory of Open Access Journals (Sweden)

G. L. Antipenko

2004-01-01

Full Text Available A new method for diagnostics of mechanical transmissions of mobile machinery is proposed in the paper. The method presupposes an application of computing equipment and its purpose is to decrease labor-consumption of diagnostics procedure and increase diagnostics efficiency.The method is based on comparison of duration of impulse periods picked up at primary transducers which are installed at transmission input and output. A signal picked up at a flywheel ring gear is taken as a reference signal.While selecting clearances of one and then the direction in speed-up - braking transmission regime changes in number of reference impulses at output provide data on angular clearance value in every gearing. As data are supplied registration and processing of results and forecasting of residual resource are to be done with the help of a program on the basis of realized algorithms for every gearing.

Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursing home patients

NARCIS (Netherlands)

Jongenelis, K; Eisses, AMH; Gerritsen, DL; Beekman, ATF; Kluiter, H; Ribbe, MW

2005-01-01

Objective To determine the diagnostic accuracy of the 30-item and shortened versions of the Geriatric Depression Scale (GDS) in diagnosing depression in older nursing home patients. Method Three hundred and thirty-three older nursing home patients participated in a prospective cross-sectional study

Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursing home patients

NARCIS (Netherlands)

Jongenelis, K; Eisses, AMH; Gerritsen, DL; Beekman, ATF; Kluiter, H; Ribbe, MW

Objective To determine the diagnostic accuracy of the 30-item and shortened versions of the Geriatric Depression Scale (GDS) in diagnosing depression in older nursing home patients. Method Three hundred and thirty-three older nursing home patients participated in a prospective cross-sectional study

Advanced DNA-Based Point-of-Care Diagnostic Methods for Plant Diseases Detection

OpenAIRE

Lau, Han Yih; Botella, Jose R.

2017-01-01

Diagnostic technologies for the detection of plant pathogens with point-of-care capability and high multiplexing ability are an essential tool in the fight to reduce the large agricultural production losses caused by plant diseases. The main desirable characteristics for such diagnostic assays are high specificity, sensitivity, reproducibility, quickness, cost efficiency and high-throughput multiplex detection capability. This article describes and discusses various DNA-based point-of care di...

Climate Model Diagnostic Analyzer

Science.gov (United States)

Lee, Seungwon; Pan, Lei; Zhai, Chengxing; Tang, Benyang; Kubar, Terry; Zhang, Zia; Wang, Wei

2015-01-01

The comprehensive and innovative evaluation of climate models with newly available global observations is critically needed for the improvement of climate model current-state representation and future-state predictability. A climate model diagnostic evaluation process requires physics-based multi-variable analyses that typically involve large-volume and heterogeneous datasets, making them both computation- and data-intensive. With an exploratory nature of climate data analyses and an explosive growth of datasets and service tools, scientists are struggling to keep track of their datasets, tools, and execution/study history, let alone sharing them with others. In response, we have developed a cloud-enabled, provenance-supported, web-service system called Climate Model Diagnostic Analyzer (CMDA). CMDA enables the physics-based, multivariable model performance evaluations and diagnoses through the comprehensive and synergistic use of multiple observational data, reanalysis data, and model outputs. At the same time, CMDA provides a crowd-sourcing space where scientists can organize their work efficiently and share their work with others. CMDA is empowered by many current state-of-the-art software packages in web service, provenance, and semantic search.

Encyclopedia of diagnostic imaging

International Nuclear Information System (INIS)

Baert, A.L.

2008-01-01

The simple A to Z format provides easy access to relevant information in the field of imaging. Extensive cross references between keywords and related articles enable efficient searches in a user-friendly manner. Fully searchable and hyperlinked electronic online edition. The aim of this comprehensive encyclopedia is to provide detailed information on diagnostic radiology contributing to the broad field of imaging. The wide range of entries are written by leading experts. They will provide basic and clinical scientists in academia, practice and industry with valuable information about the field of diagnostic imaging. Those in related fields, students, teachers, and interested laypeople will also benefit from the important and relevant information on the most recent developments. Please note that this publication is available as print only or online only or print + online set. Save 75% of the online list price when purchasing the bundle. For more information on the online version please type the publication title into the search box above, then click on the eReference version in the results list. (orig.)

The value of low-dose prospective ECG-gated dual-source CT angiography in the diagnosis of coarctation of the aorta in infants and children

Energy Technology Data Exchange (ETDEWEB)

Nie, P. [Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong (China); Wang, X., E-mail: wxming369@yahoo.com.cn [Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong (China); Cheng, Z.; Duan, Y.; Ji, X. [Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong (China); Chen, J. [CT Research Collaboration, Siemens, Beijing (China); Zhang, H. [Department of Cardiovascular Surgery, Shandong Provincial Hospital, Jinan, Shandong (China)

2012-08-15

Aim: To investigate the value of prospective electrocardiogram (ECG)-gated dual-source computed tomography (DSCT) in the diagnosis of coarctation of the aorta (CoA). Materials and methods: Seventeen patients clinically suspected of having CoA underwent prospective ECG-gated DSCT angiography and transthoracic echocardiography (TTE). Surgery was performed in all patients. The diagnostic accuracy of DSCT angiography and TTE was compared with the surgical findings as the reference standard. Image quality was evaluated using a five-point scale. Effective radiation dose was calculated from the dose-length product (DLP). Results: CoA was diagnosed in 17 patients by DSCT angiography and in 16 patients by TTE. A total of 46 separate cardiovascular abnormalities were confirmed by surgical findings. The diagnostic accuracy of DSCT angiography and TTE was 96.32% and 97.06%, respectively. There was no significant difference in the diagnostic accuracy between DSCT angiography and TTE ({chi}{sup 2} = 0, p > 0.05). The mean score of image quality was 4.2 {+-} 0.8. The mean effective dose was 0.69 {+-} 0.09 mSv. Conclusion: Prospective ECG-gated DSCT with a low radiation dose is a valuable technique in the diagnosis of CoA in infants and children.

Future prospects in dermatologic applications of lasers, nanotechnology, and other new technologies.

Science.gov (United States)

Boixeda, P; Feltes, F; Santiago, J L; Paoli, J

2015-04-01

We review novel technologies with diagnostic and therapeutic applications in dermatology. Among the diagnostic techniques that promise to become part of dermatologic practice in the future are optical coherence tomography, multiphoton laser scanning microscopy, Raman spectroscopy, thermography, and 7-T magnetic resonance imaging. Advances in therapy include novel light-based treatments, such as those applying lasers to new targets and in new wavelengths. Devices for home therapy are also appearing. We comment on the therapeutic uses of plasma, ultrasound, radiofrequency energy, total reflection amplification of spontaneous emission of radiation, light stimulation, and transepidermal drug delivery. Finally, we mention some basic developments in nanotechnology with prospects for future application in dermatology. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

Role of simulator training in developing teamwork and diagnostic skills

International Nuclear Information System (INIS)

Grimme, W.E.

1987-01-01

A review of the evolution of the control room team is necessary to understand team training needs. As control room responsibilities have increased and members have been added to the operating crews, teamwork and strong leadership has become crucial to the efficiency of these operating crews. In order to conduct effective team training in a simulated control room, it is essential that the fundamental principles of role definition and common team values are fully developed. The diagnostics model used to develop problem-solving skills must be adaptable to the dynamic environment of the control room. Once the fundamental principles of team building and a good diagnostics model are mastered, many training techniques using a simulator are available to perfect the development of team building and diagnostic skills

X-ray diodes for laser fusion plasma diagnostics

International Nuclear Information System (INIS)

Day, R.H.; Lee, P.; Saloman, E.B.; Nagel, D.J.

1981-02-01

Photodiodes with x-ray sensitive photocathodes are commonly used as broadband x-ray detectors in fusion plasma diagnostics. We have measured the risetime of the detector system and have measured the quantum efficiency between 1 to 500 A of numerous photocathode materials of practical interest. The materials studied include aluminum, copper, nickel, gold, three forms of carbon, chromium, and cesium iodide. The results of the measurements are compared with Henke's semiempirical model of photoyield. We have studied the effects of long-term cathode aging and use as a plasma diagnostic on cathode quantum efficiency. In addition, we have measured the x-ray mass-absorption coefficient of several ultrasoft x-ray windows in energy regions where data were unavailable. Windows studied were made of aluminum, Formvar, polypropylene, and Kimfoil. Measurements between 1 to 50 A were performed with the Los Alamos Scientific Laboratory's low-energy x-ray calibration facility, and the measurements between 50 to 550 A were performed at the National Bureau of Standard's synchrotron ultraviolet radiation facility

Efficient radiological assessment of the internal snapping hip syndrome

International Nuclear Information System (INIS)

Wunderbaldinger, P.; Bremer, C.; Matuszewski, L.; Marten, K.; Turetschek, K.; Rand, T.

2001-01-01

The aim of this study was to evaluate the diagnostic value/significance of various imaging techniques for demonstrating the underlying causative pathology of clinically suspected internal snapping hip syndrome. We intended to define the most efficient diagnostic imaging algorithm that leads to a specific definite therapy for this rare hip disorder. The imaging studies of 54 patients (43 women, 11 men, average age 58 years) with the clinical suspicion of internal snapping hip syndrome were compared for their diagnostic value/significance for finding the underlying pathology. Radiological workup included plain radiographs of the pelvis and hip joints (n=54), ultrasound (US) of the hip joints (n=29), computed tomography (CT) of the pelvis and proximal femur (n=17), and magnetic resonance imaging (MRI) of the pelvis/hip joint (n=21). In order to establish an efficient diagnostic algorithm we compared the diagnostic value of each imaging technique alone and in combination with the other methods. The underlying causative pathology could be established in 37% of patients (n=20) by the use of conventional radiographs alone and in 46% of the patients (n=25) by US alone, and in combination in 83% of the patients (n=45). By adding CT to the radiological workup, we established final diagnosis in 88% (in combination with X-ray; n=15/17) and 94% (together with X-ray and US; n=16/17) of the patients. Whenever MR imaging was used a causative pathology was found in all patients (100%; n=21). The most efficient radiological algorithm in the assessment of patients with internal snapping hip syndrome is the combination of plain radiography and US. MR imaging can be retained for unresolved and difficult cases. (orig.)

Diagnostic Efficiency of MR Imaging of the Knee. Relationship to time Interval between MR and Arthroscopy

International Nuclear Information System (INIS)

Barrera, M. C.; Recondo, J. A.; Aperribay, M.; Gervas, C.; Fernandez, E.; Alustiza, J. M.

2003-01-01

To evaluate the efficiency of magnetic resonance (MR) in the diagnosis of knee lesions and how the results are influenced by the time interval between MR and arthroscopy. 248 knees studied by MR were retrospectively analyzed, as well as those which also underwent arthroscopy. Arthroscopy was considered to be the gold standard, MR diagnostic capacity was evaluated for both meniscal and cruciate ligament lesions. Sensitivity, specificity and Kappa index were calculated for the set of all knees included in the study (248), for those in which the time between MR and arthroscopy was less than or equal to three months (134) and for those in which the time between both procedures was less than or equal to one month. Sensitivity, specificity and Kappa index of the MR had global values of 96.5%, 70% and 71%, respectively. When the interval between MR and arthroscopy was less than or equal to three months, sensitivity, specificity and Kappa index were 95.5%, 75% and 72%, respectively. When it was less than or equal to one month, sensitivity was 100%, specificity was 87.5% and Kappa index was 91%. MR is an excellent tool for the diagnosis of knee lesions. Higher MR values of sensitivity, specificity and Kappa index are obtained when the time interval between both procedures is kept to a minimum. (Author) 11 refs

Autism Spectrum Disorder Symptoms in Infants with Fragile X Syndrome: A Prospective Case Series

Science.gov (United States)

Hogan, Abigail L.; Caravella, Kelly E.; Ezell, Jordan; Rague, Lisa; Hills, Kimberly; Roberts, Jane E.

2017-01-01

No studies to date have prospectively examined early autism spectrum disorder (ASD) markers in infants with fragile X syndrome (FXS), who are at elevated risk for ASD. This paper describes the developmental profiles of eight infants with FXS from 9 to 24 months of age. Four meet diagnostic criteria for ASD at 24 months of age, and four do not.…

2012 HIV Diagnostics Conference: the molecular diagnostics perspective.

Science.gov (United States)

Branson, Bernard M; Pandori, Mark

2013-04-01

2012 HIV Diagnostic Conference Atlanta, GA, USA, 12-14 December 2012. This report highlights the presentations and discussions from the 2012 National HIV Diagnostic Conference held in Atlanta (GA, USA), on 12-14 December 2012. Reflecting changes in the evolving field of HIV diagnostics, the conference provided a forum for evaluating developments in molecular diagnostics and their role in HIV diagnosis. In 2010, the HIV Diagnostics Conference concluded with the proposal of a new diagnostic algorithm which included nucleic acid testing to resolve discordant screening and supplemental antibody test results. The 2012 meeting, picking up where the 2010 meeting left off, focused on scientific presentations that assessed this new algorithm and the role played by RNA testing and new developments in molecular diagnostics, including detection of total and integrated HIV-1 DNA, detection and quantification of HIV-2 RNA, and rapid formats for detection of HIV-1 RNA.

How to tackle tremor – systematic review of the literature and diagnostic work-up

Directory of Open Access Journals (Sweden)

Arthur W.G. Buijink

2012-10-01

Full Text Available BackgroundTremor is the most prevalent movement disorder in clinical practice. It is defined as involuntary, rhythmic, oscillatory movements. The diagnostic process of patients with tremor can be laborious and challenging, and a clear, systematic overview of available diagnostic techniques is lacking. Tremor can be a symptom of many diseases, but can also represent a distinct disease entity.ObjectiveThe objective of this review is to give a clear, systematic and step-wise overview of the diagnostic work-up of a patient with tremor. The clinical relevance and value of available laboratory tests in patients with tremor will be explored.MethodsWe systematically searched through EMBASE. The retrieved articles were supplemented by articles containing relevant data or provided important background information. Studies that were included investigated the value and/or usability of diagnostic tests for tremor.ResultsIn most patients, history and clinical examination by an experienced movement disorders neurologist are sufficient to establish a correct diagnosis, and further ancillary examinations will not be needed. Ancillary investigation should always be guided by tremor type(s present and other associated signs and symptoms. The main ancillary examination techniques currently are electromyography and SPECT imaging. Unfortunately, many techniques have not been studied in large prospective, diagnostic studies to be able to determine important variables like sensitivity and specificity.ConclusionWhen encountering a patient with tremor, history and careful clinical examination should guide the diagnostic process. Adherence to the diagnostic work-up provided in this review will help the diagnostic process of these patients.

Coal industry - problems and prospects. [United Kingdom

Energy Technology Data Exchange (ETDEWEB)

Siddall, N

1984-01-01

Presidential Address by Sir Norman Siddall is presented which considers the problems and prospects facing the UK coal industry. The range of changes which business management is subject to are outlined together with the coal industry's response to these changes. Fluctuations in the energy market and the economy have resulted in a customer orientated approach to marketing, and improved efficiency throughout the industry. New technology has increased the efficiency of some aspects of operations but at the some time developments in the areas of industrial relations and public accountability have limited management's ability to respond to changes in the commercial environment.

Cumulative prospect theory and mean variance analysis. A rigorous comparison

OpenAIRE

Hens, Thorsten; Mayer, Janos

2012-01-01

We compare asset allocations derived for cumulative prospect theory(CPT) based on two different methods: Maximizing CPT along the mean–variance efficient frontier and maximizing it without that restriction. We find that with normally distributed returns the difference is negligible. However, using standard asset allocation data of pension funds the difference is considerable. Moreover, with derivatives like call options the restriction to the mean-variance efficient frontier results in a siza...

Modeling Complex Workflow in Molecular Diagnostics

Science.gov (United States)

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

2010-01-01

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

Prospective analysis agriculture energy 2030. Agriculture and the challenges of energy - Synthesis

International Nuclear Information System (INIS)

Vert, Julien; Portet, Fabienne; Even, Marie-Aude; Herault, Bruno; Laisney, Celine; Mahe, Thuriane

2010-01-01

The present overview document contains the main results of the Agriculture Energy 2030 prospective study, based on the work of the group led by the CEP [Centre d'etudes et de prospective/Centre for studies and strategic foresight] at the Ministry of Agriculture, Food, Fisheries, Rural Affairs and Spatial Planning. Energy in agriculture is all too often seen as a purely cyclical problem whereas it is a major issue for the future due to its economic consequences for agricultural holdings, its links with environmental and climatic issues, and its influence on food supply chains and spatial planning. Based on the scenario method, this analysis initially involved describing the whole range of links between agriculture and energy in France and organising them into a system of variables before going on to draw up an inventory of the knowledge available. Starting out from this diagnostic approach, the group constructed four scenarios over the period to 2030: 'Regionalization and sobriety to confront the crisis', 'Twin track agriculture and energy realism', 'Health Agriculture with no major energy constraints' and 'Ecological agriculture and energy savings'. These scenarios do not form an exhaustive panorama of all possible developments of the agriculture-energy system - they are rather formalised images of what the future might hold. However, quantification and comparison of the scenarios has led to the identification of major room for progress in energy efficiency in French farming. By helping gain greater awareness of future difficulties and issues or, conversely, opportunities to be grasped, these scenarios provided input for the strategic analysis phase, the concluding stage of this exercise, and the identification of general objectives and levers for public action. (authors)

Cybernetic Security and Business Intelligence in the System of Diagnostics of Economic Security of the Enterprise

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Ruslan Skrynkovskyy

2017-10-01

Full Text Available The purpose of the article is to determine the place, the role and features of cybernetic security and improve the business intelligence scheme in the system of diagnosing economic security of the enterprise. It had been found out that: 1 the term “cybernetic security of an enterprise” should be understood as the state of the protection of the cybernetic space of the whole enterprise or individual objects of its information infrastructure (computer system, computer data, etc. from the risk of external cybernetic influence, which ensures their sustainable development and the formation of prospects, as well as timely detection, prevention and neutralization of real and potential cybernetic interruptions and threats to the interests of the enterprise; 2 the main components of cybernetic security in the system of diagnostics of economic security of the enterprise are: investigation of information and telecommunication systems and cryptosystems of the opposing sides; cybernetic effects; protection of information sphere. It was established that the main task of business intelligence in the system of diagnosing economic security of the enterprise is the verification of the reliability of business information, the provision of cybernetic protection of information resources, information and communication technologies and systems and the elimination of the possibility of misinformation of senior management by the managers of the middle level, suppliers, marketing intermediaries, clientele, competitors or contact audiences of the enterprise. The prospect of further research in this direction is the development of a system of goals of the polycriterial diagnostics of the activity (economic diagnostics of the enterprise (on the basis of the isolation and systematization of its diagnostic purposes, taking into account the presented results of the study.

Development of a molecular diagnostic test for Retinitis Pigmentosa in the Japanese population.

Science.gov (United States)

Maeda, Akiko; Yoshida, Akiko; Kawai, Kanako; Arai, Yuki; Akiba, Ryutaro; Inaba, Akira; Takagi, Seiji; Fujiki, Ryoji; Hirami, Yasuhiko; Kurimoto, Yasuo; Ohara, Osamu; Takahashi, Masayo

2018-05-21

Retinitis Pigmentosa (RP) is the most common form of inherited retinal dystrophy caused by different genetic variants. More than 60 causative genes have been identified to date. The establishment of cost-effective molecular diagnostic tests with high sensitivity and specificity can be beneficial for patients and clinicians. Here, we developed a clinical diagnostic test for RP in the Japanese population. Evaluation of diagnostic technology, Prospective, Clinical and experimental study. A panel of 39 genes reported to cause RP in Japanese patients was established. Next generation sequence (NGS) technology was applied for the analyses of 94 probands with RP and RP-related diseases. After interpretation of detected genetic variants, molecular diagnosis based on a study of the genetic variants and a clinical phenotype was made by a multidisciplinary team including clinicians, researchers and genetic counselors. NGS analyses found 14,343 variants from 94 probands. Among them, 189 variants in 83 probands (88.3% of all cases) were selected as pathogenic variants and 64 probands (68.1%) have variants which can cause diseases. After the deliberation of these 64 cases, molecular diagnosis was made in 43 probands (45.7%). The final molecular diagnostic rate with the current system combining supplemental Sanger sequencing was 47.9% (45 of 94 cases). The RP panel provides the significant advantage of detecting genetic variants with a high molecular diagnostic rate. This type of race-specific high-throughput genotyping allows us to conduct a cost-effective and clinically useful genetic diagnostic test.

Explaining the energy efficiency gap - expected utility theory versus cumulative prospect theory

OpenAIRE

Häckel, Björn; Pfosser, Stefan; Tränkler, Timm

2017-01-01

Energy efficiency is one of the key factors in mitigating the impact of climate change and preserving non-renewable resources. Although environmental and economic justifications for energy efficiency investments are compelling, there is a gap between the observable and some notion of optimized energy consumption - the so-called energy efficiency gap. Behavioral biases in individual decision making have been resonated by environmental research to explain this gap. To analyze the influence of b...

Whole exome sequencing in neurogenetic odysseys: An effective, cost- and time-saving diagnostic approach.

Directory of Open Access Journals (Sweden)

Marta Córdoba

Full Text Available Diagnostic trajectories for neurogenetic disorders frequently require the use of considerable time and resources, exposing patients and families to so-called "diagnostic odysseys". Previous studies have provided strong evidence for increased diagnostic and clinical utility of whole-exome sequencing in medical genetics. However, specific reports assessing its utility in a setting such as ours- a neurogeneticist led academic group serving in a low-income country-are rare.To assess the diagnostic yield of WES in patients suspected of having a neurogenetic condition and explore the cost-effectiveness of its implementation in a research group located in an Argentinean public hospital.This is a prospective study of the clinical utility of WES in a series of 40 consecutive patients selected from a Neurogenetic Clinic of a tertiary Hospital in Argentina. We evaluated patients retrospectively for previous diagnostic trajectories. Diagnostic yield, clinical impact on management and economic diagnostic burden were evaluated.We demonstrated the clinical utility of Whole Exome Sequencing in our patient cohort, obtaining a diagnostic yield of 40% (95% CI, 24.8%-55.2% among a diverse group of neurological disorders. The average age at the time of WES was 23 (range 3-70. The mean time elapsed from symptom onset to WES was 11 years (range 3-42. The mean cost of the diagnostic workup prior to WES was USD 1646 (USD 1439 to 1853, which is 60% higher than WES cost in our center.WES for neurogenetics proved to be an effective, cost- and time-saving approach for the molecular diagnosis of this heterogeneous and complex group of patients.

Efficient Noninferiority Testing Procedures for Simultaneously Assessing Sensitivity and Specificity of Two Diagnostic Tests

Directory of Open Access Journals (Sweden)

Guogen Shan

2015-01-01

Full Text Available Sensitivity and specificity are often used to assess the performance of a diagnostic test with binary outcomes. Wald-type test statistics have been proposed for testing sensitivity and specificity individually. In the presence of a gold standard, simultaneous comparison between two diagnostic tests for noninferiority of sensitivity and specificity based on an asymptotic approach has been studied by Chen et al. (2003. However, the asymptotic approach may suffer from unsatisfactory type I error control as observed from many studies, especially in small to medium sample settings. In this paper, we compare three unconditional approaches for simultaneously testing sensitivity and specificity. They are approaches based on estimation, maximization, and a combination of estimation and maximization. Although the estimation approach does not guarantee type I error, it has satisfactory performance with regard to type I error control. The other two unconditional approaches are exact. The approach based on estimation and maximization is generally more powerful than the approach based on maximization.

Energy prospects

International Nuclear Information System (INIS)

Lyall, K.

1991-01-01

The Business Council of Australia's study on Prospects for Improved Energy Efficiency and the Application of Renewable Energy Resources is summarised. The study estimates that replacement of all off-peak electric units in Australia with solar gas boosted systems would reduce electricity consumption for residential water heating by approximately 25% and almost halve carbon dioxide emissions resulting from residential water heating. Furthermore, substitution of all water heating units in Australia with solar gas systems would reduce total emissions by about 80%. The study concludes that while substitution on such a scale could not readily be achieved even within several decades, the estimates do indicate the significant benefits that might be realised by a long term program. 2 refs., 3 tabs

The potential diagnostic value of serum microRNA signature in patients with pancreatic cancer

DEFF Research Database (Denmark)

Johansen, Julia S; Calatayud, Dan; Albieri, Vanna

2016-01-01

Biomarkers for early diagnosis of patients with pancreatic cancer (PC) are needed. Our aim was to identify panels of miRNAs in serum in combination with CA 19-9 for use in the diagnosis of PC. Four hundred seventeen patients with PC were included prospectively from Denmark (n = 306) and Germany (n...... than in controls. These miRNAs were tested in the training cohort, and four diagnostic panels were constructed that included 5 or 12 miRNAs (miR-16, -18a, -20a, -24, -25, -27a, -29c, -30a.5p, -191, -323.3p, -345 and -483.5p). Diagnostic accuracy of detecting PC in the training cohort was AUC (Index I 0.......90-0.96) and accuracy 0.88 (0.84-0.91)]. In conclusion, we identified four diagnostic panels based on 5 or 12 miRNAs in serum that could distinguish patients with PC from HS and CP....

Diagnostic value of whole-body MRI and bone scintigraphy in the detection of osseous metastases in patients with breast cancer - a prospective double-blinded study at two hospital centers

International Nuclear Information System (INIS)

Ohlmann-Knafo, Susanne; Pickuth, D.; Kirschbaum, M.; Fenzl, G.

2009-01-01

The purpose of this study was to compare the diagnostic accuracy of whole-body MRI (WB-MRI) and bone scintigraphy (BS) for the screening of bone metastases for the first time in a large and homogeneous patient collective with breast cancer in a systematic and controlled study. 213 breast cancer patients were evaluated for bone metastases under randomized, double-blinded and prospective conditions at two hospitals. All participants were examined by WB-MRI and BS over an average period of four days. The examinations were performed separately at two different locations. The WB-MRI protocol included T 1-TSE and STIR sequences. WB-MRI and BS were reviewed independently by experienced radiologists and nuclear medicine specialists in a consensus reading. In 66 % of cases bone metastases were excluded by both procedures, and bone metastases were detected concordantly in 2 % of cases. In 7 % of cases there were discrepant results: in 7 cases BS was false-positive when WB-MRI was negative. In 5 / 7 cases BS was negative when WB-MRI identified bone metastases. In 89 % of cases BS was uncertain when WB-MRI was true-negative. In 17 % of cases WB-MRI showed important (non-) tumor-associated findings. The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy for WB-MRI were 90 %, 94 %, 82 %, 98 % and 99 % and for BS those were 40 %, 81 %, 36 %, 91 % and 93 %. (orig.)

Development of global data warehouse for beam diagnostics at SSRF

International Nuclear Information System (INIS)

Lai Longwei; Leng Yongbin; Yan Yingbing; Chen Zhichu

2015-01-01

The beam diagnostic system is adequate during the daily operation and machine study at the Shanghai Synchrotron Radiation Facility (SSRF). Without the effective event detecting mechanism, it is difficult to dump and analyze abnormal phenomena such as the global orbital disturbance, the malfunction of the BPM and the noise of the DCCT. The global beam diagnostic data warehouse was built in order to monitor the status of the accelerator and the beam instruments. The data warehouse was designed as a Soft IOC hosted on an independent server. Once abnormal phenomena happen it will be triggered and will store the relevant data for further analysis. The results show that the data warehouse can detect abnormal phenomena of the machine and the beam diagnostic system effectively, and can be used for calculating confidential indicators of the beam instruments. It provides an efficient tool for the improvement of the beam diagnostic system and accelerator. (authors)

Diagnostic value of CRP and Lp(a) in coronary heart disease.

Science.gov (United States)

Erbağci, Ayşe Binnur; Tarakçioğlu, Mehmet; Aksoy, Mehmet; Kocabaş, Ramazan; Nacak, Muradiye; Aynacioğlu, A Sükrü; Sivrikoz, Cumhur

2002-06-01

Increased lipoprotein (a) [Lp(a)] concentration was reported to be an independent risk factor for coronary heart disease (CHD). Recent epidemiological studies affirmed the value of C-reactive protein (CRP) as the strongest, univariate predictor of the cardiovascular events. We decided to establish cut-off levels providing maximum diagnostic efficiency for CHD. In this study we measured CRP and Lp(a) concentrations in patients with angiographically demonstrated CHD (group A, n: 120), patients without any angiographically demonstrable lesion (group B, n: 62) and a group of healthy subjects (group C, n: 41). Data were evaluated correcting for lipid and lipoprotein concentrations, diabetes mellitus, hypertension, smoking, age, and body mass index in men and women. ROC curve based cut-off values (comparing group A versus groups B and C) and associated diagnostic performances of the assays were evaluated. Significant increases were noted in serum CRP concentrations in men and women, in groups A vs. B,A vs. C, B vs. C. Lp(a) concentrations were not different among groups in men but were higher in group A vs. B and C in women. Optimal cut-off levels for CRP in women and men were found as 2.1 and 3.0 mg/l with the diagnostic values of 0.792 and 0.770, respectively. For Lp(a) optimal cut-off levels were found as 22.6 and 9.8 mg/dl with the diagnostic values of 0.612 and 0.596 in women and men, respectively. The CRP level is quite efficient for separation of patients from controls. Therefore keeping in mind the lack of specificity, the CRP level may be a useful tool in the diagnosis of coronary heart disease. However, the Lp(a) level is not efficient enough to support the use of Lp(a) measurement for management of coronary heart disease.

A prospective study of diagnostic conversion of major depressive disorder to bipolar disorder in pregnancy and postpartum.

Science.gov (United States)

Sharma, Verinder; Xie, Bin; Campbell, M Karen; Penava, Debbie; Hampson, Elizabeth; Mazmanian, Dwight; Pope, Carley J

2014-02-01

The aim of the present study was to determine the rate of, and risk factors for, a change in diagnosis from major depressive disorder to bipolar disorder, and from bipolar II disorder to bipolar I disorder in pregnancy and postpartum. Patients with a prior history of major depressive disorder or bipolar II disorder were recruited between 24 and 28 weeks' gestation and followed through to one year postpartum. Diagnostic interviews were conducted using the Structured Clinical Interview for DSM-IV at study intake and repeated using the Mini-International Psychiatric Interview at one, three, six, and 12 months after childbirth. Fisher's exact test was used to assess the association between various risk factors and diagnostic switch. A total of 146 participants completed the intake interview and at least one follow-up interview postpartum. Of these, 92 were diagnosed with major depressive disorder and 54 with bipolar II disorder at intake. Six women (6.52%) experienced a diagnostic change from major depressive disorder to bipolar II disorder during the first six months after childbirth. There were no cases of switching to bipolar I disorder, but in one participant the diagnosis changed from bipolar II disorder to bipolar I disorder during the three months after childbirth. Bipolar switch was associated with a family history of bipolar disorder. The postpartum period appears to be a time of high risk for a new onset of hypomania in women with major depressive disorder. Our rate of diagnostic switching to bipolar II disorder (6.52%) is at least 11- to 18-fold higher than the rates of switching in similar studies conducted in both men and women. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

High-Efficient Low-Cost Photovoltaics Recent Developments

CERN Document Server

Petrova-Koch, Vesselinka; Goetzberger, Adolf

2009-01-01

A bird's-eye view of the development and problems of recent photovoltaic cells and systems and prospects for Si feedstock is presented. High-efficient low-cost PV modules, making use of novel efficient solar cells (based on c-Si or III-V materials), and low cost solar concentrators are in the focus of this book. Recent developments of organic photovoltaics, which is expected to overcome its difficulties and to enter the market soon, are also included.

Diagnostic x-ray spectra measurements using a silicon surface barrier detector

International Nuclear Information System (INIS)

Pani, R.; Laitano, R.F.

1987-01-01

A silicon surface barrier detector having a low efficiency for x-ray is used to analyse diagnostic x-ray spectra. This characteristic is advantageous in overcoming experimental problems caused by high fluence rates typical of diagnostic x-ray beams. The pulse height distribution obtained with silicon surface barrier detectors is very different from the true photon spectra because of the presence of escaped Compton photons and the fact that detection efficiency falls abruptly when photon energy increases. A detailed analysis of the spurious effects involved in detection is made by a Monte Carlo method. A stripping procedure is described for implementation on a personal computer. The validity of this method is tested by comparison with experimental results obtained with a Ge detector. The spectra obtained with the Si detector are in fairly good agreement with the analogous spectra measured with a Ge detector. The advantages of using Si as opposed to Ge detectors in x-ray spectrometry are: its simplicity of use, its greater economy for use in routine diagnostic x-ray spectroscopy and the possibility that the stripping procedure can be implemented on a personal computer. (author)

Maternal anxiety disorders predict excessive infant crying: a prospective longitudinal study.

Science.gov (United States)

Petzoldt, Johanna; Wittchen, Hans-Ulrich; Wittich, Julia; Einsle, Franziska; Höfler, Michael; Martini, Julia

2014-09-01

To prospectively examine relations between maternal DSM-IV-TR anxiety and depressive disorders and excessive infant crying. Based on the prospective longitudinal Maternal Anxiety in Relation to Infant Development Study, n=306 expectant mothers were enrolled during early pregnancy and repeatedly interviewed until 16 months post partum. Lifetime and prospective information on maternal anxiety and depressive disorders was assessed via standardised diagnostic interviews (Composite International Diagnostic Interview for Women). Excessive crying (crying for ≥3 h per day on ≥3 days per week for ≥3 weeks) was assessed via Baby-DIPS. During the first 16 months after delivery, n=286 mother-infant dyads were available and included in the analyses. Excessive crying was reported by n=29 mothers (10.1%). Infants of mothers with anxiety disorders prior to pregnancy were at higher risk for excessive crying than infants of mothers without any anxiety disorder prior to pregnancy (OR=2.54, 95% CI 1.11 to 5.78, p=0.027). Risk was even increased when considering additionally incident anxiety disorders until delivery (OR=3.02, 95% CI 1.25 to 7.32, p=0.014) and until 16 months post partum (OR=2.87, 95% CI 1.13 to 7.28, p=0.027). Associations remained stable when adjusting for sociodemographic and perinatal covariates. Maternal depressive disorders prior to pregnancy were not significantly associated with excessive crying in this sample. Maternal lifetime and incident anxiety disorders revealed to be a robust predictor for excessive crying. Thus, early identification and monitoring of women with anxiety disorders is important to identify mother-infant dyads at risk for excessive crying. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Efficient molecular diagnostic strategy for ABCC6 in pseudoxanthoma elasticum

NARCIS (Netherlands)

Hu, Xiaofeng; Plomp, Astrid; Gorgels, Theo; Brink, Jacoline Ten; Loves, Willem; Mannens, Marcel; de Jong, Paulus T. V. M.; Bergen, Arthur A. B.

2004-01-01

Pseudoxanthoma elasticum (PXE) is a hereditary disorder of connective tissue with skin, cardiovascular, and visual involvement. In familial cases, PXE usually segregates in an autosomal recessive fashion. The aim of this manuscript is to describe an efficient strategy for DNA diagnosis of PXE. The

Interface language for diagnostic control

International Nuclear Information System (INIS)

Matone, J.T.

1985-01-01

The neutron multichannel collimator diagnostic on TFTR is run with the help of a keyboard-entered interface language. The language allows the user to interact with the real-time control and data analysis systems in a consistent and efficient manner. It uses a vocabulary that can be abbreviated into one character commands which the proficient user may concatenate into command words. This allows the user to progress quickly from a novice to an expert operating mode. A similar type interface language could be applied to many interactive applications accepting keyboard inputs

Adaptive Technology Application for Vibration-Based Diagnostics of Roller Bearings on Industrial Plants

Directory of Open Access Journals (Sweden)

Mironov Aleksey

2014-09-01

Full Text Available Roller bearings are widely used in equipment of different applications; therefore, the issues related to the assessment of bearing technical state and localization of bearing faults are quite important and relevant. The reason is that technical state of a bearing is a critical component, which determines efficiency of a mechanism or equipment. For bearings inspection and diagnostics, various methods of vibration-based diagnostics are used. The adaptive technology for vibration-based diagnostics developed in „D un D centrs” is an effective tool for evaluation of technical state of bearings in operation compared to the existing SKF method.

[Use of diagnostic templates at stages of prosthetics treatment with implant-retained restorations].

Science.gov (United States)

Gvetadze, R Sh; Abramyan, S V; Ivanov, A A; Nubaryan, A P

The comparative analysis of efficiency of various types of diagnostic templates for planning orthopedic treatment of 50 patients with partial or complete absence of teeth was performed. The patients were divided in 3 groups according to template manufacturing technique. All diagnostic templates made in accordance with clinical conditions allowed transfering digital data of the scheduled prosthetic construction for virtual implantation planning. Advantages and pitfalls of each template type are discussed.

Diagnostic accuracy of prospective ECG gated coronary computed tomography on a 256 slices scanner: Daily practice experience

Directory of Open Access Journals (Sweden)

Ahmed M. Fareed

2014-03-01

Conclusions: In a highly prevalence diseased population, prospective ECG-gated CTCA using 256-slice scanner is highly accurate for detection and quantification of the degree of coronary luminal stenosis in comparison to ICA.

Standardization of diagnostic PCR for the detection of foodborne pathogens

DEFF Research Database (Denmark)

Malorny, B.; Tassios, P.T.; Radstrom, P.

2003-01-01

In vitro amplification of nucleic acids using the polymerase chain reaction (PCR) has become, since its discovery in the 1980s, a powerful diagnostic tool for the analysis of microbial infections as well as for the analysis of microorganisms in food samples. However, despite its potential, PCR has...... neither gained wide acceptance in routine diagnostics nor been widely incorporated in standardized methods. Lack of validation and standard protocols, as well as variable quality of reagents and equipment, influence the efficient dissemination of PCR methodology from expert research laboratories to end......-user laboratories. Moreover, the food industry understandably requires and expects officially approved standards. Recognizing this, in 1999, the European Commission approved the research project, FOOD-PCR (http://www.PCR.dk), which aims to validate and standardize the use of diagnostic PCR for the detection...

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

Science.gov (United States)

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

2009-12-01

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

Left-colon water exchange preserves the benefits of whole colon water exchange at reduced cecal intubation time conferring significant advantage in diagnostic colonoscopy - a prospective, randomized controlled trial.

Science.gov (United States)

Wang, Xiangping; Luo, Hui; Xiang, Yi; Leung, Felix W; Wang, Limei; Zhang, Linhui; Liu, Zhiguo; Wu, Kaichun; Fan, Daiming; Pan, Yanglin; Guo, Xuegang

2015-07-01

Whole-colon water exchange (WWE) reduces insertion pain, increases cecal intubation success and adenoma detection rate, but requires longer insertion time, compared to air insufflation (AI) colonoscopy. We hypothesized that water exchange limited to the left colon (LWE) can speed up insertion with equivalent results. This prospective, randomized controlled study (NCT01735266) allocated patients (18-80 years) to WWE, LWE or AI group (1:1:1). The primary outcome was cecal intubation time. Three hundred subjects were randomized to the WWE (n = 100), LWE (n = 100) or AI group (n = 100). Ninety-four to ninety-five per cent of patients underwent diagnostic colonoscopy. Baseline characteristics were balanced. The median insertion time was shorter in LWE group (4.8 min (95%CI: 3.2-6.2)) than those in WWE (7.5 min (95%CI: 6.0-10.3)) and AI (6.4 min (95%CI: 4.2-9.8)) (both p rates in unsedated patients of the two water exchange methods (WWE 99%, LWE 99%) were significantly higher than that (89.8%) in AI group (p = 0.01). The final success rates were comparable among the three groups after sedation was given. Maximum pain scores and number of patients needing abdominal compression between WWE and LWE groups were comparable, both lower than those in AI group (p higher in WWE group. By preserving the benefits of WWE and reducing insertion time, LWE is appropriate for diagnostic colonoscopy, especially in settings with tight scheduling of patients. The higher PDR in the right colon in WWE group deserves to be further investigated.

Diagnostic value of chemical shift artifact in distinguishing benign lymphadenopathy

Energy Technology Data Exchange (ETDEWEB)

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

2011-11-15

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

Pilot study of a three-step diagnostic pathway for young and old patients with Parkinson's disease dementia: screen, test and then diagnose.

NARCIS (Netherlands)

Robben, S.H.M.; Sleegers, M.J.; Dautzenberg, P.LJ.; Bergen, F.S. van; Bruggen, J.P.; Olde Rikkert, M.G.M.

2010-01-01

OBJECTIVE: To pilot a three-step diagnostic model for young and old patients with Parkinson's disease dementia (PDD). METHODS: Prospective investigator-blinded study. We developed a screening questionnaire for patients with Parkinson's disease (PD) and their caregivers. Further, patients were

Diagnostic evaluation of rare lesions of the arteria poplitea

International Nuclear Information System (INIS)

Schmitt, R.; Christopoulos, G.; Froehner, S.; Binder, F.; Schweiger, H.

2001-01-01

Clinical and radiological findings of six patients are discussed who, due to a specific pathology of the arteria poplitea, developed claudicatio primarily in the lower leg. Applying MS-CT and MRI, the following lesions of the arteria poplitea wer found: bilateral aneurysm verum (1 case), unilateral aneurysm spurium (1 case), the arteria magna syndrome (1 case), entrapment syndrome (2 cases), and cystic adventitia degeneration. The outstanding diagnostic value of MR angiography combined with MR imaging is explained. Good knowledge of the specific pathology of the arteria poplitea is pre-requisite of efficient diagnostic evaluation, and prevention of thromboembolic complications, or ineffective therapy. (orig./CB) [de

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

Directory of Open Access Journals (Sweden)

E. L. Ntantis

2016-01-01

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

Diagnostic performance of sonoelastographic Tsukuba score and strain ratio in evaluation of breast masses

Directory of Open Access Journals (Sweden)

Mahmoud Abd Elaziz Dawood

2018-03-01

Full Text Available The aim of this prospective study was to evaluate the diagnostic performance of the use of strain index ratio by sonoelastography to differentiate between benign and malignant breast lesions. Patients & Methods: This prospective study including 40 females, complaining of breast masses which were suspicious to be malignant on clinical examination. All patients were submitted to B-mode Ultrasound and sonoelastography. Biopsy as a gold standard and pathological study were done for all breast lesions. Results: US examination of every mass was done and categorized according to BI-RADS categories according to ACR2013, according to US lexicon. Sonoelastography examination with Lesions classification was performed on the basis of a 5-point scoring method proposed by Tsukuba elasticity score. Then measurements of strain ratio were done. Statistical analysis of combination of the three methods was sensitivity of 96.7%, specificity of 100% when we use cut off value of 3–4 in elastography score and ≤3 cut off value of strain ratio. Conclusion: The combined use of strain ratio with Tsukuba score and BI-RADS categorization increased the diagnostic performance in differentiation between benign and malignant breast lesions. Keywords: Elastography, Breast masses, Strain ratio, Ultrasound, BI-RADS classification, Tsukuba score

Cogeneration in Australia. Situation and prospects

International Nuclear Information System (INIS)

1997-01-01

This Research Paper is mainly concerned with the status and prospects for cogeneration in Australia. An introductory chapter reviews the fundamentals of cogeneration, covering both technical and institutional aspects. A range of technologies are employed in cogeneration: these technologies and their efficiency and environmental impact effects are discussed in Chapter 2. The economics of cogeneration are a major factor in the profitability of current and potential plants. Potential factors affecting cogeneration economics are discussed .The status of cogeneration in Australia is reviewed for each State and Territory, and includes a number of case studies of existing plants. Government (federal, state, territory) policies that have a significant impact on the attractiveness of cogeneration are reviewed. Finally, the future prospects for cogeneration in Australia, drawing on the preceding chapters and a review of estimated potentials for cogeneration in Australia are presented

Progress on development of SPIDER diagnostics

Science.gov (United States)

Pasqualotto, R.; Agostini, M.; Barbisan, M.; Bernardi, M.; Brombin, M.; Cavazzana, R.; Croci, G.; Palma, M. Dalla; Delogu, R. S.; Gorini, G.; Lotto, L.; Muraro, A.; Peruzzo, S.; Pimazzoni, A.; Pomaro, N.; Rizzolo, A.; Serianni, G.; Spolaore, M.; Tardocchi, M.; Zaniol, B.; Zaupa, M.

2017-08-01

SPIDER experiment, the full size prototype of the beam source for the ITER heating neutral beam injector, has to demonstrate extraction and acceleration to 100 kV of a large negative ion hydrogen or deuterium beam with co-extracted electron fraction e-/D- SPIDER plant systems are being installed, the different diagnostic systems are in the procurement phase. Their final design is described here with a focus on some key solutions and most original and cost effective implementations. Thermocouples used to measure the power load distribution in the source and over the beam dump front surface will be efficiently fixed with proven technique and acquired through commercial and custom electronics. Spectroscopy needs to use well collimated lines of sight and will employ novel design spectrometers with higher efficiency and resolution and filtered detectors with custom built amplifiers. The electrostatic probes will be operated through electronics specifically developed to cope with the challenging environment of the RF source. The instrumented calorimeter STRIKE will use new CFC tiles, still under development. Two linear cameras, one built in house, have been tested as suitable for optical beam tomography. Some diagnostic components are off the shelf, others are custom developed: some of these are being prototyped or are under test before final production and installation, which will be completed before start of SPIDER operation.

Development of Insulation Diagnostic Data Base in High Voltage Rotating Machine

Energy Technology Data Exchange (ETDEWEB)

Ju, Y.H.; Lee, Y.J.; Kong, T.S. [Korea Electric Power Research Institute, Taejon (Korea)

2002-07-01

Since 1999, Kepri has been performed insulation diagnostic test, has about 3,000 test result data, so we need to manage the data efficiently. this study aims at developing of test data management program. (author). 7 refs., 19 figs., 11 tabs.

A population-based prospective study of optic neuritis

DEFF Research Database (Denmark)

Soelberg, K; Jarius, S; Skejoe, Hanne Pernille Bro

2017-01-01

BACKGROUND: Optic neuritis (ON) is often associated with multiple sclerosis (MS). Early diagnosis is critical to optimal patient management. OBJECTIVE: To estimate the incidence of acute ON and the rates of conversion to MS and antibody-mediated ON. METHOD: Population-based prospective study......-specific incidence was 3.28 (2.44-4.31) per 100,000 person years, 2.02 for men and 4.57 for women. At follow-up, 20 patients met the diagnostic criteria for MS, MRI lesions disseminated in space and time in 17/20 patients. AQP4-IgG was detected in none, MOG-IgG was detected in two patients. CONCLUSION...

Prospective comparison among transient elastography, supersonic shear imaging, and ARFI imaging for predicting fibrosis in nonalcoholic fatty liver disease.

Directory of Open Access Journals (Sweden)

Myoung Seok Lee

Full Text Available The diagnostic performance of supersonic shear imaging (SSI in comparison with those of transient elastography (TE and acoustic radiation force impulse imaging (ARFI for staging fibrosis in nonalcoholic fatty liver disease (NAFLD patients has not been fully assessed, especially in Asian populations with relatively lean NAFLD compared to white populations. Thus, we focused on comparing the diagnostic performances of TE, ARFI, and SSI for staging fibrosis in a head-to-head manner, and identifying the clinical, anthropometric, biochemical, and histological features which might affect liver stiffness measurement (LSM in our prospective biopsy-proven NAFLD cohort. In this study, ninety-four patients with biopsy-proven NAFLD were included prospectively. Liver stiffness was measured using TE, SSI, and ARFI within 1 month of liver biopsy. The diagnostic performance for staging fibrosis was assessed using receiver operating characteristic (ROC analysis. Anthropometric data were evaluated as covariates influencing LSM by regression analyses. Liver stiffness correlated with fibrosis stage (p < 0.05; the area under the ROC curve of TE (kPa, SSI (kPa, and ARFI (m/s were as follows: 0.757, 0.759, and 0.657 for significant fibrosis and 0.870, 0.809, and 0.873 for advanced fibrosis. Anthropometric traits were significant confounders affecting SSI, while serum liver injury markers significantly confounded TE and ARFI. In conclusion, the LSM methods had similar diagnostic performance for staging fibrosis in patients with NAFLD. Pre-LSM anthropometric evaluation may help predict the reliability of SSI.

Predicting ongoing pregnancy chances after IVF and ICSI: A national prospective study

OpenAIRE

Lintsen, Bea; Eijkemans, René; Hunault, C.C.; Bouwmans-Frijters, Clazien; Hakkaart-van Roijen, Leona; Habbema, Dik; Braat, Didi

2007-01-01

textabstractBackground: The Dutch IVF guideline suggests triage of patients for IVF based on diagnostic category, duration of infertility and female age. There is no evidence for the effectiveness of these criteria. We evaluated the predictive value of patient characteristics that are used in the Dutch IVF guideline and developed a model that predicts the IVF ongoing pregnancy chance within 12 months. Methods: In a national prospective cohort study, pregnancy chances after IVF and ICSI treatm...

Strategic interaction among hospitals and nursing facilities: the efficiency effects of payment systems and vertical integration.

Science.gov (United States)

Banks, D; Parker, E; Wendel, J

2001-03-01

Rising post-acute care expenditures for Medicare transfer patients and increasing vertical integration between hospitals and nursing facilities raise questions about the links between payment system structure, the incentive for vertical integration and the impact on efficiency. In the United States, policy-makers are responding to these concerns by initiating prospective payments to nursing facilities, and are exploring the bundling of payments to hospitals. This paper develops a static profit-maximization model of the strategic interaction between the transferring hospital and a receiving nursing facility. This model suggests that the post-1984 system of prospective payment for hospital care, coupled with nursing facility payments that reimburse for services performed, induces inefficient under-provision of hospital services and encourages vertical integration. It further indicates that the extension of prospective payment to nursing facilities will not eliminate the incentive to vertically integrate, and will not result in efficient production unless such integration takes place. Bundling prospective payments for hospitals and nursing facilities will neither remove the incentive for vertical integration nor induce production efficiency without such vertical integration. However, bundled payment will induce efficient production, with or without vertical integration, if nursing facilities are reimbursed for services performed. Copyright 2001 John Wiley & Sons, Ltd.

Chewing efficiency, bite force and oral health-related quality of life with narrow diameter implants - a prospective clinical study: results after one year.

Science.gov (United States)

Enkling, Norbert; Saftig, Marcus; Worni, Andreas; Mericske-Stern, Regina; Schimmel, Martin

2017-04-01

This prospective study aimed to investigate the evolution of chewing efficiency, maximum voluntary bite force (MBF) and oral health-related quality of life (OHRQoL) in edentulous patients treated with narrow diameter implants (NDIs) over the course of 1 year. Four NDIs (MDI ® , 3M ESPE, diameter 1.8 mm) were placed interforaminally in 20 edentulous patients. They were immediately loaded by converting the existing prosthesis into an implant overdenture. Participants were examined six times pre- and postoperatively [baseline (BL) to week 52 (w52)]. Chewing efficiency was evaluated with a colour-mixing ability test by evaluation of the standard deviation of hue (VOH, ViewGum©). MBF was measured using a digital force gauge. OHRQoL was determined with the Oral Health Impact Profile (OHIPG49). Nonparametric Brunner-Langer models were applied for statistical testing. The study failed to demonstrate an effect on chewing efficiency. MBF increased continuously during the observation period (medians: MBF[N]@BL = 46.6 [iqr 50.1]; MBF[N]@w52 = 103.9 [iqr 76.0]; P = 0.002). OHRQoL increased steeply after implant loading and continued improving (medians: BL ∑OHIPG49 = 31 [iqr 40.0]; w4 ∑OHIPG49 = 11.5 [iqr 19.5]; w52 ∑OHIPG49 = 6 [iqr 13.0], P chewing instructions. Larger studies need to confirm a positive effect on chewing efficiency and develop long-term maintenance solutions if patients become frail because no easy downgrading approaches of one-piece titanium implants exist. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparing the American and European diagnostic guidelines for cystic fibrosis: same disease, different language?

Science.gov (United States)

Ooi, Chee Y; Dupuis, Annie; Ellis, Lynda; Jarvi, Keith; Martin, Sheelagh; Gonska, Tanja; Dorfman, Ruslan; Kortan, Paul; Solomon, Melinda; Tullis, Elizabeth; Durie, Peter R

2012-07-01

The American and European cystic fibrosis (CF) guidelines recommend different diagnostic criteria. This study assessed diagnostic concordance between these recommendations. Subjects with single organ manifestations suggestive of CF (chronic sinopulmonary disease (RESP), chronic/recurrent pancreatitis (PANC) or obstructive azoospermia (AZOOSP)) were prospectively evaluated by sweat test, nasal potential difference and genotyping. Concordance in diagnostic outcomes between the two algorithms was measured using observed agreement and κ statistics. A total of 208 subjects were evaluated. Observed agreement was 84.8% and level of agreement was excellent (κ=0.87) between the American and European recommendations. The RESP phenotype was associated with the highest degree of concordance (observed agreement ≥90%, κ=0.92) compared with the PANC (observed agreement 86%, κ=0.65) and AZOOSP (observed agreement 80%, κ=0.87) phenotypes. Incorporation of nasal potential difference into the American algorithm failed to improve the overall degree of concordance (good agreement level; κ=0.75); the level of agreement was unchanged in RESP and PANC subjects, but reduced in AZOOSP subjects (from excellent to good). Extensive genotyping had limited clinical utility in the diagnosis of CF in both algorithms. Despite inconsistencies between the American and European diagnostic recommendations, concordance in diagnostic outcomes among subjects presenting with single organ manifestations of CF was good to excellent. These diagnostic guidelines provide guidance and promote rigorous evaluation for the diagnosis of CF but neither guideline should be regarded as dogma.

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

Science.gov (United States)

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

2010-06-01

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

Evidence for current diagnostic criteria of diabetes mellitus

Institute of Scientific and Technical Information of China (English)

Ritesh; Kumar[1; Lakshmana; Perumal; Nandhini[1; Sadishkumar; Kamalanathan[1; Jayaprakash; Sahoo[1; Muthupillai; Vivekanadan[1

2016-01-01

Diabetes mellitus is a non-communicable metabolic derangement afflicting several millions of individuals globally. It is associated with several micro and macrovascular complications and is also a leading cause of mortality. The unresolved issue is that of definition of the diagnostic threshold for diabetes. The World Health Organization and the American Diabetes Association (ADA) have laid down several diagnostic criteria for diagnosing diabetes and prediabetes based on the accumulating body of evidence.This review has attempted to analyse the scientific evidence supporting the justification of these differing criteria. The evidence for diagnosing diabetes is strong, and there is a concordance between the two professional bodies.The controversy arises when describing the normal lower limit of fasting plasma glucose (FPG) with little evidence favouring the reduction of the FPG by the ADA. Several studies have also shown the development of complications specific for diabetes in patients with prediabetes as defined by the current criteria though there is a significant overlap of such prevalence in individuals with normoglycemia. Large multinational longitudinal prospective studies involving subjects without diabetes and retinopathy at baseline will ideally help identify the threshold of glycemic measurements for future development of diabetes and its complications.

Efficient genome-wide association in biobanks using topic modeling identifies multiple novel disease loci.

Science.gov (United States)

McCoy, Thomas H; Castro, Victor M; Snapper, Leslie A; Hart, Kamber L; Perlis, Roy H

2017-08-31

Biobanks and national registries represent a powerful tool for genomic discovery, but rely on diagnostic codes that may be unreliable and fail to capture the relationship between related diagnoses. We developed an efficient means of conducting genome-wide association studies using combinations of diagnostic codes from electronic health records (EHR) for 10845 participants in a biobanking program at two large academic medical centers. Specifically, we applied latent Dirichilet allocation to fit 50 disease topics based on diagnostic codes, then conducted genome-wide common-variant association for each topic. In sensitivity analysis, these results were contrasted with those obtained from traditional single-diagnosis phenome-wide association analysis, as well as those in which only a subset of diagnostic codes are included per topic. In meta-analysis across three biobank cohorts, we identified 23 disease-associated loci with p<1e-15, including previously associated autoimmune disease loci. In all cases, observed significant associations were of greater magnitude than for single phenome-wide diagnostic codes, and incorporation of less strongly-loading diagnostic codes enhanced association. This strategy provides a more efficient means of phenome-wide association in biobanks with coded clinical data.

Smartphone-Based Fluorescent Diagnostic System for Highly Pathogenic H5N1 Viruses

OpenAIRE

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

2016-01-01

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

Prototyping low-cost and flexible vehicle diagnostic systems

Directory of Open Access Journals (Sweden)

Marisol GARCÍA-VALLS

2016-12-01

Full Text Available Diagnostic systems are software and hardware-based equipment that interoperate with an external monitored system. Traditionally, they have been expensive equipment running test algorithms to monitor physical properties of, e.g., vehicles, or civil infrastructure equipment, among others. As computer hardware is increasingly powerful (whereas its cost and size is decreasing and communication software becomes easier to program and more run-time efficient, new scenarios are enabled that yield to lower cost monitoring solutions. This paper presents a low cost approach towards the development of a diagnostic systems relying on a modular component-based approach and running on a resource limited embedded computer. Results on a prototype implementation are shown that validate the presented design, its flexibility, performance, and communication latency.

Comparative analysis of two rapid diagnostic tests for diagnosis of ...

African Journals Online (AJOL)

This study aims at comparing the diagnostic efficiencies of two commercially available kits for detecting Plasmodium falciparum infection in urine and blood of febrile patients for malaria diagnosis. This was an observational study in which matched blood and urine from symptomatic patients were tested for malaria using two ...

Instrumental tactile diagnostics in robot-assisted surgery

Directory of Open Access Journals (Sweden)

Solodova RF

2016-10-01

boundaries were not visually detectable, instrumental tactile diagnostics performed using MTEC provided valid identification and localization of lesions. The results of instrumental tactile diagnostics were concordant with the results of intraoperative ultrasound examination. However, in certain cases, for example, thoracoscopy, ultrasound examination is inapplicable, while MTEC-based tactile diagnostics can be efficiently utilized. Conclusion: The study proved that MTEC can be efficiently used in robot-assisted surgery allowing correct localization of visually undetectable lesions and visually undetectable boundaries of pathological changes of tissues. Keywords: tactile feedback, instrumental palpation, Medical Tactile Endosurgical Complex, tactile lesion localization

Combined cycle power plants: technological prospects for improving the efficiency

International Nuclear Information System (INIS)

Lauri, R.

2009-01-01

The combined cycle power plants characteristics are better than one course open to a closed loop presenting an electrical efficiency close to 60% do not reach for gas turbine engines for power plants and conventional steam engines. [it

Modeling efficient resource allocation patterns for arable crop ...

African Journals Online (AJOL)

optimum plans. This should be complemented with strong financial support, farm advisory services and adequate supply of modern inputs at fairly competitive prices would enhance the prospects of the small holder farmers. Keywords: efficient, resource allocation, optimization, linear programming, gross margin ...

Works carried out by DGEMP about energy prospects for 2030-2050

International Nuclear Information System (INIS)

2005-01-01

The 2004 year has been rich in publications and analyses about energy prospects. The French general direction of energy and raw materials (DGEMP) from the Ministry of Economy, Finances and Industry, has organized a round table on June 30, 2004 in order to present and compare different energy scenarios at the 2030 and 2050 prospects. The aim is to evaluate the available modeling system and to prepare the reflexions to implement. This paper presents: the limitations of a long-term energy prospect and the main hypotheses made, and the main results of the prospective studies carried out by DGEMP at the 2030 and 2050 prospects. The conclusions of this study is that there exists forbidden actions (postponing the implementation of energy saving actions, consuming fossil-fuels for thermal and power generation purposes and keeping petroleum preponderance in transportation), necessary actions (increase of energy efficiency in all sectors, saving peak-use power, changing transportation habits, developing nuclear and renewable energies), and some technology rupture needs (low emission technologies, power storage and hydrogen uses, CO 2 captation and sequestration). (J.S.)

Decentralized diagnostics based on a distributed micro-genetic algorithm for transducer networks monitoring large experimental systems.

Science.gov (United States)

Arpaia, P; Cimmino, P; Girone, M; La Commara, G; Maisto, D; Manna, C; Pezzetti, M

2014-09-01

Evolutionary approach to centralized multiple-faults diagnostics is extended to distributed transducer networks monitoring large experimental systems. Given a set of anomalies detected by the transducers, each instance of the multiple-fault problem is formulated as several parallel communicating sub-tasks running on different transducers, and thus solved one-by-one on spatially separated parallel processes. A micro-genetic algorithm merges evaluation time efficiency, arising from a small-size population distributed on parallel-synchronized processors, with the effectiveness of centralized evolutionary techniques due to optimal mix of exploitation and exploration. In this way, holistic view and effectiveness advantages of evolutionary global diagnostics are combined with reliability and efficiency benefits of distributed parallel architectures. The proposed approach was validated both (i) by simulation at CERN, on a case study of a cold box for enhancing the cryogeny diagnostics of the Large Hadron Collider, and (ii) by experiments, under the framework of the industrial research project MONDIEVOB (Building Remote Monitoring and Evolutionary Diagnostics), co-funded by EU and the company Del Bo srl, Napoli, Italy.

Structure and Computation in Immunoreagent Design: From Diagnostics to Vaccines.

Science.gov (United States)

Gourlay, Louise; Peri, Claudio; Bolognesi, Martino; Colombo, Giorgio

2017-12-01

Novel immunological tools for efficient diagnosis and treatment of emerging infections are urgently required. Advances in the diagnostic and vaccine development fields are continuously progressing, with reverse vaccinology and structural vaccinology (SV) methods for antigen identification and structure-based antigen (re)design playing increasingly relevant roles. SV, in particular, is predicted to be the front-runner in the future development of diagnostics and vaccines targeting challenging diseases such as AIDS and cancer. We review state-of-the-art methodologies for structure-based epitope identification and antigen design, with specific applicative examples. We highlight the implications of such methods for the engineering of biomolecules with improved immunological properties, potential diagnostic and/or therapeutic uses, and discuss the perspectives of structure-based rational design for the production of advanced immunoreagents. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of mammogram compression efficiency

International Nuclear Information System (INIS)

Przelaskowski, A.; Surowski, P.; Kukula, A.

2005-01-01

Lossy image coding significantly improves performance over lossless methods, but a reliable control of diagnostic accuracy regarding compressed images is necessary. The acceptable range of compression ratios must be safe with respect to as many objective criteria as possible. This study evaluates the compression efficiency of digital mammograms in both numerically lossless (reversible) and lossy (irreversible) manner. Effective compression methods and concepts were examined to increase archiving and telediagnosis performance. Lossless compression as a primary applicable tool for medical applications was verified on a set 131 mammograms. Moreover, nine radiologists participated in the evaluation of lossy compression of mammograms. Subjective rating of diagnostically important features brought a set of mean rates given for each test image. The lesion detection test resulted in binary decision data analyzed statistically. The radiologists rated and interpreted malignant and benign lesions, representative pathology symptoms, and other structures susceptible to compression distortions contained in 22 original and 62 reconstructed mammograms. Test mammograms were collected in two radiology centers for three years and then selected according to diagnostic content suitable for an evaluation of compression effects. Lossless compression efficiency of the tested coders varied, but CALIC, JPEG-LS, and SPIHT performed the best. The evaluation of lossy compression effects affecting detection ability was based on ROC-like analysis. Assuming a two-sided significance level of p=0.05, the null hypothesis that lower bit rate reconstructions are as useful for diagnosis as the originals was false in sensitivity tests with 0.04 bpp mammograms. However, verification of the same hypothesis with 0.1 bpp reconstructions suggested their acceptance. Moreover, the 1 bpp reconstructions were rated very similarly to the original mammograms in the diagnostic quality evaluation test, but the

TV Broadcast Efficiency in 5G Networks from Subscriber Prospective

KAUST Repository

Lau, Chun Pong; Shihada, Basem

2015-01-01

measuring the efficiency of a system. These metrics assess the net bitrate for a unit of spectrum bandwidth. However, there is a lack of measurement, quantifying the effectiveness of a broadcasting strategy from the user perspective. In this paper, we

Video integrated measurement system. [Diagnostic display devices

Energy Technology Data Exchange (ETDEWEB)

Spector, B.; Eilbert, L.; Finando, S.; Fukuda, F.

1982-06-01

A Video Integrated Measurement (VIM) System is described which incorporates the use of various noninvasive diagnostic procedures (moire contourography, electromyography, posturometry, infrared thermography, etc.), used individually or in combination, for the evaluation of neuromusculoskeletal and other disorders and their management with biofeedback and other therapeutic procedures. The system provides for measuring individual diagnostic and therapeutic modes, or multiple modes by split screen superimposition, of real time (actual) images of the patient and idealized (ideal-normal) models on a video monitor, along with analog and digital data, graphics, color, and other transduced symbolic information. It is concluded that this system provides an innovative and efficient method by which the therapist and patient can interact in biofeedback training/learning processes and holds considerable promise for more effective measurement and treatment of a wide variety of physical and behavioral disorders.

Nanophotonics for Molecular Diagnostics and Therapy Applications

Directory of Open Access Journals (Sweden)

João Conde

2012-01-01

Full Text Available Light has always fascinated mankind and since the beginning of recorded history it has been both a subject of research and a tool for investigation of other phenomena. Today, with the advent of nanotechnology, the use of light has reached its own dimension where light-matter interactions take place at wavelength and subwavelength scales and where the physical/chemical nature of nanostructures controls the interactions. This is the field of nanophotonics which allows for the exploration and manipulation of light in and around nanostructures, single molecules, and molecular complexes. What is more is the use of nanophotonics in biomolecular interactions—nanobiophotonics—has prompt for a plethora of molecular diagnostics and therapeutics making use of the remarkable nanoscale properties. In this paper, we shall focus on the uses of nanobiophotonics for molecular diagnostics involving specific sequence characterization of nucleic acids and for gene delivery systems of relevance for therapy strategies. The use of nanobiophotonics for the combined diagnostics/therapeutics (theranostics will also be addressed, with particular focus on those systems enabling the development of safer, more efficient, and specific platforms. Finally, the translation of nanophotonics for theranostics into the clinical setting will be discussed.

Unilateral Hemithorax Opacification on Chest Radiograph : Comparison of Diagnostic Accuracy of Chest Ultrasonography with CT

Energy Technology Data Exchange (ETDEWEB)

Namkung, Sook; Lee, Kyung Soo; Kwon, O Jung [Samsung Medical Center, Seoul (Korea, Republic of); Chung, Seung Eun [Sangkye Paek Hospital, Seoul (Korea, Republic of)

1996-12-15

To compare the diagnostic accuracy of chest ultrasonography (US) with computed tomography (CT) inpatients with opacification more than one third of unilateral hemithorax on chest radiograph (CXR). Chest US and CT scans from 41 consecutive patients with opacification more than one third of unilateral hemithorax on CXR were prospectively evaluated by two independent radiologists. Each radiologist recorded 1) the nature of pleural effusion (transudate vs. exudate), 2) presence or absence of pulmonary lesion, 3) the characteristic of pulmonary lesion (consolidation or atelectasis and tumor), and 4) presence of solid pleural tumor. The diagnostic accuracy of chest US was compared with CT scan in patients with pleural, pulmonary or other disease. In 32 patients with pleural effusion, differentiation between transudate and exudate was feasible in 27 (84%) patients with US and 26 (81%) patients with CT. In 32 patients with pulmonary and other pleural diseases, sensitivity, specificity and accuracy of US in lesion detection were 86%, 75% and 83% respectively when CT was regarded as a diagnostic gold standard. The diagnostic accuracy of chest US is comparable to CT in patients with hemithorax opacification on CXR

Unilateral Hemithorax Opacification on Chest Radiograph : Comparison of Diagnostic Accuracy of Chest Ultrasonography with CT

International Nuclear Information System (INIS)

Namkung, Sook; Lee, Kyung Soo; Kwon, O Jung; Chung, Seung Eun

1996-01-01

To compare the diagnostic accuracy of chest ultrasonography (US) with computed tomography (CT) inpatients with opacification more than one third of unilateral hemithorax on chest radiograph (CXR). Chest US and CT scans from 41 consecutive patients with opacification more than one third of unilateral hemithorax on CXR were prospectively evaluated by two independent radiologists. Each radiologist recorded 1) the nature of pleural effusion (transudate vs. exudate), 2) presence or absence of pulmonary lesion, 3) the characteristic of pulmonary lesion (consolidation or atelectasis and tumor), and 4) presence of solid pleural tumor. The diagnostic accuracy of chest US was compared with CT scan in patients with pleural, pulmonary or other disease. In 32 patients with pleural effusion, differentiation between transudate and exudate was feasible in 27 (84%) patients with US and 26 (81%) patients with CT. In 32 patients with pulmonary and other pleural diseases, sensitivity, specificity and accuracy of US in lesion detection were 86%, 75% and 83% respectively when CT was regarded as a diagnostic gold standard. The diagnostic accuracy of chest US is comparable to CT in patients with hemithorax opacification on CXR

Efficiency aspects of design and analysis of prospective cohort studies on diet, nutrition and cancer

NARCIS (Netherlands)

Kaaks, R.J.

1994-01-01

This thesis presents and analyzes methodological approaches to improve the design and analysis of prospective cohort studies on the relations between diet, nutritional status and cancer. The first chapters discuss methods to optimize the measurement of the individuals' habitual dietary

Does analgesia affect the diagnostic process in acute abdomen? a randomized clinical trial

Directory of Open Access Journals (Sweden)

Khashayar P.

2008-03-01

Full Text Available Background: About one-forth of the patients admitted to the emergency department complain of acute abdominal pain. According to surgical records, most surgeons believe that pain relief for these patients may interfere with the clinical examinations and the final diagnoses. As a result, analgesics are withheld in patients with acute abdominal pain until the determination of a definite diagnosis and suitable management plan. The purpose of this study was to evaluate the effect of analgesics on the evaluation course and treatment in acute abdomen.Methods: Two hundred patients at a surgical emergency department with acute abdominal pain were enrolled in this prospective study and randomly divided into two groups at the time of admission. The case group consisted of 98 patients who received intravenous analgesia immediately after admission. The other 102 patients in the control group did not receive analgesia until a definite diagnosis was made. Diagnostic and therapeutic procedures were similar between the two groups. The primary and final diagnoses, and the time intervals between the admission and definite diagnosis, and that between admission and surgery were gathered and analyzed.Results: The mean time to definitive diagnosis was 1.7 and 2.04 hours in the case and control groups, respectively. There was no statistically significant relationship between analgesic use and gender, age, time to definite diagnosis, or accuracy of the diagnosis. In fact, the time required to achieve a definite diagnosis and the time between admission and surgery were less in the group that had received analgesics. Conclusions: In spite of the fact that analgesics remove the very symptoms that brings patients to the emergency room, appropriate use of analgesics does not reduce diagnostic efficiency for patients with acute abdominal pain.

Diagnostics of the Factors Influencing the Export Activity of an Enterprise

Directory of Open Access Journals (Sweden)

Skrynkovskyy Ruslan M.

2017-09-01

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

Efficient diagnostic evaluation of fractures of the talus - an analysis based on examination of 40 patients

International Nuclear Information System (INIS)

Foerster, A.; Roehnert, W.; Koehler, K.

1997-01-01

Conventional radiography imaging the ankle joint in two planes is the initial technique applied, giving information on further diagnostic evaluation required. CT is of importance for such additional examination, and spiral CT in particular, as it can generate directly comparable pictures due to its standardised examination techniques. Joint surfaces are visualized without superpositions. Fractures and their numbers, dislocations as well as involvement of joint surfaces can be better detected. Also, spiral CT, due to the continuous data set generated, permits 2D reconstructions of high quality. 3D Reconstructions as a rule do not supply additional information. CT can be applied for diagnostic evaluation of the tendon and ligamentum system/soft tissue, but MRI will yield better results. (orig./CB) [de

Diagnostics for studies of novel laser ion acceleration mechanisms

Energy Technology Data Exchange (ETDEWEB)

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

2014-11-15

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

Diagnostics for studies of novel laser ion acceleration mechanisms

International Nuclear Information System (INIS)

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

2014-01-01

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

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

Science.gov (United States)

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

2015-11-15

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

Protocol of a single group prospective observational study on the diagnostic value of 3T susceptibility weighted MRI of nigrosome-1 in patients with parkinsonian symptoms: the N3iPD study (nigrosomal iron imaging in Parkinson's disease).

Science.gov (United States)

Schwarz, Stefan T; Xing, Yue; Naidu, Saadnah; Birchall, Jim; Skelly, Rob; Perkins, Alan; Evans, Jonathan; Sare, Gill; Martin-Bastida, Antonio; Bajaj, Nin; Gowland, Penny; Piccini, Paola; Auer, Dorothee P

2017-12-14

Parkinson's disease (PD) is the most common movement disorder in the elderly and is characterised clinically by bradykinesia, tremor and rigidity. Diagnosing Parkinson's can be difficult especially in the early stages. High-resolution nigrosome MRI offers promising diagnostic accuracy of patients with established clinical symptoms; however, it is unclear whether this may help to establish the diagnosis in the early stages of PD, when there is diagnostic uncertainty. In this scenario, a single photon emission CT scan using a radioactive dopamine transporter ligand can help to establish the diagnosis, or clinical follow-up may eventually clarify the diagnosis. A non-invasive, cost-effective diagnostic test that could replace this would be desirable. We therefore aim to prospectively test whether nigrosome MRI is as useful as DaTSCAN to establish the correct diagnosis in people with minor or unclear symptoms suspicious for PD. In a prospective study we will recruit 145 patients with unclear symptoms possibly caused by Parkinson's from three movement disorder centres in the UK to take part in the study. We will record the Movement Disorder Society - Unified Parkinson's Disease Rating Scale, and participants will undergo DaTSCAN and high-resolution susceptibility weighted MRI at a field strength of 3T. DaTSCANs will be assessed visually and semiquantitatively; MRI scans will be visually assessed for signal loss in nigrosome-1 by blinded investigators. We will compare how the diagnosis suggested by MRI compares with the diagnosis based on DaTSCAN and will also validate the diagnosis based on the two tests with a clinical examination performed at least 1 year after the initial presentation as a surrogate gold standard diagnostic test. The local ethics commission (Health Research Authority East Midlands - Derby Research Ethics Committee) has approved this study (REC ref.: 16/EM/0229). The study is being carried out under the principles of the Declaration of Helsinki (64

Infrared laser diagnostics for ITER

International Nuclear Information System (INIS)

Hutchinson, D.P.; Richards, R.K.; Ma, C.H.

1995-01-01

Two infrared laser-based diagnostics are under development at ORNL for measurements on burning plasmas such as ITER. The primary effort is the development of a CO 2 laser Thomson scattering diagnostic for the measurement of the velocity distribution of confined fusion-product alpha particles. Key components of the system include a high-power, single-mode CO 2 pulsed laser, an efficient optics system for beam transport and a multichannel low-noise infrared heterodyne receiver. A successful proof-of-principle experiment has been performed on the Advanced Toroidal Facility (ATF) stellerator at ORNL utilizing scattering from electron plasma frequency satellites. The diagnostic system is currently being installed on Alcator C-Mod at MIT for measurements of the fast ion tail produced by ICRH heating. A second diagnostic under development at ORNL is an infrared polarimeter for Faraday rotation measurements in future fusion experiments. A preliminary feasibility study of a CO 2 laser tangential viewing polarimeter for measuring electron density profiles in ITER has been completed. For ITER plasma parameters and a polarimeter wavelength of 10.6 microm, a Faraday rotation of up to 26 degree is predicted. An electro-optic polarization modulation technique has been developed at ORNL. Laboratory tests of this polarimeter demonstrated a sensitivity of ≤ 0.01 degree. Because of the similarity in the expected Faraday rotation in ITER and Alcator C-Mod, a collaboration between ORNL and the MIT Plasma Fusion Center has been undertaken to test this polarimeter system on Alcator C-Mod. A 10.6 microm polarimeter for this measurement has been constructed and integrated into the existing C-Mod multichannel two-color interferometer. With present experimental parameters for C-Mod, the predicted Faraday rotation was on the order of 0.1 degree. Significant output signals were observed during preliminary tests. Further experiment and detailed analyses are under way

The Diagnostic Efficiency of 99mTc-EDDA/HYNIC-Octreotate SPECT-CT in Comparison with 111In-Pentetrotide in the Detection of Neuroendocrine Tumours

Directory of Open Access Journals (Sweden)

Emel Koçyiğit Deveci

2013-12-01

Full Text Available Objective: The aim of this study was to assess the diagnostic efficiency of 99mTc-EDDA/HYNIC-Octreotate in comparison with 111Inpentetrotide scintigraphy in the detection of neuroendocrine tumors. This study also evaluates the impact of SPECT-CT hybrid imaging on somatostatin receptor scintigraphy (SRS interpretation and clinical management of these tumors. Methods: Fourteen patients were included in the study. All patients underwent a whole body and SPECT-CT imaging with both 99mTcEDDA/HYNIC-octreotate and 111In-pentetrotide. Images were evaluated both visually and semiquantitatively. Results: On patient basis, the diagnostic results of both studies were similar. The number of lesions detected by 99mTc- EDDA/HYNICOctreotate were higher than the number of lesions detected by 111In-pentetrotide however the difference was not significant (40/43( 93%, 36/43 (83% p=0.109. Semiquantitative analysis showed higher tumor/organ count ratios for both whole-body and SPECT 99mTc- EDDA/HYNIC-Octreotate scans. Conclusion: The results of this study suggested that, 99mTc- EDDA/HYNIC-Octreotate may be a better alternative to 111In- pentetrotide due to high image quality and lower radiation dose. SPECT/CT is a valuable tool for the assessment of neuroendocrine tumors by providing the precise anatomic localization of scintigraphic findings thus improving lesion detectability and characterization.

The Diagnostic Efficiency of 99mTc-EDDA/HYNIC-Octreotate SPECT-CT in Comparison with 111In-Pentetrotide in the Detection of Neuroendocrine Tumours.

Science.gov (United States)

Koçyiğit Deveci, Emel; Ocak, Meltem; Bozkurt, Murat Fani; Türker, Selcan; Kabasakal, Levent; Uğur, Omer

2013-12-01

The aim of this study was to assess the diagnostic efficiency of (99m)Tc-EDDA/HYNIC-Octreotate in comparison with (111)Inpentetrotide scintigraphy in the detection of neuroendocrine tumors. This study also evaluates the impact of SPECT-CT hybrid imaging on somatostatin receptor scintigraphy (SRS) interpretation and clinical management of these tumors. Fourteen patients were included in the study. All patients underwent a whole body and SPECT-CT imaging with both (99m)Tc- EDDA/HYNIC-octreotate and (111)In-pentetrotide. Images were evaluated both visually and semiquantitatively. On patient basis, the diagnostic results of both studies were similar. The number of lesions detected by (99m)Tc- EDDA/HYNICOctreotate were higher than the number of lesions detected by (111)In-pentetrotide however the difference was not significant (40/43( 93%), 36/43 (83%) p=0.109). Semiquantitative analysis showed higher tumor/organ count ratios for both whole-body and SPECT (99m)Tc- EDDA/HYNIC-Octreotate scans. The results of this study suggested that, (99m)Tc- EDDA/HYNIC-Octreotate may be a better alternative to (111)In- pentetrotide due to high image quality and lower radiation dose. SPECT/CT is a valuable tool for the assessment of neuroendocrine tumors by providing the precise anatomic localization of scintigraphic findings thus improving lesion detectability and characterization. None declared.

Diagnostic accuracy of surgeons and trainees in assessment of patients with acute abdominal pain.

Science.gov (United States)

2016-09-01

Diagnostic accuracy in the assessment of patients with acute abdominal pain in the emergency ward is not adequate. It has been argued that this is because the investigations are carried out predominantly by a trainee. Resource utilization could be lowered if surgeons had a higher initial diagnostic accuracy. Patients with acute abdominal pain were included in a prospective cohort study. A surgical trainee and a surgeon made independent assessments in the emergency department, recording the clinical diagnosis and proposed diagnostic investigations. A reference standard diagnosis was established by an expert panel, and the proportion of correct diagnoses was calculated. Diagnostic accuracy was expressed in terms of sensitivity, specificity, positive predictive value and negative predictive value. Interobserver agreement for the diagnosis and elements of history-taking and physical examination were expressed by means of Cohen's κ. Certainty of diagnosis was recorded using a visual analogue scale. A trainee and a surgeon independently assessed 126 patients. Trainees made a correct diagnosis in 44·4 per cent of patients and surgeons in 42·9 per cent (P = 0·839). Surgeons, however, recorded a higher level of diagnostic certainty. Diagnostic accuracy was comparable in distinguishing urgent from non-urgent diagnoses, and for the most common diseases. Interobserver agreement for the clinical diagnosis varied from fair to moderate (κ = 0·28-0·57). The diagnostic accuracy of the initial clinical assessment is not improved when a surgeon rather than a surgical trainee assesses a patient with abdominal pain in the emergency department. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

The interpretation of diagnostic tests

International Nuclear Information System (INIS)

Lamk, M.; Lamki, M.D.

1987-01-01

The progress of nuclear and other diagnostic imaging is near rampant. With almost every issue of the major journals in this field, a new diagnostic test, or at least a new utility of an old test is described. Before we accept these innovations, we have to have a clear understanding of the clinical performance of the test. The major criteria are the sensitivity and the specificity of the test. From these derived other statistical parameters such as accuracy or efficiency of that test; also, the receiver operating characteristic (ROC) curves may then be evaluated and used in comparison of different tests. When we know the prevalence of the disease tested in the population we are investigating, we can then derive the predictive value of a positive or a negative result. This introduction tries to explain these parameters to help the reader understand the literature dealing with the subject of efficacy of imaging procedures. It is not intended as a critical review of the literature on the subject or a comprehensive overview of the subject matter. The benefit derived from explaination of statistical concepts to physicians is documented in a recent publication. Explaination of these basic statistical parameters will be followed by a demonstration of the utility of multiple testing with these parameters. The reader is thereby introduced to relevant statistical concepts that must be grasped for full comprehension of published results of a new diagnostic imaging modality, or before clinical decision making

Performance Evaluation of Commercial Dengue Diagnostic Tests for Early Detection of Dengue in Clinical Samples

Directory of Open Access Journals (Sweden)

Tuan Nur Akmalina Mat Jusoh

2017-01-01

Full Text Available The shattering rise in dengue virus infections globally has created a need for an accurate and validated rapid diagnostic test for this virus. Rapid diagnostic test (RDT and reverse transcription-polymerase chain reaction (RT-PCR diagnostic detection are useful tools for diagnosis of early dengue infection. We prospectively evaluated the diagnostic performance of nonstructural 1 (NS1 RDT and real-time RT-PCR diagnostic kits in 86 patient serum samples. Thirty-six samples were positive for dengue NS1 antigen while the remaining 50 were negative when tested with enzyme-linked immunosorbent assay (ELISA. Commercially available RDTs for NS1 detection, RTK ProDetect™, and SD Bioline showed high sensitivity of 94% and 89%, respectively, compared with ELISA. GenoAmp® Trioplex Real-Time RT-PCR and RealStar® Dengue RT-PCR tests presented a comparable kappa agreement with 0.722. The result obtained from GenoAmp® Real-Time RT-PCR Dengue test showed that 14 samples harbored dengue virus type 1 (DENV-1, 8 samples harbored DENV-2, 2 samples harbored DENV-3, and 1 sample harbored DENV-4. 1 sample had a double infection with DENV-1 and DENV-2. The NS1 RDTs and real-time RT-PCR tests were found to be a useful diagnostic for early and rapid diagnosis of acute dengue and an excellent surveillance tool in our battle against dengue.

Labor Factor Efficiency in the Agricultural Industry

Science.gov (United States)

R?y, Inna U.; Shakulikova, Gulzada T.; Kozhakhmetova, Gulnar A.; Lashkareva, Olga V.; Bondarenko, Elena G.; Bermukhambetova, Botagoz B.; Baimagambetova, Zamzagul A.; Zhetessova, Mariyam T.; Beketova, Kamar N.; Anafiyaeva, Zhibek

2016-01-01

Agricultural problems associated with prospects of the rural population and agriculture in general have recently become an important factor in the modern economic policy development. The urgency of finding ways to improve the labor resource efficiency in agriculture pursuant to the state tasks is determined by the need to restore the agricultural…

Cost-efficiency of specialist hyperacute in-patient rehabilitation services for medically unstable patients with complex rehabilitation needs: a prospective cohort analysis.

Science.gov (United States)

Turner-Stokes, Lynne; Bavikatte, Ganesh; Williams, Heather; Bill, Alan; Sephton, Keith

2016-09-08

To evaluate functional outcomes, care needs and cost-efficiency of hyperacute (HA) rehabilitation for a cohort of in-patients with complex neurological disability and unstable medical/surgical conditions. A multicentre cohort analysis of prospectively collected clinical data from the UK Rehabilitation Outcomes Collaborative (UKROC) national clinical database, 2012-2015. Two HA specialist rehabilitation services in England, providing different service models for HA rehabilitation. All patients admitted to each of the units with an admission rehabilitation complexity M score of ≥3 (N=190; mean age 46 (SD16) years; males:females 63:37%). Diagnoses were acquired brain injury (n=166; 87%), spinal cord injury (n=9; 5%), peripheral neurological conditions (n=9; 5%) and other (n=6; 3%). Specialist in-patient multidisciplinary rehabilitation combined with management and stabilisation of intercurrent medical and surgical problems. Rehabilitation complexity and medical acuity: Rehabilitation Complexity Scale-version 13. Dependency and care costs: Northwick Park Dependency Scale/Care Needs Assessment (NPDS/NPCNA). Functional independence: UK Functional Assessment Measure (UK FIM+FAM). (1) reduction in dependency and (2) cost-efficiency, measured as the time taken to offset rehabilitation costs by savings in NPCNA-estimated costs of on-going care in the community. The mean length of stay was 103 (SD66) days. Some differences were observed between the two units, which were in keeping with the different service models. However, both units showed a significant reduction in dependency and acuity between admission and discharge on all measures (Wilcoxon: pspecialist HA rehabilitation can be highly cost-efficient, producing substantial savings in on-going care costs, and relieving pressure in the acute care services. 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/

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

Science.gov (United States)

Erford, Bradley T.; Klein, Lauren

2007-01-01

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

Diagnostic accuracy of ultrasound, computed tomography, and endoscopic retrograde choleangiopancreatography in the detection of obstructive jaundice

International Nuclear Information System (INIS)

Pasanen, P.A.; Partainen, K.; Pikkarainen, P.; Alhava, E.; Pirinen, A.; Janatuinen, E.

1991-01-01

The purpose of this prospective study was to investigate the diagnostic accuracy of ultrasound (US), computed tomography (CT), and endoscopic retrograde cholangiopancreatography (ERCP) in the distinction between extrahepatic and intrahepatic causes of jaundice. The limit for the inclusion to the study was defined as a serum bilirubin concentration ≥40μmol/l. Altogether 187 jaundiced patients were studied. The sensitivities of US, CT and ERCP were 63%, 77%, and 87%, respectively. The differences between all these methods were statistically significant. The specificities and positive predictive values were high, reaching 96-99%, but the negative predictive values were low, ranging between 38% and 60%. Choledochal stone disease constituted the main etiology of false-negative studies in all investigations. Imaging procedures have a prominent role in the diagnostic study of the jaundiced patient, but it is obvious that their diagnostic accuracy may vary between institutions because of the variance in local experience and expertise and because of the differences in diseases causing jaundice. 37 refs., 5 tabs

Service engineering for prospective vehicle service processes

OpenAIRE

Nagel, Alexander; Steinhilper, Rolf; Freiberger, Stefan; Thäter, Stefan

2013-01-01

Garages are - concerning the vehicle service - faced with growing complexity in automotive mechatronics and on-board bus communication technology. Because of the necessity of profound technical knowledge and smart as well as cost efficient diagnostic tools for garages, Bayreuth University and Fraunhofer IPA pick up the challenge and develop innovative service-processes for future requirements by the project "Kfz-Service Engineering 2020". In order to improve established service-processes and ...

Incidence of spontaneous twin anemia-polycythemia sequence in monochorionic-diamniotic twin pregnancies: Single-center prospective study.

Science.gov (United States)

Yokouchi, Tae; Murakoshi, Takeshi; Mishima, Takashi; Yano, Hiroko; Ohashi, Madoka; Suzuki, Takashi; Shinno, Takashi; Matsushita, Mitsuru; Nakayama, Satoru; Torii, Yuichi

2015-06-01

The purpose of this study was to prospectively estimate the incidence of spontaneous twin anemia-polycythemia sequence (TAPS) in monochorionic-diamniotic twin pregnancies. We prospectively examined umbilical cord hemoglobin (Hb) and reticulocyte count of consecutive monochorionic-diamniotic twin pregnancies delivered at Seirei Hamamatsu General Hospital from December 2006 to September 2013. We excluded cases of twin-twin transfusion syndrome, intrauterine fetal demise, and missing data (Hb and reticulocyte count missing from the medical record). TAPS was diagnosed using the postnatal criteria of intertwin Hb difference >8.0 g/dL and reticulocyte count ratio >1.7. Acute feto-fetal hemorrhage was defined as Hb difference >7 g/dL and reticulocyte count ratio <1.7. A total of 185 monochorionic-diamniotic twin pregnancies were included in this study. Three fulfilled the diagnostic criteria for postnatal TAPS, and one fulfilled the diagnostic criteria for acute feto-fetal hemorrhage. The incidence of spontaneous TAPS in monochorionic-diamniotic twin pregnancies was 1.6% (3/185) at Seirei Hamamatsu General Hospital. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

New developments in the surveillance and diagnostics technology for vibration, structure-borne sound and leakage monitoring systems

International Nuclear Information System (INIS)

Gloth, Gerrit

2009-01-01

Monitoring and diagnostic systems are of main importance for a safe and efficient operation of nuclear power plants. The author describes new developments with respect to vibration monitoring with a functional extension in the time domain for den secondary circuit, the development of a local system for the surveillance of rotating machines, the structure-borne sound monitoring with improvement of event analysis, esp. the loose part locating, leakage monitoring with a complete system for humidity measurement, and the development of a common platform for all monitoring and diagnostic systems, that allows an efficient access for comparison and cross references.

Diagnostic Accuracy of Clinical Examination and Imaging Findings for Identifying Subacromial Pain.

Science.gov (United States)

Cadogan, Angela; McNair, Peter J; Laslett, Mark; Hing, Wayne A

2016-01-01

The diagnosis of subacromial pathology is limited by the poor accuracy of clinical tests for specific pathologies. The aim of this study was to estimate the diagnostic accuracy of clinical examination and imaging features for identifying subacromial pain (SAP) defined by a positive response to diagnostic injection, and to evaluate the influence of imaging findings on the clinical diagnosis of SAP. In a prospective, diagnostic accuracy design, 208 consecutive patients presenting to their primary healthcare practitioner for the first time with a new episode of shoulder pain were recruited. All participants underwent a standardized clinical examination, shoulder x-ray series and diagnostic ultrasound scan. Results were compared with the response to a diagnostic block of xylocaineTM injected into the SAB under ultrasound guidance using ≥80% post-injection reduction in pain intensity as the positive anaesthetic response (PAR) criterion. Diagnostic accuracy statistics were calculated for combinations of clinical and imaging variables demonstrating the highest likelihood of a PAR. A PAR was reported by 34% of participants. In participants with no loss of passive external rotation, combinations of three clinical variables (anterior shoulder pain, strain injury, absence of symptoms at end-range external rotation (in abduction)) demonstrated 100% specificity for a PAR when all three were positive (LR+ infinity; 95%CI 2.9, infinity). A full-thickness supraspinatus tear on ultrasound increased the likelihood of a PAR irrespective of age (specificity 98% (95%CI 94, 100); LR+ 6.2; 95% CI 1.5, 25.7)). Imaging did not improve the ability to rule-out a PAR. Combinations of clinical examination findings and a full-thickness supraspinatus tear on ultrasound scan can help confirm, but not exclude, the presence of subacromial pain. Other imaging findings were of limited value for diagnosing SAP.

Premorbid personality in schizophrenia spectrum: a prospective study

DEFF Research Database (Denmark)

Ekstrøm, Morten; Lykke Mortensen, Erik; Sørensen, Holger J

2006-01-01

Schizophrenia has been linked with premorbid character anomalies since it was first described. However, few prospective studies of premorbid personality characteristics in schizophrenia and related disorders have been conducted. This study evaluates premorbid personality in children who developed...... to these three diagnostic categories. Twelve-year-old children destined to develop a disorder in the schizophrenia spectrum deviated significantly from healthy controls on a number of personality characteristics: they were rated significantly lower than controls on intelligence, concentration, maturity......, friendliness, cooperation, self-control and significantly higher on aggression. Non-significant trends indicated that this group displayed more deviant personality scores than psychiatric controls. Children who later develop schizophrenia spectrum disorder differed from normal controls with respect to a number...

Study of an experimental methodology for thermal properties diagnostic of building envelop

OpenAIRE

Yang , Yingying; Sempey , Alain; Vogt Wu , Tingting; Sommier , Alain; Dumoulin , Jean; Batsale , Jean ,

2017-01-01

International audience; The building envelope plays a critical role in determining levels of comfort and building efficiency. Its real thermal properties characterization is of major interest to be able to diagnose energy efficiency performance of buildings (new construction and retrofitted existing old building). Research and development on a possible methodology for energy diagnostic of the building envelop is a hot topic and necessary trend. Many kinds of sensors and instruments are used f...

PET-PANC: multicentre prospective diagnostic accuracy and health economic analysis study of the impact of combined modality 18fluorine-2-fluoro-2-deoxy-d-glucose positron emission tomography with computed tomography scanning in the diagnosis and management of pancreatic cancer.

Science.gov (United States)

Ghaneh, Paula; Hanson, Robert; Titman, Andrew; Lancaster, Gill; Plumpton, Catrin; Lloyd-Williams, Huw; Yeo, Seow Tien; Edwards, Rhiannon Tudor; Johnson, Colin; Abu Hilal, Mohammed; Higginson, Antony P; Armstrong, Tom; Smith, Andrew; Scarsbrook, Andrew; McKay, Colin; Carter, Ross; Sutcliffe, Robert P; Bramhall, Simon; Kocher, Hemant M; Cunningham, David; Pereira, Stephen P; Davidson, Brian; Chang, David; Khan, Saboor; Zealley, Ian; Sarker, Debashis; Al Sarireh, Bilal; Charnley, Richard; Lobo, Dileep; Nicolson, Marianne; Halloran, Christopher; Raraty, Michael; Sutton, Robert; Vinjamuri, Sobhan; Evans, Jonathan; Campbell, Fiona; Deeks, Jon; Sanghera, Bal; Wong, Wai-Lup; Neoptolemos, John P

2018-02-01

Pancreatic cancer diagnosis and staging can be difficult in 10-20% of patients. Positron emission tomography (PET)/computed tomography (CT) adds precise anatomical localisation to functional data. The use of PET/CT may add further value to the diagnosis and staging of pancreatic cancer. To determine the incremental diagnostic accuracy and impact of PET/CT in addition to standard diagnostic work-up in patients with suspected pancreatic cancer. A multicentre prospective diagnostic accuracy and clinical value study of PET/CT in suspected pancreatic malignancy. Patients with suspected pancreatic malignancy. All patients to undergo PET/CT following standard diagnostic work-up. The primary outcome was the incremental diagnostic value of PET/CT in addition to standard diagnostic work-up with multidetector computed tomography (MDCT). Secondary outcomes were (1) changes in patients' diagnosis, staging and management as a result of PET/CT; (2) changes in the costs and effectiveness of patient management as a result of PET/CT; (3) the incremental diagnostic value of PET/CT in chronic pancreatitis; (4) the identification of groups of patients who would benefit most from PET/CT; and (5) the incremental diagnostic value of PET/CT in other pancreatic tumours. Between 2011 and 2013, 589 patients with suspected pancreatic cancer underwent MDCT and PET/CT, with 550 patients having complete data and in-range PET/CT. Sensitivity and specificity for the diagnosis of pancreatic cancer were 88.5% and 70.6%, respectively, for MDCT and 92.7% and 75.8%, respectively, for PET/CT. The maximum standardised uptake value (SUV max. ) for a pancreatic cancer diagnosis was 7.5. PET/CT demonstrated a significant improvement in relative sensitivity ( p  = 0.01) and specificity ( p  = 0.023) compared with MDCT. Incremental likelihood ratios demonstrated that PET/CT significantly improved diagnostic accuracy in all scenarios ( p  diagnostic benefit in the diagnosis of pancreatic cancer and

IRRITABLE BOWEL SYNDROME IN CHILDREN: DIAGNOSTICS AND MODERN APPROACHES TO THERAPY

Directory of Open Access Journals (Sweden)

S.Yu. Tereshchenko

2006-01-01

Full Text Available In the article modern data on prevalence, diagnostic criteria and approaches to the treatment of irritable bowel in children are presented. The issues of the terminology and classification of recurrent abdominal pains in children are clarified, the basic pathophysiological mechanisms of the disease are indicated. Particular emphasis has been placed on the efficient therapy of the different clinical variants of irritable bowel syndrome. The role of modern spasmolytic drugs in the treatment of abdominal pain syndrome and the rational usage of laxatives in constipation in children is shown.Key words: children, irritable bowel syndrome, diagnostics, treatment.

On the economic prospects of nuclear fusion with tokamaks

International Nuclear Information System (INIS)

Pfirsch, D.; Schmitter, K.H.

1987-12-01

This paper describes a method of cost and construction energy estimation for tokamak fusion power stations conforming to the present, early stage of fusion development. The method is based on first-wall heat load constraints rather than β limitations, which, however, might eventually be the more critical of the two. It is used to discuss the economic efficiency of pure fusion, with particular reference to the European study entitled 'Environmental Impact and Economic Prospects of Nuclear Fusion'. It is shown that the claims made therein for the economic prospects of pure fusion with tokamaks, when discussed on the basis of the present-day technology, do not stand up to critical examination. A fusion-fission hybrid, however, could afford more positive prospects. Support for the stated method is even derived when it is properly applied for cost estimation of advanced gascooled and Magnox reactors, the two very examples presented by the European study to 'disprove' it. (orig.)

Field-testing of the ICHD-3 beta diagnostic criteria for classical trigeminal neuralgia

DEFF Research Database (Denmark)

Maarbjerg, Stine; Sørensen, Morten Togo; Gozalov, Aydin

2015-01-01

INTRODUCTION: We aimed to field-test the beta version of the third edition of the International Classification of Headache Disorders (ICHD-3 beta) diagnostic criteria for classical trigeminal neuralgia (TN). The proposed beta draft of the 11th version of the International Classification of Diseases...... (ICD-11 beta) is almost exclusively based on the ICHD-3 beta classification structure although slightly abbreviated. We compared sensitivity and specificity to ICHD-2 criteria, and evaluated the needs for revision. METHODS: Clinical characteristics were systematically and prospectively collected from...

Effect of prospective reimbursement on nursing home costs.

Science.gov (United States)

Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P

1993-04-01

This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and facility case-mix information from random, stratified samples of homes and residents. Data were obtained for six years (1979-1985) covering the three-year period before and after implementation of the prospective payment system. This study used a pre-post, longitudinal analytical design in which interrupted, time-series regression models were estimated to test the effects of prospective payment and other factors, e.g., facility characteristics, nursing home market factors, facility case mix, and quality of care, on nursing home costs. Prospective payment contributed to an estimated $3.03 decrease in total variable costs in the third year from what would have been expected under the previous retrospective cost-based payment system. Responsiveness to payment system efficiency incentives declined over the study period, however, indicating a growing problem in achieving further cost reductions. Some evidence suggested that cost reductions might have reduced access for public patients. Study findings are consistent with the results of other studies that have demonstrated the effectiveness of prospective payment systems in restraining nursing home costs. Potential policy trade-offs among cost containment, access, and quality assurance deserve further consideration, particularly by researchers and policymakers designing the new generation of case mix-based and other nursing home payment systems.

Clinical Characteristics of Aerobic Vaginitis and Its Association to Vaginal Candidiasis, Trichomonas Vaginitis and Bacterial Vaginosis

OpenAIRE

Jahic, Mahira; Mulavdic, Mirsada; Nurkic, Jasmina; Jahic, Elmir; Nurkic, Midhat

2013-01-01

ABSTRACT Aim of the work: Examine clinical characteristics of aerobic vaginitis and mixed infection for the purpose of better diagnostic accuracy and treatment efficiency. Materials and methods: Prospective research has been conducted at Clinic for Gynecology and Obstetrics, Department for Microbiology and Pathology at Polyclinic for laboratory diagnostic and Gynecology and Obstetrics Department at Health Center Sapna. Examination included 100 examinees with the signs of vaginitis. Examinatio...

Prospects for a bio-based succinate industry.

Science.gov (United States)

McKinlay, James B; Vieille, C; Zeikus, J Gregory

2007-09-01

Bio-based succinate is receiving increasing attention as a potential intermediary feedstock for replacing a large petrochemical-based bulk chemical market. The prospective economical and environmental benefits of a bio-based succinate industry have motivated research and development of succinate-producing organisms. Bio-based succinate is still faced with the challenge of becoming cost competitive against petrochemical-based alternatives. High succinate concentrations must be produced at high rates, with little or no by-products to most efficiently use substrates and to simplify purification procedures. Herein are described the current prospects for a bio-based succinate industry, with emphasis on specific bacteria that show the greatest promise for industrial succinate production. The succinate-producing characteristics and the metabolic pathway used by each bacterial species are described, and the advantages and disadvantages of each bacterial system are discussed.

Geochemical prospecting for uranium and thorium deposits

International Nuclear Information System (INIS)

Boyle, R.W.

1980-01-01

A brief review of analytical geochemical prospecting methods for uranium and thorium is given excluding radiometric techniques, except those utilized in the determination of radon. The indicator (pathfinder) elements useful in geochemical surveys are listed for each of the types of known uranium and thorium deposits; this is followed by sections on analytical geochemical surveys based on rocks (lithochemical surveys), unconsolidated materials (pedochemical surveys), natural waters and sediments (hydrochemical surveys), biological materials (biogeochemical surveys) and gases (atmochemical surveys). All of the analytical geochemical methods are applicable in prospecting for thorium and uranium, particularly where radiometric methods fail due to attenuation by overburden, water, deep leaching and so on. Efficiency in the discovery of uranium and/or thorium orebodies is promoted by an integrated methods approach employing geological pattern recognition in the localization of deposits, analytical geochemical surveys, and radiometric surveys. (author)

Diagnostics of communication and information environment of pedagogical program means

Directory of Open Access Journals (Sweden)

Елена Вадимовна Журавлёва

2010-06-01

Full Text Available The efficiency of pedagogical program means is considered through the correctness of a communication and information environment organization. The totality of pedagogical conditions is adduced; the communication and information environment answers these conditions. The main directions (didactic, psychological, ergonomic of analysis are determined and the methods choice for their diagnostics is grounded.

[Metformin efficiency for the adolescent PCOS treatment].

Science.gov (United States)

Kedikova, S; Sirakov, M; Boyadzhieva, M

2012-01-01

PCOS is a polyglandular heterogenic metabolic condition, which frequency in adolescence is defined between 11-26%. There are some aspects of PCOS which can be seen in a regular puberty and vice versa. This makes the adolescent PCOS a condition which is rather complicated to diagnose as well as to treat. The pathophysiology of PCOS is not fully clarified, but is well established the fundamental role of the insulin resistance and the hyperinsulinemia. This fact explains the detailed investigations of the insulin sensitizers use for the PCOS treatment. Nevertheless there is insufficient experience with this medication group for the adolescent PCOS treatment in Bulgaria. To evaluate the Metformin efficiency for the adolescent PCOS treatment. This is a prospective study including 55 girls with menstrual irregularities aged between 13 and 18 years. None of the subjects had previously been diagnosed with any endocrine pathology or had received any hormonal treatment for at least three months prior to their evaluation. They have been evaluated according to the diagnostic criteria for PCOS in adolescence accepted in 2010. The incidence of PCOS in our research was 38.9%. In 66.7% of them the body mass index was higher than normal. Insulin resistance was diagnosed in 90.5%. The insulin resistance was improved in 80% of the PCOS patients after six months therapy with Metformin 2 x 850 mg/p.d. The menstrual function was regulated in 77.8% of the cases.

Diagnostic accuracy of low-dose CT compared with abdominal radiography in non-traumatic acute abdominal pain: prospective study and systematic review.

Science.gov (United States)

Alshamari, Muhammed; Norrman, Eva; Geijer, Mats; Jansson, Kjell; Geijer, Håkan

2016-06-01

Abdominal radiography is frequently used in acute abdominal non-traumatic pain despite the availability of more advanced diagnostic modalities. This study evaluates the diagnostic accuracy of low-dose CT compared with abdominal radiography, at similar radiation dose levels. Fifty-eight patients were imaged with both methods and were reviewed independently by three radiologists. The reference standard was obtained from the diagnosis in medical records. Sensitivity and specificity were calculated. A systematic review was performed after a literature search, finding a total of six relevant studies including the present. Overall sensitivity with 95 % CI for CT was 75 % (66-83 %) and 46 % (37-56 %) for radiography. Specificity was 87 % (77-94 %) for both methods. In the systematic review the overall sensitivity for CT varied between 75 and 96 % with specificity from 83 to 95 % while the overall sensitivity for abdominal radiography varied between 30 and 77 % with specificity 75 to 88 %. Based on the current study and available evidence, low-dose CT has higher diagnostic accuracy than abdominal radiography and it should, where logistically possible, replace abdominal radiography in the workup of adult patients with acute non-traumatic abdominal pain. • Low-dose CT has a higher diagnostic accuracy than radiography. • A systematic review shows that CT has better diagnostic accuracy than radiography. • Radiography has no place in the workup of acute non-traumatic abdominal pain.

Design considerations for highly effective fluorescence excitation and detection optical systems for molecular diagnostics

Science.gov (United States)

Kasper, Axel; Van Hille, Herbert; Kuk, Sola

2018-02-01

Modern instruments for molecular diagnostics are continuously optimized for diagnostic accuracy, versatility and throughput. The latest progress in LED technology together with tailored optics solutions allows developing highly efficient photonics engines perfectly adapted to the sample under test. Super-bright chip-on-board LED light sources are a key component for such instruments providing maximum luminous intensities in a multitude of narrow spectral bands. In particular the combination of white LEDs with other narrow band LEDs allows achieving optimum efficiency outperforming traditional Xenon light sources in terms of energy consumption, heat dissipation in the system, and switching time between spectral channels. Maximum sensitivity of the diagnostic system can only be achieved with an optimized optics system for the illumination and imaging of the sample. The illumination beam path must be designed for optimum homogeneity across the field while precisely limiting the angular distribution of the excitation light. This is a necessity for avoiding spill-over to the detection beam path and guaranteeing the efficiency of the spectral filtering. The imaging optics must combine high spatial resolution, high light collection efficiency and optimized suppression of excitation light for good signal-to-noise ratio. In order to achieve minimum cross-talk between individual wells in the sample, the optics design must also consider the generation of stray light and the formation of ghost images. We discuss what parameters and limitations have to be considered in an integrated system design approach covering the full path from the light source to the detector.

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

NARCIS (Netherlands)

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

2012-01-01

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

Specific Features of Diagnostics of Efficiency of Management of Innovation Risks at Enterprises of the Baking Industry (Cost-is-no-object Approach

Directory of Open Access Journals (Sweden)

Bilynska Juliana V.

2014-03-01

Full Text Available The article analyses diagnostics of efficiency of management of innovation risks through cost optimisation. Management of costs on innovation grounds is carried out with the aim of their reduction. In order to realise measures on reduction of influence of innovation risks in the system of cost management the article specifies the most important factors and builds multi-factor models. The process of study of influence of the innovation risk upon the cost value of the sold products of bakeries is presented in the form of a scheme of logically united stages. The article takes into account all restrictions and requirements, eliminates multi-collinearity and uses MS Excel Regression analysis for modelling dynamic multi-factor models of cost value of sold products of the studied bakeries. In the result of the study the article obtains main factors that would be used for forecasting tendencies of development of the studied enterprises, development of the decision making system and improvement of methodical provision of innovation risk management.

Prospects for development of powerful, highly efficient, relativistic gyrodevices

International Nuclear Information System (INIS)

Nusinovich, G.S.; Granatstein, V.L.

1992-01-01

For various applications the required parameters of sources of powerful microwave radiation lie far beyond the capabilities of existing tubes. This provokes an interest in reconsidering basic principles of relevant microwave sources in order to search for alternative concepts in their development. One of the most promising devices in the short-wavelength region of microwaves is the cyclotron resonance maser (CRM). During the last decade, two important varieties of CRMs have been distinguished, namely, gyrotrons, which operate at frequencies close to cut-off, and cyclotron autoresonance masers (CARMs), which operate at frequencies far from cut-off. When the axial phase velocity of the wave in properly adjusted to the beam voltage and electron pitch-ratio, the efficiency of relativistic CRMs may be high (≥50%). The method of optimizing efficiency based on a partial compensation of the shift in the relativistic electron cyclotron frequency by the change in the Doppler term can be, in principle, accompanied by a corresponding profiling of the external magnetic field and/or the wave phase velocity in a slightly irregular waveguide. These methods can be used in such relativistic CRMs as relativistic gyrotrons, gyroklystrons, gyro-traveling-wave-tubes and gyrotwistrons. The most important point is their sensitivity to a spread in electron parameters. As the beam voltage grows, the operation becomes more sensitive. However, at relatively low voltages such devices are quite tolerant to electron velocity spread

Evaluation of the Effect of Diagnostic Molecular Testing on the Surgical Decision-Making Process for Patients With Thyroid Nodules.

Science.gov (United States)

Noureldine, Salem I; Najafian, Alireza; Aragon Han, Patricia; Olson, Matthew T; Genther, Dane J; Schneider, Eric B; Prescott, Jason D; Agrawal, Nishant; Mathur, Aarti; Zeiger, Martha A; Tufano, Ralph P

2016-07-01

Diagnostic molecular testing is used in the workup of thyroid nodules. While these tests appear to be promising in more definitively assigning a risk of malignancy, their effect on surgical decision making has yet to be demonstrated. To investigate the effect of diagnostic molecular profiling of thyroid nodules on the surgical decision-making process. A surgical management algorithm was developed and published after peer review that incorporated individual Bethesda System for Reporting Thyroid Cytopathology classifications with clinical, laboratory, and radiological results. This algorithm was created to formalize the decision-making process selected herein in managing patients with thyroid nodules. Between April 1, 2014, and March 31, 2015, a prospective study of patients who had undergone diagnostic molecular testing of a thyroid nodule before being seen for surgical consultation was performed. The recommended management undertaken by the surgeon was then prospectively compared with the corresponding one in the algorithm. Patients with thyroid nodules who did not undergo molecular testing and were seen for surgical consultation during the same period served as a control group. All pertinent treatment options were presented to each patient, and any deviation from the algorithm was recorded prospectively. To evaluate the appropriateness of any change (deviation) in management, the surgical histopathology diagnosis was correlated with the surgery performed. The study cohort comprised 140 patients who underwent molecular testing. Their mean (SD) age was 50.3 (14.6) years, and 75.0% (105 of 140) were female. Over a 1-year period, 20.3% (140 of 688) had undergone diagnostic molecular testing before surgical consultation, and 79.7% (548 of 688) had not undergone molecular testing. The surgical management deviated from the treatment algorithm in 12.9% (18 of 140) with molecular testing and in 10.2% (56 of 548) without molecular testing (P = .37). In the group with

Professional football players at risk for non-acute groin injuries during the first half of the season: A prospective cohort study in The Netherlands

NARCIS (Netherlands)

Gouttebarge, Vincent; Veenstra, Ersot; Goedegebuure, Simon; Frings-Dresen, Monique; Kuijer, Paul

2018-01-01

OBJECTIVES: To study the incidence, diagnostics, treatment, anatomical region and return to play of non-acute groin injuries among professional footballers in the Netherlands. DESIGN: Prospective cohort study. METHODS: Medical staff members of all Dutch professional football clubs, recording

Electronic Health Record-Driven Workflow for Diagnostic Radiologists.

Science.gov (United States)

Geeslin, Matthew G; Gaskin, Cree M

2016-01-01

In most settings, radiologists maintain a high-throughput practice in which efficiency is crucial. The conversion from film-based to digital study interpretation and data storage launched the era of PACS-driven workflow, leading to significant gains in speed. The advent of electronic health records improved radiologists' access to patient data; however, many still find this aspect of workflow to be relatively cumbersome. Nevertheless, the ability to guide a diagnostic interpretation with clinical information, beyond that provided in the examination indication, can add significantly to the specificity of a radiologist's interpretation. Responsibilities of the radiologist include, but are not limited to, protocoling examinations, interpreting studies, chart review, peer review, writing notes, placing orders, and communicating with referring providers. Most of the aforementioned activities are not PACS-centric and require a login to one or more additional applications. Consolidation of these tasks for completion through a single interface can simplify workflow, save time, and potentially reduce the incidence of errors. Here, the authors describe diagnostic radiology workflow that leverages the electronic health record to significantly add to a radiologist's ability to be part of the health care team, provide relevant interpretations, and improve efficiency and quality. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Magnetic resonance imaging for diagnostic evaluation of hernia of an invertebral disk

International Nuclear Information System (INIS)

Beyer, H.K.; Oppel, G.; Bluemm, R.; Uhlenbrock, D.

1988-01-01

The article reports experience gained within three years with diagnostic NMR imaging of the lumbar spine. On the basis of results obtained by almost 500 examinations, an optimisation concept with regard to measuring sequences and orientation of sectional cuts is presented. Imaging of the spine in three planes, with sectional layer thickness between 3 and 5 mm, using a 1.5 Tesla system, seems to yield the diagnostic optimum, and in our opinion is superior over invasive myelography and CT scanning. A prospective study we made indicates a hit rate of 97.2%, and of 100% for evaluation of the results obtained with the 1.5 Tesla system together with an evaluation of the paraxial sections. The magnetic field intensity of 1.5 Tesla especially improves the quality of images of paraxial cuts as compared with the 0.5 Tesla field system, due to the better contrast-to-noise ratio, and thinner sections. (orig.) [de

Diagnostic Performance of Ultra-Low-Dose Computed Tomography for Detecting Asbestos-Related Pleuropulmonary Diseases: Prospective Study in a Screening Setting.

Science.gov (United States)

Schaal, Marysa; Severac, François; Labani, Aissam; Jeung, Mi-Young; Roy, Catherine; Ohana, Mickaël

2016-01-01

To evaluate the diagnostic performance of Ultra-Low-Dose Chest CT (ULD CT) for the detection of any asbestos-related lesions (primary endpoint) and specific asbestos-related abnormalities, i.e. non-calcified and calcified pleural plaques, diffuse pleural thickening, asbestosis and significant lung nodules (secondary endpoints). 55 male patients (55.7±8.1 years old) with occupational asbestos exposure for at least 15 years and where CT screening was indicated were prospectively included. They all underwent a standard unenhanced chest CT (120kV, automated tube current modulation), considered as the reference, and an ULD CT (135kV, 10mA), both with iterative reconstruction. Two chest radiologists independently and blindly read the examinations, following a detailed protocol. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy and error rate of ULD CT were calculated using the exact method of Pearson with a confidence interval of 95%. Radiation dose was 17.9±1.2mGy.cm (0.25mSv) for the ULD-CT versus 288.8 ±151mGy.cm (4mSv); p value = 100%, negative predictive value = 97.8%), high for lung nodules, diffuse pleural thickening and calcified pleural plaques (sensitivity, specificity, PPV and NPV = 100%) and fair for asbestosis (sensitivity = 75%, specificity = 100%, PPV = 00%, NPV = 98.1%). Intra-reader accuracy between the ULD CT and the reference CT for the primary endpoint was 98% for the senior and 100% for the junior radiologist. Inter-reader agreement for the primary endpoint was almost perfect (Cohen's Kappa of 0.81). ULD CT in the screening of asbestos exposure related diseases has 90.9% sensitivity and 100% specificity, and could therefore be proposed as a first line examination.

Contribution of 18F-FDG PET in the diagnostic assessment of fever of unknown origin (FUO): a stratification-based meta-analysis

International Nuclear Information System (INIS)

Besson, Florent L.; Chaumet-Riffaud, Philippe; Prigent, Alain; Durand, Emmanuel; Playe, Margot; Noel, Nicolas; Lambotte, Olivier; Goujard, Cecile

2016-01-01

The aim of this study was to quantify the contribution of FDG PET to the diagnostic assessment of fever of unknown origin (FUO), taking into account the diagnostic limitations resulting from the composite nature of this entity. The PubMed/MEDLINE database was searched from 2000 to September 2015. Original articles fulfilling the following criteria were included: (1) FUO as the initial diagnosis, (2) no immunosuppressed or nosocomial condition, (3) final diagnosis not based on PET, (4) a follow-up period specified, (5) adult population, and (6) availability of adapted data for calculation of odds ratios (ORs). ORs were computed for each study and then pooled using a random effects model. Stratification-based sensitivity analyses were finally performed using the following prespecified criteria: (a) study design, (b) PET device, (c) geographic area, and (d) follow-up period. A meta-analysis of the 14 included studies showed that normal PET findings led to an increase in the absolute final diagnostic rate of 36 % abnormal PET findings to an increase of 83 %, corresponding to a pooled OR of 8.94 (95 % CI 4.18 - 19.12, Z = 5.65; p < 0.00001). The design of the studies influenced the results (OR 2.92, 95 % CI 1.00 - 8.53 for prospective studies; OR 18,57, 95 % CI 7.57 - 45.59 for retrospective studies; p = 0.01), whereas devices (dedicated or hybrid), geographic area and follow-up period did not. Abnormal PET findings are associated with a substantially increased final diagnostic rate in FUO. Consequently, FDG PET could be considered for inclusion in the first-line diagnostic work-up of FUO. Further randomized prospective studies with standardized FDG PET procedures are warranted to confirm this first-line position. (orig.)

Concordance between DSM-IV and DSM-5 criteria for delirium diagnosis in a pooled database of 768 prospectively evaluated patients using the delirium rating scale-revised-98

OpenAIRE

Meagher, David J; Morandi, Alessandro; Inouye, Sharon K; Ely, Wes; Adamis, Dimitrios; Maclullich, Alasdair J; Rudolph, James L; Neufeld, Karin; Leonard, Maeve; Bellelli, Giuseppe; Davis, Daniel; Teodorczuk, Andrew; Kriesel, Stefan; Thomas, Christine; Hasemann, Wolfgang

2014-01-01

peer-reviewed Background: The Diagnostic and Statistical Manual fifth edition (DSM-5) provides new criteria for delirium diagnosis. We examined delirium diagnosis using these new criteria compared with the Diagnostic and Statistical Manual fourth edition (DSM-IV) in a large dataset of patients assessed for delirium and related presentations. Methods: Patient data (n = 768) from six prospectively collected cohorts, clinically assessed using DSM-IV and the Delirium Rating Scale-R...

Does a Diagnostic Classification Algorithm Help to Predict the Course of Low Back Pain?

DEFF Research Database (Denmark)

Hartvigsen, Lisbeth; Kongsted, Alice; Vach, Werner

2018-01-01

). Objectives To investigate if a diagnostic classification algorithm is associated with activity limitation and LBP intensity at 2-week and 3-month follow up, and 1-year trajectories of LBP intensity, and if it improves prediction of outcome when added to a set of known predictors. Methods 934 consecutive......Study Design A prospective observational study. Background A diagnostic classification algorithm was developed by Petersen et al., consisting of 12 categories based on a standardized examination protocol with the primary purpose of identifying clinically homogeneous subgroups of low back pain (LBP...... adult patients, with new episodes of LBP, who were visiting chiropractic practices in primary care were categorized according to the Petersen classification. Outcomes were disability and pain intensity measured at 2 weeks and 3 months, and 1-year trajectories of LBP based on weekly responses to text...

Diagnostic and prognostic value of human prion detection in cerebrospinal fluid.

Science.gov (United States)

Foutz, Aaron; Appleby, Brian S; Hamlin, Clive; Liu, Xiaoqin; Yang, Sheng; Cohen, Yvonne; Chen, Wei; Blevins, Janis; Fausett, Cameron; Wang, Han; Gambetti, Pierluigi; Zhang, Shulin; Hughson, Andrew; Tatsuoka, Curtis; Schonberger, Lawrence B; Cohen, Mark L; Caughey, Byron; Safar, Jiri G

2017-01-01

Several prion amplification systems have been proposed for detection of prions in cerebrospinal fluid (CSF), most recently, the measurements of prion seeding activity with second-generation real-time quaking-induced conversion (RT-QuIC). The objective of this study was to investigate the diagnostic performance of the RT-QuIC prion test in the broad phenotypic spectrum of prion diseases. We performed CSF RT-QuIC testing in 2,141 patients who had rapidly progressive neurological disorders, determined diagnostic sensitivity and specificity in 272 cases that were autopsied, and evaluated the impact of mutations and polymorphisms in the PRNP gene, and type 1 or type 2 human prions on diagnostic performance. The 98.5% diagnostic specificity and 92% sensitivity of CSF RT-QuIC in a blinded retrospective analysis matched the 100% specificity and 95% sensitivity of a blind prospective study. The CSF RT-QuIC differentiated 94% of cases of sporadic Creutzfeldt-Jakob disease (sCJD) MM1 from the sCJD MM2 phenotype, and 80% of sCJD VV2 from sCJD VV1. The mixed prion type 1-2 and cases heterozygous for codon 129 generated intermediate CSF RT-QuIC patterns, whereas genetic prion diseases revealed distinct profiles for each PRNP gene mutation. The diagnostic performance of the improved CSF RT-QuIC is superior to surrogate marker tests for prion diseases such as 14-3-3 and tau proteins, and together with PRNP gene sequencing the test allows the major prion subtypes to be differentiated in vivo. This differentiation facilitates prediction of the clinicopathological phenotype and duration of the disease-two important considerations for envisioned therapeutic interventions. ANN NEUROL 2017;81:79-92. © 2016 American Neurological Association.

Final report. Renewable energy and energy efficiency in Mexico: Barriers and opportunities

Energy Technology Data Exchange (ETDEWEB)

Ashford, Mike

2000-09-28

The report describes the prospects for energy efficiency and greenhouse gas emissions reductions in Mexico, along with renewable energy potential. A methodology for developing emissions baselines is shown, in order to prepare project emissions reductions calculations. An application to the USIJI program was also prepared through this project, for a portfolio of energy efficiency projects.

[Coronary angioplasty with the Monorail system via 6 French diagnostic catheters].

Science.gov (United States)

Villavicencio, R; González, H; López, J; Zavala, E; Ban Hayashi, E B; Gaspar, J; Gil, M; Martínez Ríos, M A

1994-01-01

We studied the use of "Monorail" system with Express (Scimed) balloon catheters for coronary angioplasty through 6 French (F) "high-flow" diagnostic catheters (Novoste, USCI). Prospectively, from July 1992 to January 1993, angioplasty of 31 lesions in 24 patients was attempted (1.3 lesions/procedure). Twenty procedures were of a single lesion and four were multi-vessel angioplasty. Fourteen lesions were in the left anterior descending or in its branches, 10 in the left circumflex or in its branches, 6 in the right coronary artery, and one in the distal anastomosis of an internal mammary artery graft. Thirteen lesions (42%) were type A, 17 (55%) type B and one (3%) type C. Balloon sizes varied between 2.0 and 3.5 mm. Twenty-nine lesions could be successfully dilated (93.5%); two cases were unsuccessful due to an acute occlusion in one and residual stenosis of more than 50% in the other. For only one case, another balloon catheter different from the "Monorail" system was necessary to complete a multi-vessel angioplasty. Coronary visualization and manipulation of the balloon through the tip of the diagnostic catheter were satisfactory in all cases, except with the 3.5 mm balloon catheter. Coronary angioplasty with "Monorail" system balloon catheters through 6 F "high-flow" diagnostic catheters is feasible and provides a high success rate in simple and moderately complex selected lesions, including multivessel angioplasty with advantages of smaller artery punction and the feasibility of performing coronary angioplasty with the same catheter used for diagnostic angiography.

THE ROLE OF LAPAROSCOPY IN BLUNT ABDOMINAL TRAUMA: DIAGNOSTIC, THERAPEUTIC OR BOTH?

Science.gov (United States)

Mosai, F

2017-09-01

The use of laparoscopy in blunt abdominal trauma is gaining popularity as a useful diagnostic tool to avoid unnecessary laparotomies where there is diagnostic dilemma. But the feasibility of using laparoscopy for therapeutic intervention in these patients has been debated. Even though recent case reports seem to suggest that these patients can be managed using laparoscopy, the practice is not yet wildly adopted. A retrospective analysis of a prospectively collected data was done. All adult patients who presented with abdominal trauma and were offered laparoscopic surgery at DGMAH from 2012 to 2015 were reviewed. Data was retrieved from our departmental database and analysed using descriptive statistics. A total of 318 patients were reviewed and 35 patients had blunt abdominal trauma and were included in the study. All the patients were offered laparoscopy. The median age was 30, with 91% of our patients being males. The highest injury severity score calculated was 38. At least 77% of the patients were managed using laparoscopy. This includes 43% who had both diagnostic and therapeutic intervention and 34% had only diagnostic laparoscopy. Eight patients were converted to open surgery mainly due to active bleeding and complex injuries. We did not have any non-therapeutic laparotomies, with no documented procedure related morbidity and mortality. The positive outcomes seen from the study suggest that laparoscopy can be safe and feasible in both diagnostic and therapeutic interventions in carefully selected blunt abdominal trauma patients. A conversion to open surgery should not be regarded as a failure but rather as a sign of mature and sound clinical judgement acknowledging the limitations of laparoscopy and/or the surgeon.

Diagnostic accuracy of computed tomography using lower doses of radiation for patients with Crohn's disease.

LENUS (Irish Health Repository)

Craig, Orla

2012-08-01

Magnetic resonance and ultrasonography have increasing roles in the initial diagnosis of Crohn\\'s disease, but computed tomography (CT) with positive oral contrast agents is most frequently used to identify those with acute extramural complications. However, CT involves exposure of patients to radiation. We prospectively compared the diagnostic accuracy of low-dose CT (at a dose comparable to that used to obtain an abdominal radiograph) with conventional-dose CT in patients with active Crohn\\'s disease.

Physician Incentive Management in University Hospitals: Inducing Efficient Behavior Through the Allocation of Research Facilities

NARCIS (Netherlands)

K.M. Glorie (Kristiaan); J.M. van Oostrum (Jeroen); A.J. Dur (Robert); G. Kazemier (Geert); A.P.M. Wagelmans (Albert)

2010-01-01

textabstractThe imperative to improve healthcare efficiency is now stronger than ever. Rapidly increasing healthcare demand and the prospect of healthcare cost exploding require that measures be taken to make healthcare organizations become more efficiency-aware. Alignment of organizational

Measure Guideline: Air Conditioner Diagnostics, Maintenance, and Replacement

Energy Technology Data Exchange (ETDEWEB)

Springer, D.; Dakin, B.

2013-03-01

This guideline responds to the need for an efficient means of identifying, diagnosing, and repairing faults in air conditioning systems in existing homes that are undergoing energy upgrades. Inadequate airflow due to constricted ducts or undersized filters, improper refrigerant charge, and other system defects can be corrected at a fraction of the cost of equipment replacement and can yield significant savings. The guideline presents a two-step approach to diagnostics and repair.

Measure Guideline. Air Conditioner Diagnostics, Maintenance, and Replacement

Energy Technology Data Exchange (ETDEWEB)

Springer, David [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Dakin, Bill [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States)

2013-03-01

This guideline responds to the need for an efficient means of identifying, diagnosing, and repairing faults in air conditioning systems in existing homes that are undergoing energy upgrades. Inadequate airflow due to constricted ducts or undersized filters, improper refrigerant charge, and other system defects can be corrected at a fraction of the cost of equipment replacement and can yield significant savings. The guideline presents a two-step approach to diagnostics and repair.

Characteristics of Headache After an Intracranial Endovascular Procedure: A Prospective Observational Study.

Science.gov (United States)

Zhang, Linjing; Wu, Xiancong; Di, Hai; Feng, Tao; Wang, Yunxia; Wang, Jun; Cao, Xiangyu; Li, Baomin; Liu, Ruozhuo; Yu, Shengyuan

2017-03-01

Two editions of the International Classification of Headache Disorders (ICHD) diagnostic criteria for "Headache attributed to an intracranial endovascular procedure" have been published, in 2004 and 2013. 1,2 Despite studies that have suggested that the former is not very practical, the ICHD-3 beta did not contain major changes. Moreover, so far no consensus exists regarding characteristics of headache after intracranial endovascular procedure. Thus, there is a need for sound suggestions to improve the ICHD-3 beta diagnostic criteria. Using a prospective design, we identified consecutive patients with unruptured intracranial aneurysms (UIAs) with neuroendovascular treatment from January 2014 to December 2014. In total, 73 patients were enrolled, and 58 patients ultimately completed the 6-month follow-up. After the procedure, five of the 29 patients (17.2%) with pre-existing headache experienced marked worsening after the procedure, while seven of the 29 patients without prior headache developed new-onset headache post-procedurally. The headaches started within 24 hours, with a mean duration of 24-72 hours. The headaches were moderate to severe. The eligibility of these events to be considered headaches caused by neuroendovascular procedures according to the ICHD-3 beta diagnostic criteria for designation was far from ideal. Most cases of markedly worsening headaches and new-onset headaches started within 24 hours and persisted longer than that specified in the ICHD-3 beta diagnostic criteria. Moreover, considering that some items are not very practical, the ICHD-3 beta diagnostic criteria should be revised in the light of recent literature reports. © 2016 American Headache Society.

Contemporary Targets for Control of Efficient Energy Use

Directory of Open Access Journals (Sweden)

Yu. S. Petrusha

2012-01-01

Full Text Available The paper describes main principles of the methodology for control of efficient energy use in power engineering and economy sectors as a whole. Targets for control of energy use at different levels have been considered in the paper. A special attention has been paid to technical, organizational and legal aspects of energy efficiency improvement. The paper contains an analysis of the history of the given issue, the present level of its development and near-term prospects under conditions of the Republic of Belarus.

Data driven approaches for diagnostics and optimization of NPP operation

International Nuclear Information System (INIS)

Pliska, J.; Machat, Z.

2014-01-01

The efficiency and heat rate is an important indicator of both the health of the power plant equipment and the quality of power plant operation. To achieve this challenges powerful tool is a statistical data processing of large data sets which are stored in data historians. These large data sets contain useful information about process quality and equipment and sensor health. The paper discusses data-driven approaches for model building of main power plant equipment such as condenser, cooling tower and the overall thermal cycle as well using multivariate regression techniques based on so called a regression triplet - data, model and method. Regression models comprise a base for diagnostics and optimization tasks. Diagnostics and optimization tasks are demonstrated on practical cases - diagnostics of main power plant equipment to early identify equipment fault, and optimization task of cooling circuit by cooling water flow control to achieve for a given boundary conditions the highest power output. (authors)

Health Technology Assessment for Molecular Diagnostics: Practices, Challenges, and Recommendations from the Medical Devices and Diagnostics Special Interest Group.

Science.gov (United States)

Garfield, Susan; Polisena, Julie; S Spinner, Daryl; Postulka, Anne; Y Lu, Christine; Tiwana, Simrandeep K; Faulkner, Eric; Poulios, Nick; Zah, Vladimir; Longacre, Michael

2016-01-01

Health technology assessments (HTAs) are increasingly used to inform coverage, access, and utilization of medical technologies including molecular diagnostics (MDx). Although MDx are used to screen patients and inform disease management and treatment decisions, there is no uniform approach to their evaluation by HTA organizations. The International Society for Pharmacoeconomics and Outcomes Research Devices and Diagnostics Special Interest Group reviewed diagnostic-specific HTA programs and identified elements representing common and best practices. MDx-specific HTA programs in Europe, Australia, and North America were characterized by methodology, evaluation framework, and impact. Published MDx HTAs were reviewed, and five representative case studies of test evaluations were developed: United Kingdom (National Institute for Health and Care Excellence's Diagnostics Assessment Programme, epidermal growth factor receptor tyrosine kinase mutation), United States (Palmetto's Molecular Diagnostic Services Program, OncotypeDx prostate cancer test), Germany (Institute for Quality and Efficiency in Healthcare, human papillomavirus testing), Australia (Medical Services Advisory Committee, anaplastic lymphoma kinase testing for non-small cell lung cancer), and Canada (Canadian Agency for Drugs and Technologies in Health, Rapid Response: Non-invasive Prenatal Testing). Overall, the few HTA programs that have MDx-specific methods do not provide clear parameters of acceptability related to clinical and analytic performance, clinical utility, and economic impact. The case studies highlight similarities and differences in evaluation approaches across HTAs in the performance metrics used (analytic and clinical validity, clinical utility), evidence requirements, and how value is measured. Not all HTAs are directly linked to reimbursement outcomes. To improve MDx HTAs, organizations should provide greater transparency, better communication and collaboration between industry and HTA

Diagnostic imaging of the hand

Energy Technology Data Exchange (ETDEWEB)

Schmitt, Rainer [Hospital for Cardiovascular Diseases, Bad Neustadt an der Saale (Germany). Dept. of Radiology; Lanz, Ulrich [Perlach Hospital, Munich (Germany). Dept. of Hand Surgery

2008-07-01

With its complex anatomy and specialized biomechanics, the human hand has always presented physicians with a unique challenge when it comes to diagnosing and treating the diseases that afflict it. And while recent decades have seen a rapid increase in the number of therapeutic options, many diseases and injuries of the hand are still commonly misinterpreted. In diagnostic imaging of the hand, an interdisciplinary team, comprisingspecialists in radiology, surgery, and rheumatology, presents a comprehensive,reliable guide to this topographically intricate area. Highlights include: - More than 1000 high-quality illustrations - All state-of-the-art imaging modalities-including multidetector CT, with 2D displays and 3D reconstructions, and contrast-enhanced MRI with multi-channel, phased-array coils - An overview of all currently used methods of examination - A detailed presentation of the anatomic and functional foundations necessary for diagnosis - Full coverage of all disorders of the hand - Systematic treatment of each disease's definition, pathogenesis, and clinical symptoms, according to a graduated diagnostic plan - Easy-to-use format, featuring crisp images and line drawings seamlessly integrated with concise text, summary tables, and handy checklists - A heavily cross-referenced appendix of differential diagnosis tables - Emphasis on interdisciplinary consultation throughout designed to help both radiologists and clinicians develop the most efficient and effective strategies for evaluating and treating patients, Diagnostic imaging of the hand will leave specialists of all levels with a fresh appreciation for - and a richer understanding of - the expanding array of cutting-edge alternatives for diagnosing and treating disorders of the hand. (orig.)

Diagnostic imaging of the hand

International Nuclear Information System (INIS)

Schmitt, Rainer; Lanz, Ulrich

2008-01-01

With its complex anatomy and specialized biomechanics, the human hand has always presented physicians with a unique challenge when it comes to diagnosing and treating the diseases that afflict it. And while recent decades have seen a rapid increase in the number of therapeutic options, many diseases and injuries of the hand are still commonly misinterpreted. In diagnostic imaging of the hand, an interdisciplinary team, comprisingspecialists in radiology, surgery, and rheumatology, presents a comprehensive,reliable guide to this topographically intricate area. Highlights include: - More than 1000 high-quality illustrations - All state-of-the-art imaging modalities-including multidetector CT, with 2D displays and 3D reconstructions, and contrast-enhanced MRI with multi-channel, phased-array coils - An overview of all currently used methods of examination - A detailed presentation of the anatomic and functional foundations necessary for diagnosis - Full coverage of all disorders of the hand - Systematic treatment of each disease's definition, pathogenesis, and clinical symptoms, according to a graduated diagnostic plan - Easy-to-use format, featuring crisp images and line drawings seamlessly integrated with concise text, summary tables, and handy checklists - A heavily cross-referenced appendix of differential diagnosis tables - Emphasis on interdisciplinary consultation throughout designed to help both radiologists and clinicians develop the most efficient and effective strategies for evaluating and treating patients, Diagnostic imaging of the hand will leave specialists of all levels with a fresh appreciation for - and a richer understanding of - the expanding array of cutting-edge alternatives for diagnosing and treating disorders of the hand. (orig.)

Future thinking improves prospective memory performance and plan enactment in older adults

NARCIS (Netherlands)

Altgassen, A.M.; Rendell, P.G.; Bernhard, A.; Henry, J.D.; Bailey, P.E.; Phillips, L.H.; Kliegel, M.

2015-01-01

Efficient intention formation might improve prospective memory by reducing the need for resource-demanding strategic processes during the delayed performance interval. The present study set out to test this assumption and provides the first empirical assessment of whether imagining a future action

Review of recent LHCb results and prospects for Run II

CERN Document Server

Hicheur, A

2015-01-01

As first Run II data acquisition has begun, it is useful to expose the pending questions by reviewing some of the most recent results obtained with Run I data analyses. Early results of the current data taking and middle-term prospects are also shown to illustrate the efficiency of the acquisition and analysis chain.

Efficiency of histidine rich protein II-based rapid diagnostic tests for monitoring malaria transmission intensities in an endemic area

Science.gov (United States)

Modupe, Dokunmu Titilope; Iyabo, Olasehinde Grace; Oladoke, Oladejo David; Oladeji, Olanrewaju; Abisola, Akinbobola; Ufuoma, Adjekukor Cynthia; Faith, Yakubu Omolara; Humphrey, Adebayo Abiodun

2018-04-01

In recent years there has been a global decrease in the prevalence of malaria due to scaling up of control measures, hence global control efforts now target elimination and eradication of the disease. However, a major problem associated with elimination is asymptomatic reservoir of infection especially in endemic areas. This study aims to determine the efficiency of histidine rich protein II (HRP-2) based rapid diagnostic tests (RDT) for monitoring transmission intensities in an endemic community in Nigeria during the pre-elimination stage. Plasmodium falciparum asymptomatic malaria infection in healthy individuals and symptomatic cases were detected using HRP-2. RDT negative tests were re-checked by microscopy and by primer specific PCR amplification of merozoite surface protein 2 (msp-2) for asexual parasites and Pfs25 gene for gametocytes in selected samples to detect low level parasitemia undetectable by microscopy. The mean age of the study population (n=280) was 6.12 years [95% CI 5.16 - 7.08, range 0.5 - 55], parasite prevalence was 44.6% and 36.3% by microscopy and RDT respectively (p =0.056). The parasite prevalence of 61.5% in children aged >2 - 10 years was significantly higher than 3.7% rate in adults >18years (p malaria in endemic areas.

Diagnostic nerve ultrasonography

International Nuclear Information System (INIS)

Baeumer, T.; Grimm, A.; Schelle, T.

2017-01-01

For the diagnostics of nerve lesions an imaging method is necessary to visualize peripheral nerves and their surrounding structures for an etiological classification. Clinical neurological and electrophysiological investigations provide functional information about nerve lesions. The information provided by a standard magnetic resonance imaging (MRI) examination is inadequate for peripheral nerve diagnostics; however, MRI neurography is suitable but on the other hand a resource and time-consuming method. Using ultrasonography for peripheral nerve diagnostics. With ultrasonography reliable diagnostics of entrapment neuropathies and traumatic nerve lesions are possible. The use of ultrasonography for neuropathies shows that a differentiation between different forms is possible. Nerve ultrasonography is an established diagnostic tool. In addition to the clinical examination and clinical electrophysiology, structural information can be obtained, which results in a clear improvement in the diagnostics. Ultrasonography has become an integral part of the diagnostic work-up of peripheral nerve lesions in neurophysiological departments. Nerve ultrasonography is recommended for the diagnostic work-up of peripheral nerve lesions in addition to clinical and electrophysiological investigations. It should be used in the clinical work-up of entrapment neuropathies, traumatic nerve lesions and spacy-occupying lesions of nerves. (orig.) [de

Field-based systems and advanced diagnostics

International Nuclear Information System (INIS)

Eryurek, E.

1998-01-01

Detection and characterization of anomalies in an industrial plant provide improved plant availability and plant efficiency thus yielding increased economic efficiency. Traditionally, detection of process anomalies is done at a high-level control system through various signal validation methods. These signal validation techniques rely on data from transmitters, which measure related process variables. Correlating these signals and deducing anomalies often is a very time consuming and a difficult task. Delays in detecting these anomalies can be costly during plant operation. Conventional centralized approaches also suffer from their dependence on detailed mathematical models of the processes. Smart field devices have the advantage of providing the necessary information directly to the control system as anomalies develop during operation of the processes enabling operators to take necessary steps to either prevent an unnecessary shut down before the problem becomes serious or schedule maintenance on the problematic loop. Fisher-Rosemount's PlantWeb TM architecture addresses 'Enhanced Measurement, Advanced Diagnostics and Control in the Field'. PlantWeb TM builds open process management systems by networking intelligent field devices, scalable control and systems platforms, and integrated modular software. A description of PlantWeb TM and how it improves various process conditions and reduces operating cost of a plant as well as a high level description of 'Enhanced Measurement, Advanced Diagnostics and Control in the Field', will be provided in this paper. PlantWeb TM is the trademark for Fisher-Rosemount's new field-based architecture that uses emerging technologies to utilize the power of intelligent field devices and deliver critical process and equipment information to improve plant performance. (author)

Tune-Based Halo Diagnostics

International Nuclear Information System (INIS)

Cameron, Peter

2003-01-01

Tune-based halo diagnostics can be divided into two categories -- diagnostics for halo prevention, and diagnostics for halo measurement. Diagnostics for halo prevention are standard fare in accumulators, synchrotrons, and storage rings, and again can be divided into two categories -- diagnostics to measure the tune distribution (primarily to avoid resonances), and diagnostics to identify instabilities (which will not be discussed here). These diagnostic systems include kicked (coherent) tune measurement, phase-locked loop (PLL) tune measurement, Schottky tune measurement, beam transfer function (BTF) measurements, and measurement of transverse quadrupole mode envelope oscillations. We refer briefly to tune diagnostics used at RHIC and intended for the SNS, and then present experimental results. Tune-based diagnostics for halo measurement (as opposed to prevention) are considerably more difficult. We present one brief example of tune-based halo measurement

Diagnostic capability of Pulsar perimetry in pre-perimetric and early glaucoma.

Science.gov (United States)

Hirasawa, Kazunori; Takahashi, Natsumi; Matsumura, Kazuhiro; Kasahara, Masayuki; Shoji, Nobuyuki

2017-06-12

This study aimed to compare the diagnostic capability of Pulsar perimetry (Pulsar) in pre-perimetric glaucoma (PPG) and early glaucoma (EG) with that of Flicker perimetry (Flicker) and spectral-domain optical conference tomography (SD-OCT). This prospective cross-sectional study included 25 eyes of 25 PPG patients, 35 eyes of 35 EG patients, and 42 eyes of 42 healthy participants. The diagnostic capability using the area under the curve (AUC) of the best parameter and agreement of detectability between structural and functional measurements were compared. For PPG patients, the AUC of Pulsar, Flicker, OCT-disc, and OCT-macular was 0.733, 0.663, 0.842, and 0.780, respectively. The AUC of Flicker was significantly lower than that of OCT-disc (p = 0.016). For EG patients, the AUC of Pulsar, Flicker, OCT-disc, and OCT-macular were 0.851, 0.869, 0.907, and 0.861, respectively. There was no significant difference in AUC among these methods. The agreement between structural and functional measurements expressed by kappa value ranged from -0.16 to 0.07 for PPG and from 0.01 to 0.25 for EG. Although the diagnostic capability of Pulsar in the PPG and EG groups was equal to that of Flicker and SD-OCT, the agreements between structural and functional measurements for both PPG and EG were poor.

Masticatory efficiency of shortened dental arch subjects with ...

African Journals Online (AJOL)

Objective: The objective of this study was to compare the masticatory efficiency in subjects with shortened dental arch (SDA) before and after restoration with removable partial denture (RPD). Materials and Methods: This was a prospective study carried out on 36 consecutive patients. The subjects were asked to chew 5 g of ...

Diagnostic accuracy of low-dose 256-slice multi-detector coronary CT angiography using iterative reconstruction in patients with suspected coronary artery disease

Energy Technology Data Exchange (ETDEWEB)

Hou, Yang; Ma, Yue; Wang, Yuke; Yu, Mei; Guo, Qiyong [Shengjing Hospital of China Medical University, Department of Radiology, Shenyang (China); Fan, Weipeng [Central Hospital of Anshan, Department of Radiology, Anshan (China); Vembar, Mani [CT Clinical Science Philips Healthcare, Cleveland, OH (United States)

2014-01-15

To evaluate the accuracy of low-dose coronary CTA with iterative reconstruction (IR) in the diagnosis of coronary artery disease (CAD) in patients with suspected CAD. Ninety-six patients with suspected CAD underwent low-dose prospective electrocardiogram-gated coronary CTA, with images reconstructed using IR. Image quality (IQ) of coronary segments were graded on a 4-point scale (4, excellent; 1, non-diagnostic). With invasive coronary angiography (ICA) considered the ''gold standard'', the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of coronary CTA were calculated on segment-, vessel- and patient-based levels. The patient data were divided into two groups (Agatston scores of ≥ 400 and <400). The differences in diagnostic performance between the two groups were tested. Diagnostic image quality was found in 98.1 % (1,232/1,256) of segments. The sensitivity, specificity, PPV, NPV and accuracy were 90.8 %, 95.3 %, 81.8 %, 97.8 % and 94.3 % (segment-based) and 97.2 %, 83.3 %, 94.6 %, 90.9 % and 93.8 % (patient-based). Significant differences between the two groups were seen in specificity, PPV and accuracy (92.1 % vs. 97.9 %, 76.0 % vs. 86.7 %, 91.7 % vs. 96.6 %, P < 0.05; segment-based). The average effective dose was 1.30 ± 0.15 mSv. Low-dose prospective coronary CTA with IR can acquire satisfactory image quality and show high diagnostic accuracy in patients with suspected CAD; however, blooming continues to pose a challenge in severely calcified segments. (orig.)

Uranium prospecting; La prospection de l'uranium

Energy Technology Data Exchange (ETDEWEB)

Roubault, M [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1955-07-01

This report is an instruction book for uranium prospecting. It appeals to private prospecting. As prospecting is now a scientific and technical research, it cannot be done without preliminary studies. First of all, general prospecting methods are given with a recall of fundamental geologic data and some general principles which are common with all type of prospecting. The peculiarities of uranium prospecting are also presented and in particular the radioactivity property of uranium as well as the special aspect of uranium ores and the aspect of neighbouring ores. In a third part, a description of the different uranium ores is given and separated in two different categories: primary and secondary ores, according to the place of transformation, deep or near the crust surface respectively. In the first category, the primary ores include pitchblende, thorianite and rare uranium oxides as euxenite and fergusonite for example. In the second category, the secondary ores contain autunite and chalcolite for example. An exhaustive presentation of the geiger-Mueller counter is given with the presentation of its different components, its functioning and utilization and its maintenance. The radioactivity interpretation method is showed as well as the elaboration of a topographic map of the measured radioactivity. A brief presentation of other detection methods than geiger-Mueller counters is given: the measurement of fluorescence and a chemical test using the fluorescence properties of uranium salts. Finally, the main characteristics of uranium deposits are discussed. (M.P.)

Development of technique for diagnostics of social reserves of development of collective labour potential

OpenAIRE

Голубєв, Станіслав Миколайович

2015-01-01

The problems of diagnostics of social reserves of the collective labour potential are considered in the article. The aim of this study is to develop diagnostic techniques of social reserves of the collective labour potential in the work and the essence of the concept of "social reserves" as a subject of study of economics and their features in the study of collective labour potential. The use of these reserves can increase the efficiency of the labour collective processes by improving coopera...

Coronary computed tomography angiography using prospective electrocardiography-gated axial scans with 64-detector computed tomography. Evaluation of stair-step artifacts and padding time

International Nuclear Information System (INIS)

Kimura, Fumiko; Umezawa, Tatsuo; Asano, Tomonari; Chihara, Ruri; Nishi, Naoko; Nishimura, Shigeyoshi; Sakai, Fumikazu

2010-01-01

We compared stair-step artifacts and radiation dose between prospective electrocardiography (ECG)-gated coronary computed tomography angiography (prospective CCTA) and retrospective CCTA using 64-detector CT and determined the optimal padding time (PT) for prospective CCTA. We retrospectively evaluated 183 patients [mean heart rate (HR) <65 beats/min, maximum HR instability <5 beats/min] who had undergone CCTA. We scored stair-step artifacts from 1 (severe) to 5 (none) and evaluated the effective dose in 53 patients with retrospective CCTA and 130 with prospective CCTA (PT 200 ms, n=32; PT 50 ms, n=98). Mean artifact scores were 4.3 in both retrospective and prospective CCTAs. However, statistically more arteries scored <3 (nonassessable) on prospective CCTA (P<0.001). Mean scores for prospective CCTA with 200- and 50-ms PT were 4.1 and 4.3, respectively (no significant difference). The radiation dose of prospective CCTA was reduced by 59.1% to 80.7%. Prospective CCTA reduces the radiation dose and allows diagnostic imaging in most cases but shows more nonevaluable artifacts than retrospective CCTA. Use of 50-ms instead of 200-ms PT appears to maintain image quality in patients with a mean HR <65 beats/min and HR instability of <5 beats/min. (author)

Clinical prospective study with radioiodinated monoclonal antibodies directed against colorectal cancer

International Nuclear Information System (INIS)

Chatal, J.F.; Douillard, J.Y.; Kremer, M.; Curtet, C.; Le Mevel, B.; Saccavini, J.C.; Maurel, C.; Aubry, J.

1985-01-01

The diagnostic application of three monoclonal antibodies are studied: an anti-carcinoembryonic antigen (CEA) antibody designated as 202 and two monoclonal antibodies, designated as 17-1A and 19-9, which recognize different antigens associated with gastrointestinal carcinomas. The complementary specificity of these antibodies was determined by an immuno-histochemical study and the scintigraphic detection parameters by a radiopharmacokinetic study in colic-tumour-bearing nude mice. On the basis of a prospective study, the value of immunoscintigraphy was compared with conventional methods such as ultrasonography and computed tomography for localization of recurrences of colorectal cancers. (UK)

Intellectual property considerations for molecular diagnostic development with emphasis on companion diagnostics.

Science.gov (United States)

Glorikian, Harry; Warburg, Richard Jeremy; Moore, Kelly; Malinowski, Jennifer

2018-02-01

The development of molecular diagnostics is a complex endeavor, with multiple regulatory pathways to consider and numerous approaches to development and commercialization. Companion diagnostics, devices which are "essential for the safe and effective use of a corresponding drug or diagnostic product" (see U.S. Food & Drug Administration, In Vitro Diagnostics - Companion Diagnostics, U.S. Dept. of Health & Human Services(2016), available at https://www.fda.gov/medicaldevices/productsandmedicalprocedures/invitrodiagnostics/ucm407297.htm ) and complementary diagnostics, which are more broadly associated with a class of drug, are becoming increasingly important as integral components of the implementation of precision medicine. Areas covered: The following article will highlight the intellectual property ('IP') considerations pertinent to molecular diagnostics development with special emphasis on companion diagnostics. Expert opinion/commentary Summary: For all molecular diagnostics, intellectual property (IP) concerns are of paramount concern, whether the device will be marketed only in the United States or abroad. Taking steps to protect IP at each stage of product development is critical to optimize profitability of a diagnostic product. Also the legal framework around IP protection of diagnostic technologies has been changing over the previous few years and can be expected to continue to change in the foreseeable near future, thus, a comprehensive IP strategy should take into account the fact that changes in the law can be expected.

Problems of steam turbine diagnostics and the 'Simens' diagnosis system

International Nuclear Information System (INIS)

Tserner, V.; Andrea, K.

1993-01-01

Diagnostics system, allowing one to detect changes in the state on single turbine elements at an early stage is described. Besides this system allows one to utilize the turbine plant optimally and efficiency from the viewpoint of the equipment durability. Specially oriented monitoring of the turbine plant and equipment element state saves resources necessary to keep up the working order of the equipment

Side effects after diagnostic lumbar puncture and lumbar iohexol myelography

International Nuclear Information System (INIS)

Sand, T.; Stovner, L.J.; Salvesen, R.; Dale, L.

1987-01-01

A prospective, controlled study was performed to compare side effect incidences after lumbar iohexol myelography (n=97) and diagnostic lumbar puncture (n=85). No significant side effect incidence differences (iohexol vs. controls) were found regarding number of patients with any side effect (63 vs. 73%), headache (44 vs. 54%), nausea, dizziness, visual, auditory, or psychic symptoms. Early-onset headache occurred significantly more often in the iohexol group (16 vs 5%), while postural headache occurred most frequently after lumbar puncture (25 vs. 41%). These results suggest that apart from the slight early-onset headache, most side effets after lumbar iohexol myelography are related to the puncture per se, not to the contrast agent. (orig.)

Radiation sterilization of medical products- current trends and future prospects

International Nuclear Information System (INIS)

Sharma, G.

1997-01-01

In medical practice use of sterile pharmaceuticals and single use disposable medical devices is steadily increasing. Sterile pharmaceuticals like injections and ophthalmic ointments are required for therapy. Medical devices are employed for diagnostic, drug administration or corrective purposes, and as implants for temporary, short term or long term residence in the human system. All these products are made available in sterile form by treating them to a suitable process of sterilization i.e. dry/wet heat, ethylene oxide (EtO) gas or ionizing radiation. In this paper current trends and future prospects of radiation sterilization of medical products are given in detail. 9 refs., 7 tabs

An optimal ultrasonographic diagnostic test for early gout: A prospective controlled study.

Science.gov (United States)

Norkuviene, Eleonora; Petraitis, Mykolas; Apanaviciene, Indre; Virviciute, Dalia; Baranauskaite, Asta

2017-08-01

Objective To identify the optimal sites for classification of early gout by ultrasonography. Methods Sixty patients with monosodium urate crystal-proven gout (25 with early gout [≤2-year symptom duration], 35 with late gout [>2-year symptom duration], and 36 normouricemic healthy controls) from one centre were prospectively evaluated. Standardized blinded ultrasound examination of 36 joints and the triceps and patellar tendons was performed to identify tophi and the double contour (DC) sign. Results Ultrasonographic sensitivity was lower in early than late gout. Binary logistic regression analysis showed that two ultrasonographic signs (tophi in the first metatarsophalangeal joint [odds ratio, 16.46] and the DC sign in the ankle [odds ratio, 25.18]) significantly contributed to the final model for early gout diagnosis (sensitivity and specificity of 84% and 81%, respectively). The inter-reader reliability kappa value for the DC sign and tophi was 0.712. Conclusions Four-joint investigation (both first metatarsophalangeal joints for tophi and both ankles for the DC sign) is feasible and reliable and could be proposed as a screening test for early ultrasonographic gout classification in daily practice.

Fair in the face: modern diagnostics of midfacial trauma

International Nuclear Information System (INIS)

Zajaczek, J.E.W.; Rodt, T.; Keberle, M.

2007-01-01

Modern diagnostics of midfacial trauma are embedded in a diagnostic concept that is oriented to the therapeutic relevance for the individual. Critical analysis of the indicated and efficient radiological method in the acute phase shows that MSCT is currently the method of choice in the diagnosis of midfacial trauma. Besides extensive acquisition of data in the shortest time the possibilities of modern post-processing provide a three-dimensional picture of the often complex injuries in real time. Other perilous injuries are often more important especially for the polytrauma patient. With modern scan protocols intracranial injuries as well as injuries of bone and soft tissue of the head and neck region can be diagnosed during a single examination. Radiology plays a key role for the economically oriented strategy of patient care. (orig.)

Nanoparticle functionalization for brain targeting drug delivery and diagnostic

DEFF Research Database (Denmark)

Gomes, Maria João; Mendes, Bárbara; Martins, Susana

2016-01-01

carriers to cross the BBB and achieve brain, and their functionalization strategies are described; and finally the delivery of nanoparticles to the target moiety, as diagnostics or therapeutics. Therefore, this chapter is focused on how the nanoparticle surface may be functionalized for drug delivery......Nanobiotechnology has been demonstrated to be an efficient tool for targeted therapy as well as diagnosis, with particular emphasis on brain tumor and neurodegenerative diseases. On this regard, the aim of this chapter is focused on engineered nanoparticles targeted to the brain, so that they have...... and diagnostics. Furthermore, it is also mentioned that some BBB targets were already used as transport mediators to central nervous system by functionalization on nanoparticles. It summarizes the nanoparticles potential in therapeutics and molecular targeting to BBB, and also an approach of the nanoparticle...

The clinical usefulness of extravascular lung water and pulmonary vascular permeability index to diagnose and characterize pulmonary edema: a prospective multicenter study on the quantitative differential diagnostic definition for acute lung injury/acute respiratory distress syndrome

Science.gov (United States)

2012-01-01

Introduction Acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) is characterized by features other than increased pulmonary vascular permeability. Pulmonary vascular permeability combined with increased extravascular lung water content has been considered a quantitative diagnostic criterion of ALI/ARDS. This prospective, multi-institutional, observational study aimed to clarify the clinical pathophysiological features of ALI/ARDS and establish its quantitative diagnostic criteria. Methods The extravascular lung water index (EVLWI) and the pulmonary vascular permeability index (PVPI) were measured using the transpulmonary thermodilution method in 266 patients with PaO2/FiO2 ratio ≤ 300 mmHg and bilateral infiltration on chest radiography, in 23 ICUs of academic tertiary referral hospitals. Pulmonary edema was defined as EVLWI ≥ 10 ml/kg. Three experts retrospectively determined the pathophysiological features of respiratory insufficiency by considering the patients' history, clinical presentation, chest computed tomography and radiography, echocardiography, EVLWI and brain natriuretic peptide level, and the time course of all preceding findings under systemic and respiratory therapy. Results Patients were divided into the following three categories on the basis of the pathophysiological diagnostic differentiation of respiratory insufficiency: ALI/ARDS, cardiogenic edema, and pleural effusion with atelectasis, which were noted in 207 patients, 26 patients, and 33 patients, respectively. EVLWI was greater in ALI/ARDS and cardiogenic edema patients than in patients with pleural effusion with atelectasis (18.5 ± 6.8, 14.4 ± 4.0, and 8.3 ± 2.1, respectively; P edema or pleural effusion with atelectasis patients (3.2 ± 1.4, 2.0 ± 0.8, and 1.6 ± 0.5; P edema patients. A PVPI value of 2.6 to 2.85 provided a definitive diagnosis of ALI/ARDS (specificity, 0.90 to 0.95), and a value < 1.7 ruled out an ALI/ARDS diagnosis (specificity, 0.95). Conclusion

Patient dosimetry in diagnostic radiology

International Nuclear Information System (INIS)

Shrimpton, P.C.

2000-01-01

Full text: X-ray examinations remain an essential and widely used diagnostic tool in medicine and hence the most significant source of exposure to man-made radiation for populations. Patterns of practice in diagnostic radiology continue to evolve, with overall growth in the numbers of procedures worldwide and, particularly in developed countries, increasing importance for complex procedures such as computed tomography (CT) and interventional techniques. In order to maximise the benefits from x-rays relative to the associated radiation risks, there is a need to ensure the prior justification of all examinations and the optimisation of patient protection such that doses are as low as reasonably practicable to meet specific clinical requirements. Accordingly, patient dosimetry is a fundamental requirement in diagnostic radiology. Detailed measurements for the assessment of risks or comparison of different types of procedure require the estimation of organ and effective doses. Such comprehensive dosimetry necessarily involves the simulation of clinical practice using anthropomorphic phantoms, with either measurements in a physical phantom or calculations utilising a mathematical phantom. Simpler measurements for the routine monitoring of dose in x-ray departments can be based on practical quantities such as entrance surface dose, dose-area product and, for CT, weighted CT dose index and dose-length product. Widescale surveys reveal significant variations between departments in the typical doses for a given type of procedure and potential scope for dose reductions. In order to promote improvements in practice, the results of periodic dose surveys in departments should be compared with appropriate standards, such as diagnostic reference levels for adult and paediatric patients, that are set nationally or locally for the purposes of promoting critical review of the equipment and techniques in use. Patient dosimetry should form an essential element of routine quality

Prediagnostic circulating concentrations of plasma insulin-like growth factor-I and risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition

NARCIS (Netherlands)

Perez-Cornago, Aurora; Appleby, Paul N.; Tipper, Sarah; Key, Timothy J.; Allen, Naomi E.; Nieters, Alexandra; Vermeulen, Roel; Roulland, Sandrine; Casabonne, Delphine; Kaaks, Rudolf; Fortner, Renee T.; Boeing, Heiner; Trichopoulou, Antonia; La Vecchia, Carlo; Klinaki, Eleni; Hansen, Louise; Tjønneland, Anne; Bonnet, Fabrice; Fagherazzi, Guy; Boutron-Ruault, Marie Christine; Pala, Valeria; Masala, Giovanna; Sacerdote, Carlotta; Peeters, Petra H.; Bueno-de-Mesquita, H. Bas; Weiderpass, Elisabete; Dorronsoro, Miren; Quirós, J. Ramón; Barricarte, Aurelio; Gavrila, Diana; Agudo, Antonio; Borgquist, Signe; Rosendahl, Ann H.; Melin, Beatrice; Wareham, Nick; Khaw, Kay Tee; Gunter, Marc; Riboli, Elio; Vineis, Paolo; Travis, Ruth C.

2017-01-01

Insulin-like growth factor (IGF)-I has cancer promoting activities. However, the hypothesis that circulating IGF-I concentration is related to risk of lymphoma overall or its subtypes has not been examined prospectively. IGF-I concentration was measured in pre-diagnostic plasma samples from a nested

Analysis and prospectives of the mechanism of release of energy efficiency titles

International Nuclear Information System (INIS)

Pastore, P.

2009-01-01

Starting from the Third annual report on the mechanism of release of energetic efficiency titles and considering the Decree Ministerial 21/12/2007, there is an analysis of the better aspects of the mechanism of release of energetic efficiency titles introduced from the norms regarding the previous annual relations. Particularly important is the role carried out from the Authority of the Electric Power and the Gas in the action of control and monitoring of the market. In this direction they have been formulated various deliberations. Analyzing the results obtained from the market of energetic efficiency titles in the course of 2007, it has been caught up 98% of the established objectives. In the course of the same year they have been cancelled many titles, as a result of verification activity. The obtained results refer to the geographic distribution, to the exchanged volumes and to the costs of the titles. At last some criticalities are placed in evidence that remain in the mechanism and that they can be resolved in order to improve the market. [it

A comparison of standard radiological examinations, computed tomography, scintigraphy and angiography in the recidivistic diagnostic of bone tumors

International Nuclear Information System (INIS)

Schaeffer, G.

1986-01-01

In a retrospective study the diagnostic efficiency of standard radiography, computed tomography (CT), bone scintigraphy and angiography in the diagnosis of tumor recidivism was studied using 54 patients with an operatively treated bone tumor. The highest diagnostic sensitivity (100%) was achieved with the help of CT. For the determination or exclusion of a recidivistic bone tumor, the diagnostic strength of the individual procedures lies in their combinations, but these combinations should be made on the basis of the tumor type and disease. (MBC) [de

Applications of prospecting geochemical techniques to the search for and to the study of uranium deposits in metropolitan France

International Nuclear Information System (INIS)

Grimbert, Arnold

1957-01-01

After having recalled facts which leaded the CEA to use new geochemical techniques for the prospecting of uranium deposits through sampling and analysis of soils and waters, the author describes the organisation and methods implemented for this prospecting activity: team composition for sampling and analysis, role of each engineer and technician in the prospecting stages (preliminary study, routine prospecting, result interpretation), sampling and analysis processes. He also reports campaigns of geochemical prospecting: study of the La Chapelle Largeau deposit (objectives, geological context, preliminary study, routine prospecting, study of geochemical anomalies), tactical research on Verneix indices (study of radioactivity anomaly discovered by radio-prospecting), strategical searches in a non prospected area in the South of Avallon. The author discusses the issues of efficiency and cost price of this geochemical prospecting technique in soils and in waters. Appendices present the equipment and operation modality for soil sampling, and for soil sample preparation, and principles, equipment and products for soil analysis and for water analysis [fr

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

Science.gov (United States)

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

2018-07-01

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

One-year prospective replication study of an untreated sample of community dysthymia subjects.

Science.gov (United States)

McCullough, J P; McCune, K J; Kaye, A L; Braith, J A; Friend, R; Roberts, W C; Belyea-Caldwell, S; Norris, S L; Hampton, C

1994-07-01

This study replicates an earlier naturalistic-prospective investigation of nontreatment, community DSM-III-R dysthymia subjects. Major goals were to determine spontaneous remission rates and monitor the stability of psychosocial functioning levels over time. Twenty-four dysthymia subjects were followed for 1 year. Three remissions (13%) were diagnosed at the final interview. At a 4-year diagnostic follow-up contact with the remitters only, one remitter had relapsed and two remained in remission. Subjects were monitored for depressive symptom intensity, personality functioning, general medical distress, cognitive functioning, coping stylistics, interpersonal functioning, quality of their social support resources, and general family functioning. Stable levels of psychosocial functioning were maintained across all measures over the 1-year period. Current psychometric findings confirm the conclusions of the earlier nontreatment prospective study that dysthymia is a chronic mood disorder with stable psychosocial features and is unlikely to remit spontaneously over time.

SCREENING FOR OVARIAN CANCER: REALITY AND PROSPECTS. REVIEW OF THE LITERATURE

Directory of Open Access Journals (Sweden)

E. V. Gerfanova

2015-01-01

Full Text Available A review article presents the modern methods of screening and early diagnosis of primary ovarian cancer (OC. This issue is still relevant in view of the continuing upward trend in incidence rate ratios along with a slight decrease in mortality and 5-year survival rate, as well as the lack of clear definition of the concept of pathogenesis. The diagnostic value of tumor markers and their potential, advantages and disadvantages are discussed. In light of this the need becomes evident for combination of tumor markers with radiological method of imaging, such as transvaginal sonography as the most affordable, safe and multi-reproducible method enabling to most accurately determine the nature of the process, its nosology belonging, as well as to carry out the required dynamic monitoring within a short time. More advanced imaging techniques such as computer tomography or magnetic resonance imaging proved too expensive for widespread use in view of their limited sensitivity and specificity. Attempt to assess the performance of marker screening on the base of CA-125 in groups, divided by clinical and pathogenic way of OC development also proved to be ineffective. Currently, none of the presented algorithms can meet the criteria of economic efficiency, even in the most developed countries. In view of the above, possible options to enhance their performance by developing reliable multimarker panels, the use of ultrasound color power doppler mapping, and others are considered. In addition, the feasibility and application prospects of ultrasound elastometry, mass-spectrometry, IVDMIA tests, OVA dx-test as part of screening programs are discussed. The data of recent studies on the direct comparison of diagnostic tests is given. The importance of genetic counseling for persons at high risk of cancer development process is noted. In case of mutation detection in the BRCA1, BRCA2 genes, in some countries a wide range of preventive activities is recommended

Veterinary Molecular Diagnostics

NARCIS (Netherlands)

Roest, H.I.J.; Engelsma, M.Y.; Weesendorp, E.; Bossers, A.; Elbers, A.R.W.

2017-01-01

In veterinary molecular diagnostics, samples originating from animals are tested. Developments in the farm animals sector and in our societal attitude towards pet animals have resulted in an increased demand for fast and reliable diagnostic techniques. Molecular diagnostics perfectly matches this

Diagnostic and Prognostic Stratification in the Emergency Department Using Urinary Biomarkers of Nephron Damage

Science.gov (United States)

Nickolas, Thomas L.; Schmidt-Ott, Kai M.; Canetta, Pietro; Forster, Catherine; Singer, Eugenia; Sise, Meghan; Elger, Antje; Maarouf, Omar; Sola-Del Valle, David Antonio; O'Rourke, Matthew; Sherman, Evan; Lee, Peter; Geara, Abdallah; Imus, Philip; Guddati, Achuta; Polland, Allison; Rahman, Wasiq; Elitok, Saban; Malik, Nasir; Giglio, James; El-Sayegh, Suzanne; Devarajan, Prasad; Hebbar, Sudarshan; Saggi, Subodh J.; Hahn, Barry; Kettritz, Ralph; Luft, Friedrich C.; Barasch, Jonathan

2012-01-01

Objectives This study aimed to determine the diagnostic and prognostic value of urinary biomarkers of intrinsic acute kidney injury (AKI) when patients were triaged in the emergency department. Background Intrinsic AKI is associated with nephron injury and results in poor clinical outcomes. Several urinary biomarkers have been proposed to detect and measure intrinsic AKI. Methods In a multicenter prospective cohort study, 5 urinary biomarkers (urinary neutrophil gelatinase–associated lipocalin, kidney injury molecule-1, urinary liver-type fatty acid binding protein, urinary interleukin-18, and cystatin C) were measured in 1,635 unselected emergency department patients at the time of hospital admission. We determined whether the biomarkers diagnosed intrinsic AKI and predicted adverse outcomes during hospitalization. Results All biomarkers were elevated in intrinsic AKI, but urinary neutrophil gelatinase-associated lipocalin was most useful (81% specificity, 68% sensitivity at a 104-ng/ml cutoff) and predictive of the severity and duration of AKI. Intrinsic AKI was strongly associated with adverse in-hospital outcomes. Urinary neutrophil gelatinase-associated lipocalin and urinary kidney injury molecule 1 predicted a composite outcome of dialysis initiation or death during hospitalization, and both improved the net risk classification compared with conventional assessments. These biomarkers also identified a substantial subpopulation with low serum creatinine at hospital admission, but who were at risk of adverse events. Conclusion Urinary biomarkers of nephron damage enable prospective diagnostic and prognostic stratification in the emergency department. PMID:22240130

Efficiency of the Clinical Veterinary Diagnostic Practices and Drug Choices for Infectious Diseases in Livestock in Bangladesh

DEFF Research Database (Denmark)

Haider, Najmul; Khan, S. U.; Islam, A.

2017-01-01

) and foot-and-mouth disease (FMD). We conducted the study from May 2009 to August 2010 in three government veterinary hospitals where veterinarians collected samples from sick livestock and recorded the presumptive diagnosis on the basis of clinical presentations. Samples were tested for PPR and FMD using...... competency of these veterinarians needs to be improved and access to laboratory diagnostic facilities could help veterinarians to improve the diagnostics and outcomes. The rational use of antibiotics by veterinarians in animals must be ensured....... validation process for PPR (kappa: 0.25) and FMD (kappa 0.36) indicated a poor performance of the presumptive diagnoses. Most of the animals (93%) were treated with antibiotics. Our findings indicate that veterinarians can detect animals not infected with FMD or PPR but miss the true cases. The clinical...

An Artificial Intelligence Approach for Gears Diagnostics in AUVs.

Science.gov (United States)

Marichal, Graciliano Nicolás; Del Castillo, María Lourdes; López, Jesús; Padrón, Isidro; Artés, Mariano

2016-04-12

In this paper, an intelligent scheme for detecting incipient defects in spur gears is presented. In fact, the study has been undertaken to determine these defects in a single propeller system of a small-sized unmanned helicopter. It is important to remark that although the study focused on this particular system, the obtained results could be extended to other systems known as AUVs (Autonomous Unmanned Vehicles), where the usage of polymer gears in the vehicle transmission is frequent. Few studies have been carried out on these kinds of gears. In this paper, an experimental platform has been adapted for the study and several samples have been prepared. Moreover, several vibration signals have been measured and their time-frequency characteristics have been taken as inputs to the diagnostic system. In fact, a diagnostic system based on an artificial intelligence strategy has been devised. Furthermore, techniques based on several paradigms of the Artificial Intelligence (Neural Networks, Fuzzy systems and Genetic Algorithms) have been applied altogether in order to design an efficient fault diagnostic system. A hybrid Genetic Neuro-Fuzzy system has been developed, where it is possible, at the final stage of the learning process, to express the fault diagnostic system as a set of fuzzy rules. Several trials have been carried out and satisfactory results have been achieved.

An Artificial Intelligence Approach for Gears Diagnostics in AUVs

Directory of Open Access Journals (Sweden)

Graciliano Nicolás Marichal

2016-04-01

Full Text Available In this paper, an intelligent scheme for detecting incipient defects in spur gears is presented. In fact, the study has been undertaken to determine these defects in a single propeller system of a small-sized unmanned helicopter. It is important to remark that although the study focused on this particular system, the obtained results could be extended to other systems known as AUVs (Autonomous Unmanned Vehicles, where the usage of polymer gears in the vehicle transmission is frequent. Few studies have been carried out on these kinds of gears. In this paper, an experimental platform has been adapted for the study and several samples have been prepared. Moreover, several vibration signals have been measured and their time-frequency characteristics have been taken as inputs to the diagnostic system. In fact, a diagnostic system based on an artificial intelligence strategy has been devised. Furthermore, techniques based on several paradigms of the Artificial Intelligence (Neural Networks, Fuzzy systems and Genetic Algorithms have been applied altogether in order to design an efficient fault diagnostic system. A hybrid Genetic Neuro-Fuzzy system has been developed, where it is possible, at the final stage of the learning process, to express the fault diagnostic system as a set of fuzzy rules. Several trials have been carried out and satisfactory results have been achieved.

Plasma Diagnostics

Energy Technology Data Exchange (ETDEWEB)

Zaveryaev, V [Kurchatov Institute, Moscow (Russian Federation); others, and

2012-09-15

The success in achieving peaceful fusion power depends on the ability to control a high temperature plasma, which is an object with unique properties, possibly the most complicated object created by humans. Over years of fusion research a new branch of science has been created, namely plasma diagnostics, which involves knowledge of almost all fields of physics, from electromagnetism to nuclear physics, and up-to-date progress in engineering and technology (materials, electronics, mathematical methods of data treatment). Historically, work on controlled fusion started with pulsed systems and accordingly the methods of plasma parameter measurement were first developed for short lived and dense plasmas. Magnetically confined hot plasmas require the creation of special experimental techniques for diagnostics. The diagnostic set is the most scientifically intensive part of a plasma device. During many years of research operation some scientific tasks have been solved while new ones arose. New tasks often require significant changes in the diagnostic system, which is thus a very flexible part of plasma machines. Diagnostic systems are designed to solve several tasks. As an example here are the diagnostic tasks for the International Thermonuclear Experimental Reactor - ITER: (1) Measurements for machine protection and basic control; (2) Measurements for advanced control; (3) Additional measurements for performance evaluation and physics. Every new plasma machine is a further step along the path to the main goal - controlled fusion - and nobody knows in advance what new phenomena will be met on the way. So in the planning of diagnostic construction we should keep in mind further system upgrading to meet possible new scientific and technical challenges. (author)

Scope for improved eco-efficiency varies among diverse cropping systems.

Science.gov (United States)

Carberry, Peter S; Liang, Wei-li; Twomlow, Stephen; Holzworth, Dean P; Dimes, John P; McClelland, Tim; Huth, Neil I; Chen, Fu; Hochman, Zvi; Keating, Brian A

2013-05-21

Global food security requires eco-efficient agriculture to produce the required food and fiber products concomitant with ecologically efficient use of resources. This eco-efficiency concept is used to diagnose the state of agricultural production in China (irrigated wheat-maize double-cropping systems), Zimbabwe (rainfed maize systems), and Australia (rainfed wheat systems). More than 3,000 surveyed crop yields in these three countries were compared against simulated grain yields at farmer-specified levels of nitrogen (N) input. Many Australian commercial wheat farmers are both close to existing production frontiers and gain little prospective return from increasing their N input. Significant losses of N from their systems, either as nitrous oxide emissions or as nitrate leached from the soil profile, are infrequent and at low intensities relative to their level of grain production. These Australian farmers operate close to eco-efficient frontiers in regard to N, and so innovations in technologies and practices are essential to increasing their production without added economic or environmental risks. In contrast, many Chinese farmers can reduce N input without sacrificing production through more efficient use of their fertilizer input. In fact, there are real prospects for the double-cropping systems on the North China Plain to achieve both production increases and reduced environmental risks. Zimbabwean farmers have the opportunity for significant production increases by both improving their technical efficiency and increasing their level of input; however, doing so will require improved management expertise and greater access to institutional support for addressing the higher risks. This paper shows that pathways for achieving improved eco-efficiency will differ among diverse cropping systems.

Selective reminding of prospective memory in Multiple Sclerosis.

Science.gov (United States)

McKeever, Joshua D; Schultheis, Maria T; Sim, Tiffanie; Goykhman, Jessica; Patrick, Kristina; Ehde, Dawn M; Woods, Steven Paul

2017-04-19

Multiple sclerosis (MS) is associated with prospective memory (PM) deficits, which may increase the risk of poor functional/health outcomes such as medication non-adherence. This study examined the potential benefits of selective reminding to enhance PM functioning in persons with MS. Twenty-one participants with MS and 22 healthy adults (HA) underwent a neuropsychological battery including a Selective Reminding PM (SRPM) experimental procedure. Participants were randomly assigned to either: (1) a selective reminding condition in which participants learn (to criterion) eight prospective memory tasks in a Selective Reminding format; or (2) a single trial encoding condition (1T). A significant interaction was demonstrated, with MS participants receiving greater benefit than HAs from the SR procedure in terms of PM performance. Across diagnostic groups, participants in the SR conditions (vs. 1T conditions) demonstrated significantly better PM performance. Individuals with MS were impaired relative to HAs in the 1T condition, but performance was statistically comparable in the SR condition. This preliminary study suggests that selective reminding can be used to enhance PM cue detection and retrieval in MS. The extent to which selective reminding of PM is effective in naturalistic settings and for health-related behaviours in MS remains to be determined.

Brain computer tomography in critically ill patients - a prospective cohort study

International Nuclear Information System (INIS)

Purmer, Ilse M; Iperen, Erik P van; Beenen, Ludo F M; Kuiper, Michael J; Binnekade, Jan M; Vandertop, Peter W; Schultz, Marcus J; Horn, Janneke

2012-01-01

Brain computer tomography (brain CT) is an important imaging tool in patients with intracranial disorders. In ICU patients, a brain CT implies an intrahospital transport which has inherent risks. The proceeds and consequences of a brain CT in a critically ill patient should outweigh these risks. The aim of this study was to critically evaluate the diagnostic and therapeutic yield of brain CT in ICU patients. In a prospective observational study data were collected during one year on the reasons to request a brain CT, expected abnormalities, abnormalities found by the radiologist and consequences for treatment. An “expected abnormality” was any finding that had been predicted by the physician requesting the brain CT. A brain CT was “diagnostically positive”, if the abnormality found was new or if an already known abnormality was increased. It was “diagnostically negative” if an already known abnormality was unchanged or if an expected abnormality was not found. The treatment consequences of the brain CT, were registered as “treatment as planned”, “treatment changed, not as planned”, “treatment unchanged”. Data of 225 brain CT in 175 patients were analyzed. In 115 (51%) brain CT the abnormalities found were new or increased known abnormalities. 115 (51%) brain CT were found to be diagnostically positive. In the medical group 29 (39%) of brain CT were positive, in the surgical group 86 (57%), p 0.01. After a positive brain CT, in which the expected abnormalities were found, treatment was changed as planned in 33%, and in 19% treatment was changed otherwise than planned. The results of this study show that the diagnostic and therapeutic yield of brain CT in critically ill patients is moderate. The development of guidelines regarding the decision rules for performing a brain CT in ICU patients is needed

[Diagnostic efficiency of decline rate of signal intensity and apparent diffusion coefficient with different b values for differentiating benign and malignant breast lesions on diffusion-weighted 3.0T magnetic resonance imaging].

Science.gov (United States)

Jiang, Jing; Liu, Wanhua; Ye, Yuanyuan; Wang, Rui; Li, Fengfang; Peng, Chengyu

2014-06-17

To investigate the diagnostic efficiency of decline rate of signal intensity and apparent diffusion coefficient with different b values for differentiating benign and malignant breast lesions on diffusion-weighted 3.0 T magnetic resonance imaging. A total of 152 patients with 162 confirmed histopathologically breast lesions (85 malignant and 77 benign) underwent 3.0 T diffusion-weighted magnetic resonance imaging. Four b values (0, 400, 800 and 1 000 s/mm²) were used. The signal intensity and ADC values of breast lesions were measured respectively. The signal intensity decline rate (SIDR) and apparent diffusion coefficient decline rate (ADCDR) were calculated respectively. SIDR = (signal intensity of lesions with low b value-signal intensity of lesions with high b value)/signal intensity of lesions with low b value, ADCDR = (ADC value of lesions with low b value-ADC value of lesions with high b value) /ADC value of lesions with low b value. The independent sample t-test was employed for statistical analyses and the receiver operating characteristic (ROC) curve for evaluating the diagnosis efficiency of SIDR and ADCDR values. Significant differences were observed in SIDR between benign and malignant breast lesions with b values of 0-400, 400-800 and 800-1 000 s/mm². The sensitivities of SIDR for differentiating benign and malignant breast lesions were 61.2%, 68.2% and 67.1%, the specificities 74.0%, 85.7% and 67.5%, the diagnosis accordance rates 67.3%, 76.5% and 67.3%, the positive predictive values 72.2%, 84.1% and 69.5% and the negative predictive values 63.3%, 71.0% and 65.0% respectively. Significant differences were observed in ADCDR between benign and malignant breast lesions with b values of 400-800 s/mm² and 800-1 000 s/mm². The sensitivities of SDR for differentiating benign and malignant breast lesions were 80.0% and 65.9%, the specificities 72.7% and 65.0%, the diagnostic accordance rates 76.5% and 65.4%, the positive predictive values 76.4% and 67

[An overview of neurometabolic diseases in Tunisia. a 3-year prospective study].

Science.gov (United States)

Kraoua, I; Benrhouma, H; Rouissi, A; Youssef-Turki, I Ben; Zouari, B; Kaabachi, N; Gouider-Khouja, N

2009-01-01

Neurometabolic diseases are a large group of genetic diseases. In our country, the diagnostic and therapeutic approach to theses diseases is rather difficult. The aim of our study was to determine the frequency of neurometabolic diseases in the hospital population, to describe the problems in diagnosing these conditions and difficulties encountered during patient care. Our goal was to propose guidelines for a practical diagnostic and therapeutic approach to neurometabolic disorders in our country. We have conducted a prospective study over a 3-year period including all patients diagnosed with "metabolic disease" and followed at the Child and Adolescent Neurology Department of the National Institute of Neurology of Tunis. One hundred and thirty-six patients were included (2.4% of our patients). Mean age was 7.3 +/- 5.1 years. Mean age at onset was 4.3 years. There was a high consanguinity rate. Respiratory chain defects were the most frequently suspected diseases (16.9%), followed by lysosomal diseases (8.8%). Chromatography, initially systematically prescribed, became targeted with a higher diagnostic efficacy. Metabolic diseases diagnosed as certain, represented 22% of the studied cases. This can be explained by the insufficiency of available laboratory tests of confirmation. The prescription of specific treatment was insufficient, even for confirmed pathologies (14.7%) because of the high cost of these therapies. The diagnostic approach has to be rational, targeted, multidisciplinar and conducted within a care network. Diagnostic priority should focus on treatable neurometabolic diseases. The establishment of a systematized registry and neonatal screening for the main treatable neurometabolic diseases constitute the final objective of our work to prepare for biochemical and genetic studies.

Comparison of Three Techniques for Arthrocentesis of the Carpal Joint in Dromedary Camels: A Prospective Study

OpenAIRE

Adel M. Badawy; Eman A. Eshra

2016-01-01

The aim of this prospective study was to determine the appropriate approaches for arthrocentesis of the carpal joint in dromedary camels and to compare between these approaches with regard to their success rate, feasibility, accuracy and ease of performance. Twenty-two cadaveric camel forelimbs obtained from 11 camel cadavers, and 4 living camels (6 joints) underwent arthrocentesis for therapeutic and diagnostic purposes, were used in this study. For studying gross anatomy of the suggested ap...

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

Directory of Open Access Journals (Sweden)

Cheng Y

2015-08-01

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

A framework for establishing the technical efficiency of Electricity Distribution Counties (EDCs) using Data Envelopment Analysis

International Nuclear Information System (INIS)

Mullarkey, Shane; Caulfield, Brian; McCormack, Sarah; Basu, Biswajit

2015-01-01

Highlights: • Six models are employed to establish the technical efficiency of Electricity Distribution Counties. • A diagnostic parameter is incorporated to account for differences across Electricity Distribution Counties. • The amalgamation of Electricity Distribution Counties leads to improved efficiency in the production of energy. - Abstract: European Energy market liberalization has entailed the restructuring of electricity power markets through the unbundling of electricity generation, transmission and distribution, supply activities and introducing competition into electricity generation. Under these new electricity market regimes, it is important to have an evaluation tool that is capable of examining the impacts of these market changes. The adoption of Data Envelopment Analysis as a form of benchmarking for electricity distribution regulation is one method to conduct this analysis. This paper applies a Data Envelopment Analysis framework to the electricity distribution network in Ireland to explore the merits of using this approach, to determine the technical efficiency and the potential scope for efficiency improvements through reorganizing and the amalgamation of the distribution network in Ireland. The results presented show that overall grid efficiency is improved through this restructuring. A diagnostic parameter is defined and pursued to account for aberrations across Electricity Distribution Counties as opposed to the traditionally employed environmental variables. The adoption of this diagnostic parameter leads to a more intuitive understanding of Electricity Distribution Counties

A prospective study of autistic-like traits in unaffected siblings of probands with autism spectrum disorder.

Science.gov (United States)

Georgiades, Stelios; Szatmari, Peter; Zwaigenbaum, Lonnie; Bryson, Susan; Brian, Jessica; Roberts, Wendy; Smith, Isabel; Vaillancourt, Tracy; Roncadin, Caroline; Garon, Nancy

2013-01-01

The presence of autistic-like traits in relatives of individuals with autism spectrum disorder (ASD) is well recognized, but, to our knowledge, the emergence of these traits early in development has not been studied. To prospectively investigate the emergence of autistic-like traits in unaffected (no ASD diagnosis) infant siblings of probands diagnosed as having ASD. Two groups of children unaffected with ASD were assessed prospectively-siblings of probands diagnosed as having ASD (high risk [HR]) and control subjects with no family history of ASD (low risk [LR]). Scores on a measure of autistic-like traits at 12 months of age were used in a cluster analysis of the entire sample. A prospective study of infant siblings of probands with ASD from 3 diagnostic centers in Canada. The study included 170 HR and 90 LR children, none of whom was diagnosed as having ASD at age 3 years. The Autism Observation Scale for Infants was used to measure autistic-like traits and derive clusters at 12 months of age. Clusters were compared on ASD symptoms, cognitive abilities, and social-emotional difficulties at age 3 years. Two clusters were identified. Cluster 1 (n = 37; 14.2% of total sample) had significantly higher levels of autistic-like traits compared with cluster 2. Within cluster 1, 33 children came from the siblings (19.4% of HR group) and only 4 came from the control subjects (4.5% of LR group). At age 3 years, children from cluster 1 had more social-communication impairment (effect size > 0.70; P autism phenotype by 12 months of age in approximately 19% of HR siblings who did not meet ASD diagnostic criteria at age 3 years.

Smartphone-Based Fluorescent Diagnostic System for Highly Pathogenic H5N1 Viruses

Science.gov (United States)

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

2016-01-01

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

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