49 CFR 396.7 - Unsafe operations forbidden.

Science.gov (United States)

2010-10-01

... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS INSPECTION, REPAIR, AND MAINTENANCE § 396.7 Unsafe operations forbidden. (a) General. A motor vehicle shall not be operated in such a condition as to likely cause an accident or a breakdown of the vehicle. (b) Exemption. Any motor vehicle...

Permitted and forbidden sets in symmetric threshold-linear networks.

Science.gov (United States)

Hahnloser, Richard H R; Seung, H Sebastian; Slotine, Jean-Jacques

2003-03-01

The richness and complexity of recurrent cortical circuits is an inexhaustible source of inspiration for thinking about high-level biological computation. In past theoretical studies, constraints on the synaptic connection patterns of threshold-linear networks were found that guaranteed bounded network dynamics, convergence to attractive fixed points, and multistability, all fundamental aspects of cortical information processing. However, these conditions were only sufficient, and it remained unclear which were the minimal (necessary) conditions for convergence and multistability. We show that symmetric threshold-linear networks converge to a set of attractive fixed points if and only if the network matrix is copositive. Furthermore, the set of attractive fixed points is nonconnected (the network is multiattractive) if and only if the network matrix is not positive semidefinite. There are permitted sets of neurons that can be coactive at a stable steady state and forbidden sets that cannot. Permitted sets are clustered in the sense that subsets of permitted sets are permitted and supersets of forbidden sets are forbidden. By viewing permitted sets as memories stored in the synaptic connections, we provide a formulation of long-term memory that is more general than the traditional perspective of fixed-point attractor networks. There is a close correspondence between threshold-linear networks and networks defined by the generalized Lotka-Volterra equations.

Penning trap mass spectrometry Q-value determinations for highly forbidden β-decays

Science.gov (United States)

Sandler, Rachel; Bollen, Georg; Eibach, Martin; Gamage, Nadeesha; Gulyuz, Kerim; Hamaker, Alec; Izzo, Chris; Kandegedara, Rathnayake; Redshaw, Matt; Ringle, Ryan; Valverde, Adrian; Yandow, Isaac; Low Energy Beam Ion Trap Team

2017-09-01

Over the last several decades, extremely sensitive, ultra-low background beta and gamma detection techniques have been developed. These techniques have enabled the observation of very rare processes, such as highly forbidden beta decays e.g. of 113Cd, 50V and 138La. Half-life measurements of highly forbidden beta decays provide a testing ground for theoretical nuclear models, and the comparison of calculated and measured energy spectra could enable a determination of the values of the weak coupling constants. Precision Q-value measurements also allow for systematic tests of the beta-particle detection techniques. We will present the results and current status of Q value determinations for highly forbidden beta decays. The Q values, the mass difference between parent and daughter nuclides, are measured using the high precision Penning trap mass spectrometer LEBIT at the National Superconducting Cyclotron Laboratory.

Oxygen abundance in metal-poor dwarfs, derived from the forbidden line

Science.gov (United States)

Spite, M.; Spite, F.

1991-12-01

The oxygen abundance is redetermined in a few metal-poor dwarfs, using the oxygen forbidden line at 630 nm rather than the oxygen triplet at 777 nm previously used by Abia and Rebolo (1989). The ratios form O/Fe are clearly lower than the previous ones and are in agreement with the ratios found in the metal-poor red giants, suggesting that no real difference exists between dwarfs and giants. Finally, it can be argued that, pending the acquisition of additional information, the oxygen abundances derived from the forbidden line are more reliable than the abundances found from the triplet.

Meson-Exchange Enhancement of First-Forbidden $\\beta$-Transitions in the Lead Region

CERN Multimedia

Delaure, B J P; Severijns, N

2002-01-01

Both on-line and off-line low temperature nuclear orientation is used to measure the $\\beta$-asymmetry parameter for the first-forbidden g.s. $\\rightarrow$~g.s. $\\beta$-transitions of $^{205}$Hg, $^{207,209}$Tl, $^{209}$Pb and $^{213}$Bi. From this, the ratio of the rank-zero and the rank-one strengths in these decays can be deduced, with the rank of a $\\beta$-transition being defined as the total angular momentum of the lepton system. Combining this result with the experimental ${ft}$-values yields for the first time a purely experimental determination of the rank-zero contribution in these $\\Delta$ J = 0 first-forbidden transitions. This provides an independent check of the large enhancement (of about 100% over the impulse approximation) of the rank-zero matrix element of $\\gamma_{5} $, caused by meson exchange currents (MEC), which was recently obtained from a comparison of calculated first-forbidden $\\beta$-decay rates with experimentally observed values for nuclei in the lead region (A = 205-212). Measur...

Observations of the 63 micron forbidden O I line in Herbig-Haro objects

International Nuclear Information System (INIS)

Cohen, M.; Hollenbach, D.J.; Haas, M.R.; Erickson, E.F.

1988-01-01

The paper presents observations of the 63 micron forbidden O I line from Herbig-Haro objects and their exciting stars. Forbidden O I 63 micron emission is detected toward the HH-exciting stars T Tau, DG Tau, L1551 IRS 5, and toward the HH objects HH 7-11, HH 42A, and HH 43 which are displaced from their exciting stars. The forbidden O I emission is associated with these flows on the basis of its spatial coincidence and its negative radial velocities. If the exciting stars drive bipolar flows in which the 63 micron emission follows that at 6300 A, the absence of redshifted 63 micron lines from the three exciting stars might indicate that the disks hypothesized to overlie the receding lobes of these flows are still optically thick in the far-infrared. 50 references

Communication: Proper treatment of classically forbidden electronic transitions significantly improves detailed balance in surface hopping

Energy Technology Data Exchange (ETDEWEB)

Sifain, Andrew E. [Department of Physics and Astronomy, University of Southern California, Los Angeles, California 90089-0485 (United States); Wang, Linjun [Department of Chemistry, Zhejiang University, Hangzhou 310027 (China); Prezhdo, Oleg V. [Department of Physics and Astronomy, University of Southern California, Los Angeles, California 90089-0485 (United States); Department of Chemistry, University of Southern California, Los Angeles, California 90089-1062 (United States)

2016-06-07

Surface hopping is the most popular method for nonadiabatic molecular dynamics. Many have reported that it does not rigorously attain detailed balance at thermal equilibrium, but does so approximately. We show that convergence to the Boltzmann populations is significantly improved when the nuclear velocity is reversed after a classically forbidden hop. The proposed prescription significantly reduces the total number of classically forbidden hops encountered along a trajectory, suggesting that some randomization in nuclear velocity is needed when classically forbidden hops constitute a large fraction of attempted hops. Our results are verified computationally using two- and three-level quantum subsystems, coupled to a classical bath undergoing Langevin dynamics.

E-cigarettes forbidden in offices and closed areas

CERN Document Server

2013-01-01

Be reminded that all people on the CERN site must comply with the following notice from the Medical Service: “In the same manner as for ordinary cigarettes, the use of e-cigarettes is forbidden in all offices and closed areas.” If you have any question, please write to medical.service@cern.ch HSE Unit/ GS-ME Department

Forbidden coupling and inhibited decay: a study of disconnection

International Nuclear Information System (INIS)

Bolzan, J.F.; Palmer, W.F.; Pinsky, S.S.

1975-01-01

An attempt is made to correlate deviation from ideal mixing mass formula, high energy scattering behavior, and violation of the Okubo-Zweig-Iizuka rule. Pole or cut nature of the intermediary is discussed. Timelike and spacelike forbidden communications are compared. Off-shell effects are examined. Some problems for phenomenology are revealed

A minisum model with forbidden regions for locating a semi-desirable facility in the plane

DEFF Research Database (Denmark)

Brimberg, Jack; Juel, Henrik

-desirable facility which accounts for the service costs by a standard minisum objective with arbitrary travel distance function. The social costs are imputed by specifying around each demand point or population center a convex forbidden region, also defined by an arbitrary distance metric, in which the new facility...... may not be located. A general solution algorithm is suggested, and the methodology applied to circular forbidden regions and special travel distance functions....

A minisum model with forbidden regions for locating a semi-desirable facility in the plane

DEFF Research Database (Denmark)

Juel, Henrik; Brimberg, Jack

1998-01-01

-desirable facility that accounts for the service costs by a standard minisum objective with arbitrary travel distance function. The social costs are imputed by specifying around each demand point or population center a convex forbidden region, also defined by an arbitrary distance metric, in which the new facility...... may not be located. A general solution algorithm is suggested, and the methodology is applied to circular forbidden regions and special travel distance functions....

The Forbidden Signs

DEFF Research Database (Denmark)

Kilstrup, Mogens

2016-01-01

While the field of semiotics has been active since it was started by Peirce, it appears like the last decade has been especially productive with a number of important new concepts being developed within the biosemiotics community. The novel concept of the Semiotic scaffold by Hoffmeyer is an impo......While the field of semiotics has been active since it was started by Peirce, it appears like the last decade has been especially productive with a number of important new concepts being developed within the biosemiotics community. The novel concept of the Semiotic scaffold by Hoffmeyer...... is an important addition that offers insight into the hardware requirements for bio-semiosis. As any type of semiosis must be dependent upon Semiotic scaffolds, I recently argued that the process of semiosis has to be divided into two separate processes of sign establishment and sign interpretation....... I also show that biological semiosis offers examples of forbidden signs, where the faulty interpretation of signs may lead to decimation of whole evolutionary lines of organisms. A new concept of Evolutionary memory which is applicable to both human and biological semiosis is explained...

Tasting the Forbidden Fruit: The Social Context of Debut Sexual ...

African Journals Online (AJOL)

Tasting the Forbidden Fruit: The Social Context of Debut Sexual Encounters Among Young Persons in a Rural Nigerian Community. ... Alternatively, you can download the PDF file directly to your computer, from where it can be opened using a PDF reader. To download the PDF, click the Download link above.

Selection rule engineering of forbidden transitions of a hydrogen atom near a nanogap

Science.gov (United States)

Kim, Hyunyoung Y.; Kim, Daisik S.

2018-01-01

We perform an analytical study on the allowance of forbidden transitions for a hydrogen atom placed near line dipole sources, mimicking light emanating from a one-dimensional metallic nanogap. It is shown that the rapid variation of the electric field vector, inevitable in the near zone, completely breaks the selection rule of Δl=±1. While the forbidden transitions between spherically symmetric S states, such as 2S to 1S or 3S to 1S (Δl=0), are rather robust against selection rule breakage, Δl=±2 transitions such as between 3D and 1S or 3D and 2S states are very vulnerable to the spatial variation of the perturbing electric field. Transitions between 2S and 3D states are enhanced by many orders of magnitude, aided by the quadratic nature of both the perturbing Hamiltonian and D wavefunctions. The forbidden dipole moment, which approaches one Bohr radius times the electric charge in the vicinity of the gap, can be written in a simple closed form owing to the one-dimensional nature of our gap. With large enough effective volume together with the symmetric nature of the excited state wavefunctions, our work paves way towards atomic physics application of infinitely long nanogaps.

Forbidden lines of highly ionized ions for localized plasma diagnostics

International Nuclear Information System (INIS)

Hinnov, E.; Fonck, R.; Suckewer, S.

1980-06-01

Numerous optically forbidden lines resulting from magnetic dipole transitions in low-lying electron configurations of highly ionized Fe, Ti and Cr atoms have been identified in PLT and PDX tokamak discharges, and applied for localized diagnostics in the high-temperature (0.5 to 3.0 keV) interior of these plasmas. The measurements include determination of local ion densities and their variation in time, and of ion motions (ion temperature, plasma rotations) through Doppler effect of the lines. These forbidden lines are particularly appropriate for such measurements because under typical tokamak conditions their emissivities are quite high (10 11 to 10 14 photons/cm 3 -sec), and their relatively long wavelengths allow the use of intricate optical techniques and instrumentation. The spatial location of the emissivity is directly measurable, and tends to occur near radii where the ionization potential of the ion in question is equal to the local electron temperature. In future larger and presumably higher-temperature tokamaks analogous measurements with somewhat heavier atoms, particularly krypton, and perhaps zirconium appear both feasible and desirable

Rare and forbidden decays

CERN Document Server

Trampetic, Josip

2002-01-01

In these lectures I first cover radiative and semileptonic B decays, including the QCD corrections for the quark subprocesses. The exclusive modes and the evaluation of the hadronic matrix elements, i.e. the relevant hadronic form factors, are the second step. Small effects due to the long-distance, spectator contributions, etc. are discussed next. The second section we started with non-leptonic decays, typically $B \\to \\pi\\pi, K\\pi, \\rho\\pi,...$ We describe in more detail our prediction for decays dominated by the $b\\to s \\eta_c$ transition. Reports on the most recent experimental results are given at the end of each subsection. In the second part of the lectures I discuss decays forbidden by the Lorentz and gauge invariance, and due to the violation of the angular moment conservation, generally called the Standard Model-forbiden decays. However, the non-commutative QED and/or non-commutative Standard Model (NCSM), developed in a series of works in the last few years allow some of those decay modes. These ar...

Allowed and forbidden transition parameters for Fe XV

International Nuclear Information System (INIS)

Nahar, Sultana N.

2009-01-01

A comprehensive set of fine structure energy levels, oscillator strengths (f), line strengths (S), and radiative decay rates (A) for bound-bound transitions in Fe XV is presented. The allowed electric dipole (E1) transitions were obtained from the relativistic Breit-Pauli R-matrix method which is based on the close coupling approximation. A total of 507 fine structure energy levels with n ≤ 10, l ≤ 9, and 0 ≤ J ≤ 10 are found. They agree within 1% with the available observed energies. These energy levels yield a total of 27,812 E1, same-spin multiplets and intercombination transitions. The A values are in good agreement with those compiled by NIST and other existing values for most transitions. Forbidden transitions are obtained from a set of 20 configurations with orbitals ranging from 1s to 5f using the relativistic code SUPERSTRUCTURE (SS) in the Breit-Pauli approximation. From a set of 123 fine structure levels, a total of 6962 S and A values are presented for forbidden electric quadrupole (E2), electric octupole (E3), magnetic dipole (M1), and magnetic quadrupole (M2) transitions. The energies from SS calculations agree with observed energies to within 1-3%. A values for E2, M1 transitions agree very well with the available values for most transitions while those for M2 transitions show variable agreement. The large set of transition parameters presented should be applicable for both diagnostics and spectral modeling in the X-ray, ultraviolet, and optical regions of astrophysical plasmas.

Experimental observation on asymmetric energy flux within the forbidden frequency band in the LC transmission line

International Nuclear Information System (INIS)

Tao Feng; Chen Weizhong; Pan Junting; Xu Wen; Du Sidan

2012-01-01

We study the energy flux in a nonlinear electrical transmission line consisting of two coupled segments which are identical in structure and different in parameters. The asymmetry of energy flux caused by nonlinear wave has been observed experimentally in the forbidden band of the line. The experiment shows whether the energy can flow through the transmission line depends on the amplitude of the boundary driving voltages, which can be well explained in the theoretical framework of nonlinear supratransmission. The numerical simulation based on Kirchhoff’s laws further verifies the existence of the asymmetric energy flux in the forbidden band.

Investigation of the parity forbidden alpha decay of 20Ne

International Nuclear Information System (INIS)

Disque, M.

1978-01-01

In this thesis the alpha decay of excited states in 20 Ne is investigated. The excited neon states are formed by proton bombardment of 19 F at proton energie of 340 and 670 kev. The ratio E of the parity forbidden alpha decays leading to the ground state of 160 to the allowed decays is determined. The results are E = 7.4 x 10 -5 resonance at 340 kev, E = 4.2 x 10 -3 resonance at 670 kev. (FKS)

The use of psychoactive prescription drugs among DUI suspects.

Science.gov (United States)

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

2015-10-01

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

Revisiting the `forbidden' region: AGN radiative feedback with radiation trapping

Science.gov (United States)

Ishibashi, W.; Fabian, A. C.; Ricci, C.; Celotti, A.

2018-06-01

Active galactic nucleus (AGN) feedback, driven by radiation pressure on dust, is an important mechanism for efficiently coupling the accreting black hole to the surrounding environment. Recent observations confirm that X-ray selected AGN samples respect the effective Eddington limit for dusty gas in the plane defined by the observed column density versus the Eddington ratio, the so-called NH - λ plane. A `forbidden' region occurs in this plane, where obscuring clouds cannot be long-lived, due to the action of radiation pressure on dust. Here we compute the effective Eddington limit by explicitly taking into account the trapping of reprocessed radiation (which has been neglected in previous works), and investigate its impact on the NH - λ plane. We show that the inclusion of radiation trapping leads to an enhanced forbidden region, such that even Compton-thick material can potentially be disrupted by sub-Eddington luminosities. We compare our model results to the most complete sample of local AGNs with measured X-ray properties, and find good agreement. Considering the anisotropic emission from the accretion disc, we also expect the development of dusty outflows along the polar axis, which may naturally account for the polar dust emission recently detected in several AGNs from mid-infrared observations. Radiative feedback thus appears to be the key mechanism regulating the obscuration properties of AGNs, and we discuss its physical implications in the context of co-evolution scenarios.

Nuclear Pedigree Criteria of Suspected HNPCC

Directory of Open Access Journals (Sweden)

Kładny Józef

2003-01-01

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

Reply to ''Comment on enhancement of forbidden nuclear beta decay by high-intensity radio-frequency fields''

International Nuclear Information System (INIS)

Reiss, H.R.

1984-01-01

The negative conclusion in the Comment of Becker, Schlicher, and Scully about electromagnetic enhancement of beta decay is shown to be faulty. They have found an algebraic oversight in my paper, but correction of that oversight yields results strongly resembling the original. Becker, Schlicher, and Scully fail to find this. They then conduct an analysis which is highly implicit and incomplete. In attempting to analyze their very complicated expressions they claim not to find significant electromagnetic effects. Yet they also lose completely the electron retardation term of conventional forbidden beta decay. When they attempt to explain the difference between their results and mine, they misconstrue the momentum-translation technique and end up in a logical contradiction. They attempt also to apply a ''no-go'' theorem applicable only to plane-wave particles to my theory, which is built around the use of bound-state nuclear wave functions. This makes the no-go theorem inapplicable

The forbidden beauty of quasicrystals

International Nuclear Information System (INIS)

McGrath, R.; Grimm, U.; Diehl, R.

2005-01-01

Two decades after they were discovered, the unusual properties of quasicrystals continue to fascinate researchers from a range of disciplines. 20 years ago last month Danny Shechtman of the Technion Institute in Israel announced the discovery of a new metallic alloy. At the time Shechtman had been on sabbatical leave at the National Bureau of Standards in Washington DC, investigating the properties of mixtures of metals that had been melted together and rapidly cooled. He found that one of these alloys - aluminium manganese - displayed a diffraction pattern with 10-fold rotational symmetry. However, such symmetries were supposed to be forbidden by the laws of crystallography. This discovery generated huge excitement, confusion and significant opposition. The Journal of Applied Physics, for example, rejected Shechtman's first paper detailing the discovery on the grounds that it would not interest the physicists who read the journal. Linus Pauling - a giant of 20th-century crystallography - also dismissed the findings. But these early doubts were soon swept away by new experimental evidence, and Shechtman's paper - which was finally published in Physical Review Letters in November 1984 - has since become one of the most-cited research articles in the scientific literature. The strange new materials he had discovered were dubbed quasicrystals, a shorthand form of 'quasiperiodic crystals'. (U.K.)

Beta decay and other processes in strong electromagnetic fields

International Nuclear Information System (INIS)

Akhmedov, E. Kh.

2011-01-01

We consider effects of the fields of strong electromagnetic waves on various characteristics of quantum processes. After a qualitative discussion of the effects of external fields on the energy spectra and angular distributions of the final-state particles as well as on the total probabilities of the processes (such as decay rates and total cross sections), we present a simple method of calculating the total probabilities of processes with production of nonrelativistic charged particles. Using nuclear β decay as an example, we study the weak- and strong-field limits, as well as the field-induced β decay of nuclei stable in the absence of the external fields, both in the tunneling and multiphoton regimes. We also consider the possibility of accelerating forbidden nuclear β decays by lifting the forbiddeness due to the interaction of the parent or daughter nuclei with the field of a strong electromagnetic wave. It is shown that for currently attainable electromagnetic fields all effects on total β-decay rates are unobservably small.

Photoabsorption Spectrum and Optically Forbidden Transitions of Krypton by Electron Impact

Institute of Scientific and Technical Information of China (English)

苑震生; 朱林繁; 李文斌; 成华东; 徐克尊

2002-01-01

A high resolution fast electron energy loss spectrometer with multi-channel energy analysis was employed. The maxima just above the threshold 4p-1(2P1/2), which is regarded as a shape resonance, was obtained at 16.3 eV. The optically forbidden excitations of 4s electron were measured for the first time, and the energy positions are 23.75 eV(4s-15s), 25.66 eV (4s-16s/4d) and 26.60 eV(4s-17s/5d).

Unexpected strong attraction in the presence of continuum bound state

International Nuclear Information System (INIS)

Delfino, A.; Frederico, T.

1992-06-01

The result of few-particle ground-state calculation employing a two-particle non-local potential supporting a continuum bound state in addition to a negative-energy bound state has occasionally revealed unexpected large attraction in producing a very strongly bound ground state. In the presence of the continuum bound state the difference of phase shift between zero and infinite energies has an extra jump of φ as in the presence of an additional bound state. The wave function of the continuum bound state is identical with that of a strongly bound negative-energy state, which leads us to postulate a pseudo bound state in the two-particle system in order to explain the unexpected attraction. The role of the Pauli forbidden states is expected to be similar to these pseudo states. (author)

Refinement of the gross theory of nuclear {beta}-decay, and hindrance of the first-forbidden transition of rank 1

Energy Technology Data Exchange (ETDEWEB)

Nakata, Hidehiko [Waseda Univ., Tokyo (Japan). Dept. of Physics; Tachibana, Takahiro; Yamada, Masami

1997-03-01

Recently the gross theory of nuclear {beta}-decay was refined for odd-odd nuclei. In this refinement, the effect of the selection rule of {beta}-transitions from the ground states of odd-odd nuclei to those of even-even nuclei was taken into account based on a statistical consideration. The transitions to the first 2{sup +} excited states in even-even nuclei were also taken into account according to the selection rule approximately. In that study, it was found that the transitions between 1{sup -} ground states of the odd-odd nuclei and 0{sup +} ground states of even-even nuclei, belonging to the first-forbidden transitions of rank 1, are strongly hindered. A reduction factor was introduced for the transitions to the ground states of even-even nuclei to take into account this hindrance. It was also found that the strength functions of the Gamow-Teller transitions obtained from the conventional gross theory are underestimated by a factor of about 3. In order to improve this underestimation, the Lorentz-type function was adopted for the one-particle strength function in the model instead of the hyperbolic-secant-type function. In the present study we have newly analyzed the experimental ft-values of odd-A nuclei, and found that the first-forbidden transitions of rank 1 are also considerably hindered between the ground states. Following the above refinement we have calculated the {beta}-ray spectra of some odd-odd short-lived fission products with the use of the refined gross theory. These results are compared not only with the experiments by Rudstam et al. but also with the conventional gross theory. (author)

Age and violent-content labels make video games forbidden fruits for youth.

Science.gov (United States)

Bijvank, Marije Nije; Konijn, Elly A; Bushman, Brad J; Roelofsma, Peter H M P

2009-03-01

To protect minors from exposure to video games with objectionable content (eg, violence and sex), the Pan European Game Information developed a classification system for video games (eg, 18+). We tested the hypothesis that this classification system may actually increase the attractiveness of games for children younger than the age rating. Participants were 310 Dutch youth. The design was a 3 (age group: 7-8, 12-13, and 16-17 years) x 2 (participant gender) x 7 (label: 7+, 12+, 16+, 18+, violence, no violence, or no label control) x 2 (game description: violent or nonviolent) mixed factorial. The first 2 factors were between subjects, whereas the last 2 factors were within subjects. Three personality traits (ie, reactance, trait aggressiveness, and sensation seeking) were also included in the analyses. Participants read fictitious video game descriptions and rated how much they wanted to play each game. Results revealed that restrictive age labels and violent-content labels increased the attractiveness of video games for all of the age groups (even 7- to 8-year-olds and girls). Although the Pan European Game Information system was developed to protect youth from objectionable content, this system actually makes such games forbidden fruits. Pediatricians should be aware of this forbidden-fruit effect, because video games with objectionable content can have harmful effects on children and adolescents.

Enhanced light scattering of the forbidden longitudinal optical phonon mode studied by micro-Raman spectroscopy on single InN nanowires

International Nuclear Information System (INIS)

Schaefer-Nolte, E O; Stoica, T; Gotschke, T; Limbach, F A; Gruetzmacher, D; Calarco, R; Sutter, E; Sutter, P

2010-01-01

In the literature, there are controversies on the interpretation of the appearance in InN Raman spectra of a strong scattering peak in the energy region of the unscreened longitudinal optical (LO) phonons, although a shift caused by the phonon-plasmon interaction is expected for the high conductance observed in this material. Most measurements on light scattering are performed on ensembles of InN nanowires (NWs). However, it is important to investigate the behavior of individual nanowires and here we report on micro-Raman measurements on single nanowires. When changing the polarization direction of the incident light from parallel to perpendicular to the wire, the expected reduction of the Raman scattering was observed for transversal optical (TO) and E 2 phonon scattering modes, while a strong symmetry-forbidden LO mode was observed independently on the laser polarization direction. Single Mg- and Si-doped crystalline InN nanowires were also investigated. Magnesium doping results in a sharpening of the Raman peaks, while silicon doping leads to an asymmetric broadening of the LO peak. The results can be explained based on the influence of the high electron concentration with a strong contribution of the surface accumulation layer and the associated internal electric field.

Enhanced Light Scattering of the Forbidden longitudinal Optical Phonon Mode Studied by Micro-Raman Spectroscopy on Single InN nanowires

International Nuclear Information System (INIS)

Sutter, E.; Schafer-Nolte, E.O.; Stoica, T.; Gotschke, T.; Limbach, F.A.; Sutter, P.; Grutzmacher, D.; Calarco, R.

2010-01-01

In the literature, there are controversies on the interpretation of the appearance in InN Raman spectra of a strong scattering peak in the energy region of the unscreened longitudinal optical (LO) phonons, although a shift caused by the phonon-plasmon interaction is expected for the high conductance observed in this material. Most measurements on light scattering are performed on ensembles of InN nanowires (NWs). However, it is important to investigate the behavior of individual nanowires and here we report on micro-Raman measurements on single nanowires. When changing the polarization direction of the incident light from parallel to perpendicular to the wire, the expected reduction of the Raman scattering was observed for transversal optical (TO) and E2 phonon scattering modes, while a strong symmetry-forbidden LO mode was observed independently on the laser polarization direction. Single Mg- and Si-doped crystalline InN nanowires were also investigated. Magnesium doping results in a sharpening of the Raman peaks, while silicon doping leads to an asymmetric broadening of the LO peak. The results can be explained based on the influence of the high electron concentration with a strong contribution of the surface accumulation layer and the associated internal electric field.

Enhanced light scattering of the forbidden longitudinal optical phonon mode studied by micro-Raman spectroscopy on single InN nanowires.

Science.gov (United States)

Schäfer-Nolte, E O; Stoica, T; Gotschke, T; Limbach, F A; Sutter, E; Sutter, P; Grützmacher, D; Calarco, R

2010-08-06

In the literature, there are controversies on the interpretation of the appearance in InN Raman spectra of a strong scattering peak in the energy region of the unscreened longitudinal optical (LO) phonons, although a shift caused by the phonon-plasmon interaction is expected for the high conductance observed in this material. Most measurements on light scattering are performed on ensembles of InN nanowires (NWs). However, it is important to investigate the behavior of individual nanowires and here we report on micro-Raman measurements on single nanowires. When changing the polarization direction of the incident light from parallel to perpendicular to the wire, the expected reduction of the Raman scattering was observed for transversal optical (TO) and E(2) phonon scattering modes, while a strong symmetry-forbidden LO mode was observed independently on the laser polarization direction. Single Mg- and Si-doped crystalline InN nanowires were also investigated. Magnesium doping results in a sharpening of the Raman peaks, while silicon doping leads to an asymmetric broadening of the LO peak. The results can be explained based on the influence of the high electron concentration with a strong contribution of the surface accumulation layer and the associated internal electric field.

Large-scale evaluation of β -decay rates of r -process nuclei with the inclusion of first-forbidden transitions

Science.gov (United States)

Marketin, T.; Huther, L.; Martínez-Pinedo, G.

2016-02-01

Background: r -process nucleosynthesis models rely, by necessity, on nuclear structure models for input. Particularly important are β -decay half-lives of neutron-rich nuclei. At present only a single systematic calculation exists that provides values for all relevant nuclei making it difficult to test the sensitivity of nucleosynthesis models to this input. Additionally, even though there are indications that their contribution may be significant, the impact of first-forbidden transitions on decay rates has not been systematically studied within a consistent model. Purpose: Our goal is to provide a table of β -decay half-lives and β -delayed neutron emission probabilities, including first-forbidden transitions, calculated within a fully self-consistent microscopic theoretical framework. The results are used in an r -process nucleosynthesis calculation to asses the sensitivity of heavy element nucleosynthesis to weak interaction reaction rates. Method: We use a fully self-consistent covariant density functional theory (CDFT) framework. The ground state of all nuclei is calculated with the relativistic Hartree-Bogoliubov (RHB) model, and excited states are obtained within the proton-neutron relativistic quasiparticle random phase approximation (p n -RQRPA). Results: The β -decay half-lives, β -delayed neutron emission probabilities, and the average number of emitted neutrons have been calculated for 5409 nuclei in the neutron-rich region of the nuclear chart. We observe a significant contribution of the first-forbidden transitions to the total decay rate in nuclei far from the valley of stability. The experimental half-lives are in general well reproduced for even-even, odd-A , and odd-odd nuclei, in particular for short-lived nuclei. The resulting data table is included with the article as Supplemental Material. Conclusions: In certain regions of the nuclear chart, first-forbidden transitions constitute a large fraction of the total decay rate and must be

Searches for Rare or Forbidden Semileptonic Charm Decays

International Nuclear Information System (INIS)

Lees, J.P.

2011-01-01

We present searches for rare or forbidden charm decays of the form X c + → h ± (ell) ± (ell) (# prime# )+ , where X c + is a charm hardron (D + , D s + , or Λ c + ), h ± is a pion, kaon, or proton, and (ell) (# prime# )± is an electron or muon. The analysis is based on 384 fb -1 of e + e - annihilation data collected at or close to the Υ(4S) resonance with the BABAR detector at the SLAC National Accelerator Laboratory. No significant signal is observed for any of the 35 decay modes that are investigated. We establish 90% confidence-level upper limits on the branching fractions between 1 x 10 -6 and 44 x 10 -6 depending on the channel. In most cases, these results represent either the first limits or significant improvements on existing limits for the decay modes studied.

Forbidden fruit: inattention to attractive alternatives provokes implicit relationship reactance.

Science.gov (United States)

DeWall, C Nathan; Maner, Jon K; Deckman, Timothy; Rouby, D Aaron

2011-04-01

Being inattentive to attractive relationship alternatives can enhance relationship well-being. The current investigation, however, demonstrates that implicitly preventing people from attending to desirable relationship alternatives may undermine, rather than bolster, the strength of that person's romantic relationship. Consistent with the notion of "forbidden fruit," we found that subtly limiting people's attention to attractive alternatives reduced relationship satisfaction and commitment and increased positive attitudes toward infidelity (Experiment 1), increased memory for attractive relationship alternatives (Experiment 2), and increased attention to attractive alternatives (Experiment 3). Findings suggest that although attention to attractive alternatives can harm one's relationship, situations that implicitly limit one's attention to alternatives can, rather ironically, increase the temptation of alternatives and undermine relationship well-being.

NEW STRONG-LINE ABUNDANCE DIAGNOSTICS FOR H II REGIONS: EFFECTS OF κ-DISTRIBUTED ELECTRON ENERGIES AND NEW ATOMIC DATA

Energy Technology Data Exchange (ETDEWEB)

Dopita, Michael A.; Sutherland, Ralph S.; Nicholls, David C.; Kewley, Lisa J.; Vogt, Frédéric P. A., E-mail: Michael.Dopita@anu.edu.au [Research School of Astronomy and Astrophysics, Australian National University, Cotter Rd., Weston ACT 2611 (Australia)

2013-09-01

Recently, Nicholls et al., inspired by in situ observations of solar system astrophysical plasmas, suggested that the electrons in H II regions are characterized by a κ-distribution of energies rather than a simple Maxwell-Boltzmann distribution. Here, we have collected together new atomic data within a modified photoionization code to explore the effects of both the new atomic data and the κ-distribution on the strong-line techniques used to determine chemical abundances in H II regions. By comparing the recombination temperatures (T {sub rec}) with the forbidden line temperatures (T {sub FL}), we conclude that κ ∼ 20. While representing only a mild deviation from equilibrium, this result is sufficient to strongly influence abundances determined using methods that depend on measurements of the electron temperature from forbidden lines. We present a number of new emission line ratio diagnostics that cleanly separate the two parameters determining the optical spectrum of H II regions—the ionization parameter q or U and the chemical abundance, 12+log(O/H). An automated code to extract these parameters is presented. Using the homogeneous data set from van Zee et al., we find self-consistent results between all of these different diagnostics. The systematic errors between different line ratio diagnostics are much smaller than those found in the earlier strong-line work. Overall, the effect of the κ-distribution on the strong-line abundances derived solely on the basis of theoretical models is rather small.

Searches for Rare or Forbidden Semileptonic Charm Decays

Energy Technology Data Exchange (ETDEWEB)

Lees, J.P.

2011-08-15

We present searches for rare or forbidden charm decays of the form X{sub c}{sup +} {yields} h{sup {+-}}{ell}{sup {-+}}{ell}{sup ({prime})+}, where X{sub c}{sup +} is a charm hardron (D{sup +}, D{sub s}{sup +}, or {Lambda}{sub c}{sup +}), h{sup {+-}} is a pion, kaon, or proton, and {ell}{sup ({prime}){+-}} is an electron or muon. The analysis is based on 384 fb{sup -1} of e{sup +}e{sup -} annihilation data collected at or close to the {Upsilon}(4S) resonance with the BABAR detector at the SLAC National Accelerator Laboratory. No significant signal is observed for any of the 35 decay modes that are investigated. We establish 90% confidence-level upper limits on the branching fractions between 1 x 10{sup -6} and 44 x 10{sup -6} depending on the channel. In most cases, these results represent either the first limits or significant improvements on existing limits for the decay modes studied.

Strongly coupled band in 140Gd

International Nuclear Information System (INIS)

Falla-Sotelo, F.; Oliveira, J.R.B.; Rao, M.N.

2005-01-01

Several high-K states are known to exist in the mass 130-140 region. For the N=74 even-even isotopes, Kπ = 8 - isomers, with lifetimes ranging from ns to ms, are known in 128 Xe, 130 Ba, 132 Ce, 134 Nd, 136 Sm, and 138 Gd[. In 140 Gd, we have observed for the first time a band also based on an Iπ = 8 - state. This could be the first case of a Kπ = 8 - state observed in an N=76 even-even isotope. The systematics of the Kπ = 8 - isomeric states in N=74 isotopes has been studied by A.M. Bruce et al. These states decay towards the K = 0 ground state band, and the transitions are K-forbidden. The 140 Gd case presents strong similarities but also some significant differences with relation to the N=74 isotopes. We propose the same configuration but with larger deformation in 140 Gd

Internal bremsstrahlung accompanying non-unique second-forbidden β-decay of 36Cl

International Nuclear Information System (INIS)

Basha, A.M.; Khalil, E.I.; Hussein, M.; Ragab, H.S.; El-Konsol, S.

1991-01-01

The inner Bremsstrahlung spectrum (I.B.) associated with the non-unique second forbidden β-transition of 36 Cl was measured using a single channel NaI (Tl) scintillation spectrometer. After making all the necessary corrections, the experimental results were compared with the corresponding theoretical distributions due to the KUB, Lewis and Ford, Nilsson, Ford and Martin and Chang and Falkoff. Also a comparison with those calculated according to Nilsson theory after applying the shape correction factor (M. KUB) was done. The measured spectrum is found to show fairly good agreement with M. KUB theory and is found to deviate thereafter from all five theories. (orig.)

Guidelines for identifying suspect/counterfeit material

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-09-01

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

The β+ decay of 234Np and other isospin-forbidden 0+ -> 0+ Fermi transitions

International Nuclear Information System (INIS)

Yap, C.T.; Saw, E.L.

1984-01-01

Although experimental values of the Fermi nuclear matrix elements vary widely from about 1x10 -3 to 40x10 -3 for isospin-forbidden 0 + ->0 + β transitions, theoretical calculations using the Coulomb potential and Nilsson wave functions yielded values of Msub(F) in reasonably good agreement, except that of 234 Np. However, our calculation of Msub(F) for this decay as a function of the deformation parameter β yielded a value of Msub(F) in good agreement with experiment for values of β between 0.1 and 0.2. (orig.)

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

Science.gov (United States)

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

Study of an Isospin-Forbidden $0^{+} \\rightarrow 0^{+}$ Transition in $^{38m}$K

CERN Multimedia

2002-01-01

There is at present a discrepancy between the precisely determined value of $V_{ud}^{2}$ obtained from $0^{+} \\rightarrow 0^{+} $ nuclear $\\beta$-decay and the less precisely determined value inferred from neutron decay. One possible explanation for this discrepancy involves the " Coulomb " corrections that must be applied to the nuclear decay rates. We propose to investigate one class of these corrections (for charge-dependent configuration-mixing) by measuring the isospin-forbidden $0^{+} \\rightarrow 0^{+}$ decay rate in $^{38m}$K. $^{38m}$K decay is particularly interesting because it is predicted to have the largest charge-dependent mixing correction of any of the transitions used in the $V_{ud}^{2}$ determination.

Spooky Suspects

Science.gov (United States)

Pacifici, Lara

2011-01-01

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

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

Science.gov (United States)

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

2008-06-01

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

Forbidden atomic transitions driven by an intensity-modulated laser trap.

Science.gov (United States)

Moore, Kaitlin R; Anderson, Sarah E; Raithel, Georg

2015-01-20

Spectroscopy is an essential tool in understanding and manipulating quantum systems, such as atoms and molecules. The model describing spectroscopy includes the multipole-field interaction, which leads to established spectroscopic selection rules, and an interaction that is quadratic in the field, which is not often employed. However, spectroscopy using the quadratic (ponderomotive) interaction promises two significant advantages over spectroscopy using the multipole-field interaction: flexible transition rules and vastly improved spatial addressability of the quantum system. Here we demonstrate ponderomotive spectroscopy by using optical-lattice-trapped Rydberg atoms, pulsating the lattice light and driving a microwave atomic transition that would otherwise be forbidden by established spectroscopic selection rules. This ability to measure frequencies of previously inaccessible transitions makes possible improved determinations of atomic characteristics and constants underlying physics. The spatial resolution of ponderomotive spectroscopy is orders of magnitude better than the transition frequency would suggest, promising single-site addressability in dense particle arrays for quantum computing applications.

A search for rare and forbidden decays of η-meson with GAMS-4π

International Nuclear Information System (INIS)

Binon, F.; Blik, A.; Gorin, A.; Donskov, S.; Inaba, S.; Kolosov, V.; Ladygin, M.; Lednev, A.; Lishin, V.; Manuilov, I.; Mikhailov, Yu.; Pegneux, J.P.; Polyakov, V.; Samoylenko, V.; Sobol, A.; Stroot, J.P.; Sugonyaev, V.; Takamatsu, K.; Tsuru, T.; Khaustov, G.

2006-01-01

A search for the rare and forbidden neutral decays of η-meson with the GAMS-4π setup has been performed. The charge-exchange reaction at 32.5 GeV/c was used as a source of 3.7-bar 10 6 η-mesons. At the 90% confidence level the following upper limits were obtained: BR(η->3γ) -4 , BR(η->4γ) -4 , BR(η->π o π o ) -4 , BR(η->π o π o γ) -3 , BR(η->π o π o γγ) -3 , BR(η->3π o γ) -4 , BR(η->4π o ) -5

Optical Dark-Field and Electron Energy Loss Imaging and Spectroscopy of Symmetry-Forbidden Modes in Loaded Nanogap Antennas.

Science.gov (United States)

Brintlinger, Todd; Herzing, Andrew A; Long, James P; Vurgaftman, Igor; Stroud, Rhonda; Simpkins, B S

2015-06-23

We have produced large numbers of hybrid metal-semiconductor nanogap antennas using a scalable electrochemical approach and systematically characterized the spectral and spatial character of their plasmonic modes with optical dark-field scattering, electron energy loss spectroscopy with principal component analysis, and full wave simulations. The coordination of these techniques reveal that these nanostructures support degenerate transverse modes which split due to substrate interactions, a longitudinal mode which scales with antenna length, and a symmetry-forbidden gap-localized transverse mode. This gap-localized transverse mode arises from mode splitting of transverse resonances supported on both antenna arms and is confined to the gap load enabling (i) delivery of substantial energy to the gap material and (ii) the possibility of tuning the antenna resonance via active modulation of the gap material's optical properties. The resonant position of this symmetry-forbidden mode is sensitive to gap size, dielectric strength of the gap material, and is highly suppressed in air-gapped structures which may explain its absence from the literature to date. Understanding the complex modal structure supported on hybrid nanosystems is necessary to enable the multifunctional components many seek.

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

Energy Technology Data Exchange (ETDEWEB)

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

2006-03-15

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

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

International Nuclear Information System (INIS)

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

2006-01-01

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

Seasonal variation among tuberculosis suspects in four countries

DEFF Research Database (Denmark)

Mabaera, Biggie; Naranbat, Nymadawa; Katamba, Achilles

2009-01-01

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

Selecting foils for identification lineups: matching suspects or descriptions?

Science.gov (United States)

Tunnicliff, J L; Clark, S E

2000-04-01

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

RPC Calculations for K-forbidden Transitions in {sup 183}W, Evidence for Large Inertial Parameter Connected with High-lying Rotational Bands

Energy Technology Data Exchange (ETDEWEB)

Malmskog, S G [AB Atomenergi, Nykoeping (Sweden); Wahlborn, S [Div. of Theore tical Physics, Royal Inst. of Technology Stockholm (Sweden)

1967-09-15

Recent measurements have shown that the transitions deexciting the 453 keV 7/2{sup -} level in {sup 183}W to the K = 1/2{sup -} and 3/2{sup -} bands are strongly retarded. The data for B(M1) and B(E2) are analyzed in terms of the RPC model (rotation + particle motion + coupling). With the {delta}K = 1 (Coriolis) coupling, the K-forbidden M1-transitions proceed via admixtures of high-lying 5/2{sup -} bands. A reasonable and unambiguous fit to the data is obtained by varying the strength of the coupling. Allowing for various uncertainties and corrections, one finds that the inertial parameter (the inverse of the coupling constant, i. e. 2J(2{pi}){sup 2}/({Dirac_h}){sup 2} may have values between roughly 1 and 3 times the rigid rotator value of 2J(2{pi}){sup 2}/({Dirac_h}){sup 2}, thus being unexpectedly large. Calculations with the {delta}K=2 coupling were also performed and turn out not to give better agreement with experiment.

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

International Nuclear Information System (INIS)

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

2015-01-01

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

Electron impact excitation of complex atoms and ions. Pt. 2: forbidden transitions in Ni+

International Nuclear Information System (INIS)

Watts, M.S.T.; Berrington, K.A.; Burke, P.G.

1996-01-01

This letter reports the first application of the new R-matrix program package RMATRX II to electron impact excitation of a near neutral open d-shell ion. In this calculation for Ni + , all states corresponding to the configuration 3d 9 , 3d 8 4s and 3d 8 4p have been included in the expansion of the total wavefunction. Thermally averaged collision strengths for forbidden transitions involving the even parity states are presented in tabular form for temperatures between 5000 K and 20 000 K. The importance of including accurate C1 expansions for both the target and the (N + 1)-electron terms is demonstrated. (Author)

Generalized laws of refraction that can lead to wave-optically forbidden light-ray fields.

Science.gov (United States)

Courtial, Johannes; Tyc, Tomáš

2012-07-01

The recent demonstration of a metamaterial phase hologram so thin that it can be classified as an interface in the effective-medium approximation [Science 334, 333 (2011)] has dramatically increased interest in generalized laws of refraction. Based on the fact that scalar wave optics allows only certain light-ray fields, we divide generalized laws of refraction into two categories. When applied to a planar cross section through any allowed light-ray field, the laws in the first category always result in a cross section through an allowed light-ray field again, whereas the laws in the second category can result in a cross section through a forbidden light-ray field.

Beyond neutral and forbidden links: morphological matches and the assembly of mutualistic hawkmoth-plant networks.

Science.gov (United States)

Sazatornil, Federico D; Moré, Marcela; Benitez-Vieyra, Santiago; Cocucci, Andrea A; Kitching, Ian J; Schlumpberger, Boris O; Oliveira, Paulo E; Sazima, Marlies; Amorim, Felipe W

2016-11-01

A major challenge in evolutionary ecology is to understand how co-evolutionary processes shape patterns of interactions between species at community level. Pollination of flowers with long corolla tubes by long-tongued hawkmoths has been invoked as a showcase model of co-evolution. Recently, optimal foraging models have predicted that there might be a close association between mouthparts' length and the corolla depth of the visited flowers, thus favouring trait convergence and specialization at community level. Here, we assessed whether hawkmoths more frequently pollinate plants with floral tube lengths similar to their proboscis lengths (morphological match hypothesis) against abundance-based processes (neutral hypothesis) and ecological trait mismatches constraints (forbidden links hypothesis), and how these processes structure hawkmoth-plant mutualistic networks from five communities in four biogeographical regions of South America. We found convergence in morphological traits across the five communities and that the distribution of morphological differences between hawkmoths and plants is consistent with expectations under the morphological match hypothesis in three of the five communities. In the two remaining communities, which are ecotones between two distinct biogeographical areas, interactions are better predicted by the neutral hypothesis. Our findings are consistent with the idea that diffuse co-evolution drives the evolution of extremely long proboscises and flower tubes, and highlight the importance of morphological traits, beyond the forbidden links hypothesis, in structuring interactions between mutualistic partners, revealing that the role of niche-based processes can be much more complex than previously known. © 2016 The Authors. Journal of Animal Ecology © 2016 British Ecological Society.

Interviewing strategically to elicit admissions from guilty suspects.

Science.gov (United States)

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

2015-06-01

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

The Halal status of additives in milk and dairy products

Directory of Open Access Journals (Sweden)

Midhat Jašić

2007-06-01

Full Text Available The market of halal products in the world keeps growing and there are more and more requests for certifying and proving the halal status of a food product. Halal in Islamic regulations means allowed for eating. Islamic laws related to the food, strictly forbid the use of food originating from pork, alcohol, blood and other products that are not in accordance with Islamic rules. In order to get the halal status, dairy products have to prove that they do not contain raw mater and additives that are forbidden. Level of allowance is related with their status which can be Halal (permitted, Haram (forbidden and Mashbuh (suspected. In establishing the system for Halal foodprocessing, proactive preventive process approach is used. In validation of the process there are analytical methods to prove the origin of the food. Specially difficult is to prove the presence of additives which during the process experience chemical transformations. The ELISA PCR, HLPC methods are used for the validation. This paper presents additives that are the most common in milk processing and can have Haram (forbidden by Islamic rules and Mashbuh (suspected origin.

E1-forbidden transition rates in ions of astrophysical interest

International Nuclear Information System (INIS)

Träbert, E

2014-01-01

Transition rates in atomic systems may appear to be of little importance in steady-state plasmas that are observed at great distances from Earth. However, some of the transition rates compete with collision rates, and in these cases certain line intensity ratios are affected and can serve as remote indicators of density. In the low-density environments of stellar coronae and planetary nebulae, the transition rates of interest are mostly spin-forbidden E1 decays, higher-multipole order transitions (M1, E2, M2, M3), and hyperfine-induced transitions. On Earth, measurements of the long upper level lifetimes of these atomic systems require the use of ion traps. A fair number of test cases with lifetimes in the range from nanoseconds to many seconds have been treated successfully, and the evolution of calculations along with the experimental progress is notable. A new generation of cold ion traps is expected to extend the atomic lifetime measurements on multiply charged ions into the range of many minutes. (paper)

Forbidden Structures for Planar Perfect Consecutively Colourable Graphs

Directory of Open Access Journals (Sweden)

Borowiecka-Olszewska Marta

2017-05-01

Full Text Available A consecutive colouring of a graph is a proper edge colouring with posi- tive integers in which the colours of edges incident with each vertex form an interval of integers. The idea of this colouring was introduced in 1987 by Asratian and Kamalian under the name of interval colouring. Sevast- janov showed that the corresponding decision problem is NP-complete even restricted to the class of bipartite graphs. We focus our attention on the class of consecutively colourable graphs whose all induced subgraphs are consecutively colourable, too. We call elements of this class perfect consecutively colourable to emphasise the conceptual similarity to perfect graphs. Obviously, the class of perfect consecutively colourable graphs is induced hereditary, so it can be characterized by the family of induced forbidden graphs. In this work we give a necessary and sufficient conditions that must be satisfied by the generalized Sevastjanov rosette to be an induced forbid- den graph for the class of perfect consecutively colourable graphs. Along the way, we show the exact values of the deficiency of all generalized Sevastjanov rosettes, which improves the earlier known estimating result. It should be mentioned that the deficiency of a graph measures its closeness to the class of consecutively colourable graphs. We motivate the investigation of graphs considered here by showing their connection to the class of planar perfect consecutively colourable graphs.

Strongly coupled band in {sup 140}Gd

Energy Technology Data Exchange (ETDEWEB)

Falla-Sotelo, F.; Oliveira, J.R.B.; Rao, M.N. [Instituto de Fisica, Universidade de Sao Paulo, Sao Paulo (Brazil)] (and others)

2005-07-01

Several high-K states are known to exist in the mass 130-140 region. For the N=74 even-even isotopes, K{pi} = 8{sup -} isomers, with lifetimes ranging from ns to ms, are known in {sup 128}Xe, {sup 130}Ba, {sup 132}Ce, {sup 134}Nd, {sup 136}Sm, and {sup 138}Gd[. In {sup 140}Gd, we have observed for the first time a band also based on an I{pi} = 8{sup -} state. This could be the first case of a K{pi} = 8{sup -} state observed in an N=76 even-even isotope. The systematics of the K{pi} = 8{sup -} isomeric states in N=74 isotopes has been studied by A.M. Bruce et al. These states decay towards the K = 0 ground state band, and the transitions are K-forbidden. The {sup 140}Gd case presents strong similarities but also some significant differences with relation to the N=74 isotopes. We propose the same configuration but with larger deformation in {sup 140}Gd.

One step beyond the electric dipole approximation: An experiment to observe the 5p → 6p forbidden transition in atomic rubidium

Science.gov (United States)

Ponciano-Ojeda, F.; Hernández-Gómez, S.; Mojica-Casique, C.; Ruiz-Martínez, E.; López-Hernández, O.; Colín-Rodríguez, R.; Ramírez-Martínez, F.; Flores-Mijangos, J.; Sahagún, D.; Jáuregui, R.; Jiménez-Mier, J.

2018-01-01

An advanced undergraduate experiment to study the 5 P 3 / 2 → 6 P 3 / 2 electric quadrupole transition in rubidium atoms is presented. The experiment uses two external cavity diode lasers, one operating at the D2 rubidium resonance line and the other built with commercial parts to emit at 911 nm. The lasers produce the 5 s → 5 p → 6 p excitation sequence in which the second step is the forbidden transition. Production of atoms in the 6 P 3 / 2 state is observed by detection of the 420 nm fluorescence that results from electric dipole decay into the ground state. Lines whose widths are significantly narrower than the Doppler width are used to study the hyperfine structure of the 6 P 3 / 2 state in rubidium. The spectra illustrate characteristics unique to electric dipole forbidden transitions, like the electric quadrupole selection rules; they are also used to show general aspects of two-color laser spectroscopy such as velocity selection and hyperfine pumping.

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

Directory of Open Access Journals (Sweden)

Thomas Nash

2013-06-01

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

Inner Bremsstrahlung accompanying the non-unique first forbidden β-decay of 141Ce

International Nuclear Information System (INIS)

Khalil, E.I.

1993-01-01

The inner Bremsstrahlung (I.B.) spectrum accompanying the β-decay of 141 Ce (non-unique first forbidden β-transition) was measured using a single channel scintillation spectrometer. The measured I.B. was analyzed by the variable width peeling-off method. This analyzed and corrected I.B. was compared with those calculated according to the original theories of Knipp and Uhlenbeck as well as of Bloch (KUB), the coulomb corrected theories of Lewis and Ford and of Nilsson, and according to detour-transition calculations of the Ford and Martin theory. Ths shape correction factor suggested by Konopinski and Uhlenbeck on the Fermi β-decay theory was applied to the calculated I.B. based on Nilsson's theory (modified KUB theory). The experimental results are in better agreement with the modified KUB theory than the other theories. (orig.)

Quantum-chemical studies of quasi-one-dimensional electron systems. Part 2. Cumulenes and origin of the forbidden zone

Directory of Open Access Journals (Sweden)

Yuriy Kruglyak

2015-06-01

Full Text Available This review is devoted to the basic problem in quantum theory of quasi-one-dimensional electron systems like polyenes (Part 1 and cumulenes (Part 2 – physical origin of the forbidden zone in these and analogous 1D electron systems due to two possible effects – Peierls instability (bond alternation and Mott instability (electron correlation. Both possible contradiction and coexistence of the Mott and Peierls instabilities are summerized on the basis of the Kiev quantum chemistry team research projects.

Forbidden transitions in excitation by electron impact in Co3+: an R-matrix approach

International Nuclear Information System (INIS)

Stancalie, V

2011-01-01

Collision strengths for the electron-impact excitation of forbidden transitions between 136 terms arising from 3d 6 , 3d 5 4s and 3d 5 4p configurations of Co 3+ have been calculated using the R-matrix method. The accuracy of a series of models for the target terms was considered, which form the basis for R-matrix collision calculations. The importance of including configuration interaction wave functions both in the target-state expansion and in the (N+1)-electron quadratically integrable function expansion is discussed. Collision strengths were calculated for incident electron energies up to 6 Ryd. These results are believed to be the first such values for this system and will be important for plasma modelling.

48 CFR 403.303 - Reporting suspected antitrust violations.

Science.gov (United States)

2010-10-01

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

Radio ejection and broad forbidden emission lines in the Seyfert galaxy NGC 7674

International Nuclear Information System (INIS)

Unger, S.W.; Pedlar, A.; Axon, D.J.

1988-01-01

The Seyfert nucleus in NGC7674 (Mkn533) is remarkable for its broad asymmetric forbidden line profiles, which extend 2000 kms -1 blueward of the systemic velocity. The galaxy also has a compact nuclear radio source. We have obtained new high-resolution radio observations of NGC7674, using the European VLBI network and the VLA, and optical spectroscopic observations using the Isaac Newton Telescope. The radio maps reveal a triple radio source with a total angular extent of about 0.7 arcsec, and provide evidence that the radio emission is powered by collimated ejection. In the plane of the sky, the ejection axis appears roughly perpendicular to the galactic rotation axis. Although the dominant radio components are separated by 0.5 arcsec, the broad [OIII]λ5007 line emission is confined to within about 0.25 arcsec of the continuum nucleus. (author)

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

NARCIS (Netherlands)

Bruijnes, Merijn

2016-01-01

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

48 CFR 1403.303 - Reporting suspected antitrust violations.

Science.gov (United States)

2010-10-01

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

Gufa, a unique cultural ritual--a tale of forbidden sun and a girl

Science.gov (United States)

Shrestha, Pritisha

2015-08-01

Gufa, one of the traditional rituals has been performed in Nepal since time immemorial by an especial indigenous Newar people. Gufa, in its literal translation means cave. Just like in the cave where darkness seeps deep within its wall as the sun’s ray cannot penetrate, in the ritual of Gufa, a young girl who just had her first period is hidden in a dark room for twelve consecutive days. The girl, by strict custom and ritual performance stays in the room, protected from the sun’s light. From her female elders, she also receives informal education on family and societal values and norms.Sun, the reason behind our existence, is forbidden for the girl to observe. This very aspect of purely shunning away from the sun has become the crucial aspect for delving into the explanations offered by cultural astronomy. The present paper would argue that astronomy and astronomy education should not only focus on looking into the future, but also should go back to the ancient civilization to comprehend ritual performance our forefathers had learned from gazing the sky.After twelve days, the girl is carefully brought out to an open space where she sees the forbidden sun and symbolically marries the star via ritual. The logic behind the union after a pure restriction is to protect her sensitive young body and to ward off any harm to her reproductive parts from the sun’s harsh rays.From astronomical point, this logic behind protecting the girl from the effects of then deemed harmful rays should be studied. In ancient times, who with which instruments could have possibly fathom the life-giving sun could harness harmful solar rays. Although it looks like a primitive custom of hiding the girl immediately during her first period, there are logical social, cultural and scientific reasons for doing it even today in modern, urban and among the educated Newar households of Nepal and abroad.The paper would expound the importance of traditional ritual performance and its nexus with

Detection of a pneumonia virus of mice (PVM) in an African hedgehog (Atelerix arbiventris) with suspected wobbly hedgehog syndrome (WHS).

Science.gov (United States)

Madarame, Hiroo; Ogihara, Kikumi; Kimura, Moe; Nagai, Makoto; Omatsu, Tsutomu; Ochiai, Hideharu; Mizutani, Tetsyuya

2014-09-17

A pneumonia virus of mice (PVM) from an African hedgehog (Atelerix arbiventris) with suspected wobbly hedgehog syndrome (WHS) was detected and genetically characterized. The affected hedgehog had a nonsuppurative encephalitis with vacuolization of the white matter, and the brain samples yielded RNA reads highly homogeneous to PVM strain 15 (96.5% of full genomic sequence homology by analysis of next generation sequencing). PVM antigen was also detected in the brain and the lungs immunohistochemically. A PVM was strongly suggested as a causative agent of encephalitis of a hedgehog with suspected WHS. This is a first report of PVM infection in hedgehogs. Copyright © 2014 Elsevier B.V. All rights reserved.

Suspects in criminal investigations of rape

Directory of Open Access Journals (Sweden)

Marinković Darko

2014-01-01

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

Full Polarization Analysis of Resonant Superlattice and Forbidden x-ray Reflections in Magnetite

International Nuclear Information System (INIS)

Wilkins, S.B.; Bland, S.R.; Detlefs, B.; Beale, T.A.W.; Mazzoli, C.; Joly, Y.; Hatton, P.D.; Lorenzo, J.E.; Brabers, V.A.M.

2009-01-01

Despite being one of the oldest known magnetic materials, and the classic mixed valence compound, thought to be charge ordered, the structure of magnetite below the Verwey transition is complex and the presence and role of charge order is still being debated. Here, we present resonant x-ray diffraction data at the iron K-edge on forbidden (0, 0, 2n+1) C and superlattice (0, 0, 2n+1/2)C reflections. Full linear polarization analysis of the incident and scattered light was conducted in order to explore the origins of the reflections. Through simulation of the resonant spectra we have confirmed that a degree of charge ordering takes place, while the anisotropic tensor of susceptibility scattering is responsible for the superlattice reflections below the Verwey transition. We also report the surprising result of the conversion of a significant proportion of the scattered light from linear to nonlinear polarization.

Forbidden Raman scattering processes. I. General considerations and E1--M1 scattering

International Nuclear Information System (INIS)

Harney, R.C.

1979-01-01

The generalized theory of forbidden Raman scattering processes is developed in terms of the multipole expansion of the electromagnetic interaction Hamiltonian. Using the general expressions, the theory of electric dipole--magnetic dipole (E1--M1) Raman scattering is derived in detail. The 1 S 0 → 3 P 1 E1--M1 Raman scattering cross section in atomic magnesium is calculated for two applicable laser wavelengths using published f-value data. Since resonantly enhanced cross sections larger than 10 -29 cm 2 /sr are predicted it should be possible to experimentally observe this scattering phenomenon. In addition, by measuring the frequency dependence of the cross section near resonance, it may be possible to directly determine the relative magnitudes of the Axp and AxA contributions to the scattering cross section. Finally, possible applications of the effect in atomic and molecular physics are discussed

The clinical course of patients with suspected pulmonary embolism

NARCIS (Netherlands)

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

1997-01-01

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

Experimental investigations of strong interactions in non-perturbative QCD region

International Nuclear Information System (INIS)

Lindenbaum, S.J.; Samuel, S.

1992-01-01

We have experimentally investigated the reactions π - p → φφn (OZI forbidden), φK + K - n (OZI allowed), K - p →φφ{ σ λ } (OZI allowed),φK + K - { σ λ }(OZI allowed),bar pp → φ φ π 0 (OZI forbidden), φK + K - π 0 (OZI allowed). By comparing the OZI forbidden (glueball filter) reactions with the OZI allowed and taking a global view we hope to critically test our hypothesis that the g T (2010), g T' (2300), and g T double-prime(2340) all with I G J PC = 0 + 2 ++ are produced by 1--3 2 ++ glueballs. We have searched for a Quark-Gluon Plasma by using 14.6 GeV/c x A Si ions incident on Au, Cu and Si. The novel detector used was a large solid angle TPC system. Although we found considerable strangeness enhancement this is explainable by conventional cascade physics including N* production. We have been engaged in phenomenological analyses in both glueball and heavy ion work. We have found that the θ(1720) is the same as the 0 ++ f 0 (1720) we discovered earlier. Furthermore that the G(1590) can be explained as a sum of the f 0 (1400) and f 0 (1720) and does not require a new resonant state. We have also found that the strangeness enhancement discovered in heavy ion collisions so far is explainable by conventional physics. We are in the STAR Collaboration at RHIC which uses a large TPC system to search for a Quark-Gluon Plasma

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

Science.gov (United States)

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

2016-09-01

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

Energy position of bistable defect (CiCs)0 in 'B' configuration in a forbidden zone of n-Si

International Nuclear Information System (INIS)

Dolgolenko, A.P.; Litovchenko, P.G.; Varentsov, M.D.

2003-01-01

Float-zone and phosphorus-doped n-Si samples after irradiation by fast-pile neutrons and subsequent annealing at room temperature were investigated. The calculation of effective concentration of carriers after irradiation was carried out in the framework of Gossick's model taking into account the recharges of defects both in conducting matrix of n-Si and in the space-charge region of defect clusters. The distribution function of electrons on the acceptor level of bistable defect (C i C s ) 0 when the concentration of this defect is the function of the Fermi level in conducting matrix of n-Si is determined. The concentration of bistable interstitial-carbon-substitutional-carbon pair and its energy level at (E c - 0,123 eV) in forbidden band of silicon were calculated. On the observable level of stable configuration C i C s (A - )-defects at (E c - 0,147 eV) the theoretical change of carriers concentration in the conduction band simulated by the recharges (C i C s ) 0 was imposed. The concentration of these (C i C s ) 0 -defects has been changed in the process of their recharges. It is shown that in n-Si with high carbon and oxygen concentration after affiliating of oxygen atoms to bistable defect (C i C s ) 0 in a forbidden band of n-Si the stable defects not only in 'A' but also in 'B' configurations are formed with energy levels at (E c - 0,13 eV) and (E c - 0,09 eV)

Resolution of Surveillance Report No. PAD-BDW-95-004 for suspect bolts installed in the 105 KW roof addition structure

International Nuclear Information System (INIS)

Frier, W.A.

1995-01-01

A DOE RL surveillance determined that a test report (WHC-SD-NR-TRP-020) was less than adequate. As a result, WHC removed nine of the previous in-situ tested A325 suspect bolts and contracted with Koon-Hall Testing Corporation to perform hardness and tensile testing and chemical composition analysis of the removed bolts. WHC also contracted with ADVENT Engineering, Inc., to perform an evaluation of the Koon-Hall test results and to respond to the concerns identified in the DOE RL surveillance. The Koon-Hall Laboratory test results and the assessments strongly support the conclusion that the suspect bolts are indeed the equivalent of A325 high-strength, Type-1 bolts and have been properly heat-treated

Solving the strongly coupled 2D gravity III. String suspectibility and topological N-point functions

International Nuclear Information System (INIS)

Gervais, J.-L.; Roussel, J.-F.

1996-01-01

For pt.II see ibid., vol 426, p.140-86, 1994. We spell out the derivation of novel features, put forward earlier in a letter, of two-dimensional gravity in the strong coupling regime, at C L =7, 13, 19. Within the operator approach previously developed, they neatly follow from the appearance of a new cosmological term/marginal operator, different from the standard weak-coupling one, that determines the world-sheet interaction. The corresponding string susceptibility is obtained and found real contrary to the continuation of the KPZ formula. Strongly coupled (topological like) models - only involving zero-mode degrees of freedom - are solved up to sixth order, using the Ward identities which follow from the dependence upon the new cosmological constant. They are technically similar to the weakly coupled ones, which reproduce the matrix model results, but gravity and matter quantum numbers are entangled differently. (orig.)

First-forbidden mirror β-decays in A = 17 mass region and the role of proton halo in 17F

International Nuclear Information System (INIS)

Michel, N.; Okolowicz, J.; Ploszajczak, M.; Okolowicz, J.; Nowacki, F.; Ploszajczak, M.

2001-01-01

The first-forbidden β-decay of 17 Ne into the 'halo' state J π 1/2 + 1 of 17 F presents one of the largest measured asymmetries for mirror β-decay feeding bound final states. This asymmetry is studied in the framework of the Shell Model Embedded in the Continuum (SMEC). The spatial extent of single particle orbits calculated in SMEC is constrained by the proton capture cross-section 16 O(p,γ) 17 F. This allows to estimate the mirror symmetry breaking in 17 F and 17 O nuclei. (authors)

Supra-transmission and bistability in nonlinear media with a photonic and electronic forbidden band gap; Supratransmission et bistabilite nonlineaire dans les milieux a bandes interdites photoniques et electroniques

Energy Technology Data Exchange (ETDEWEB)

Chevriaux, D

2007-06-15

We study wave scattering in different nonlinear media possessing a natural forbidden band gap. In particular, we show the existence of a bistable behavior in media governed by the sine-Gordon equation (short pendular chain, Josephson junction array, quantum Hall bilayer), or the nonlinear Schroedinger equation (Kerr and Bragg media), in discrete and continuous models. These different media are submitted to periodic boundary conditions with a frequency in the forbidden band gap and an amplitude that determines their stability states. Indeed, for a sufficient amplitude (supra-transmission), the medium switches from reflector to transmitter, hence allowing the output signal to jump from evanescent to large values. We give a complete analytical description of the bistability that allows to understand the different stationary states observed and to predict the switch of one state to the other. (author)

Observation of strongly forbidden solid effect dynamic nuclear polarization transitions via electron-electron double resonance detected NMR

Energy Technology Data Exchange (ETDEWEB)

Smith, Albert A.; Corzilius, Björn; Haze, Olesya; Swager, Timothy M.; Griffin, Robert G., E-mail: rgg@mit.edu [Department of Chemistry and Francis Bitter Magnet Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139 (United States)

2013-12-07

We present electron paramagnetic resonance experiments for which solid effect dynamic nuclear polarization transitions were observed indirectly via polarization loss on the electron. This use of indirect observation allows characterization of the dynamic nuclear polarization (DNP) process close to the electron. Frequency profiles of the electron-detected solid effect obtained using trityl radical showed intense saturation of the electron at the usual solid effect condition, which involves a single electron and nucleus. However, higher order solid effect transitions involving two, three, or four nuclei were also observed with surprising intensity, although these transitions did not lead to bulk nuclear polarization—suggesting that higher order transitions are important primarily in the transfer of polarization to nuclei nearby the electron. Similar results were obtained for the SA-BDPA radical where strong electron-nuclear couplings produced splittings in the spectrum of the indirectly observed solid effect conditions. Observation of high order solid effect transitions supports recent studies of the solid effect, and suggests that a multi-spin solid effect mechanism may play a major role in polarization transfer via DNP.

A search for rare and forbidden decays of {eta}-meson with GAMS-4{pi}

Energy Technology Data Exchange (ETDEWEB)

Binon, F. [Universite Libre de Bruxelles, CP 229, B-1050 Brussels (Belgium); Blik, A. [Institute for High Energy Physics, 142281, Protvino (Russian Federation); Gorin, A. [Institute for High Energy Physics, 142281, Protvino (Russian Federation); Donskov, S. [Institute for High Energy Physics, 142281, Protvino (Russian Federation); Inaba, S. [National Laboratory for High Energy Physics - KEK, Tsukuba, Ibaraki 305-0801 (Japan); Kolosov, V. [Institute for High Energy Physics, 142281, Protvino (Russian Federation); Ladygin, M. [Institute for High Energy Physics, 142281, Protvino (Russian Federation); Lednev, A. [Institute for High Energy Physics, 142281, Protvino (Russian Federation); Lishin, V. [Institute for High Energy Physics, 142281, Protvino (Russian Federation); Manuilov, I. [Institute for High Energy Physics, 142281, Protvino (Russian Federation); Mikhailov, Yu. [Institute for High Energy Physics, 142281, Protvino (Russian Federation); Pegneux, J.P. [Laboratoire d' Annecy de Physique des Particules, F-74019 Annecy-le-Vieux (France); Polyakov, V. [Institute for High Energy Physics, 142281, Protvino (Russian Federation); Samoylenko, V. [Institute for High Energy Physics, 142281, Protvino (Russian Federation); Sobol, A. [Institute for High Energy Physics, 142281, Protvino (Russian Federation); Stroot, J.P. [Universite Libre de Bruxelles, CP 229, B-1050 Brussels (Belgium); Sugonyaev, V. [Institute for High Energy Physics, 142281, Protvino (Russian Federation); Takamatsu, K. [National Laboratory for High Energy Physics - KEK, Tsukuba, Ibaraki 305-0801 (Japan); Tsuru, T. [National Laboratory for High Energy Physics - KEK, Tsukuba, Ibaraki 305-0801 (Japan); Khaustov, G. [Institute for High Energy Physics, 142281, Protvino (Russian Federation)

2006-12-15

A search for the rare and forbidden neutral decays of {eta}-meson with the GAMS-4{pi} setup has been performed. The charge-exchange reaction at 32.5 GeV/c was used as a source of 3.7-bar 10{sup 6}{eta}-mesons. At the 90% confidence level the following upper limits were obtained: BR({eta}->3{gamma})<1.6-bar 10{sup -4}, BR({eta}->4{gamma})<2.8-bar 10{sup -4}, BR({eta}->{pi}{sup o}{pi}{sup o})<3.5-bar 10{sup -4}, BR({eta}->{pi}{sup o}{pi}{sup o}{gamma})<1.7-bar 10{sup -3}, BR({eta}->{pi}{sup o}{pi}{sup o}{gamma}{gamma})<4.0-bar 10{sup -3}, BR({eta}->3{pi}{sup o}{gamma})<2.4-bar 10{sup -4}, BR({eta}->4{pi}{sup o})<2.0-bar 10{sup -5}.

Asymptotic Structure in the Classically Forbidden Region of the Hooke's Atoms

International Nuclear Information System (INIS)

Wang Xuemei

2013-01-01

The two-electron Hooke's atom — a quantum mechanical system with two electrons bound in a harmonic potential — is well known for its exact analytical properties at certain oscillator strengths. The Hooke's atoms with more than two electrons offer more scope for valuable practical applications. In this work, we study the asymptotic structure of these Hooke's atoms in the classically forbidden region. The leading-order term of the long-range expression for the KS exchange-correlation potential v xc (r) is shown to be −1/r. The second and third higher order terms are also exactly obtained. Various components of v xc (r) are also studied. It is shown that the leading term of O(1/r) in v xc (r) is due to the pure Pauli correlation, while the leading contribution of the Coulomb correlation is of O(1/r 3 ). Neither of them makes contribution to the term of O(1/r 2 ), which is shown to be solely due to the kinetic correlation effect. Results for the two-electron Hooke's atom were obtained before in the literature. Our results reduce to those of the two-electron Hooke's atom as a special case. (condensed matter: electronic structure, electrical, magnetic, and optical properties)

Talking heads : interviewing suspects from a cultural perspective

OpenAIRE

Beune, K.

2009-01-01

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

Electrodynamical forbiddance of a strong quadrupole interaction in surface enhanced optical processes. Experimental confirmation of the existence in fullerene C{sub 60}

Energy Technology Data Exchange (ETDEWEB)

Polubotko, A. M., E-mail: alex.marina@mail.ioffe.ru [Russian Academy of Sciences, Ioffe Physical Technical Institute (Russian Federation); Chelibanov, V. P., E-mail: Chelibanov@gmail.com [State University of Information Technologies, Mechanics and Optics (Russian Federation)

2017-02-15

It is demonstrated that in the SERS and SEIRA spectra of the fullerene C{sub 60}, the lines, which are forbidden in usual Raman and IR spectra and allowed in SERS and SEIRA, are absent. In addition the enhancement SERS coefficient in a single molecule detection regime is ~10{sup 8} instead of the value 10{sup 14}–10{sup 15}, characteristic for this phenomenon. These results are explained by the existence of so-called electrodynamical forbiddance of a strong quadrupole light-molecule interaction, which arises because of belonging of C{sup 60} to the icosahedral symmetry group and due to the electrodynamical law divE = 0.

Measurements of visible forbidden lines and ion distributions of tungsten highly charged ions at the LHD

International Nuclear Information System (INIS)

Kato, D.; Sakaue, H.A.; Murakami, I.; Goto, M.; Morita, S.; Nakamura, N.; Koike, F.; Sasaki, Akira; Ding, X.-B.; Dong, C.-Z.

2013-01-01

Visible lines, which are presumably associated with forbidden lines from tungsten highly charged ions, were clearly observed in a spectrum of 370 - 410 nm recorded shortly after a tungsten pellet injection at the LHD. One of the measured lines has been assigned to a magnetic-dipole (M1) line of the ground-term fine-structure transition of W 26+ . Photon emission was observed at 44 lines of sight divided along the vertical direction of a horizontally elongated poloidal cross section of the LHD plasma. The line-integrated intensity of the lines along each line of sight indicates peaked profiles near the plasma center, while visible line emissions of neutral hydrogen and helium recoded in the same sampling time have a maximum located in the peripheral region of the poloidal cross section. (author)

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

Energy Technology Data Exchange (ETDEWEB)

Berninger, M S

1982-10-06

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

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

African Journals Online (AJOL)

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

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

International Nuclear Information System (INIS)

Berninger, M.S.

1982-01-01

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

Experimental investigations of strong interaction in the non-perturbative QCD region

International Nuclear Information System (INIS)

Lindenbaum, S.J.; Samuel, S.

1993-09-01

A critical investigation of non-perturbative QCD require investigating glueballs, search for a Quark Gluon Plasma (OGP), and search for strangelets. In the glueball area the data obtained (E- 881) at 8 GeV/c were analyzed for π - + p → φφn (OZI forbidden), φK + K - n (OZI allowed), K - p → φφ(ΛΣ) (OZI allowed), and bar pp → φφ → φφπ 0 (OZI forbidden), φK + K - π 0 (OZI allowed). By comparing the OZI forbidden (glueball filter reactions) with the OZI allowed and previous 22 GeV/c π - p → φφn or φK + K - n data a further critical test of the so far unsuccessfully challenged hypothesis that our g T (2010), g T '(2300) and g T double-prime(2340) all with I G J PC = 0 + 2 ++ are produced by 1-3 2 ++ glueballs will be made. In the QGP search with a large-solid-angle TPC a good Ξ signal was observed. The ratio of Ξ to single strange quark particles such as λ is a better indication of strangeness enhancement in QGP formation. The data indicate enhancement by a factor ∼ 2 over cascade model (corrected to observed strangeness) predictions, but it is definitely far from conclusive at this stage since the result is model dependent. Double λ topologies of the type needed to discover light strangelets in the nanosecond lifetime region were found. In addition, research has been accomplished in three main areas: bosonic technicolor and strings, buckministerfullerene C 60 and neutrino oscillations in a dense neutrino gas

Spatial epidemiology of suspected clinical leptospirosis in Sri Lanka.

Science.gov (United States)

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

2012-04-01

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

Using Internet Artifacts to Profile a Child Pornography Suspect

OpenAIRE

Marcus K. Rogers; Kathryn C. Seigfried-Spellar

2014-01-01

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

Les dépenses interdites des collectivités locales The Forbidden Expenses of Local Entities

Directory of Open Access Journals (Sweden)

Jean-François Boudet

2009-09-01

Full Text Available Les différentes réformes dites de « décentralisation » entreprises en France notamment depuis 1982 laisseraient entendre que les collectivités locales ont toute latitude dans la gestion de leurs compétences et de leurs finances. Il n’en rien, car, au-delà de dépenses obligatoires, les collectivités locales se voient interdire certaines dépenses. Le caractère unitaire de l’Etat expliquerait cette interdiction.In France, since 1982, the so-called “decentralisation” reforms would imply that local governments are independent with regard to the management of their resources and budget. This is not the case: aside from mandatory expenses, a few expenditures are forbidden to local governments. The unitary character of the State would explain this interdiction.

Prime Suspect, Second Row Center

Science.gov (United States)

Laird, Ellen A.

2011-01-01

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

Exploration of the forbidden regions of the Ramachandran plot (ϕ-ψ) with QTAIM.

Science.gov (United States)

Momen, Roya; Azizi, Alireza; Wang, Lingling; Ping, Yang; Xu, Tianlv; Kirk, Steven R; Li, Wenxuan; Manzhos, Sergei; Jenkins, Samantha

2017-10-04

A new QTAIM interpretation of the Ramachandran plot is formulated from the most and least facile eigenvectors of the second-derivative matrix of the electron density with a set of 29 magainin-2 peptide conformers. The presence of QTAIM eigenvectors associated with the most and least preferred directions of electronic charge density explained the role of hydrogen bonding, HH contacts and the glycine amino acid monomer in peptide folding. The highest degree of occupation of the QTAIM interpreted Ramachandran plot was found for the glycine amino acid monomer compared with the remaining backbone peptide bonds. The mobility of the QTAIM eigenvectors of the glycine amino acid monomer was higher than for the other amino acids and was comparable to that of the hydrogen bonding, explaining the flexibility of the magainin-2 backbone. We experimented with a variety of hybrid QTAIM-Ramachandran plots to highlight and explain why the glycine amino acid monomer largely occupies the 'forbidden' region on the Ramachandran plot. In addition, the new hybrid QTAIM-Ramachandran plots contained recognizable regions that can be associated with concepts familiar from the conventional Ramachandran plot whilst retaining the character of the QTAIM most and least preferred regions.

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

OpenAIRE

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

2016-01-01

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

Magnetic resonance angiography in suspected cerebral vasculitis

International Nuclear Information System (INIS)

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

2004-01-01

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

Magnetic resonance angiography in suspected cerebral vasculitis

Energy Technology Data Exchange (ETDEWEB)

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

2004-06-01

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

Imaging trends in suspected appendicitis-a Canadian perspective.

Science.gov (United States)

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

2017-06-01

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

Radiative Rates for Forbidden Transitions in Doubly-Ionized Fe-Peak Elements

Science.gov (United States)

Fivet, Vanessa; Quinet, P.; Bautista, M.

2012-05-01

Accurate and reliable atomic data for lowly-ionized Fe-peak species (Sc, Ti, V, Cr, Mn, Fe, Co, Ni and Cu) are of paramount importance for the analysis of the high resolution astrophysical spectra currently available. The third spectra of several iron group elements have been observed in different galactic sources like Herbig-Haro objects in the Orion Nebula [1] and stars like Eta Carinae [2]. However, forbidden transitions between low-lying metastable levels of doubly-ionized iron-peak ions have been very little investigated so far and radiative rates for those lines remain sparse or inexistent. We are carrying out a systematic study of the electronic structure of doubly-ionized iron-peak elements. The magnetic dipole (M1) and electric quadrupole (E2) transition probabilities are computed using the pseudo-relativistic Hartree-Fock (HFR) code of Cowan [3] and the central Thomas-Fermi-Dirac potential approximation implemented in AUTOSTRUCTURE [4]. This multi-platform approach allows for consistency checks and intercomparison and has proven very successful in the study of the complex Fe-peak species where many different effects contribute [5]. References [1] A. Mesa-Delgado et al., MNRAS 395 (2009) 855 [2] S. Johansson et al., A&A 361 (2000) 977 [3] R.D. Cowan, The Theory of Atomic Structure and Spectra, Berkeley: Univ. California Press (1981) [4] N.R. Badnell, J. Phys. B: At. Mol. Opt. Phys. 30 (1997) 1 [5] M. Bautista et al., ApJ 718 (2010) L189

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-12-01

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

Four-quasiparticle isomers and K-forbidden transitions in 176Lu

International Nuclear Information System (INIS)

McGoram, T.R.; Dracoulis, G.D.; Kibedi, T.; Mullins, M.; Byrne, A.P.; Baxter, A.M.

2000-01-01

Full text: The odd-odd nucleus 176 Lu has been the subject of extensive experimental and theoretical investigation over the last forty years. Much of this interest has stemmed from the role of 176 Lu in the s-process in nucleosynthesis. From a nuclear structure perspective, 176 Lu resides in a region of the nuclear chart where collective rotation and high-K, multi-quasiparticle states compete to form the yrast line (the locus of state with the lowest energy at a given angular momentum). The electromagnetic decay of intermediate and high-K states is often hindered due to the K-selection rule, while apparent violations of this selection rule have been ascribed to Coriolis mixing, shape changes in the gamma-degree of freedom, and so-called 'statistical' mixing. The relative importance of these mechanisms remains an open question. We present here the results of gamma-ray and conversion-electron spectroscopic measurements, performed at the Heavy Ion Facility at the Australian National University in Canberra, using the reaction 176 Yb( 7 Li, α3n) at a beam energy of 45 MeV. Two new four-quasiparticle isomers have been established, with mean lives of 400(100)ns and 58(5)μs, and spin projections and parities of 12 + and (14 + ) respectively. The shorter--lived isomer displays both normal and anomalous K-forbidden decays, which we show is the result of two-state mixing between the isomeric state and a member of a two-quasiparticle rotational band. The implied mixing matrix element of only 5 eV shows explicitly that very small mixing matrix elements may be responsible for anomalous K-hindered decays

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

Science.gov (United States)

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

2008-03-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2011-03-15

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

Percutaneous cholecystocentesis in cats with suspected hepatobiliary disease.

Science.gov (United States)

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

2017-12-01

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

Handbook for Response to Suspect Radioactive Materials

International Nuclear Information System (INIS)

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

2005-01-01

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

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

Science.gov (United States)

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

2008-04-01

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

Police officers' perceptions and experiences with mentally disordered suspects.

Science.gov (United States)

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

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

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

Directory of Open Access Journals (Sweden)

Peige Song

2017-04-01

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

Suspected Child Maltreatment: Recognize and Respond

Science.gov (United States)

Kemple, Kristen Mary; Kim, Hae Kyoung

2011-01-01

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

Comparison of Cine-MRI and Transthoracic Echocardiography for the Assessment of Aortic Root Diameters in Patients with Suspected Marfan Syndrome.

Science.gov (United States)

Bannas, P; Rybczynski, M; Sheikhzadeh, S; von Kodolitsch, Y; Derlin, T; Yamamura, J; Lund, G; Adam, G; Groth, M

2015-11-01

Patients with Marfan syndrome require repeated imaging for monitoring of aortic root aneurysms. Therefore, we evaluated the agreement and reproducibility of cine-MRI and echocardiography measurements of the sinuses of Valsalva in patients with suspected Marfan syndrome. 51 consecutive patients with suspected Marfan syndrome were prospectively examined using cine-MRI and echocardiography. Two readers independently measured aortic root diameters at the level of the sinuses of Valsalva in both cine-MRI and echocardiography. Statistics included intraclass correlation coefficient, Pearson correlation coefficient, Bland-Altman analysis, and two-sided t-test. In 38 of the 51 individuals (74.5 %), the diagnosis of Marfan syndrome was established according to the criteria of the Ghent-2 nosology. Cine-MRI measurements of the sinuses of Valsalva revealed a strong correlation with echocardiography (r = 0.929), but a statistically significant bias of -1.0  mm (p Marfan syndrome. © Georg Thieme Verlag KG Stuttgart · New York.

Measurement of the spin-forbidden decay rate (3s3d)1D2¿(3s3p)3 P2,1 in 24Mg

DEFF Research Database (Denmark)

Therkildsen, K. T.; Jensen, Brian Bak; Ryder, C. P.

2009-01-01

We have measured the spin-forbidden decay rate from (3s3d)D12¿(3s3p)P32,1 in M24g atoms trapped in a magneto-optical trap. The total decay rate, summing up both exit channels (3s3p)P31 and (3s3p)P32 , yields 196±10s-1 in excellent agreement with resent relativistic many-body calculations of Porse...

DNA typing from vaginal smear slides in suspected rape cases

Directory of Open Access Journals (Sweden)

Dayse Aparecida da Silva

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

Forbidden Friends as Forbidden Fruit: Parental Supervision of Friendships, Contact with Deviant Peers, and Adolescent Delinquency

Science.gov (United States)

Keijsers, Loes; Branje, Susan; Hawk, Skyler T.; Schwartz, Seth J.; Frijns, Tom; Koot, Hans M.; van Lier, Pol; Meeus, Wim

2012-01-01

Spending leisure time with deviant peers may have strong influences on adolescents' delinquency. The current 3-wave multi-informant study examined how parental control and parental prohibition of friendships relate to these undesirable peer influences. To this end, annual questionnaires were administered to 497 Dutch youths (283 boys, mean age =…

STATUS GIZI DAN STATUS IODIUM PADA BALITA DENGAN SUSPECT DOWN SYNDROME

Directory of Open Access Journals (Sweden)

Hastin Dyah K.

2012-10-01

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

Suspecting Neurological Dysfunction From E Mail Messages ...

African Journals Online (AJOL)

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

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

Science.gov (United States)

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

2017-04-05

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

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

Science.gov (United States)

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

2017-03-17

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

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

NARCIS (Netherlands)

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

2012-01-01

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

Circadian profiling reveals higher histamine plasma levels and lower diamine oxidase serum activities in 24% of patients with suspected histamine intolerance compared to food allergy and controls.

Science.gov (United States)

Pinzer, T C; Tietz, E; Waldmann, E; Schink, M; Neurath, M F; Zopf, Y

2018-04-01

Histamine intolerance is thought to trigger manifold clinical symptoms after ingesting histamine-rich food due to reduced activity of diamine oxidase (DAO). No study has hitherto systematically assessed daily fluctuations of histamine levels and DAO activities in symptomatic patients. The aim of the study was to investigate the presence of histamine intolerance, to therefore establish day profiles of histamine levels and DAO activities, and to compare the results between patients with suspected histamine intolerance, food allergy and healthy controls. We determined day profiles of histamine plasma levels and DAO serum activities in 33 patients with suspected histamine intolerance, in 21 patients with proven food allergy and in 10 healthy control patients. Clinical symptoms, food intolerances and further clinical and laboratory chemical parameters were evaluated. Twenty-four percent (8 of 33) suspected histamine-intolerant patients showed elevated histamine levels during the day. That might be caused by constantly and significantly reduced DAO activities in these patients compared to food-allergic and control patients. The remaining 25 patients presented normal histamine levels and DAO activities, but an increased prevalence of multiple food intolerances compared to the other subgroup of suspected histamine-intolerants. There was no correlation between subjective complaints and serological histamine parameters in patients with suspected histamine intolerance. We determined by daily profiling that decreased DAO activities correlated with elevated histamine levels in a subgroup of suspected histamine-intolerants. This finding discriminates these patients from food intolerant individuals with similar clinical symptoms and strongly suggests the presence of histamine intolerance. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

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

International Nuclear Information System (INIS)

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

2014-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-07-01

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

Spinal cord magnetic resonance imaging in suspected multiple sclerosis

International Nuclear Information System (INIS)

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

2000-01-01

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

MRI for clinically suspected pediatric appendicitis: an implemented program

Energy Technology Data Exchange (ETDEWEB)

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

2012-09-15

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

Electron collisions with Fe-peak elements: Forbidden transitions between the low lying valence states 3d6, 3d54s, and 3d54p of Fe III

International Nuclear Information System (INIS)

McLaughlin, B.M.; Scott, M.P.; Sunderland, A.G.; Noble, C.J.; Burke, V.M.; Ramsbottom, C.A.; Reid, R.H.G.; Hibbert, A.; Bell, K.L.; Burke, P.G.

2007-01-01

Effective collision strengths are presented for the Fe-peak element Fe III at electron temperatures (T e in degrees Kelvin) in the range 2 x 10 3 to 1 x 10 6 . Forbidden transitions results are given between the 3d 6 , 3d 5 4s, and the 3d 5 4p manifolds applicable to the modeling of laboratory and astrophysical plasmas

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

Science.gov (United States)

Offiah, Amaka

Aim: To optimise the digital (radiographic) imaging of children presenting with suspected non-accidental injury (NAI). Objectives: (i) To evaluate existing radiographic quality criteria, and to develop a more suitable system if these are found to be inapplicable to skeletal surveys obtained in suspected NAI. (ii) To document differences in image quality between conventional film-screen and the recently installed Fuji5000R computed radiography (CR) system at Great Ormond Street Hospital for Children, (iii) To document the extent of variability in the standard of skeletal surveys obtained in the UK for suspected NAI. (iv) To determine those radiographic parameters which yield the highest diagnostic accuracy, while still maintaining acceptable radiation dose to the child, (v) To determine how varying degrees of edge-enhancement affect diagnostic accuracy. (vi) To establish the accuracy of soft compared to hard copy interpretation of images in suspected NAI. Materials and Methods: (i) and (ii) Retrospective analysis of 286 paediatric lateral spine radiographs by two observers based on the Commission of European Communities (CEC) quality criteria, (iii) Review of the skeletal surveys of 50 consecutive infants referred from hospitals throughout the United Kingdom (UK) with suspected NAI. (iv) Phantom studies. Leeds TO. 10 and TO. 16 test objects were used to compare the relationship between film density, exposure parameters and visualisation of object details, (iv) Clinical study. Anteroposterior and lateral post mortem skull radiographs of six consecutive infants were obtained at various exposures. Six observers independently scored the images based on visualisation of five criteria, (v) and (vi) A study of diagnostic accuracy in which six observers independently interpreted 50 radiographs from printed copies (with varying degrees of edge-enhancement) and from a monitor. Results: The CEC criteria are useful for optimisation of imaging parameters and allow the detection

Herbal hepatotoxicity: suspected cases assessed for alternative causes.

Science.gov (United States)

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

2013-09-01

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

Police training in interviewing and interrogation methods: A comparison of techniques used with adult and juvenile suspects.

Science.gov (United States)

Cleary, Hayley M D; Warner, Todd C

2016-06-01

Despite empirical progress in documenting and classifying various interrogation techniques, very little is known about how police are trained in interrogation methods, how frequently they use various techniques, and whether they employ techniques differentially with adult versus juvenile suspects. This study reports the nature and extent of formal (e.g., Reid Technique, PEACE, HUMINT) and informal interrogation training as well as self-reported technique usage in a diverse national sample (N = 340) of experienced American police officers. Officers were trained in a variety of different techniques ranging from comparatively benign pre-interrogation strategies (e.g., building rapport, observing body language or speech patterns) to more psychologically coercive techniques (e.g., blaming the victim, discouraging denials). Over half the sample reported being trained to use psychologically coercive techniques with both adults and juveniles. The majority (91%) receive informal, "on the job" interrogation training. Technique usage patterns indicate a spectrum of psychological intensity where information-gathering approaches were used most frequently and high-pressure tactics less frequently. Reid-trained officers (56%) were significantly more likely than officers without Reid training to use pre-interrogation and manipulation techniques. Across all analyses and techniques, usage patterns were identical for adult and juvenile suspects, suggesting that police interrogate youth in the same manner as adults. Overall, results suggest that training in specific interrogation methods is strongly associated with usage. Findings underscore the need for more law enforcement interrogation training in general, especially with juvenile suspects, and highlight the value of training as an avenue for reducing interrogation-induced miscarriages of justice. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

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

Science.gov (United States)

2010-01-01

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

Incidence of clinically suspected venous thromboembolism in British Indian patients.

Science.gov (United States)

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

2018-05-01

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

A case of myofibroblastic sarcoma in the maxillary region suspected to be radiation-induced

International Nuclear Information System (INIS)

Sato, Hisashi; Kobayashi, Wataru; Kurita, Takayuki; Narita, Kenji; Fukui, Roh; Kimura, Hiroto

2004-01-01

Myofibroblastic sarcoma is an extremely rare malignant tumor in the oral and maxillofacial region. We report a case of myofibroblastic sarcoma probably induced by irradiation for maxillary sinus cancer. The patient was a 61-year-old man whose present history was as follows. In October 1989, he presented with pain in the left maxillary molar region. A squamous cell carcinoma of the left maxillary sinus was diagnosed, and he was treated with external irradiation of 50 Gy combined with chemotherapy. Left maxillectomy was done in February 1990. The postoperative course was satisfactory. However, in June 1998, he presented again with a tumor arising in the posterior region of the defect on the left side of the maxilla. Although histopathological examination of a biopsy specimen revealed granulation tissue with inflammatory changes, the tumor grew rapidly. The tumor was therefore suspected to be malignant and was resected under general anesthesia. Histopathological examination revealed atypical and spindle tumor cells with immunohistochemically positive staining for α-smooth muscle actin, desmin, vimentin, and muscle specific actin, but negative staining for h-caldesmon. On the basis of these histopathological and clinical findings, a final diagnosis of a myofibroblastic sarcoma of the maxillary region was made. The lesion was strongly suspected to be a radiation-induced tumor. The patient was followed up for 4 years 5 months after operation. The subsequent course was satisfactory, with no signs of recurrence or distant metastasis. (author)

Vascular factors in suspected normal pressure hydrocephalus

Science.gov (United States)

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

2016-01-01

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

Structure of two-, four-, and six-quasiparticle isomers in 174Yb and K-forbidden decays

Science.gov (United States)

Dracoulis, G. D.; Lane, G. J.; Kondev, F. G.; Byrne, A. P.; Kibédi, T.; Watanabe, H.; Ahmad, I.; Carpenter, M. P.; Freeman, S. J.; Janssens, R. V.; Hammond, N. J.; Lauritsen, T.; Lister, C. J.; Mukherjee, G.; Seweryniak, D.; Chowdhury, P.; Tandel, S. K.

2005-04-01

The stable nucleus 174Yb has been studied using deep-inelastic reactions and time-correlated γ-ray spectroscopy. New intrinsic states assigned include a 370-ns isomer at 1765 keV, which we associate with a predicted Kπ=7- two-quasineutron configuration. Analysis of the alignment and in-band properties of its rotational band, identified using time-correlated coincidences, allows characterization of the configuration. The properties of a newly identified rotational band built on the known 830-μs isomer at 1518 keV support the 6+, 2-quasineutron configuration assignment proposed previously. The 6+ band is fed by a four-quasiparticle, Kπ=14+ isomer at 3699 keV and several higher multiquasiparticle states, including a six-quasiparticle isomer at 6147 keV with K=(22,23). The results are discussed in terms of the states predicted on the basis of multiquasiparticle calculations. The anomalously fast K-forbidden transition strengths from the 14+ isomer are attributed to either K mixing in the neutron configuration or to random mixing in the high-level-density region. The 7- isomer decays are not abnormal, whereas the very hindered E2 transition from the 6+ isomer to the ground-state band remains unexplained.

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

International Nuclear Information System (INIS)

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

2006-01-01

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

Observations of far-infrared line profiles in the Orion-KL region

International Nuclear Information System (INIS)

Crawford, M.K.; Lugten, J.B.; Fitelson, W.; Genzel, R.; Melnick, G.; Harvard-Smithsonian Center for Astrophysics, Cambridge, MA)

1986-01-01

Measurements of several far-infrared emission line profiles in the Orion-KL region are reported. The emission from the CO, OH, and forbidden O I emission lines toward the BN-KL and H2 peak 1 positions probably comes from dense, hot molecular gas in the Orion-KL shock. The CO and forbidden O I lines have similar profiles, suggesting that the high-velocity forbidden O I emission also arises in magnetohydrodynamic cloud shocks. The velocity centroids of the lines are somewhat blueshifted. The far-infrared data thus support the interpretation that the blue asymmetry of the H2 2 micron lines is not mainly due to differential dust extinction, but rather to the kinematics and geometry of the shocked gas in the Orion-KL outflow. The forbidden O I and CO lines, however, have significantly less extreme blueshifted emission than the H2 lines. Both the forbidden O I 63 micron and forbidden C II 158 micron lines have features strongly supporting a common origin near the surface of the Orion molecular cloud. 28 references

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

Directory of Open Access Journals (Sweden)

Bossuyt Patrick MM

2010-10-01

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

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

International Nuclear Information System (INIS)

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

1995-01-01

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

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

Science.gov (United States)

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

2010-01-01

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

Methods for Characterisation of unknown Suspect Radioactive Samples

International Nuclear Information System (INIS)

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

2001-01-01

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

Prevalence of pulmonary TB and spoligotype pattern of Mycobacterium tuberculosis among TB suspects in a rural community in Southwest Ethiopia

Directory of Open Access Journals (Sweden)

Deribew Amare

2012-03-01

Full Text Available Abstract Background In Ethiopia where there is no strong surveillance system and state of the art diagnostic facilities are limited, the real burden of tuberculosis (TB is not well known. We conducted a community based survey to estimate the prevalence of pulmonary TB and spoligotype pattern of the Mycobacterium tuberculosis isolates in Southwest Ethiopia. Methods A total of 30040 adults in 10882 households were screened for pulmonary TB in Gilgel Gibe field research centre in Southwest Ethiopia. A total of 482 TB suspects were identified and smear microscopy and culture was done for 428 TB suspects. Counseling and testing for HIV/AIDS was done for all TB suspects. Spoligotyping was done to characterize the Mycobacterium tuberculosis isolates. Results Majority of the TB suspects were females (60.7% and non-literates (83.6%. Using smear microscopy, a total of 5 new and 4 old cases of pulmonary TB cases were identified making the prevalence of TB 30 per 100,000. However, using the culture method, we identified 17 new cases with a prevalence of 76.1 per 100,000. There were 4.3 undiagnosed pulmonary TB cases for every TB case who was diagnosed through the passive case detection mechanism in the health facility. Eleven isolates (64.7% belonged to the six previously known spoligotypes: T, Haarlem and Central-Asian (CAS. Six new spoligotype patterns of Mycobacterium tuberculosis, not present in the international database (SpolDB4 were identified. None of the rural residents was HIV infected and only 5 (5.5% of the urban TB suspects were positive for HIV. Conclusion The prevalence of TB in the rural community of Southwest Ethiopia is low. There are large numbers of undiagnosed TB cases in the community. However, the number of sputum smear-positive cases was very low and therefore the risk of transmitting the infection to others may be limited. Active case finding through health extension workers in the community can improve the low case detection rate

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

International Nuclear Information System (INIS)

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

2013-01-01

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

[Detection of the lethal process in plankton noctiluca by means of a forbidden transition of ESR of Mn2+ ion].

Science.gov (United States)

Kamenev, S E; Kopvillem, U Kh; Pasynkov, A S; Sharipov, R Z

1981-01-01

A forbidden ESR line of Mn2+ that is connected with the penetration of Mn into the plancton organism and binding it to a marcomolecule is selected from the experiment. A method for saturating the plancton organism with paramagnetic ions is proposed. It is shown that the constant of the axial electric field in the spin hamiltonian of Mn2+ ion described the dynamics of a selforganizing system. It is tested that the lethal process in the plancton with paramagnetic ion enrichment originated from boson avalanche. Experiments are performed with plancton noctiluca which illustrate the occurrence of avalancheline lethal process in the case of paramagnetic ion enrichment with limiting concentration. The meaning of these results for the problems of oceanology and pollution-ocean inhabitants interaction in the case of paramagnetic ions is discussed.

Extra-appendiceal findings in pediatric abdominal CT for suspected appendicitis

Energy Technology Data Exchange (ETDEWEB)

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

2014-07-15

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

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

Science.gov (United States)

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

2016-03-01

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

Autism spectrum disorder symptoms in juvenile suspects of sex offenses.

Science.gov (United States)

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

2009-02-01

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

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.

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

Science.gov (United States)

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

2014-09-01

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

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

Directory of Open Access Journals (Sweden)

Zuzana Kalinová

2015-09-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2018-02-15

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

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

International Nuclear Information System (INIS)

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

2018-01-01

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

48 CFR 903.303 - Reporting suspected antitrust violations.

Science.gov (United States)

2010-10-01

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

Talking heads : interviewing suspects from a cultural perspective

NARCIS (Netherlands)

Beune, K.

2009-01-01

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

48 CFR 3.303 - Reporting suspected antitrust violations.

Science.gov (United States)

2010-10-01

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

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

Science.gov (United States)

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

2015-02-01

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

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

Science.gov (United States)

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

2013-10-28

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

Correlates and Suspected Causes of Obesity in Children

Science.gov (United States)

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

2009-01-01

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

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

Science.gov (United States)

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

2011-09-01

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

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

Science.gov (United States)

Iqbal, Asif; Badoo, Shoaib; Naqeeb, Ruqsana

2017-01-01

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

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

Directory of Open Access Journals (Sweden)

Asif Iqbal

2017-01-01

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

Mismeasurement and the resonance of strong confounders: correlated errors.

Science.gov (United States)

Marshall, J R; Hastrup, J L; Ross, J S

1999-07-01

Confounding in epidemiology, and the limits of standard methods of control for an imperfectly measured confounder, have been understood for some time. However, most treatments of this problem are based on the assumption that errors of measurement in confounding and confounded variables are independent. This paper considers the situation in which a strong risk factor (confounder) and an inconsequential but suspected risk factor (confounded) are each measured with errors that are correlated; the situation appears especially likely to occur in the field of nutritional epidemiology. Error correlation appears to add little to measurement error as a source of bias in estimating the impact of a strong risk factor: it can add to, diminish, or reverse the bias induced by measurement error in estimating the impact of the inconsequential risk factor. Correlation of measurement errors can add to the difficulty involved in evaluating structures in which confounding and measurement error are present. In its presence, observed correlations among risk factors can be greater than, less than, or even opposite to the true correlations. Interpretation of multivariate epidemiologic structures in which confounding is likely requires evaluation of measurement error structures, including correlations among measurement errors.

Risk Factors and Bacterial Profile of Suspected Neonatal ...

African Journals Online (AJOL)

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

The Life of Pi Star: Exploring the Exciting and Forbidden Worlds of the Benzophenone Photophore.

Science.gov (United States)

Dormán, György; Nakamura, Hiroyuki; Pulsipher, Abigail; Prestwich, Glenn D

2016-12-28

The widespread applications of benzophenone (BP) photochemistry in biological chemistry, bioorganic chemistry, and material science have been prominent in both academic and industrial research. BP photophores have unique photochemical properties: upon n-π* excitation at 365 nm, a biradicaloid triplet state is formed reversibly, which can abstract a hydrogen atom from accessible C-H bonds; the radicals subsequently recombine, creating a stable covalent C-C bond. This light-directed covalent attachment process is exploited in many different ways: (i) binding/contact site mapping of ligand (or protein)-protein interactions; (ii) identification of molecular targets and interactome mapping; (iii) proteome profiling; (iv) bioconjugation and site-directed modification of biopolymers; (v) surface grafting and immobilization. BP photochemistry also has many practical advantages, including low reactivity toward water, stability in ambient light, and the convenient excitation at 365 nm. In addition, several BP-containing building blocks and reagents are commercially available. In this review, we explore the "forbidden" (transitions) and excitation-activated world of photoinduced covalent attachment of BP photophores by touring a colorful palette of recent examples. In this exploration, we will see the pros and cons of using BP photophores, and we hope that both novice and expert photolabelers will enjoy and be inspired by the breadth and depth of possibilities.

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.

Study of once and twice forbidden {beta} transitions; Contribution a l'etude de transitions {beta} une fois et deux fois interdites

Energy Technology Data Exchange (ETDEWEB)

Hocquenghem, J C [Commissariat a l' Energie Atomique, Grenoble (France). Centre d' Etudes Nucleaires

1967-09-01

The realisation of an experimental set up for directional angular correlation measurements allowed us to determine {beta} - {gamma} angular correlations. These measurements together with the determination of the {beta} shape-factor have been made for the following transitions: the first forbidden {beta}{sup -} transitions of 386 keV in the {sup 177}Lu disintegration and of 352 keV in the {sup 175}Yb disintegration. The experimental results have been compared with theoretical predictions of the Nilsson's model; the twice forbidden {beta}{sup -} transition of 473 keV in the {sup 94}Nb disintegration. The {beta} transition nuclear matrix elements have been extracted from the experimental results. Comparison have been made with the theoretical values calculated by taking for nuclear wavefunctions those obtained by diagonalization of the residual interaction and assuming that protons and neutrons outside the {sup 90}Zr core are respectively on the 1 g 9/2 and 2 d 5/2 orbits. (author) [French] La realisation d'un ensemble de mesures de correlations angulaires directionnelles nous a permis la mesure de correlations {beta} - {gamma} en fonction de l'energie. En completant celles-ci par la mesure du facteur de forme du spectre {beta}, nous avons pu etudier ainsi: d'une part, les transitions {beta}{sup -} une fois interdites de 386 keV de la desintegration de {sup 177}Lu et de 352 keV de la desintegration de {sup 175}Yb, Les resultats experimentaux ont ete compares aux valeurs calculees dans le modele de Nilsson; d'autre part, la transition {beta}- deux fois interdite de 473 keV de la desintegration de {sup 94}Nb. Les elements de matrice nucleaire de la transition {beta}, extraits des resultats experimentaux, ont ete compares aux valeurs theoriques calculees. Les fonctions d'ondes nucleaires utilisees ont ete obtenues par diagonalisation de l'interaction residuelle en supposant que les protons et les neutrons, en dehors du coeur forme par le {sup 90}Zr, sont respectivement

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

Energy Technology Data Exchange (ETDEWEB)

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

2013-08-15

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

Suspected infection in afebrile patients : Are they septic?

NARCIS (Netherlands)

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

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

Pathologically confirmed autoimmune encephalitis in suspected Creutzfeldt-Jakob disease

NARCIS (Netherlands)

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

2015-01-01

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

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

Science.gov (United States)

Abbas, Madeline-Sophie

2018-04-06

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

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

International Nuclear Information System (INIS)

Minamimoto, Ryogo; Takahashi, Nobukazu; Inoue, Tomio

2007-01-01

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

A suspected case of Addison's disease in cattle.

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Lambacher, Bianca; Wittek, Thomas

2015-09-01

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

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

International Nuclear Information System (INIS)

FRENCH, M.S.

2006-01-01

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

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

Science.gov (United States)

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

2016-07-01

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

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

Directory of Open Access Journals (Sweden)

Shan-Shan Li

2018-05-01

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

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

African Journals Online (AJOL)

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

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

Science.gov (United States)

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

1995-07-26

was not normal. At the onset of suspected gram-negative sepsis, severity of underlying illness and in-hospital use of vasopressors are strong and consistent predictors of short- and long-term survival. Our data validate the McCabe and Jackson severity of illness scoring system for predicting long-term survival after sepsis. Physical dysfunction and more poorly perceived general health occur commonly after sepsis.

Does this adult patient with suspected bacteremia require blood cultures?

Science.gov (United States)

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

2012-08-01

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

Thoracic computed tomography in patients with suspected malignant pleural effusions

International Nuclear Information System (INIS)

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

2001-01-01

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

A prospective evaluation of whole-exome sequencing as a first-tier molecular test in infants with suspected monogenic disorders.

Science.gov (United States)

Stark, Zornitza; Tan, Tiong Y; Chong, Belinda; Brett, Gemma R; Yap, Patrick; Walsh, Maie; Yeung, Alison; Peters, Heidi; Mordaunt, Dylan; Cowie, Shannon; Amor, David J; Savarirayan, Ravi; McGillivray, George; Downie, Lilian; Ekert, Paul G; Theda, Christiane; James, Paul A; Yaplito-Lee, Joy; Ryan, Monique M; Leventer, Richard J; Creed, Emma; Macciocca, Ivan; Bell, Katrina M; Oshlack, Alicia; Sadedin, Simon; Georgeson, Peter; Anderson, Charlotte; Thorne, Natalie; Melbourne Genomics Health Alliance; Gaff, Clara; White, Susan M

2016-11-01

To prospectively evaluate the diagnostic and clinical utility of singleton whole-exome sequencing (WES) as a first-tier test in infants with suspected monogenic disease. Singleton WES was performed as a first-tier sequencing test in infants recruited from a single pediatric tertiary center. This occurred in parallel with standard investigations, including single- or multigene panel sequencing when clinically indicated. The diagnosis rate, clinical utility, and impact on management of singleton WES were evaluated. Of 80 enrolled infants, 46 received a molecular genetic diagnosis through singleton WES (57.5%) compared with 11 (13.75%) who underwent standard investigations in the same patient group. Clinical management changed following exome diagnosis in 15 of 46 diagnosed participants (32.6%). Twelve relatives received a genetic diagnosis following cascade testing, and 28 couples were identified as being at high risk of recurrence in future pregnancies. This prospective study provides strong evidence for increased diagnostic and clinical utility of singleton WES as a first-tier sequencing test for infants with a suspected monogenic disorder. Singleton WES outperformed standard care in terms of diagnosis rate and the benefits of a diagnosis, namely, impact on management of the child and clarification of reproductive risks for the extended family in a timely manner.Genet Med 18 11, 1090-1096.

Cholescintigraphy and ultrasonography in patients suspected of having acute cholecystitis

DEFF Research Database (Denmark)

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

1988-01-01

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

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

International Nuclear Information System (INIS)

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

1983-01-01

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

Exome Sequencing in Suspected Monogenic Dyslipidemias

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

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

2010-01-01

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

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

Science.gov (United States)

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

2018-01-22

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

PMS2 Involvement in Patients Suspected of Lynch Syndrome

NARCIS (Netherlands)

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

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

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

Science.gov (United States)

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

2017-06-01

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

Investigation of suspected chronic fatigue syndrome/myalgic encephalopathy.

Science.gov (United States)

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

2016-02-09

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

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

DEFF Research Database (Denmark)

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

2017-01-01

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

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

Directory of Open Access Journals (Sweden)

Marcos Picini

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

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

International Nuclear Information System (INIS)

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

2003-01-01

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

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

Science.gov (United States)

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

2014-01-01

Creutzfeldt-Jakob disease (CJD) and autoimmune encephalitis with antibodies against neuronal surface antigens (NSA-abs) may present with similar clinical features. Establishing the correct diagnosis has practical implications in the management of care for these patients. To determine the frequency of NSA-abs in the cerebrospinal fluid of patients with suspected CJD and in patients with pathologically confirmed (ie, definite) CJD. A mixed prospective (suspected) and retrospective (definite) CJD cohort study was conducted in a reference center for detection of NSA-abs. The population included 346 patients with suspected CJD and 49 patients with definite CJD. Analysis of NSA-abs in cerebrospinal fluid with brain immunohistochemistry optimized for cell-surface antigens was performed. Positive cases in the suspected CJD group were further studied for antigen specificity using cell-based assays. All definite CJD cases were comprehensively tested for NSA-abs, with cell-based assays used for leucine-rich glioma-inactivated 1 (LGI1), contactin-associated protein-like 2 (CASPR2), N-methyl-d-aspartate (NMDA), and glycine (GlY) receptors. Neuronal surface antigens were detected in 6 of 346 patients (1.7%) with rapid neurologic deterioration suggestive of CJD. None of these 6 patients fulfilled the diagnostic criteria for probable or possible CJD. The target antigens included CASPR2, LGI1, NMDAR, aquaporin 4, Tr (DNER [δ/notch-like epidermal growth factor-related receptor]), and an unknown protein. Four of the patients developed rapidly progressive dementia, and the other 2 patients had cerebellar ataxia or seizures that were initially considered to be myoclonus without cognitive decline. The patient with Tr-abs had a positive 14-3-3 test result. Small cell lung carcinoma was diagnosed in the patient with antibodies against an unknown antigen. All patients improved or stabilized after appropriate treatment. None of the 49 patients with definite CJD had NSA-abs. A low, but

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

International Nuclear Information System (INIS)

1996-05-01

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

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

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-05-01

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

Interdisciplinary action of nurses to children with suspected sexual abuse

Directory of Open Access Journals (Sweden)

Lia Leão Ciuffo

2014-04-01

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

MRI for clinically suspected pediatric appendicitis: case interpretation

International Nuclear Information System (INIS)

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

2014-01-01

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

MRI for clinically suspected pediatric appendicitis: case interpretation

Energy Technology Data Exchange (ETDEWEB)

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

2014-05-15

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

Forensic application of phylogenetic analyses - Exploration of suspected HIV-1 transmission case.

Science.gov (United States)

Siljic, Marina; Salemovic, Dubravka; Cirkovic, Valentina; Pesic-Pavlovic, Ivana; Ranin, Jovan; Todorovic, Marija; Nikolic, Slobodan; Jevtovic, Djordje; Stanojevic, Maja

2017-03-01

Transmission of human immunodeficiency virus (HIV) between individuals may have important legal implications and therefore may come to require forensic investigation based upon phylogenetic analysis. In criminal trials results of phylogenetic analyses have been used as evidence of responsibility for HIV transmission. In Serbia, as in many countries worldwide, exposure and deliberate transmission of HIV are criminalized. We present the results of applying state of the art phylogenetic analyses, based on pol and env genetic sequences, in exploration of suspected HIV transmission among three subjects: a man and two women, with presumed assumption of transmission direction from one woman to a man. Phylogenetic methods included relevant neighbor-joining (NJ), maximum likelihood (ML) and Bayesian methods of phylogenetic trees reconstruction and hypothesis testing, that has been shown to be the most sensitive for the reconstruction of epidemiological links mostly from sexually infected individuals. End-point limiting-dilution PCR (EPLD-PCR) assay, generating the minimum of 10 sequences per genetic region per subject, was performed to assess HIV quasispecies distribution and to explore the direction of HIV transmission between three subjects. Phylogenetic analysis revealed that the viral sequences from the three subjects were more genetically related to each other than to other strains circulating in the same area with the similar epidemiological profile, forming strongly supported transmission chain, which could be in favour of a priori hypothesis of one of the women infecting the man. However, in the EPLD based phylogenetic trees for both pol and env genetic region, viral sequences of one subject (man) were paraphyletic to those of two other subjects (women), implying the direction of transmission opposite to the a priori assumption. The dated tree in our analysis confirmed the clustering pattern of query sequences. Still, in the context of unsampled sequences and

9 CFR 381.74 - Poultry suspected of having biological residues.

Science.gov (United States)

2010-01-01

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

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

Science.gov (United States)

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

2010-01-01

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

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

Directory of Open Access Journals (Sweden)

Pedro Figueiredo

2010-01-01

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

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

International Nuclear Information System (INIS)

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

2006-01-01

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

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

International Nuclear Information System (INIS)

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

2015-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-07-06

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

Calculation of parity violating effects in the 62P/sub 1/2/-72P/sub 1/2/ forbidden M1 transition in thallium

International Nuclear Information System (INIS)

Neuffer, D.B.

1977-05-01

Calculations are presented of the E1 amplitude expected in forbidden M1 transitions of Tl and Cs if parity is violated in the neutral weak e-N interaction, as proposed in a number of gauge models, including that of Weinberg and Salam. Valence electron wave functions are generated as numerical solutions to the Dirac equation in a modified Tietz central potential. These wave functions are used to calculate allowed E1 transition rates, hfs splittings, and Stark E1 transition ampitudes. These results are compared with experiment and the agreement is generally good. The relativistic Tl 6 2 P/sub 1/2/-7 2 P/sub 1/2/ M1 transition amplitude M is also calculated, and corrections due to interconfiguration interaction, Breit interaction, and hfs mixing are included. The parity violating E1 amplitude E/sub PV/ is calculated and a value for the circular dichroism in the Weinberg model delta = -2.6 x 10 -3 is obtained. Parity violating effects in other Tl transitions are discussed. Contributions to the M1 amplitude for the forbidden Cs 6 2 S/sub 1/2/-7 2 S/sub 1/2/ and 6 2 S/sub 1/2/-8 2 S/sub 1/2/ transitions and to the Cs 6 2 S/sub 1/2/ g-factor anomaly from relativistic effects, Breit interaction, interconfiguration interaction, and hfs mixing are calculated, and it is found that this current theoretical description is not entirely adequate. The parity violating E1 amplitude E/sub PV/ for the 6S/sub 1/2/-7 2 S/sub 1/2/ and 6S/sub 1/2/-8 2 S/sub 1/2/ transitions is evaluated. With a measured value M/sub expt/ and the Weinberg value Q/sub W/ = -99, a circular dichroism delta = 1.64 x 10 -4 for the 6 2 S/sub 1/2/-7 2 S/sub 1/2/ transition is found

A case of an 8-year-old boy who was strongly suspected of suffering from familial angiolipomatosis

Directory of Open Access Journals (Sweden)

Yutaka Kanamori

2015-06-01

Full Text Available Familial angiolipomatosis is a rare inherited disease mainly diagnosed in the adult stage. It is usually inherited in an autosomal recessive manner; however, some cases of autosomal dominant mode of inheritance have been reported. The disease may be misdiagnosed as neurofibromatosis type I in some cases due to the similar feature of multiple subcutaneous soft masses. However, familial angiolipomatosis is not associated with malignant tumors and it is very important to distinguish these two conditions. We report here the rare case of a subcutaneous mass that was composed of fat tissues and some fibrous tissue with small venous vessels and capillaries in an 8-year-old boy whose father also has a long history of generalized multiple angiolipomas. These facts strongly suggest that the patient suffers from familial angiolipomatosis and careful follow-up is needed in the future.

Creating fair lineups for suspects with distinctive features

OpenAIRE

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

2009-01-01

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

Usefulness of unenhanced helical CT in patients with suspected ureteral colic

Energy Technology Data Exchange (ETDEWEB)

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

2002-07-01

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

The economics of cardiac biomarker testing in suspected myocardial infarction.

Science.gov (United States)

Goodacre, Steve; Thokala, Praveen

2015-03-01

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

How useful is gastroesophageal reflux scintigraphy in suspected childhood aspiration?

International Nuclear Information System (INIS)

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

1988-01-01

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

How useful is gastroesophageal reflux scintigraphy in suspected childhood aspiration

Energy Technology Data Exchange (ETDEWEB)

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

1988-05-01

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

Lineup Composition, Suspect Position, and the Sequential Lineup Advantage

Science.gov (United States)

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

2008-01-01

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

Submillimeter and far-infrared line observations of M17 SW - A clumpy molecular cloud penetrated by ultraviolet radiation

Science.gov (United States)

Stutzki, J.; Genzel, R.; Harris, A. I.; Stacey, G. J.; Jaffe, D. T.

1988-01-01

Millimeter, submillimeter, and far-IR spectroscopic observations of the M17 SW star formation region are reported. Strong forbidden C II 158 micron and CO J = 7 - 6 line emission arises in an H II region/molecular cloud interface of several pc thickness. Weaker forbidden C II emission appears to be extended over 15 pc throughout the molecular cloud. CO J = 14 - 13 and forbidden O I 145 micron spectra indicate high temperatures and densities for both molecular and atomic gas in the interface. The results require the molecular cloud near the interface to be clumpy or filamentary. The extended forbidden C II emission throughout the molecular cloud has a level around 20 times higher than expected from a single molecular cloud interface exposed to an ultraviolet radiation field typical of the solar neighborhood. The high gas temperature of molecular material in the UV-illuminated interface region suggests that CO self-shielding and heating of CO by photoelectrons are important.

Interviewing strategically to elicit admissions from guilty suspects

OpenAIRE

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

2015-01-01

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

Electron impact excitation of Fe-peak elements: forbidden transitions in the 3d5 manifold of Fe IV

International Nuclear Information System (INIS)

McLaughlin, B M; Hibbert, A; Scott, M P; Noble, C J; Burke, V M; Burke, P G

2005-01-01

Electron-impact excitation collision strengths of the Fe-peak element Fe IV are calculated in the close-coupling approximation using the R-matrix suite of codes PRMAT designed for parallel processors. One hundred and eight LS-coupled states arising from the 3d 5 , 3d 4 4s and 3d 4 4p configurations of Fe IV, are retained in the present calculations. Detailed multi-configuration interaction target wavefunctions are used with the aid of 3p 2 → 3d 2 electron promotions and a 4dbar correlation orbital in the present calculations. Effective collision strengths for optically forbidden transitions, which are extremely important in the analysis of lines in the Fe IV spectra, are obtained by averaging the electron collision strengths for a wide range of incident electron energies, over a Maxwellian distribution of velocities. Results are presented for electron temperatures (T e in Kelvin) in the range 3.3 ≤ Log T e ≤ 6.0 applicable to many laboratory and astrophysical plasmas for transitions within the 3d 5 manifold. The present results compared to previous investigations provide improved results for important lines in the Fe IV spectrum

Cortical capillary dysfunction in patients suspected of Alzheimer’s disease

DEFF Research Database (Denmark)

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

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

Cognitive Linguistic Performances of Multilingual University Students Suspected of Dyslexia

Science.gov (United States)

Lindgren, Signe-Anita; Laine, Matti

2011-01-01

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

Genotype-phenotype correlation in patients suspected of having Sotos syndrome

NARCIS (Netherlands)

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

2004-01-01

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

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

NARCIS (Netherlands)

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

2004-01-01

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

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

African Journals Online (AJOL)

2012-01-03

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

Intraoperative ultrasonography in nine dogs with intra-abdominal neoplasm suspect

Directory of Open Access Journals (Sweden)

Daniella Matos da Silva

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

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

Science.gov (United States)

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

2014-01-01

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

Spatial Distribution of the Forbidden 1.707 mm Rovibronic Emission on Io

Science.gov (United States)

de Pater, Imke; de Kleer, Katherine; Adamkovics, Mate

2017-10-01

Io’s forbidden SO 1.707 mm rovibronic transition was discovered in 1999 when the satellite was observed with the NIRSPEC spectrometer on the Keck telescope while in eclipse [1]. The emission, at the time indicative of a rotational temperature of 1000 K, was attributed to SO molecules in the excited a1D state, ejected as such from the vent at a thermodynamic quenching temperature of ~1500 K. We suggested Loki as its source, a volcano that was exceptionally active during this period. In subsequent years we found that the disk-averaged SO emission varies substantially over time [2]. In November 2002 we observed Io in eclipse with Keck’s NIRSPEC coupled to the Adaptive Optics (AO) system, and identified a latitudinal variation in SO: most emission came from the equator and the south, and practically no emission was detected in the north [3]. To further investigate the nature of the SO emission, we observed Io in eclipse with the near-infrared integral field spectrograph OSIRIS, coupled to the AO system, on the Keck II telescope on UT 27 July 2010 and 25 December 2015. On the latter date we observed simultaneously with the NIRSPEC spectrometer at a high spectral resolution (R ~ 25,000). On these dates Callisto and Ganymede, resp., were close enough to be used for wavefront sensing. The angular resolution of our images is ~0.1”, or ~10 resolution elements across Io’s disk. The emission is extended; preliminary results show that in 2010 most of the emission originated in the north, and in 2015 it appeared to be more confined to the equatorial region. Potential connections to active volcanoes, or absence thereof, and model fits to the emission bands including LTE vs non-LTE contributions will be discussed. [1]: de Pater, I., et al., 2002. Icarus, 156, 296-301.[2]: Laver, C., et al. 2007. Icarus, 189, 401-408.[3]: de Pater, I. et al., 2007. Icarus, 191, 172-182.

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

Directory of Open Access Journals (Sweden)

Jing-Min Guo

2015-10-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-03-15

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

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

Directory of Open Access Journals (Sweden)

R. Gehring

2001-07-01

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

Use of budesonide Turbuhaler in young children suspected of asthma

DEFF Research Database (Denmark)

Bisgaard, H; Pedersen, S; Nikander, K

1994-01-01

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

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

African Journals Online (AJOL)

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

Electric field measurements from satellites-to-forbidden line ratios in an Omega-Upgrade laser-produced plasma. Semi-annual report, February 1--May 31, 1996

International Nuclear Information System (INIS)

Griem, H.R.; Elton, R.C.; Welch, B.L.

1996-01-01

Under this FY-96 NLUF program, the authors began their search for satellite lines to forbidden transitions for localized laser-induced electric field measurements by preparing in their laboratory a flat-field grazing incidence spectrograph for use on the OMEGA-Upgrade facility. This involved wavelength calibration using a (small) laser-produced plasma, as well as designing and constructing a mounting table compatible with the large 60-beam target chamber at LLE. Beginning in April 1996 they installed and aligned the spectrograph at LLE. Following final alignment on Monday, April 29, they obtained the following day their first time-integrated spectral data in the 30--250 angstrom range. A total of 28 successful shots were obtained. For most shots, two beams of the OMEGA-Upgrade laser were used at nominal uv-pulse widths of 1.1 ns and energies ranging from 76--470 J/beam, with focal spots of 80--450 microm and irradiances covering approximately 10 14 --10 16 Watt/cm 2 . Planar targets used consisted of Mg and NaF, as well as boron mounted on a plastic film, with some of the former two overcoated with 5 microm of CH on each side for containing the plasma, at least during the early portion of the pulse. Preliminary analyses indicate that they do indeed observe the desired Li-like L-shell spectra for oxygen, fluorine, sodium and magnesium, as well as L-shell lines in the corresponding H-(Balmer) and He-like species. Similarly, they recorded K-shell lines from B and C. Sample traces for Mg and Na fluoride from their soft x-ray spectrograph are shown. Both of these shots were obtained at a rather low applied irradiance of 2 X 10 14 W/cm 2 , and were chosen mainly for line identification. The parent Li-like 2s-3p allowed lines corresponding to the forbidden-line satellites sought for E-field determinations are clearly present. The calculated satellite line intensity relative to the intensity from this 2s-3p transition is ∼ 3%

Observation of forbidden (E2) lines in the ultraviolet spectra of Ca II, Sr II, and Ba II by inductively coupled plasma emission spectroscopy

International Nuclear Information System (INIS)

Doidge, Peter S.

2013-01-01

Forbidden (electric quadrupole, E2) transitions of the type ns 2 S 1/2 –nd 2 D 3/2 and ns 2 S 1/2 –nd 2 D 5/2 in the ultraviolet spectra of singly ionized Ca, Sr, and Ba (with n = 4, 5 or 6 for Ca, Sr, and Ba, respectively) have been observed in the emission spectrum of an inductively coupled argon plasma. Wavelengths and wavenumbers of the six lines are reported and the values are in good agreement with those expected from literature data for the energy levels involved. - Highlights: • Wavelengths measured using commercially available ICP emission spectrometer • First wavelength and wavenumber measurements of some E2 lines of Ba +, Ca +, Sr + • Evidence for small plasma shifts in the wavenumbers of Ba + and Sr +

Respiratory viral infections in infants with clinically suspected pertussis.

Science.gov (United States)

Ferronato, Angela E; Gilio, Alfredo E; Vieira, Sandra E

2013-01-01

to evaluate the frequency of respiratory viral infections in hospitalized infants with clinical suspicion of pertussis, and to analyze their characteristics at hospital admission and clinical outcomes. a historical cohort study was performed in a reference service for pertussis, in which the research of respiratory viruses was also a routine for infants hospitalized with respiratory problems. All infants reported as suspected cases of pertussis were included. Tests for Bordetella pertussis (BP) (polymerase chain reaction/culture) and for respiratory viruses (RVs) (immunofluorescence) were performed. Patients who received macrolides before hospitalization were excluded. Clinical data were obtained from medical records. Among the 67 patients studied, BP tests were positive in 44%, and 26% were positive for RV. There was no etiological identification in 35%, and RV combined with BP was identified in 5%. All patients had similar demographic characteristics. Cough followed by inspiratory stridor or cyanosis was a strong predictor of pertussis, as well as prominent leukocytosis and lymphocytosis. Rhinorrhea and dyspnea were more frequent in viral infections. Macrolides were discontinued in 40% of patients who tested positive for RV and negative for BP. the results suggest that viral infection can be present in hospitalized infants with clinical suspicion of pertussis, and etiological tests may enable a reduction in the use of macrolides in some cases. However, the etiological diagnosis of respiratory virus infection, by itself, does not exclude the possibility of infection with BP. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

2010-10-01

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

Parity-Forbidden Transitions and Their Impact on the Optical Absorption Properties of Lead-Free Metal Halide Perovskites and Double Perovskites.

Science.gov (United States)

Meng, Weiwei; Wang, Xiaoming; Xiao, Zewen; Wang, Jianbo; Mitzi, David B; Yan, Yanfa

2017-07-06

Using density functional theory calculations, we analyze the optical absorption properties of lead (Pb)-free metal halide perovskites (AB 2+ X 3 ) and double perovskites (A 2 B + B 3+ X 6 ) (A = Cs or monovalent organic ion, B 2+ = non-Pb divalent metal, B + = monovalent metal, B 3+ = trivalent metal, X = halogen). We show that if B 2+ is not Sn or Ge, Pb-free metal halide perovskites exhibit poor optical absorptions because of their indirect band gap nature. Among the nine possible types of Pb-free metal halide double perovskites, six have direct band gaps. Of these six types, four show inversion symmetry-induced parity-forbidden or weak transitions between band edges, making them not ideal for thin-film solar cell applications. Only one type of Pb-free double perovskite shows optical absorption and electronic properties suitable for solar cell applications, namely, those with B + = In, Tl and B 3+ = Sb, Bi. Our results provide important insights for designing new metal halide perovskites and double perovskites for optoelectronic applications.

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

Science.gov (United States)

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

2000-01-01

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

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

Science.gov (United States)

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

2018-01-01

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

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

Science.gov (United States)

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

2018-01-11

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

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

Science.gov (United States)

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

2017-08-15

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

Use of biomarkers in triage of patients with suspected stroke.

Science.gov (United States)

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

2011-05-01

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

Differential Diagnosis of Children with Suspected Childhood Apraxia of Speech

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

Behrman, Bruce W; Richards, Regina E

2005-06-01

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

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

Science.gov (United States)

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

2015-09-01

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

Composition determination of quaternary GaAsPN layers from single X-ray diffraction measurement of quasi-forbidden (002) reflection

Energy Technology Data Exchange (ETDEWEB)

Tilli, J.-M., E-mail: juha-matti.tilli@iki.fi; Jussila, H.; Huhtio, T.; Sopanen, M. [Department of Micro and Nanosciences, Aalto University, P.O. Box 13500, FI-00076 Aalto (Finland); Yu, K. M. [Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720 (United States)

2014-05-28

GaAsPN layers with a thickness of 30 nm were grown on GaP substrates with metalorganic vapor phase epitaxy to study the feasibility of a single X-ray diffraction (XRD) measurement for full composition determination of quaternary layer material. The method is based on the peak intensity of a quasi-forbidden (002) reflection, which is shown to vary with changing arsenic content for GaAsPN. The method works for thin films with a wide range of arsenic contents and shows a clear variation in the reflection intensity as a function of changing layer composition. The obtained thicknesses and compositions of the grown layers are compared with accurate reference values obtained by Rutherford backscattering spectroscopy combined with nuclear reaction analysis measurements. Based on the comparison, the error in the XRD defined material composition becomes larger with increasing nitrogen content and layer thickness. This suggests that the dominating error source is the deteriorated crystal quality due to the nonsubstitutional incorporation of nitrogen into the crystal lattice and strain relaxation. The results reveal that the method overestimates the arsenic and nitrogen content within error margins of about 0.12 and about 0.025, respectively.

How to explore and report children with suspected non-accidental trauma

International Nuclear Information System (INIS)

Adamsbaum, Catherine; Mejean, Nathalie; Merzoug, Valerie; Rey-Salmon, Caroline

2010-01-01

Child abuse is a controversial problem of special concern. Recent reports have focused on the broad variability of reporting to child protection services. Radiologists play a key role in the early diagnosis and imaging of suspected inflicted injury. Imaging must be performed and then interpreted with rigour. The aims of this review are: To review the recent recommended guidelines for imaging in cases of suspicion of abuse. These include a highly detailed complete skeletal survey with centered views, whilst brain CT and/or MRI are mandatory in children younger than 2 years. The use of abdominal imaging is debatable if the child has no symptoms. All siblings younger than 2 years should be assessed in the same way while the diagnosis of abuse is investigated. Body MRI is an interesting modality that remains a ''work-in-progress''. To highlight that dating of both brain and skeletal injuries is imprecise. The main point is, however, to determine if the pattern is of ''age-different'' lesions. This not only provides a strong argument for the diagnosis of abuse, but also indicates repetitive violence with a high risk for further injury and death. To remember that the medical perspective is to protect the child. Thus, radiologists must communicate clearly the suspicion of abuse and the degree of certainty to clinicians to aid reporting or hospitalization. (orig.)

How to explore and report children with suspected non-accidental trauma

Energy Technology Data Exchange (ETDEWEB)

Adamsbaum, Catherine [Paris Descartes University, St Vincent de Paul Hospital, Radiology Department, Pediatric Imaging, Paris Cedex 14 (France); Mejean, Nathalie; Merzoug, Valerie [St Vincent de Paul Hospital, Radiology Department, Pediatric Imaging, Paris Cedex 14 (France); Rey-Salmon, Caroline [Hotel Dieu Hospital, AP-HP, Medico-Judicial Unit, Paris (France)

2010-06-15

Child abuse is a controversial problem of special concern. Recent reports have focused on the broad variability of reporting to child protection services. Radiologists play a key role in the early diagnosis and imaging of suspected inflicted injury. Imaging must be performed and then interpreted with rigour. The aims of this review are: To review the recent recommended guidelines for imaging in cases of suspicion of abuse. These include a highly detailed complete skeletal survey with centered views, whilst brain CT and/or MRI are mandatory in children younger than 2 years. The use of abdominal imaging is debatable if the child has no symptoms. All siblings younger than 2 years should be assessed in the same way while the diagnosis of abuse is investigated. Body MRI is an interesting modality that remains a ''work-in-progress''. To highlight that dating of both brain and skeletal injuries is imprecise. The main point is, however, to determine if the pattern is of ''age-different'' lesions. This not only provides a strong argument for the diagnosis of abuse, but also indicates repetitive violence with a high risk for further injury and death. To remember that the medical perspective is to protect the child. Thus, radiologists must communicate clearly the suspicion of abuse and the degree of certainty to clinicians to aid reporting or hospitalization. (orig.)

Comparison of CT and MRI for Diagnosis of Suspected Scaphoid Fractures

NARCIS (Netherlands)

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

2011-01-01

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

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

DEFF Research Database (Denmark)

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

2011-01-01

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

Observation of the Forbidden Magnetic Dipole Transition 6{sup 2}P{sub ½} --> 7{sup 2}P{sub ½} in Atomic Thallium

Science.gov (United States)

Chu, S.

1976-10-01

A measurement of the 6{sup 2}P{sub ½} --> 7{sup 2}P{sub ½} forbidden magnetic dipole matrix element in atomic thallium is described. A pulsed, linearly polarized dye laser tuned to the transition frequency is used to excite the thallium vapor from the 6{sup 2}P{sub ½} ground state to the 7{sup 2}P{sub ½} excited state. Interference between the magnetic dipole M1 amplitude and a static electric field induced E1 amplitude results in an atomic polarization of the 7{sup 2}P{sub ½} state, and the subsequent circular polarization of 535 nm fluorescence. The circular polarization is seen to be proportional to / as expected, and measured for several transitions between hyperfine levels of the 6{sup 2}P{sub ½} and 7{sup 2}P{sub ½} states. The result is = -(2.11 +- 0.30) x 10{sup -5} parallel bar e parallel bar dirac constant/2mc, in agreement with theory.

The role of MRI in suspected inner ear malformations

International Nuclear Information System (INIS)

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

2003-01-01

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

Value of noncontrast spiral CT for suspected acute appendicitis

International Nuclear Information System (INIS)

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

1998-01-01

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

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

Science.gov (United States)

2010-07-01

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

Neurological signs in 23 dogs with suspected rostral cerebellar ischaemic stroke

DEFF Research Database (Denmark)

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

2016-01-01

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

Prevalence of IgE sensitization in Danish children with suspected asthma

DEFF Research Database (Denmark)

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

2013-01-01

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

Mapping low- and high-density clouds in astrophysical nebulae by imaging forbidden line emission

Science.gov (United States)

Steiner, J. E.; Menezes, R. B.; Ricci, T. V.; Oliveira, A. S.

2009-06-01

Emission line ratios have been essential for determining physical parameters such as gas temperature and density in astrophysical gaseous nebulae. With the advent of panoramic spectroscopic devices, images of regions with emission lines related to these physical parameters can, in principle, also be produced. We show that, with observations from modern instruments, it is possible to transform images taken from density-sensitive forbidden lines into images of emission from high- and low-density clouds by applying a transformation matrix. In order to achieve this, images of the pairs of density-sensitive lines as well as the adjacent continuum have to be observed and combined. We have computed the critical densities for a series of pairs of lines in the infrared, optical, ultraviolet and X-rays bands, and calculated the pair line intensity ratios in the high- and low-density limit using a four- and five-level atom approximation. In order to illustrate the method, we applied it to Gemini Multi-Object Spectrograph (GMOS) Integral Field Unit (GMOS-IFU) data of two galactic nuclei. We conclude that this method provides new information of astrophysical interest, especially for mapping low- and high-density clouds; for this reason, we call it `the ld/hd imaging method'. Based on observations obtained at the Gemini Observatory, which is operated by the Association of Universities for Research in Astronomy, Inc., under a cooperative agreement with the National Science Foundation on behalf of the Gemini partnership: the National Science Foundation (United States); the Science and Technology Facilities Council (United Kingdom); the National Research Council (Canada), CONICYT (Chile); the Australian Research Council (Australia); Ministério da Ciência e Tecnologia (Brazil) and Secretaria de Ciencia y Tecnologia (Argentina). E-mail: steiner@astro.iag.usp.br

Faint planetary nebulae in the Magellanic Clouds - central star properties and nebular abundances for the Jacoby sample

International Nuclear Information System (INIS)

Henry, R.B.C.; Liebert, J.; Boroson, T.A.

1989-01-01

Forty-four of the LMC and SMC planetary nebulae contained in Jacoby's (1980) sample are studied. Spectrophotometric observations were used to infer the Stoy temperatures, luminosities, and radii of the central stars. For objects in which forbidden O III electron temperatures could be determined, the nebular abundances of He, N, O, and Ne were calculated and compared with values for giant H II regions for the relevant host galaxy. When the present abundance results were compared with previously published results for planetary nebulae in the LMC, SMC, and the Galaxy, a strong correlation was found for O/H versus Ne/H and strong anticorrelations were found for O/H versus forbidden O III temperature, and N/O versus O/H. 69 refs

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

Science.gov (United States)

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

2009-01-01

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

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

NARCIS (Netherlands)

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

2003-01-01

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

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

NARCIS (Netherlands)

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

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

Sonography as an initial study in patients with suspected ureteral stone

International Nuclear Information System (INIS)

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

1999-01-01

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

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

Science.gov (United States)

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

2002-02-01

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

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

Science.gov (United States)

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

2018-03-30

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

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

Directory of Open Access Journals (Sweden)

Wolfe Rory

2006-06-01

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

Using Internet Artifacts to Profile a Child Pornography Suspect

Directory of Open Access Journals (Sweden)

Marcus K. Rogers

2014-03-01

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

Comparison of cine-MRI and transthoracic echocardiography for the assessment of aortic root diameters in patients with suspected Marfan syndrome

Energy Technology Data Exchange (ETDEWEB)

Bannas, P.; Derlin, T.; Yamamura, J.; Lund, G.; Adam, G. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Diagnostic and Interventional Radiology; Rybczynski, M.; Sheikhzadeh, S.; Kodolitsch, Y. von [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of General and Interventional Cardiology; Groth, M. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Section for Pediatric Radiology

2015-11-15

Patients with Marfan syndrome require repeated imaging for monitoring of aortic root aneurysms. Therefore, we evaluated the agreement and reproducibility of cine-MRI and echocardiography measurements of the sinuses of Valsalva in patients with suspected Marfan syndrome. 51 consecutive patients with suspected Marfan syndrome were prospectively examined using cine-MRI and echocardiography. Two readers independently measured aortic root diameters at the level of the sinuses of Valsalva in both cine-MRI and echocardiography. Statistics included intraclass correlation coefficient, Pearson correlation coefficient, Bland-Altman analysis, and two-sided t-test. In 38 of the 51 individuals (74.5 %), the diagnosis of Marfan syndrome was established according to the criteria of the Ghent-2 nosology. Cine-MRI measurements of the sinuses of Valsalva revealed a strong correlation with echocardiography (r=0.929), but a statistically significant bias of -1.0 mm (p<0.001). The mean absolute diameter for sinuses of Valsalva obtained by cine-MRI was 32.3 ± 5.8 mm as compared to 33.4 ± 5.4 mm obtained by echocardiography. Interobserver agreement of measurements of the sinuses of Valsalva was higher for cine-MRI than for echocardiography (p=0.029). Despite small, but statistically significant differences in terms of agreement and reproducibility, cine-MRI and echocardiographic measurements of aortic root diameters provide comparable results without a significant clinical difference. Therefore both techniques may be used for monitoring of the aortic root in patients with Marfan syndrome.

Comparison of cine-MRI and transthoracic echocardiography for the assessment of aortic root diameters in patients with suspected Marfan syndrome

International Nuclear Information System (INIS)

Bannas, P.; Derlin, T.; Yamamura, J.; Lund, G.; Adam, G.; Rybczynski, M.; Sheikhzadeh, S.; Kodolitsch, Y. von; Groth, M.

2015-01-01

Patients with Marfan syndrome require repeated imaging for monitoring of aortic root aneurysms. Therefore, we evaluated the agreement and reproducibility of cine-MRI and echocardiography measurements of the sinuses of Valsalva in patients with suspected Marfan syndrome. 51 consecutive patients with suspected Marfan syndrome were prospectively examined using cine-MRI and echocardiography. Two readers independently measured aortic root diameters at the level of the sinuses of Valsalva in both cine-MRI and echocardiography. Statistics included intraclass correlation coefficient, Pearson correlation coefficient, Bland-Altman analysis, and two-sided t-test. In 38 of the 51 individuals (74.5 %), the diagnosis of Marfan syndrome was established according to the criteria of the Ghent-2 nosology. Cine-MRI measurements of the sinuses of Valsalva revealed a strong correlation with echocardiography (r=0.929), but a statistically significant bias of -1.0 mm (p<0.001). The mean absolute diameter for sinuses of Valsalva obtained by cine-MRI was 32.3 ± 5.8 mm as compared to 33.4 ± 5.4 mm obtained by echocardiography. Interobserver agreement of measurements of the sinuses of Valsalva was higher for cine-MRI than for echocardiography (p=0.029). Despite small, but statistically significant differences in terms of agreement and reproducibility, cine-MRI and echocardiographic measurements of aortic root diameters provide comparable results without a significant clinical difference. Therefore both techniques may be used for monitoring of the aortic root in patients with Marfan syndrome.

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

DEFF Research Database (Denmark)

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

2017-01-01

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

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

Directory of Open Access Journals (Sweden)

José Gregorio Pérez V.

2016-08-01

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

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

International Nuclear Information System (INIS)

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

1985-01-01

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

Observations of the symbiotic star AS 296

International Nuclear Information System (INIS)

Gutierrez-Moreno, A.; Moreno, H.

1990-01-01

Observations of the symbiotic star AS 296 are presented. The spectra, obtained during the quiescent phase, are typical of this kind of object. They show strong molecular bands and some forbidden emission lines, including faint forbidden Fe VII and Ca V lines. Measured intensities of the emission lines are given. Some of the physical parameters of the object are derived. Recently this object has been observed in outburst by Heathcote (1988); a copy of one such spectrum is presented with a brief qualitative description of its main features. 28 refs

Search for the forbidden decays η→3γ and η→π0γ and the rare decay η→π0π0γγ

International Nuclear Information System (INIS)

Nefkens, B.M.K.; Prakhov, S.; Clajus, M.; Marusic, A.; McDonald, S.; Phaisangittisakul, N.; Price, J.W.; Starostin, A.; Tippens, W.B.; Allgower, C.E.; Spinka, H.; Bekrenv, V.; Koulbardis, A.; Kozlenko, N.; Kruglov, S.; Lopatin, I.; Briscoe, W.J.; Shafi, A.; Comfort, J.R.; Craig, K.

2005-01-01

A new upper limit is presented for the branching ratio (BR) of η→3γ. This decay is not allowed by charge-conjugation invariance. We have determined that BR(η→3γ) -5 . We also obtained BR(η→π 0 γ→3γ) -5 ; this decay mode is absolutely forbidden, as it violates conservation of angular momentum. Finally, we have established that BR(η→π 0 π 0 γγ) -3 in a restricted diphoton-energy region. All three upper limits are at the 90% confidence level. They were obtained by using the Crystal Ball multiphoton spectrometer at the AGS and are based on the analysis of 28 million η mesons produced in the π - p→ηn reaction close to threshold

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

Science.gov (United States)

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

2017-01-01

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

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

LENUS (Irish Health Repository)

McEvoy, M M

2011-09-01

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

PMS2 involvement in patients suspected of Lynch syndrome.

Science.gov (United States)

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

2009-04-01

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

CT coronary angiographic evaluation of suspected anginal chest pain.

Science.gov (United States)

Moss, Alastair J; Newby, David E

2016-02-15

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

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

International Nuclear Information System (INIS)

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

2003-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2003-05-01

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

Creating fair lineups for suspects with distinctive features.

Science.gov (United States)

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

2009-12-01

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

A suspected case of rocuronium-sugammadex complex-induced anaphylactic shock after cesarean section.

Science.gov (United States)

Yamaoka, Masakazu; Deguchi, Miki; Ninomiya, Kiichiro; Kurasako, Toshiaki; Matsumoto, Mutsuko

2017-02-01

An anaphylactic reaction during a cesarean section occurs rarely, and rocuronium is thought to be one of the common agents causing perioperative anaphylaxis. Here we report an anaphylactic shock after cesarean section that is suggested to be induced by the rocuronium-sugammadex complex. A 36-year-old primigravida underwent an elective cesarean section under general anesthesia due to placenta previa. While the operation was completed uneventfully, she developed anaphylactic shock following sugammadex administration. She was successfully managed with rapid treatments. Serum tryptase level was significantly elevated. Although sugammadex was first suspected to be the causative agent, the result of intradermal skin tests with sugammadex were negative. Surprisingly, a subsequent intradermal test with undiluted rocuronium caused the patient to fall into a state of shock. Furthermore, a later skin-prick test with pre-mixed rocuronium-sugammadex complex also revealed a strong positive reaction, and a test with only rocuronium showed negative. We finally concluded that the rocuronium-sugammadex complex is the causative agent in this case. To the best of our knowledge, this is the first report suggesting anaphylaxis caused by the rocuronium-sugammadex complex. This case highlights the importance of appropriate examinations to determinate the pathogenesis of anaphylaxis in order to establish risk reduction strategies.

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-02-01

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

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

International Nuclear Information System (INIS)

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

2003-01-01

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

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

International Nuclear Information System (INIS)

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

2002-01-01

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

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

Science.gov (United States)

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

2017-01-01

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

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

International Nuclear Information System (INIS)

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

2018-01-01

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

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

Directory of Open Access Journals (Sweden)

Nerissa S. Bauer

2017-10-01

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

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

Science.gov (United States)

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

2009-01-01

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

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

International Nuclear Information System (INIS)

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

1998-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1996-03-01

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

Pre-school children with suspected autism spectrum disorders: do girls and boys have the same profiles?

Science.gov (United States)

Andersson, Gunilla Westman; Gillberg, Christopher; Miniscalco, Carmela

2013-01-01

The male to female ratio is raised in autism spectrum disorders (ASD). Previous studies have suggested that girls with ASD have more problems with communication than boys, but boys show more repetitive behaviours than girls. In this study, 20 girls, 1.8-3.9 years of age were matched for chronological and developmental age with 20 boys with suspected ASD. All the children were recruited after population screening and referral by Child Health Care Services to a specialised neuropsychiatry clinic, where they underwent comprehensive neuropsychiatric assessments. Comparisons were made with regard to diagnosis, developmental profiles and global disability. No significant gender differences were found. There were strong correlations between results obtained in different developmental areas. The results suggest that either (1) previous studies finding clear gender differences may have overrated discrepancies between girls and boys in ASD, or that (2) there may be girls, who will not be identified in the early years with our current screening instruments. More research with a much larger population representative study samples is required. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

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

2015-10-01

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

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

Science.gov (United States)

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

2017-07-01

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

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

Science.gov (United States)

Schützwohl, Achim; Morjaria, Sheena; Alvis, Shahin

2011-09-15

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

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

Directory of Open Access Journals (Sweden)

Takeo Fujiwara

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

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

Science.gov (United States)

Fujiwara, Takeo; Kawachi, Ichiro

2014-01-01

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

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

Science.gov (United States)

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

2009-01-27

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

Cost-effectiveness of routine imaging of suspected appendicitis.

Science.gov (United States)

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

2018-01-01

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

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

International Nuclear Information System (INIS)

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

2012-01-01

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

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

DEFF Research Database (Denmark)

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

2010-01-01

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

MRI diagnosis of suspected atlanto-occipital dissociation in childhood

International Nuclear Information System (INIS)

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

1999-01-01

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

Laser spectroscopy of the 5P3/2 → 6Pj (j = 1/2 and 3/2) electric dipole forbidden transitions in atomic rubidium

Science.gov (United States)

Ponciano-Ojeda, F.; Hernández-Gómez, S.; Mojica-Casique, C.; Hoyos, L. M.; Flores-Mijangos, J.; Ramírez-Martínez, F.; Sahagún, D.; Jáuregui, R.; Jiménez-Mier, J.

2018-04-01

Doppler-free optical double-resonance spectroscopy is used to study the 5S1/2 → 5P3/2 → 6Pj (j = 3/2,1/2) excitation sequence in room-temperature rubidium atoms. This involves a 5S1/2 → 5P3/2 electric dipole preparation step followed by the 5P3/2 → 6Pj electric quadrupole excitation. The electric dipole forbidden transitions occur at 911.0 nm (j = 3/2) and 917.5 nm (j = 1/2). Production of atoms in the 6Pj states is detected by observing their direct decay to the ground state through emission of blue photons (λ ≈ 420 nm). A detailed experimental and theoretical study of the dependence on the relative linear polarizations of excitation beams is made. It is shown that specific electric quadrupole selection rules over magnetic quantum numbers are directly related to the relative orientation of the linear polarization of the excitation beams.

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

Science.gov (United States)

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

2015-01-01

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

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

International Nuclear Information System (INIS)

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

2001-01-01

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

Investigation of suspected TRALI cases in 2006–2011

Directory of Open Access Journals (Sweden)

Marjeta Maček Kvanka

2012-12-01

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

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

Science.gov (United States)

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

2010-01-01

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

Presentation of suspected pediatric uveitis.

Science.gov (United States)

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

2014-01-01

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

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

International Nuclear Information System (INIS)

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

2002-01-01

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

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

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A Araghi – Sooreh

2012-05-01

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

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

Directory of Open Access Journals (Sweden)

Abbas Ali Eskandarian

2014-01-01

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

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

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Jung Jin Lee

2014-01-01

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

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

NARCIS (Netherlands)

van Prooijen, J.W.

2006-01-01

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

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

DEFF Research Database (Denmark)

Matzen, P; Malchow-Møller, A; Brun, B

1983-01-01

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

Black blood MRI in suspected large artery primary angiitis of the central nervous system.

Science.gov (United States)

Pfefferkorn, Thomas; Linn, Jennifer; Habs, Maximilian; Opherk, Christina; Cyran, Clemens; Ottomeyer, Caroline; Straube, Andreas; Dichgans, Martin; Nikolaou, Konstantin; Saam, Tobias

2013-07-01

Single case reports suggest that black blood MRI (T1-weighted fat and blood suppressed sequences with and without contrast injection; BB-MRI) may visualize intracranial vessel wall contrast enhancement (CE) in primary angiitis of the central nervous system (PACNS). In this single-center observational pilot study we prospectively investigated the value of BB-MRI in the diagnosis of large artery PACNS. Patients with suspected large artery PACNS received a standardized diagnostic program including BB-MRI. Vessel wall CE was graded (grade 0-2) by two experienced readers blinded to clinical data and correlated to the final diagnosis. Four of 12 included patients received a final diagnosis of PACNS. All of them showed moderate (grade 1) to strong (grade 2) vessel wall CE at the sites of stenosis. A moderate (grade 1) vessel wall CE grade was also observed in 6 of the remaining 8 patients in whom alternative diagnoses were made: arteriosclerotic disease (n = 4), intracranial dissection (n = 1), and Moyamoya disease (n = 1). Our pilot study demonstrates that vessel wall CE is a frequent finding in PACNS and its mimics. Larger trials will be necessary to evaluate the utility of BB-MRI in the diagnostic workup of PACNS. Copyright © 2012 by the American Society of Neuroimaging.

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-11-15

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

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

OpenAIRE

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

2017-01-01

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

The impact of ultrasound in suspected acute appendicitis

International Nuclear Information System (INIS)

Gracey, D.; McClure, M.J.

2007-01-01

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

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

International Nuclear Information System (INIS)

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

1990-01-01

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

Evaluation of 278 hla-b27 positive patients suspected of seronegative spondyloarthropathies

International Nuclear Information System (INIS)

Eman, S.J.; Badri, S.; Khosravi, A.

2007-01-01

To determine HLA-B27 prevalence in patients suspected of Seronegative spondyloarthropathy referred to the Transplantation Department of Blood Transfusion Organization, and to evaluate clinical findings among HLA-B27 positive patients. One thousand six hundred ten patients having clinical manifestation of seronegative SpAs were screened for HLA typing by serological methods from January 1997 to June 2002 at Transplantation Department of Blood Transfusion Organization, Ahwaz, Iran. Serologic-based HLA typing using Antigen-specific sera to determine a person's HLA type was performed. Among these patients, individuals found HLA-B27 positive were investigated regarding clinical findings, age, and sex distribution. In this study the frequency of HLA-B27 antigen was 17.26% (278 cases). The minimum age in males was 10 years and the maximum age in female was 70 years. Median age with seronegative SpAs findings (34.2% including 28.42% females, 71.57% males) was 20-30 years. Based on our results, the most frequent clinical manifestation, was peripheral joints arthritis (58.7%; 34.35% females, 65.65 % males). There were no association between any of the major clinical manifestations and age or sex distribution. These findings confirm the strong association of the HLA B27 allele with various types of spondyloarthritis and suggests that HLA typing would help in the diagnosis of seronagative SpAs, specially ankylosing spondylitis with indeterminate clinical presentation and also in identifying at risk family members. (author)

Early diagnosis of dengue virus infection in clinically suspected cases

International Nuclear Information System (INIS)

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

2016-01-01

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

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

International Nuclear Information System (INIS)

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

2013-01-01

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

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

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Yupin Suputtamongkol

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

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

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

2016-11-01

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

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

NARCIS (Netherlands)

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

2004-01-01

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

A Suspected Pelvic Aneurysmal Bone Cyst in Pregnancy

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Rayan Elkattah

2013-01-01

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

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

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Skarphedinsson Sigurdur

2010-11-01

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

Evaluation of basophil activation test in suspected food hypersensitivity.

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

2017-07-01

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

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

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

2011-07-01

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

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

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Achim Schützwohl

2011-07-01

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

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

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

2017-01-01

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

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

DEFF Research Database (Denmark)

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

2002-01-01

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

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

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

2013-07-01

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

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

OpenAIRE

Iqbal, Asif; Badoo, Shoaib; Naqeeb, Ruqsana

2017-01-01

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

Spin-orbit coupling and transport in strongly correlated two-dimensional systems

Science.gov (United States)

Huang, Jian; Pfeiffer, L. N.; West, K. W.

2017-05-01

Measuring the magnetoresistance (MR) of ultraclean GaAs two-dimensional holes for a large rs range of 20-50, two striking behaviors in relation to the spin-orbit coupling (SOC) emerge in response to strong electron-electron interaction. First, in exact correspondence to the zero-field metal-to-insulator transition (MIT), the sign of the MR switches from being positive in the metallic regime to being negative in the insulating regime when the carrier density crosses the critical density pc of MIT (rs˜39 ). Second, as the SOC-driven correction Δ ρ to the MR decreases with reducing carrier density (or the in-plane wave vector), it exhibits an upturn in the close proximity just above pc where rs is beyond 30, indicating a substantially enhanced SOC effect. This peculiar behavior echoes with a trend of delocalization long suspected for the SOC-interaction interplay. Meanwhile, for p 40 , in contrast to the common belief that a magnet field enhances Wigner crystallization, the negative MR is likely linked to enhanced interaction.

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

OpenAIRE

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

2014-01-01

IMPORTANCE Creutzfeldt-Jakob disease (CJD) and autoimmune encephalitis with antibodies against neuronal surface antigens (NSA-abs) may present with similar clinical features. Establishing the correct diagnosis has practical implications in the management of care for these patients. OBJECTIVE To determine the frequency of NSA-abs in the cerebrospinal fluid of patients with suspected CJD and in patients with pathologically confirmed (ie, definite) CJD. DESIGN, SETTING, AND PARTICIPANTS A mixed ...

Sex disparities in tuberculosis suspect evaluation: a cross-sectional analysis in rural Uganda.

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Miller, C R; Davis, J L; Katamba, A; Sserwanga, A; Kakeeto, S; Kizito, F; Cattamanchi, A

2013-04-01

Six primary health care centers in rural Uganda. To compare the quality of tuberculosis (TB) evaluation for men and women presenting to primary health care facilities in high-burden settings. Cross-sectional study using indicators derived from the International Standards of Tuberculosis Care (ISTC) to compare the quality of TB evaluation services provided to men and women. Of 161 230 patient visits between January 2009 and December 2010, 112 329 (69.7%) were women. We considered 3308 (2.1%) patients with cough ≥2 weeks as TB suspects, of whom 1871 (56.6%) were women. Female TB suspects were less likely to be referred for sputum smear examination (45.9% vs. 61.6%, P ISTC (33.0% vs. 45.6%, P ISTC-recommended care (RR 0.79, 95%CI 0.72-0.86, P < 0.001). Strategies to ensure that women receive appropriate TB evaluation could provide a valuable opportunity for increasing case detection while also promoting equitable and universal access to care.

Abdominal CT Does Not Improve Outcome for Children with Suspected Acute Appendicitis

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Danielle I. Miano

2015-12-01

Full Text Available Introduction: Acute appendicitis in children is a clinical diagnosis, which often requires preoperative confirmation with either ultrasound (US or computed tomography (CT studies. CTs expose children to radiation, which may increase the lifetime risk of developing malignancy. US in the pediatric population with appropriate clinical follow up and serial exam may be an effective diagnostic modality for many children without incurring the risk of radiation. The objective of the study was to compare the rate of appendiceal rupture and negative appendectomies between children with and without abdominal CTs; and to evaluate the same outcomes for children with and without USs to determine if there were any associations between imaging modalities and outcomes. Methods: We conducted a retrospective chart review including emergency department (ED and inpatient records from 1/1/2009–2/31/2010 and included patients with suspected acute appendicitis. Results: 1,493 children, aged less than one year to 20 years, were identified in the ED with suspected appendicitis. These patients presented with abdominal pain who had either a surgical consult or an abdominal imaging study to evaluate for appendicitis, or were transferred from an outside hospital or primary care physician office with the stated suspicion of acute appendicitis. Of these patients, 739 were sent home following evaluation in the ED and did not return within the subsequent two weeks and were therefore presumed not to have appendicitis. A total of 754 were admitted and form the study population, of which 20% received a CT, 53% US, and 8% received both. Of these 57%, 95% CI [53.5,60.5] had pathology-proven appendicitis. Appendicitis rates were similar for children with a CT (57%, 95% CI [49.6,64.4] compared to those without (57%, 95% CI [52.9,61.0]. Children with perforation were similar between those with a CT (18%, 95% CI [12.3,23.7] and those without (13%, 95% CI [10.3,15.7]. The proportion of

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

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

2017-08-01

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

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

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Sylvia Marie Biso

2017-01-01

Full Text Available Background. Acute coronary syndrome (ACS can complicate acute ischemic stroke, causing significant morbidity and mortality. To date, literatures that describe poststroke acute coronary syndrome and its morbidity and mortality burden are lacking. Methods. This is a single center, retrospective study where clinical characteristics, cardiac evaluation, and management of patients with suspected poststroke ACS were compared and analyzed for their association with inpatient mortality and 1-year all-cause mortality. Results. Of the 82 patients, 32% had chest pain and 88% had ischemic ECG changes; mean peak troponin level was 18, and mean ejection fraction was 40%. The medical management group had older individuals (73 versus 67 years, p<0.05, lower mean peak troponin levels (12 versus 49, p<0.05, and lower mean length of stay (12 versus 25 days, p<0.05 compared to those who underwent stent or CABG. Troponin levels were significantly associated with 1-year all-cause mortality. Conclusion. Age and troponin level appear to play a role in the current clinical decision making for patient with suspected poststroke ACS. Troponin level appears to significantly correlate with 1-year all-cause mortality. In the management of poststroke acute coronary syndrome, optimal medical therapy had similar inpatient and all-cause mortality compared to PCI and/or CABG.

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

Science.gov (United States)

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

2017-01-01

Background Acute coronary syndrome (ACS) can complicate acute ischemic stroke, causing significant morbidity and mortality. To date, literatures that describe poststroke acute coronary syndrome and its morbidity and mortality burden are lacking. Methods This is a single center, retrospective study where clinical characteristics, cardiac evaluation, and management of patients with suspected poststroke ACS were compared and analyzed for their association with inpatient mortality and 1-year all-cause mortality. Results Of the 82 patients, 32% had chest pain and 88% had ischemic ECG changes; mean peak troponin level was 18, and mean ejection fraction was 40%. The medical management group had older individuals (73 versus 67 years, p < 0.05), lower mean peak troponin levels (12 versus 49, p < 0.05), and lower mean length of stay (12 versus 25 days, p < 0.05) compared to those who underwent stent or CABG. Troponin levels were significantly associated with 1-year all-cause mortality. Conclusion Age and troponin level appear to play a role in the current clinical decision making for patient with suspected poststroke ACS. Troponin level appears to significantly correlate with 1-year all-cause mortality. In the management of poststroke acute coronary syndrome, optimal medical therapy had similar inpatient and all-cause mortality compared to PCI and/or CABG. PMID:29130017

Quality of CT pulmonary angiography for suspected pulmonary embolus in pregnancy

International Nuclear Information System (INIS)

U-King-Im, Jean Marie; Freeman, Susan J.; Boylan, Teresa; Cheow, Heok K.

2008-01-01

The main objective of this study was to assess the quality of CT pulmonary angiography (CTPA) for suspected pulmonary embolus (PE) in the pregnant population. We retrospectively identified 40 consecutive pregnant patients who underwent CTPA from January 2005 to December 2006. Forty consecutive age-matched non-pregnant women were used as a control group. Studies were subjectively graded according to overall image quality by two readers in consensus, in randomised and blinded manner. Moreover, contrast enhancement of pulmonary arteries was subjectively and objectively evaluated. The proportion of sub-optimal studies was more than three times higher in the pregnant group (27.5%, n = 11) compared with the non-pregnant group (7.5%, n = 3; p = 0.015). Mean contrast enhancement was consistently higher in the non-pregnant group compared with pregnant group, both subjectively and objectively. The percentage of inadequately opacified vascular segments was more than two times higher in the pregnant group (28.7%, n = 264) than in the non-pregnant group (13.3%, n 122; p = 0.0001). The incidence of sub-optimal CTPA studies is higher in pregnancy when compared with an age-matched non-pregnant control group. In addition to radiation issues, this should also be considered when implementing diagnostic strategies for suspected PE in pregnancy. (orig.)

Influence on intraocular pressure of the postural change and daily activities in the early morning in suspected glaucoma patients

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Ting Chen

2014-05-01

Full Text Available AIM:To evaluate the influence on intraocular pressure(IOPof the postural change and daily activities in the early morning in suspected glaucoma patients.METHODS:The supine and sitting IOP were measured and analyzed on 51 suspected glaucoma patients(100 eyeswith Icare rebound tonometer before and after getting up and daily activities in the early morning. RESULTS: The mean of sitting IOP of 51 patients was 17.12±4.53mmHg, which was significantly lower than the mean of supine IOP(19.14±5.51mmHg. The mean of IOP before and after daily activity of 51 patients were 17.12±4.53mmHg and 14.44±3.90mmHg respectively, which showed significantly difference. CONCLUSION:Postural change and daily activities can result in significant changes of IOP in suspected glaucoma patients.

Efficacy of Patient Selection for Diagnostic Coronary Angiography in Suspected Coronary Artery Disease

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Francisco Flávio Costa Filho

2015-11-01

Full Text Available AbstractBackground:Guidelines recommend that in suspected stable coronary artery disease (CAD, a clinical (non-invasive evaluation should be performed before coronary angiography.Objective:We assessed the efficacy of patient selection for coronary angiography in suspected stable CAD.Methods:We prospectively selected consecutive patients without known CAD, referred to a high-volume tertiary center. Demographic characteristics, risk factors, symptoms and non-invasive test results were correlated to the presence of obstructive CAD. We estimated the CAD probability based on available clinical data and the incremental diagnostic value of previous non-invasive tests.Results:A total of 830 patients were included; median age was 61 years, 49.3% were males, 81% had hypertension and 35.5% were diabetics. Non-invasive tests were performed in 64.8% of the patients. At coronary angiography, 23.8% of the patients had obstructive CAD. The independent predictors for obstructive CAD were: male gender (odds ratio [OR], 3.95; confidence interval [CI] 95%, 2.70 - 5.77, age (OR for 5 years increment, 1.15; CI 95%, 1.06 - 1.26, diabetes (OR, 2.01; CI 95%, 1.40 - 2.90, dyslipidemia (OR, 2.02; CI 95%, 1.32 - 3.07, typical angina (OR, 2.92; CI 95%, 1.77 - 4.83 and previous non-invasive test (OR 1.54; CI 95% 1.05 - 2.27.Conclusions:In this study, less than a quarter of the patients referred for coronary angiography with suspected CAD had the diagnosis confirmed. A better clinical and non-invasive assessment is necessary, to improve the efficacy of patient selection for coronary angiography.

Suspected nitrite poisoning in pigs caused by Capsella bursa-pastoris (L. Medik. ('herderstassie', shepherd's purse : case report

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W.J. Wiese

2001-07-01

Full Text Available Nitrite poisoning in pigs was suspected when 4 of 18 pigs died in a piggery near Ellisras in the Northern Province. The pigs showed typical brownish discolouration of the blood at autopsy. It was established that they ingested vegetable tops and weeds from the adjacent garden as part of their daily ration. Of the available plants, only Capsella bursa-pastoris contained nitrites. The drinking water and some of the other plants tested positive for nitrates but not for nitrites. This is the first report of suspected nitrite poisoning in pigs caused by Capsella bursa-pastoris.

Clinical value of FDG-PET/CT in suspected paraneoplastic syndromes: a retrospective analysis of 137 patients

Energy Technology Data Exchange (ETDEWEB)

Bjoern Kristensen, Stine; Hess, Soeren; Petersen, Henrik; Hoeilund-Carlsen, Poul Flemming [Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark)

2015-12-15

Paraneoplastic syndromes (PNS) are relatively infrequent manifestations appearing before or after a cancer declares itself. Autoimmune mechanisms may be involved, but their cause and pathogenesis are often unknown. Due to disparity of symptoms, PNS remain a major diagnostic challenge. We examined the value of FDG-PET/CT for ruling in or out malignancy in a heterogeneous group of patients with suspected PNS. We retrospectively extracted data from all patients referred 2009-2013 with suspected PNS. Data included age, sex, follow-up period, scan report, further diagnostic procedures, and final clinical diagnosis. Conclusions of the scan reports were compared to the final follow-up outcome as determined during an average follow-up of 31 months (range 6-51.5) in patients who were not diagnosed with cancer in immediate continuation of a positive PET/CT scan. A total of 137 patients were included. Main causes for referral were neurological (n = 67), rheumatological (n = 25), dermatological (n = 18), nephrological (n = 6), haematological (n = 2), abnormal biochemistry (n = 11), and others (n = 8). The cancer prevalence was 8.8 %. The FDG-PET/CT results were as follows: nine true positives, 22 false positives, 103 true negatives, and three false negatives. Corresponding diagnostic values were: sensitivity 75 %, specificity 82 %, accuracy 82 %, and positive and negative predictive values of 29 % and 97 %, respectively. FDG-PET/CT has in patients with suspected PNS an impressively high negative predictive value and may be of value in ruling out PNS, the more so, the more the number of false positives can be minimized or used in differential diagnosis. We believe that FDG-PET/CT may become an important adjunct to the work-up and triage of patients with suspected PNS. (orig.)

A method based on temporal concept analysis for detecting and profiling human trafficking suspects

NARCIS (Netherlands)

Poelmans, J.; Elzinga, P.; Viaene, S.; Dedene, G.; Hamza, M.H.

2010-01-01

Human trafficking and forced prostitution are a serious problem for the Amsterdam-Amstelland police (the Netherlands). In this paper, we present a method based on Temporal Concept Analysis for detecting and profiling human trafficking suspects. Using traditional Formal Concept Analysis, we first

Cortical capillary dysfunction in patients suspected of Alzheimer’s disease

DEFF Research Database (Denmark)

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

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

Magnetic resonance imaging in the evaluation of suspected osteonecrosis of the knee

Energy Technology Data Exchange (ETDEWEB)

Pollack, M S; Dalinka, M K; Kressel, H Y; Spritzer, C E; Lotke, P A

1987-02-01

Magnetic resonance imaging (MRI) was performed on 19 patients with suspected or proven osteonecrosis of the knee. The results were compared to radionuclide and plain radiographic studies when possible. The patients were grouped into one of three categories: patients with disease predisposing them to osteonecrosis (e.g. systemic lupus erythematosus (SLE), steroid use, and renal transplants), older patients without risk factors with acute onset of symptoms, and patients with knee pain months or years following trauma. In six patients with symptoms and predisposing diseases, MRI was abnormal in four cases, all of whom had bilateral abnormalities. In the ten older patients with classical symptoms, MRI was abnormal in seven, and bilateral abnormalities were present in three patients. The three patients with a history of antecedent trauma had normal MRI studies. Two patients with history and scintigraphic evidence of osteonecrosis had negative MRI scans. MRI may be of value in patients with suspected or proven osteonecrosis of the knee by demonstrating bilateral disease in patients with unilateral symptoms, showing the extent of involvement, and establishing the presence or absence of bone marrow changes in patients with positive bone scans and negative plain films.

A systematic and detailed investigation of radiative rates for forbidden transitions of astrophysical interest in doubly ionized iron peak elements

Science.gov (United States)

Quinet, Pascal; Fivet, Vanessa; Bautista, Manuel

2015-08-01

The knowledge of accurate and reliable atomic data for lowly ionized iron peak elements, from scandium to copper, is of paramount importance for the analysis of the high resolution spectra currently available. The third spectra of several iron group elements have been observed in different galactic sources like Herbig-Haro objects in the Orion Nebula [1] and stars like Eta Carinae [2]. However, forbidden transitions between low-lying metastable levels of doubly ionized species have been little investigated so far and radiative rates for those lines remain sparse or inexistent.In the present contribution, we report on the recent study we have performed concerning the determination of magnetic dipole (M1) and electric quadrupole (E2) transition probabilities in those ions. For the calculations, we have extensively used the pseudo-relativistic Hartree-Fock (HFR) code of Cowan [3] and the central Thomas-Fermi-Dirac potential approximation implemented in AUTOSTRUCTURE [4]. This multi-platform approach allowed us to check the consistency and to assess the accuracy of the results obtained.[1] Mesa-Delgado A. et al., MNRAS 395, 855 (2009)[2] Johansson S. et al., A&A 361, 977 (2000)[3] Cowan R.D., The Theory of Atomic Structure and Spectra, Univ. California Press, Berkeley (1981)[4] Badnell N.R., J. Phys. B: At. Mol. Opt. Phys. 30, 1 (1997)

Coronary 64-slice CT angiography predicts outcome in patients with known or suspected coronary artery disease

Energy Technology Data Exchange (ETDEWEB)

Gaemperli, Oliver; Valenta, Ines; Schepis, Tiziano [University Hospital Zurich NUK C 32, Cardiovascular Center, Zurich (Switzerland); Husmann, Lars; Scheffel, Hans; Desbiolles, Lotus; Leschka, Sebastian; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich NUK C 32, Cardiovascular Center, Zurich (Switzerland); University of Zurich, Zurich Center for Integrative Human Physiology (ZIHP), Zurich (Switzerland)

2008-06-15

The aim of this study was to assess the prognostic value of 64-slice CT angiography (CTA) in patients with known or suspected coronary artery disease (CAD). Sixty-four-slice coronary CTA was performed in 220 patients [mean age 63 {+-} 11 years, 77 (35%) female] with known or suspected CAD. CTA images were analyzed with regard to the presence and number of coronary lesions. Patients were followed-up for the occurrence of the following clinical endpoints: death, nonfatal myocardial infarction, unstable angina, and coronary revascularization. During a mean follow-up of 14 {+-} 4 months, 59 patients (27%) reached at least one of the predefined clinical endpoints. Patients with abnormal coronary arteries on CTA (i.e., presence of coronary plaques) had a 1st-year event rate of 34%, whereas in patients with normal coronary arteries no events occurred (event rate, 0%, p < 0.001). Similarly, obstructive lesions ({>=}50% luminal narrowing) on CTA were associated with a high first-year event rate (59%) compared to patients without stenoses (3%, p < 0.001). The presence of obstructive lesions was a significant independent predictor of an adverse cardiac outcome. Sixty-four-slice CTA predicts cardiac events in patients with known or suspected CAD. Conversely, patients with normal coronary arteries on CTA have an excellent mid-term prognosis. (orig.)

[¹⁸F]Fluorodeoxyglucose (FDG)-Positron Emission Tomography (PET)/Computed Tomography (CT) in Suspected Recurrent Breast Cancer

DEFF Research Database (Denmark)

Hildebrandt, Malene Grubbe; Gerke, Oke; Baun, Christina

2016-01-01

PURPOSE: To prospectively investigate the diagnostic accuracy of [(18)F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) with dual-time-point imaging, contrast-enhanced CT (ceCT), and bone scintigraphy (BS) in patients with suspected breast cancer recurrence....... PATIENTS AND METHODS: One hundred women with suspected recurrence of breast cancer underwent 1-hour and 3-hour FDG-PET/CT, ceCT, and BS within approximately 10 days. The study was powered to estimate the precision of the individual imaging tests. Images were visually interpreted using a four...

Pre-admission antibiotics for suspected cases of meningococcal disease.

Science.gov (United States)

Sudarsanam, Thambu D; Rupali, Priscilla; Tharyan, Prathap; Abraham, Ooriapadickal Cherian; Thomas, Kurien

2017-06-14

Meningococcal disease can lead to death or disability within hours after onset. Pre-admission antibiotics aim to reduce the risk of serious disease and death by preventing delays in starting therapy before confirmation of the diagnosis. To study the effectiveness and safety of pre-admission antibiotics versus no pre-admission antibiotics or placebo, and different pre-admission antibiotic regimens in decreasing mortality, clinical failure, and morbidity in people suspected of meningococcal disease. We searched CENTRAL (6 January 2017), MEDLINE (1966 to 6 January 2017), Embase (1980 to 6 January 2017), Web of Science (1985 to 6 January 2017), LILACS (1982 to 6 January 2017), and prospective trial registries to January 2017. We previously searched CAB Abstracts from 1985 to June 2015, but did not update this search in January 2017. Randomised controlled trials (RCTs) or quasi-RCTs comparing antibiotics versus placebo or no intervention, in people with suspected meningococcal infection, or different antibiotics administered before admission to hospital or confirmation of the diagnosis. Two review authors independently assessed trial quality and extracted data from the search results. We calculated the risk ratio (RR) and 95% confidence interval (CI) for dichotomous data. We included only one trial and so did not perform data synthesis. We assessed the overall quality of the evidence using the GRADE approach. We found no RCTs comparing pre-admission antibiotics versus no pre-admission antibiotics or placebo. We included one open-label, non-inferiority RCT with 510 participants, conducted during an epidemic in Niger, evaluating a single dose of intramuscular ceftriaxone versus a single dose of intramuscular long-acting (oily) chloramphenicol. Ceftriaxone was not inferior to chloramphenicol in reducing mortality (RR 1.21, 95% CI 0.57 to 2.56; N = 503; 308 confirmed meningococcal meningitis; 26 deaths; moderate-quality evidence), clinical failures (RR 0.83, 95% CI 0.32 to

<strong>Mini-project>

DEFF Research Database (Denmark)

Katajainen, Jyrki

2008-01-01

In this project the goal is to develop the safe * family of containers for the CPH STL. The containers to be developed should be safer and more reliable than any of the existing implementations. A special focus should be put on strong exception safety since none of the existing prototypes available...

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

Directory of Open Access Journals (Sweden)

Hellen Martins da Silveira

2017-11-01

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

Diagnosis of suspected venous thromboembolic disease in pregnancy

International Nuclear Information System (INIS)

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

2006-01-01

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

Control of Suspect/Counterfeit and Defective Items

Energy Technology Data Exchange (ETDEWEB)

Sheriff, Marnelle L.

2013-09-03

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

Evidence for strong Holocene earthquake(s) in the Wabash Valley seismic zone

International Nuclear Information System (INIS)

Obermeier, S.

1991-01-01

Many small and slightly damaging earthquakes have taken place in the region of the lower Wabash River Valley of Indiana and Illinois during the 200 years of historic record. Seismologists have long suspected the Wabash Valley seismic zone to be capable of producing earthquakes much stronger than the largest of record (m b 5.8). The seismic zone contains the poorly defined Wabash Valley fault zone and also appears to contain other vaguely defined faults at depths from which the strongest earthquakes presently originate. Faults near the surface are generally covered with thick alluvium in lowlands and a veneer of loess in uplands, which make direct observations of faults difficult. Partly because of this difficulty, a search for paleoliquefaction features was begun in 1990. Conclusions of the study are as follows: (1) an earthquake much stronger than any historic earthquake struck the lower Wabash Valley between 1,500 and 7,500 years ago; (2) the epicentral region of the prehistoric strong earthquake was the Wabash Valley seismic zone; (3) apparent sites have been located where 1811-12 earthquake accelerations can be bracketed

Pramana – Journal of Physics | Indian Academy of Sciences

Indian Academy of Sciences (India)

2015-05-06

May 6, 2015 ... The heavy-ion collision provides a unique many-body environment where local domains of strongly interacting chiral medium may occur and in a sense allow environmental symmetry 'violation' phenomena. For example, certain anomalous transport processes, forbidden in usual medium, become possible ...

Reliability of Examination Findings in Suspected Community-Acquired Pneumonia.

Science.gov (United States)

Florin, Todd A; Ambroggio, Lilliam; Brokamp, Cole; Rattan, Mantosh S; Crotty, Eric J; Kachelmeyer, Andrea; Ruddy, Richard M; Shah, Samir S

2017-09-01

The authors of national guidelines emphasize the use of history and examination findings to diagnose community-acquired pneumonia (CAP) in outpatient children. Little is known about the interrater reliability of the physical examination in children with suspected CAP. This was a prospective cohort study of children with suspected CAP presenting to a pediatric emergency department from July 2013 to May 2016. Children aged 3 months to 18 years with lower respiratory signs or symptoms who received a chest radiograph were included. We excluded children hospitalized ≤14 days before the study visit and those with a chronic medical condition or aspiration. Two clinicians performed independent examinations and completed identical forms reporting examination findings. Interrater reliability for each finding was reported by using Fleiss' kappa (κ) for categorical variables and intraclass correlation coefficient (ICC) for continuous variables. No examination finding had substantial agreement (κ/ICC > 0.8). Two findings (retractions, wheezing) had moderate to substantial agreement (κ/ICC = 0.6-0.8). Nine findings (abdominal pain, pleuritic pain, nasal flaring, skin color, overall impression, cool extremities, tachypnea, respiratory rate, and crackles/rales) had fair to moderate agreement (κ/ICC = 0.4-0.6). Eight findings (capillary refill time, cough, rhonchi, head bobbing, behavior, grunting, general appearance, and decreased breath sounds) had poor to fair reliability (κ/ICC = 0-0.4). Only 3 examination findings had acceptable agreement, with the lower 95% confidence limit >0.4: wheezing, retractions, and respiratory rate. In this study, we found fair to moderate reliability of many findings used to diagnose CAP. Only 3 findings had acceptable levels of reliability. These findings must be considered in the clinical management and research of pediatric CAP. Copyright © 2017 by the American Academy of Pediatrics.

SUSPECTED HYPERVITAMINOSIS D IN RED-RUMPED AGOUTI ( DASYPROCTA LEPORINA) RECEIVING A COMMERCIAL RODENT DIET.

Science.gov (United States)

Anderson, Kadie M; Lewandowski, Albert; Dennis, Patricia M

2018-03-01

An 8 yr, intact male red-rumped agouti ( Dasyprocta leporina) was evaluated for weight loss. Examination revealed poor body condition, hypercalcemia, elevated serum 25-hydroxyvitamin D, metastatic calcification of soft tissues, and hyperechoic kidneys. The diet, formulated for laboratory rodents, contained elevated levels of vitamin D 3 . Histopathology from a female conspecific that died 5 mo prior identified dystrophic mineralization and nephrosclerosis, suggestive of a vitamin D 3 toxicity. The male agouti responded well to a dietary reduction in vitamin D 3 and calcium. Six months into therapy, progressive renal failure was identified and was further managed with enalapril, phosphorus binders, and dietary manipulation. Suspected vitamin D 3 toxicity has been reported in pacas ( Cuniculus paca) and agouti and has been linked to exposure to New World primate diets. In this brief communication, an agouti developed suspected hypervitaminosis D after receiving a commercial rodent diet commonly fed to this species in captivity.

GC-MS quantification of suspected volatile allergens in fragrances. 2. Data treatment strategies and method performances.

Science.gov (United States)

Bassereau, Maud; Chaintreau, Alain; Duperrex, Stéphanie; Joulain, Daniel; Leijs, Hans; Loesing, Gerd; Owen, Neil; Sherlock, Alan; Schippa, Christine; Thorel, Pierre-Jean; Vey, Matthias

2007-01-10

The performances of the GC-MS determination of suspected allergens in fragrance concentrates have been investigated. The limit of quantification was experimentally determined (10 mg/L), and the variability was investigated for three different data treatment strategies: (1) two columns and three quantification ions; (2) two columns and one quantification ion; and (3) one column and three quantification ions. The first strategy best minimizes the risk of determination bias due to coelutions. This risk was evaluated by calculating the probability of coeluting a suspected allergen with perfume constituents exhibiting ions in common. For hydroxycitronellal, when using a two-column strategy, this may statistically occur more than once every 36 analyses for one ion or once every 144 analyses for three ions in common.

Overview of suspected adverse reactions to veterinary medicinal products reported in South Africa (March 2001 - February 2002 : report

Directory of Open Access Journals (Sweden)

V. Naidoo

2002-07-01

Full Text Available An overview of reports of suspected adverse drug reactions received by the Veterinary Pharmacovigilance and Medicines Information Centre during the period March 2001 to February 2002 is given. A total of 77 reports were received. The majority of reports involved suspected adverse reactions that occurred in dogs and cats. Most products implicated in the reports were Stock Remedies. The products were predominantly administered either by veterinarians or trained paraveterinary professionals. Although the majority of reports were received from veterinary pharmaceutical companies, the proportion of reports received directly from veterinarians increased compared with previous years.

131I-MIBG Scintigraphy in the Evaluation of Suspected Pheochromocytoma

International Nuclear Information System (INIS)

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

1992-01-01

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

Cytogenetic dosimetry in suspected cases of ionizing radiation occupational exposure

International Nuclear Information System (INIS)

Ramalho, Adriana T.; Costa, Maria Lucia P.; Oliveira, Monica S.; Silva, Francisco Cesar A. da

2001-01-01

Cytogenetic dosimetry is very useful in routine as well as in serious accident situations in which exposed individuals do not wear physical dosimeters. Since 1984, the technique of cytogenetic dosimetry has been used as a routine in our laboratory at IRD/CNEN to complement the data of physical dosimetry. In the period from 1984 to 2000, 138 cases of occupational overexposure of individual dosimeters were investigated by us. In total, only in 36 of the 138 cases investigated the overexposure was confirmed by cytogenetic dosimetry. The data indicates a total confirmation index of just 26% of the suspected cases.(author)

Suspected resistance of MDT-MB in Multibacillary Leprosy of Hansen's disease: Two case reports

Directory of Open Access Journals (Sweden)

Yudo Irawan

2016-12-01

Full Text Available Resistance to multidrug therapy (MDT is one of the complications in the treatment of Hansen’s disease/Morbus Hansen (MH. There are two types of resistancy, which are primary and secondary. MDT-multibacillary (MB resistance must be suspected when no clinical improvement and the acid-fast bacilli (AFB index is not reduced after 12 months of therapy. A 28-year-old woman with paresthesia on her face, arms and legs since 2.5 years ago, accompanied by thickening of the right posterior tibial nerve. The AFB examination showed a bacteriological index (BI of 15/6 and morphological index (MI of 0.50%. The second case, a 42-year-old man came with paresthetic lesions on his face, chest, back, both arms and legs since 2 years ago, accompanied by thickening of ulnar and lateral peroneal nerve. The BI was 12/5 and the MI was 0.40%. Both patients were diagnosed with borderline lepromatous type of MH and received MDT-MB for 12 months. Diagnosis of suspected resistance was established because no clinical improvement or any significant decrease of AFB index after completing the MDT treatment. The patients had secondary resistance after polymerase chain reaction evaluation showed that they were still rifampicin-sensitive. There was clinical improvement and significant decrease in FAB index after the patients continued the MDT-MB treatment with 600 mg additional rifampicin. The diagnosis of bacterial resistance should be made based on clinical evaluation before completion of treatment. Based on the two case reports, the resistance suspected may be secondary. Treatment using additional regimen can be initiated once the resistance has been proven.

V/P SPECT as a diagnostic tool for pregnant women with suspected pulmonary embolism

Energy Technology Data Exchange (ETDEWEB)

Bajc, Marika; Olsson, Berit; Joegi, Jonas [Skaane University Hospital and Lund University, Clinical Physiology and Nuclear Medicine, Lund (Sweden); Gottsaeter, Anders [Skaane University Hospital, Vascular Diseases, Malmoe (Sweden); Hindorf, Cecilia [Skaane University Hospital, Radiation Physics, Lund (Sweden)

2015-07-15

The purpose of the study was to assess the prevalence of pulmonary embolism (PE) and other lung diseases among pregnant women with suspected PE and to calculate the radiation exposure to patient and fetus in this population. As a secondary aim, we evaluated the negative predictive value of a normal ventilation/perfusion single photon emission computed tomography (V/P SPECT) examination in pregnancy. We studied all 127 pregnant women who had suspected PE and had undergone V/P SPECT at our institution in the course of a 5-year period. Radiation exposure to patient and fetus and the negative predictive value of a normal V/P SPECT examination were also measured. V/P SPECT identified PE in 11 women (9 %). Moreover, in 15 women (12 %) the examination revealed pneumonia (in 2 cases in addition to PE) and in 1 woman signs of airway obstruction were revealed. Among the 116/127 women (91 %) where PE was ruled out by V/P SPECT, none was diagnosed subsequently with PE or deep venous thrombosis (DVT) during the same pregnancy or puerperal period. For P SPECT, the calculated fetal absorbed dose was < 0.6 mGy,and the calculated breast absorbed dose 0.6 mGy. For V SPECT, the calculated fetal absorbed dose was < 0.014 mGy and the breast absorbed dose 0.25 mGy. The prevalence of PE was low (9 %) among pregnant women with suspected disease. Pneumonia was diagnosed in 12 % of patients. The negative predictive value of V/P SPECT was high, and the radiation exposure from V/P SPECT was low both for fetus and patient. (orig.)

Patch testing in Israeli children with suspected allergic contact dermatitis: A retrospective study and literature review.

Science.gov (United States)

Zafrir, Yaron; Trattner, Akiva; Hodak, Emmillia; Eldar, Oren; Lapidoth, Moshe; Ben Amitai, Dan

2018-01-01

Childhood allergic contact dermatitis is recognized as a significant clinical problem. The objective was to evaluate the rate of positive patch tests in Israeli children with clinically suspected allergic contact dermatitis, identify possible sex and age differences, compare results with those in Israeli adults, and review pediatric studies in the literature. The study sample included 343 children and adolescents (197 female, 146 male; 1-18 years of age, mean age 11.8 years) with clinically suspected allergic contact dermatitis who underwent patch testing with a standard pediatric series of 23 allergens at a tertiary medical center from 1999 to 2012. Data on clinical characteristics and test results were collected retrospectively from the medical files. Ninety-eight subjects (28.6%) (75 girls [38.1%], 23 boys [15.8%]) had at least one positive reaction. The most frequent reactions were to nickel sulfate, followed by potassium dichromate and cobalt chloride. Nickel sulfate sensitivity was more common in girls, especially those younger than 3 years and older than 12 years. The prevalence of contact sensitization was similar in subjects with and without atopic dermatitis (50% and 51%, respectively). Nickel is the most common allergen in Israeli children, especially girls. Patch testing should be performed in children with clinically suspected allergic contact dermatitis regardless of atopic background. © 2017 Wiley Periodicals, Inc.

Mandatory imaging cuts costs and reduces the rate of unnecessary surgeries in the diagnostic work-up of patients suspected of having appendicitis

Energy Technology Data Exchange (ETDEWEB)

Lahaye, M.J.; Lambregts, D.M.J.; Mutsaers, E.; Beets-Tan, R.G.H. [Maastricht University Medical Centre, Department of Radiology, Maastricht (Netherlands); Essers, B.A.B. [Maastricht University Medical Centre, Department of Epidemiology and Medical Technology, Maastricht (Netherlands); Breukink, S.; Beets, G.L. [Maastricht University Medical Centre, Department of Surgery, Maastricht (Netherlands); Cappendijk, V.C. [Jeroen Bosch Hospital, Department of Radiology, ' s Hertogenbosch (Netherlands)

2015-05-01

To evaluate whether mandatory imaging is an effective strategy in suspected appendicitis for reducing unnecessary surgery and costs. In 2010, guidelines were implemented in The Netherlands recommending the mandatory use of preoperative imaging to confirm/refute clinically suspected appendicitis. This retrospective study included 1,556 consecutive patients with clinically suspected appendicitis in 2008-2009 (756 patients/group I) and 2011-2012 (800 patients/group II). Imaging use (none/US/CT and/or MRI) was recorded. Additional parameters were: complications, medical costs, surgical and histopathological findings. The primary study endpoint was the number of unnecessary surgeries before and after guideline implementation. After clinical examination by a surgeon, 509/756 patients in group I and 540/800 patients in group II were still suspected of having appendicitis. In group I, 58.5% received preoperative imaging (42% US/12.8% CT/3.7% both), compared with 98.7% after the guidelines (61.6% US/4.4% CT/ 32.6% both). The percentage of unnecessary surgeries before the guidelines was 22.9%. After implementation, it dropped significantly to 6.2% (p<0.001). The surgical complication rate dropped from 19.9% to 14.2%. The average cost-per-patient decreased by 594 EUR from 2,482 to 1,888 EUR (CL:-1081; -143). Increased use of imaging in the diagnostic work-up of patients with clinically suspected appendicitis reduced the rate of negative appendectomies, surgical complications and costs. (orig.)

Early Chest Computed Tomography Scan to Assist Diagnosis and Guide Treatment Decision for Suspected Community-acquired Pneumonia.

Science.gov (United States)

Claessens, Yann-Erick; Debray, Marie-Pierre; Tubach, Florence; Brun, Anne-Laure; Rammaert, Blandine; Hausfater, Pierre; Naccache, Jean-Marc; Ray, Patrick; Choquet, Christophe; Carette, Marie-France; Mayaud, Charles; Leport, Catherine; Duval, Xavier

2015-10-15

Clinical decision making relative to community-acquired pneumonia (CAP) diagnosis is difficult. Chest radiograph is key in establishing parenchymal lung involvement. However, radiologic performance may lead to misdiagnosis, rendering questionable the use of chest computed tomography (CT) scan in patients with clinically suspected CAP. To assess whether early multidetector chest CT scan affects diagnosis and management of patients visiting the emergency department with suspected CAP. A total of 319 prospectively enrolled patients with clinically suspected CAP underwent multidetector chest CT scan within 4 hours. CAP diagnosis probability (definite, probable, possible, or excluded) and therapeutic plans (antibiotic initiation/discontinuation, hospitalization/discharge) were established by emergency physicians before and after CT scan results. The adjudication committee established the final CAP classification on Day 28. Chest radiograph revealed a parenchymal infiltrate in 188 patients. CAP was initially classified as definite in 143 patients (44.8%), probable or possible in 172 (53.8%), and excluded in 4 (1.2%). CT scan revealed a parenchymal infiltrate in 40 (33%) of the patients without infiltrate on chest radiograph and excluded CAP in 56 (29.8%) of the 188 with parenchymal infiltrate on radiograph. CT scan modified classification in 187 (58.6%; 95% confidence interval, 53.2-64.0), leading to 50.8% definite CAP and 28.8% excluded CAP, and 80% of modifications were in accordance with adjudication committee classification. Because of CT scan, antibiotics were initiated in 51 (16%) and discontinued in 29 (9%), and hospitalization was decided in 22 and discharge in 23. In CAP-suspected patients visiting the emergency unit, early CT scan findings complementary to chest radiograph markedly affect both diagnosis and clinical management. Clinical trial registered with www.clinicaltrials.gov (NCT 01574066).

Dental postoperative bleeding complications in patients with suspected and documented liver disease.

Science.gov (United States)

Hong, C H; Scobey, M W; Napenas, J J; Brennan, M T; Lockhart, P B

2012-10-01

The aims of this study were to determine the frequency of bleeding complications following dental procedures in patients with known or suspected chronic liver disease and whether international normalized ratio (INR) determination could aid in predicting bleeding complications in these patients. We identified 90 patients (mean age: 51 ± 9 years) in this retrospective chart review. Sixty-nine patients had a known history of chronic liver disease and 21 had suspected chronic liver disease. Descriptive statistics were determined. Independent sample t-test and one-way variance test were utilized for continuous variables and chi-square test for dichotomous variables. The mean INR value for all patients was 1.2 ± 0.3. The INR value was significantly associated with the diagnosis of liver cirrhosis, the diagnoses of Hepatitis B and C together, the presence of ascites alone, and the number of clinical signs and symptoms (i.e. ascites, jaundice and encephalopathy) present. Nine patients with INR values between 1.5 and 2 underwent invasive dental procedures without postoperative bleeding complications. There were no episodes of postoperative bleeding in patients. The findings suggest that clinicians should not rely solely on an INR value to predict post-procedure bleeding in patients with liver disease. © 2012 John Wiley & Sons A/S.

Accuracy of CT-guided joint aspiration in patients with suspected infection status post-total hip arthroplasty

Energy Technology Data Exchange (ETDEWEB)

Tomas, Xavier; Garcia-Diez, Ana Isabel; Pomes, Jaime [Universidad de Barcelona, Department of Radiology, Hospital Clinic, Barcelona (Spain); Bori, Guillem; Garcia, Sebastian; Gallart, Xavier; Martinez, Juan Carlos; Riba, Josep [Universidad de Barcelona, Department of Orthopaedics, Hospital Clinic, Barcelona (Spain); Soriano, Alex; Mensa, Josep [Universidad de Barcelona, Department of Infectious Diseases, Hospital Clinic, Barcelona (Spain); Rios, Jose [Statistical Unit de Suport a la Estadistica I Metodologia IDIBAPS, Barcelona (Spain); Almela, Manel [Universidad de Barcelona, Department of Microbiology, Hospital Clinic, Barcelona (Spain)

2011-01-15

To determine the accuracy of guided computed tomography aspiration in the detection of septic hip prosthesis before surgery. Sixty-three patients (35 women and 28 men; age range, 29-86 years; mean age, 71 years) with clinically suspected septic hip prosthesis were prospectively studied with independent review board (IRB) approval. Volume and microbiological cultures of aspirated fluid and several computed tomography imaging findings such as periprosthetic fluid collections, prosthetic acetabular malposition, and heterotopic ossification were analyzed. All patients underwent revision surgery and infection was finally diagnosed in 33 patients. Statistical comparative analysis was performed comparing computed tomography aspiration and surgical findings (95% CI; level of significance at P = 0.05 two-sided) with 70% sensitivity, 100% specificity, 84% accuracy, 100% positive predictive value, and 75% negative predictive value. Using Fisher's exact test, the presence of periprosthetic fluid collections (P = 0.001), prosthetic acetabular malposition (P = 0.025) and aspirated fluid volume (P = 0.009) were significantly higher in infected than in non-infected prostheses, whereas heterotopic ossification was not (P = 0.429). Computed tomography aspiration is accurate to preoperatively diagnose septic hip prosthesis on the basis of volume and bacterial cultures of aspirated joint fluid. Furthermore, imaging findings such as periprosthetic fluid collections and prosthetic acetabular malposition strongly suggest infected prosthesis. (orig.)

Accuracy of CT-guided joint aspiration in patients with suspected infection status post-total hip arthroplasty

International Nuclear Information System (INIS)

Tomas, Xavier; Garcia-Diez, Ana Isabel; Pomes, Jaime; Bori, Guillem; Garcia, Sebastian; Gallart, Xavier; Martinez, Juan Carlos; Riba, Josep; Soriano, Alex; Mensa, Josep; Rios, Jose; Almela, Manel

2011-01-01

To determine the accuracy of guided computed tomography aspiration in the detection of septic hip prosthesis before surgery. Sixty-three patients (35 women and 28 men; age range, 29-86 years; mean age, 71 years) with clinically suspected septic hip prosthesis were prospectively studied with independent review board (IRB) approval. Volume and microbiological cultures of aspirated fluid and several computed tomography imaging findings such as periprosthetic fluid collections, prosthetic acetabular malposition, and heterotopic ossification were analyzed. All patients underwent revision surgery and infection was finally diagnosed in 33 patients. Statistical comparative analysis was performed comparing computed tomography aspiration and surgical findings (95% CI; level of significance at P = 0.05 two-sided) with 70% sensitivity, 100% specificity, 84% accuracy, 100% positive predictive value, and 75% negative predictive value. Using Fisher's exact test, the presence of periprosthetic fluid collections (P = 0.001), prosthetic acetabular malposition (P = 0.025) and aspirated fluid volume (P = 0.009) were significantly higher in infected than in non-infected prostheses, whereas heterotopic ossification was not (P = 0.429). Computed tomography aspiration is accurate to preoperatively diagnose septic hip prosthesis on the basis of volume and bacterial cultures of aspirated joint fluid. Furthermore, imaging findings such as periprosthetic fluid collections and prosthetic acetabular malposition strongly suggest infected prosthesis. (orig.)

Forming 'Forbidden' Identities Online: Atheism in Indonesia

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Saskia Schäfer

2016-12-01

Full Text Available This article discusses the online activism of Indonesian atheists. While most of the little existent scholarship on atheism in Indonesia views the controversial cases in the light of the violation of Western-style rights to free speech and religious liberty, a closer look at the public discourses both online and offline reveals a more complex picture. The article embeds atheist activism and the well-known case of Alexander An in the changing landscape of religion and state in post-Suharto Indonesia. It points at the intricate relationship between atheism and blasphemy and shows how activists not only carve a space for themselves online, but also seek to counter the negative and anti-religious image that decades-long campaigning has created for atheists. Activists use Facebook, Twitter, messaging systems, and forums such as Quora, both to become visible and yet allow for anonymity. Their online communication and activism is often coupled with offline meetings. In this way, atheists allow for a thriving ‘community’, and also present atheism positively in public. However, to defend atheism this way also has its downsides, as it aligns Indonesian atheists with an international network of mainly Western-funded human rights activists and thus runs the risk of further alienating them from a nation that strongly defines itself along religious identity.

Neurohormonal activation and diagnostic value of cardiac peptides in patients with suspected mild heart failure

DEFF Research Database (Denmark)

Mikkelsen, Kirsten V.; Bie, Peter; Møller, Jacob E.

2006-01-01

accuracy of cardiac peptides to detect any left ventricular dysfunction (LVD) in patients referred from primary care with suspected HF before institution of medical therapy. METHODS: Of 166 referred patients 150 were consecutively included (14 were excluded and two refused consent). Echocardiography...

Impact of round-the-clock CSF Gram stain on empirical therapy for suspected central nervous system infections.

Science.gov (United States)

Tissot, F; Prod'hom, G; Manuel, O; Greub, G

2015-09-01

The impact of round-the-clock cerebrospinal fluid (CSF) Gram stain on overnight empirical therapy for suspected central nervous system (CNS) infections was investigated. All consecutive overnight CSF Gram stains between 2006 and 2011 were included. The impact of a positive or a negative test on empirical therapy was evaluated and compared to other clinical and biological indications based on institutional guidelines. Bacterial CNS infection was documented in 51/241 suspected cases. Overnight CSF Gram stain was positive in 24/51. Upon validation, there were two false-positive and one false-negative results. The sensitivity and specificity were 41 and 99 %, respectively. All patients but one had other indications for empirical therapy than Gram stain alone. Upon obtaining the Gram result, empirical therapy was modified in 7/24, including the addition of an appropriate agent (1), addition of unnecessary agents (3) and simplification of unnecessary combination therapy (3/11). Among 74 cases with a negative CSF Gram stain and without formal indication for empirical therapy, antibiotics were withheld in only 29. Round-the-clock CSF Gram stain had a low impact on overnight empirical therapy for suspected CNS infections and was associated with several misinterpretation errors. Clinicians showed little confidence in CSF direct examination for simplifying or withholding therapy before definite microbiological results.

Forbidden Access

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C. Colloca TS/FM

2004-01-01

TS/FM group informs you that, for the replacement of the door of the main entrance at bldg. 500, the access will be closed to the public between 19 and 30 July 2004. Access to the Main Building complex will be assured at any time through both of the side doors and from bldg. 64. For more information, please contact 73273. C. Colloca TS/FM

Electron densities in planetary nebulae

International Nuclear Information System (INIS)

Stanghellini, L.; Kaler, J.B.

1989-01-01

Electron densities for 146 planetary nebulae have been obtained for analyzing a large sample of forbidden lines by interpolating theoretical curves obtained from solutions of the five-level atoms using up-to-date collision strengths and transition probabilities. Electron temperatures were derived from forbidden N II and/or forbidden O III lines or were estimated from the He II 4686 A line strengths. The forbidden O II densities are generally lower than those from forbidden Cl III by an average factor of 0.65. For data sets in which forbidden O II and forbidden S II were observed in common, the forbidden O II values drop to 0.84 that of the forbidden S II, implying that the outermost parts of the nebulae might have elevated densities. The forbidden Cl II and forbidden Ar IV densities show the best correlation, especially where they have been obtained from common data sets. The data give results within 30 percent of one another, assuming homogeneous nebulae. 106 refs

[Colorectal Carcinoma with Suspected Lynch Syndrome: A Multidisciplinary Algorithm].

Science.gov (United States)

Schneider, R; Schneider, C; Büttner, R; Reinacher-Schick, A; Tannapfel, A; Fürst, A; Rüschoff, J; Jakobeit, C; Royer-Pokora, B; Möslein, G

2015-12-01

Lynch syndrome is the most frequent hereditary cancer syndrome, accounting for approximately 3-5 % of all colorectal cancers. In addition, it is the most frequent predisposing hereditary cause of endometrial cancer and is also associated with gastric cancer, ovarian cancer, cancer of the urinary tract as well as several other cancers. In clinical practise Lynch syndrome is frequently not detected and many clinicians admit uncertainties regarding diagnostic procedures. Also, counselling of patients is considered difficult regarding therapeutic - especially prophylactic surgical and chemopreventive options and recommendations. Based on a review of available literature we discuss optimized strategies for improved detection of suspected Lynch syndrome patients. The aim of this review is to establish a clinical algorithm of how to proceed on a diagnostic level and to discuss surgical options at the time of a colorectal cancer. In order to identify patients with Lynch syndrome, family history should be ascertained and evaluated in regards to fulfilment of the Amsterdam-II- and/or the revised Bethesda criteria. Subsequently immunohistochemical staining for the mismatch-repair-genes, BRAF testing for MLH1 loss of expression, as well as testing for microsatellite instability in some, followed by genetic counselling and mutation analysis when indicated, is recommended. Pathological identification of suspected Lynch syndrome is readily feasible and straightforward. However, the need of performing these analyses in the tumor biopsy at the time of (gastroenterological) diagnosis of CRC neoplasia is essential, in order to offer patients the option of a prophylactically extended surgery and - as recommended in the German S3 guidelines - to discuss the option of a merely prophylactical hysterectomy and oophorectomy (if postmenopausal) in women. Close cooperation between gastroenterologists, pathologists and surgeons is warranted, so that patients may benefit from options of

Reimbursement and Insurance Coverage in Cases of Suspected Sexual Abuse in the Emergency Department.

Science.gov (United States)

Kupfer, Gary M.; Giardino, Angelo P.

1995-01-01

Emergency department charts of 186 suspected preadolescent victims of sexual abuse (SSA) were compared with 623 patients evaluated for upper limb fracture. Hospital costs of SSA patients were more often and to a greater degree underwritten by the hospital itself because of lower reimbursement and a higher percentage of uninsured and publicly…

Feasibility of abdominal plain film images in evaluation suspected drug smuggler

International Nuclear Information System (INIS)

Sormaala, Markus J.; Salonen, Hanna-Mari; Mattila, Ville M.; Kivisaari, Arto; Autti, Taina

2012-01-01

Objective: Drug smuggling in the gastrointestinal tract has soared within the last 20 years. Though illegal substances in the gastrointestinal tract can be visualized with ultrasound, MRI and CT, the abdominal radiograph has by far remained the most frequently used way of detecting smuggled drugs. The purpose of the study was to evaluate the inter-radiologist interpretation error and the reliability of the abdominal radiograph in detecting smuggled drugs. Materials and methods: A total of 279 abdominal radiographs of suspected smugglers were classified by three radiologists as clearly positive or negative for drug smuggling. All available information about the cases was collected from the customs officers and police. Results: Out of these cases 203 (73%) were interpreted as negative and 35 (13%) as positive by all three radiologists. In 86% of the cases there was, therefore, an inter-radiological agreement in interpreting the images. In 41 (14%) cases, however, there was an inter-radiologist disagreement. Kappa-value for inter-observer variability was 0.70. Conclusions: In up to a seventh of the abdominal radiographs the interpretation can be challenging even for an experienced radiologist. False positive interpretation can lead to innocent passengers being detained in vain. As negatively interpreted images usually result in releasing of the suspect, there is no way of knowing how many false negative occur. This makes the abdominal radiograph a suboptimal examination, and low dose CT should be considered as the screening modality for gastrointestinal drug smugglers

Feasibility of abdominal plain film images in evaluation suspected drug smuggler

Energy Technology Data Exchange (ETDEWEB)

Sormaala, Markus J., E-mail: markus.sormaala@welho.com [Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland); Salonen, Hanna-Mari, E-mail: hanna-mari.salonen@hus.fi [Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland); Mattila, Ville M., E-mail: ville.mattila@uta.fi [Department of Orthopedic Surgery and Trauma, Tampere University Hospital, Tampere (Finland); Kivisaari, Arto, E-mail: arto.kivisaari@hus.fi [Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland); Autti, Taina, E-mail: taina.autti@hus.fi [Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland)

2012-09-15

Objective: Drug smuggling in the gastrointestinal tract has soared within the last 20 years. Though illegal substances in the gastrointestinal tract can be visualized with ultrasound, MRI and CT, the abdominal radiograph has by far remained the most frequently used way of detecting smuggled drugs. The purpose of the study was to evaluate the inter-radiologist interpretation error and the reliability of the abdominal radiograph in detecting smuggled drugs. Materials and methods: A total of 279 abdominal radiographs of suspected smugglers were classified by three radiologists as clearly positive or negative for drug smuggling. All available information about the cases was collected from the customs officers and police. Results: Out of these cases 203 (73%) were interpreted as negative and 35 (13%) as positive by all three radiologists. In 86% of the cases there was, therefore, an inter-radiological agreement in interpreting the images. In 41 (14%) cases, however, there was an inter-radiologist disagreement. Kappa-value for inter-observer variability was 0.70. Conclusions: In up to a seventh of the abdominal radiographs the interpretation can be challenging even for an experienced radiologist. False positive interpretation can lead to innocent passengers being detained in vain. As negatively interpreted images usually result in releasing of the suspect, there is no way of knowing how many false negative occur. This makes the abdominal radiograph a suboptimal examination, and low dose CT should be considered as the screening modality for gastrointestinal drug smugglers.

A proposed new imaging pathway for patients with suspected lung cancer

International Nuclear Information System (INIS)

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

2012-01-01

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

A proposed new imaging pathway for patients with suspected lung cancer

Energy Technology Data Exchange (ETDEWEB)

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

2012-06-15

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

Barriers and Motivators for Referral of Patients with Suspected Lynch Syndrome to Cancer Genetic Services: A Qualitative Study

Science.gov (United States)

Tan, Yen Y.; Fitzgerald, Lisa J.

2014-01-01

This article explores the views of general practitioners and specialists on their referral of patients with suspected Lynch syndrome to cancer genetic services. Using a purposive maximum variation sampling strategy, we conducted semi-structured interviews face-to-face with 28 general practitioners and specialists in public or private hospitals and specialist clinics between March and August 2011. General practitioners and specialists were recruited in a major metropolitan area in Australia. Interview transcripts were reviewed by two independent researchers, and thematic analysis was performed using NVivo10 software. The main barriers and motivators identified were: (1) clinician-related (e.g., familiarity with Lynch syndrome and family history knowledge); (2) patient-related (e.g., patients’ interests and personal experience with cancer); and (3) organizational-related (e.g., access to services, guidelines and referral pathway). Referral of patients with suspected Lynch syndrome to cancer genetic services is motivated and hindered by a range of individual, interpersonal and organizational factors. In order to improve the care and quality of life of patients and family with suspected Lynch syndrome, further research is needed to develop supportive tools for clinicians. PMID:25562140

Barriers and Motivators for Referral of Patients with Suspected Lynch Syndrome to Cancer Genetic Services: A Qualitative Study

Directory of Open Access Journals (Sweden)

Yen Y. Tan

2014-02-01

Full Text Available This article explores the views of general practitioners and specialists on their referral of patients with suspected Lynch syndrome to cancer genetic services. Using a purposive maximum variation sampling strategy, we conducted semi-structured interviews face-to-face with 28 general practitioners and specialists in public or private hospitals and specialist clinics between March and August 2011. General practitioners and specialists were recruited in a major metropolitan area in Australia. Interview transcripts were reviewed by two independent researchers, and thematic analysis was performed using NVivo10 software. The main barriers and motivators identified were: (1 clinician-related (e.g., familiarity with Lynch syndrome and family history knowledge; (2 patient-related (e.g., patients’ interests and personal experience with cancer; and (3 organizational-related (e.g., access to services, guidelines and referral pathway. Referral of patients with suspected Lynch syndrome to cancer genetic services is motivated and hindered by a range of individual, interpersonal and organizational factors. In order to improve the care and quality of life of patients and family with suspected Lynch syndrome, further research is needed to develop supportive tools for clinicians.

Overview of suspected adverse reactions to veterinary medicinal products reported in South Africa (March 2002 – February 2003

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V. Naidoo

2003-07-01

Full Text Available The Veterinary Pharmacovigilance and Medicines Information Centre is responsible for the monitoring of veterinary adverse drug reactions in South Africa. An overview of reports of suspected adverse drug reactions received by the centre during the period March 2002 to February 2003 is given. In total, 40 reports were received. This had declined from the previous year. Most reports involved suspected adverse reactions that occurred in dogs and cats. Most of the products implicated were Stock Remedies. The animal owner predominantly administered these products. Only 1 report was received from a veterinary pharmaceutical company. Increasing numbers of reports are being received from veterinarians.

Empathy in the field: Towards a taxonomy of empathic communication in information gathering interviews with suspected sex offenders

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Coral June Dando

2016-01-01

Full Text Available Research suggests that those suspected of sexual offending might be more willing to reveal information about their crimes if interviewers display empathic behaviour. However, the literature concerning investigative empathy is in its infancy, and so as yet is not well understood. This study explores empathy in a sample of real-life interviews conducted by police officers in England with suspected sex offenders. Using qualitative methodology, the presence and type of empathic verbal behaviours displayed was examined. Resulting categories were quantitatively analysed to investigate their occurrence overall, and across interviewer gender. We identified four distinct types of empathy, some of which were used significantly more often

Evaluation of a new fluorescent reagent, fluorescent brightener 85, for the diagnosis of suspected onychomycosis compared with potassium hydroxide.

Science.gov (United States)

Yue, Xueping; Wang, Aiping; Wang, Hongwei; Li, Qing; Yue, Xiuling

2018-04-01

Onychomycosis is a common fungal infection in dermatology clinics. The commonly used diagnostic method, potassium hydroxide (KOH) direct microscopy, does not have a high-positive detection rate. Therefore, a new diagnostic method is needed to confirm onychomycosis. The objective of this research was to use fluorescent brightener 85 (FB 85), a new fluorescent reagent for fungi detection, and to evaluate this new method based on the diagnostic positive rate, accuracy and efficiency in suspected onychomycosis compared with the KOH method. Subungual debris was collected from clinically suspected onychomycosis cases and divided into two parts. The parts were examined by FB 85 and 10% KOH solution, respectively. In total, 108 patients with suspected onychomycosis were recruited. The positive rates of FB 85 and KOH were 88.9% and 55.6%, respectively. The patients showed significant statistical differences (P < .001). Compared with the KOH method, the FB 85 fluorescent method was an accurate and efficient method with a higher positive rate. This method could increase the diagnostic accuracy and efficiency of onychomycosis detection. © 2017 Blackwell Verlag GmbH.

Distemper in raccoons and foxes suspected of having rabies

Science.gov (United States)

Habermann, R.T.; Herman, C.M.; Williams, F.P.

1958-01-01

1) Twenty-one raccoons and 3 red foxes were collected from areas where suspected rabies occurred. All were found to be nonrabid. 2) Distemper was diagnosed in 14 of the 21 raccoons by demonstrating intracytoplasmic and intranuclear inclusions in the brain and visceral tissues. Two of the 3 foxes were considered to have distemper; the clinical signs were typical and mouse inoculation tests were negative for rabies. 3) Deaths of the other 7 raccoons were attributed to: leishmaniasis 1, gastritis 1, bronchopneumonia 1, parasitism 2, car injury 1; 1 showed no significant lesions. The death of 1 fox was attributed to parasitism. 4) Distemper may be a frequent cause of death in raccoons and foxes, in epizootics which simulate rabies.

Results of photorefractive keratectomy in keratoconus suspects at 4 years.

Science.gov (United States)

Bilgihan, K; Ozdek, S C; Konuk, O; Akata, F; Hasanreisoglu, B

2000-01-01

We studied the long-term results of photorefractive keratectomy (PRK) in keratoconus suspects detected by videokeratography (TMS). Bilateral inferior corneal steepening was detected in 6 candidates for PRK presenting with moderate myopia or astigmatism. Mean follow-up was 44.5 +/- 4.4 months (range, 38 to 54 mo). Mean spherical equivalent refraction was -5.18 +/- 1.60 D (mean sphere, -4.73 D; mean cyclinder, -0.92 D) which was stable for at least the preceding year. The quantitative measurement of inferior corneal steepening (I-S value) was greater than +1.60 (mean, 1.83 +/- 0.11) in all eyes. An Aesculap Meditec Mel 60 excimer laser was used for the PRK procedures and mean follow-up was 44.5 months. Postoperative pachymetric measurements were also performed in 6 eyes. Postoperative uncorrected visual acuity was 20/20 in 8 eyes (66.6%) and 20/32 or better in all eyes with a mean postoperative spherical equivalent refraction of -0.70 +/- 0.74 D (mean sphere, -0.63 D; mean cyclinder, -0.39 D). Five eyes (41.6%) were within +/- 0.50 D spherical equivalent refraction. Inferior steepening was associated with thinning of the inferior cornea which was statistically significantly thinner than the superior thickness (Student's t-test, P < .05). There were no wound healing problems or any sign that the excimer laser adversely affected the cornea during follow-up. Photorefractive keratectomy seems to be a safe procedure for reducing or eliminating myopia or astigmatism in keratoconus suspect eyes-most probably forme fruste keratoconus-with a stable refraction, but this may be different in eyes with early keratoconus, known to be a progressive disease.

Cerebrospinal Fluid Lumbar Tapping Utilization for Suspected Ventriculoperitoneal Shunt Under-Drainage Malfunctions.

Science.gov (United States)

Lee, Jong-Beom; Ahn, Ho-Young; Lee, Hong-Jae; Yang, Ji-Ho; Yi, Jin-Seok; Lee, Il-Woo

2017-01-01

The diagnosis of shunt malfunction can be challenging since neuroimaging results are not always correlated with clinical outcomes. The purpose of this study was to evaluate the efficacy of a simple, minimally invasive cerebrospinal fluid (CSF) lumbar tapping test that predicts shunt under-drainage in hydrocephalus patients. We retrospectively reviewed the clinical and radiological features of 48 patients who underwent routine CSF lumbar tapping after ventriculoperitoneal shunt (VPS) operation using a programmable shunting device. We compared shunt valve opening pressure and CSF lumbar tapping pressure to check under-drainage. The mean pressure difference between valve opening pressure and CSF lumbar tapping pressure of all patients were 2.21±24.57 mmH 2 O. The frequency of CSF lumbar tapping was 2.06±1.26 times. Eighty five times lumbar tapping of 41 patients showed that their VPS function was normal which was consistent with clinical improvement and decreased ventricle size on computed tomography scan. The mean pressure difference in these patients was -3.69±19.20 mmH 2 O. The mean frequency of CSF lumbar tapping was 2.07±1.25 times. Fourteen cases of 10 patients revealed suspected VPS malfunction which were consistent with radiological results and clinical symptoms, defined as changes in ventricle size and no clinical improvement. The mean pressure difference was 38.07±23.58 mmH 2 O. The mean frequency of CSF lumbar tapping was 1.44±1.01 times. Pressure difference greater than 35 mmH 2 O was shown in 2.35% of the normal VPS function group (2 of 85) whereas it was shown in 64.29% of the suspected VPS malfunction group (9 of 14). The difference was statistically significant ( p =0.000001). Among 10 patients with under-drainage, 5 patients underwent shunt revision. The causes of the shunt malfunction included 3 cases of proximal occlusion and 2 cases of distal obstruction and valve malfunction. Under-drainage of CSF should be suspected if CSF lumbar tapping

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

Science.gov (United States)

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

2017-09-01

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

Cost analysis of inappropriate treatments for suspected dermatomycoses

Directory of Open Access Journals (Sweden)

Emanuela Fiammenghi

2015-06-01

Full Text Available Superficial mycoses are estimated to affect more than 20-25% of the world’s population with a consistent increase over the years. Most patients referred to our clinic for suspected dermatomycoses have already been treated with pharmacotherapy, without a previous mycological examination and many show changes in the clinical manifestations. Indeed, some medications, such as steroids, antiviral, antibiotics and antihistamines are not able to erase a fungal infection, but also they can cause atypical clinical manifestations. The consequences of inappropriate treatment include delayed diagnosis, prolonged healing time, and additional costs. The aims of this study were (1 to evaluate the incidence of increased costs attributable to inappropriate therapy sustained by the National Health Service and patients and (2 to highlight the importance of mycological evaluation before starting treatment, in order to improve diagnostic accuracy. An observational retrospective and prospective study was performed from September 2013 to February 2014, in 765 patients referred to our center (University Hospital “ Federico II” in Naples, Italy, for suspected mycological infection. The following treatments (alone or in combination were defined as inappropriate: (1 cortisone in a patient with at least one positive site; (2 antifungals in (a patients with all negative sites or (b ineffective antifungal treatment (in terms of drug chosen, dose or duration in those with all positive sites; or (3 antibiotics; (4 antivirals or (5 antihistamines, in patients with ≥ 1 positive site. Five hundred and fifty patients were using medications before the assessment visit. The total amount of avoidable costs related to inappropriate previous treatments was € 121,417, representing 74% of the total treatment costs. 253/550 patients received drugs also after the visit. For these patients, the cost of treatment prescribed after mycological testing was € 42,952, with a decrease

Isolation & characterization of Brucella melitensis isolated from patients suspected for human brucellosis in India

Science.gov (United States)

Barua, Anita; Kumar, Ashu; Thavaselvam, Duraipandian; Mangalgi, Smita; Prakash, Archana; Tiwari, Sapana; Arora, Sonia; Sathyaseelan, Kannusamy

2016-01-01

Background & objectives: Brucellosis is endemic in the southern part of India. A combination of biochemical, serological and molecular methods is required for identification and biotyping of Brucella. The present study describes the isolation and biochemical, molecular characterization of Brucella melitensis from patients suspected for human brucellosis. Methods: The blood samples were collected from febrile patients suspected to have brucellosis. A total of 18 isolates were obtained from 102 blood samples subjected to culture. The characterization of these 18 isolates was done by growth on Brucella specific medium, biochemical reactions, CO2 requirement, H2S production, agglutination with A and M mono-specific antiserum, dye sensitivity to basic fuchsin and thionin. Further, molecular characterization of the isolates was done by amplification of B. melitensis species specific IS711 repetitive DNA fragment and 16S (rRNA) sequence analysis. PCR-restriction fragment length polymorphism (RFLP) analysis of omp2 locus and IS711 gene was also done for molecular characterization. Results: All 102 suspected samples were subjected to bacteria isolation and of these, 18 isolates could be recovered on blood culture. The biochemical, PCR and PCR-RFLP and 16s rRNA sequencing revealed that all isolates were of B. melitensis and matched exactly with reference strain B. melitensis 16M. Interpretation & conclusions: The present study showed an overall isolation rate of 17.64 per cent for B. melitensis. There is a need to establish facilities for isolation and characterization of Brucella species for effective clinical management of the disease among patients as well as surveillance and control of infection in domestic animals. Further studies are needed from different geographical areas of the country with different level of endemicity to plan and execute control strategies against human brucellosis. PMID:27488010

Left atrial appendage morphology in patients with suspected cardiogenic stroke without known atrial fibrillation.

Directory of Open Access Journals (Sweden)

Miika Korhonen

Full Text Available The left atrial appendage (LAA is the typical origin for intracardiac thrombus formation. Whether LAA morphology is associated with increased stroke/TIA risk is controversial and, if it does, which morphological type most predisposes to thrombus formation. We assessed LAA morphology in stroke patients with cryptogenic or suspected cardiogenic etiology and in age- and gender-matched healthy controls. LAA morphology and volume were analyzed by cardiac computed tomography in 111 patients (74 males; mean age 60 ± 11 years with acute ischemic stroke of cryptogenic or suspected cardiogenic etiology other than known atrial fibrillation (AF. A subgroup of 40 patients was compared to an age- and gender-matched control group of 40 healthy individuals (21 males in each; mean age 54 ± 9 years. LAA was classified into four morphology types (Cactus, ChickenWing, WindSock, CauliFlower modified with a quantitative qualifier. The proportions of LAA morphology types in the main stroke group, matched stroke subgroup, and control group were as follows: Cactus (9.0%, 5.0%, 20.0%, ChickenWing (23.4%, 37.5%, 10.0%, WindSock (47.7%, 35.0%, 67.5%, and CauliFlower (19.8%, 22.5%, 2.5%. The distribution of morphology types differed significantly (P<0.001 between the matched stroke subgroup and control group. The proportion of single-lobed LAA was significantly higher (P<0.001 in the matched stroke subgroup (55% than the control group (6%. LAA volumes were significantly larger (P<0.001 in both stroke study groups compared to controls patients. To conclude, LAA morphology differed significantly between stroke patients and controls, and single-lobed LAAs were overrepresented and LAA volume was larger in patients with acute ischemic stroke of cryptogenic or suspected cardiogenic etiology.

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

International Nuclear Information System (INIS)

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

1983-01-01

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

41 CFR 102-38.50 - What must we do when an executive agency suspects violations of 40 U.S.C. 559, fraud, bribery, or...

Science.gov (United States)

2010-07-01

... executive agency suspects violations of 40 U.S.C. 559, fraud, bribery, or criminal collusion in connection... an executive agency suspects violations of 40 U.S.C. 559, fraud, bribery, or criminal collusion in.... 559, fraud, bribery, or criminal collusion in connection with the disposal of personal property, the...

111indium-antimyosin immunoscintigraphy in suspected myocarditis

International Nuclear Information System (INIS)

Krause, T.; Schuemichen, C.; Joseph, A.; Moser, E.; Zeiher, A.

1991-01-01

111 Indium-monoclonal antimyosin scans were carried out in 21 patients with suspected myocarditis, confirmed by reduced ejection volume, pericardial effusion and clinical follow up in 12 patients. Coronary heart disease was excluded angiographically in all cases. Quantitative evaluation of myocardial 111 In-antimyosin accumulation 48 hours after injection showed a pathological uptake in 10/12 patients with increased heart/lung ratios (Q 48 >1,58). Ratios were also elevated in 2 patients with cardiomyopathy, 2 suffering from vasculitis and 1 with dermatomyositis. Four patients without proven cardiac disease had normal ratios (Q 48 ≤1,58). Examination after 24 hours was of limited value, depending on the residual blood pool activity. Visual analysis of the scans showed a high interobserver variation despite a positive correlation with quantitative analysis (48 h p.i.: r=0,72; p 111 In-antimyosin scan as a screening method prior to myocardial biopsy. However, scintigraphy cannot definitely elucidate the cause of myocardial damage. Therefore, myocardial biopsy is still recommended after positive antimyosin scans. (orig.) [de

Suspected primary immune deficiency in a Donge de Bordeaux dog : short communication

Directory of Open Access Journals (Sweden)

R.G. Lobetti

2002-07-01

Full Text Available A young Donge de Bordeaux dog was presented with chronic intermittent antibiotic responsive gastrointestinal and respiratory disease. Further evaluation showed bacterial lymphadenitis, bacterial tracheitis, normal white cell and differential cell counts, hypogammaglobulinaemia, and the absence of B-lymphocytes but the presence of T-lymphocytes in the lymphoid tissue stained with lymphocyte markers. As the dog came from a narrow genetic base, with related dogs showing similar clinical signs, possible B-cell congenital immune deficiency was suspected.

Image-guided biopsy in patients with suspected ovarian carcinoma: a safe and effective technique?

International Nuclear Information System (INIS)

Griffin, Nyree; Grant, Lee A.; Freeman, Susan J.; Berman, Laurence H.; Sala, Evis; Jimenez-Linan, Mercedes; Earl, Helena; Ahmed, Ahmed Ashour; Crawford, Robin; Brenton, James

2009-01-01

In patients with suspected advanced ovarian carcinoma, a precise histological diagnosis is required before commencing neo-adjuvant chemotherapy. This study aims to determine the diagnostic accuracy and complication rate of percutaneous biopsies performed under ultrasound or computed tomography guidance. Between 2002 to 2007, 60 consecutive image-guided percutaneous biopsies were performed in patients with suspected ovarian cancer. The following variables were recorded: tissue biopsied, imaging technique, experience of operator, biopsy needle gauge, number of passes, complications, and final histology. Forty-seven patients had omental biopsies, 12 pelvic mass biopsies, and 1 para-aortic lymph node biopsy. Thirty-five biopsies were performed under ultrasound, 25 under computed tomography guidance. Biopsy needle gauges ranged from 14-20 swg with two to five passes for each patient. There were no complications. Histology was obtained in 52 (87%) patients. Percutaneous image-guided biopsy of peritoneal disease or pelvic mass is safe with high diagnostic accuracy. The large-gauge biopsy needle is as safe as the small gauge needle, but has the added value of obtaining tissue samples for immunohistochemistry and genomic studies. (orig.)

Forbidden energy band gap in diluted a-Ge1−xSix:N films

International Nuclear Information System (INIS)

Guarneros, C.; Rebollo-Plata, B.; Lozada-Morales, R.; Espinosa-Rosales, J.E.; Portillo-Moreno, J.; Zelaya-Angel, O.

2012-01-01

By means of electron gun evaporation Ge 1−x Si x :N thin films, in the entire range 0 ≤ x ≤ 1, were prepared on Si (100) and glass substrates. The initial vacuum reached was 6.6 × 10 −4 Pa, then a pressure of 2.7 × 10 −2 Pa of high purity N 2 was introduced into the chamber. The deposition time was 4 min. Crucible-substrate distance was 18 cm. X-ray diffraction patterns indicate that all the films were amorphous (a-Ge 1−x Si x :N). The nitrogen concentration was of the order of 1 at% for all the films. From optical absorption spectra data and by using the Tauc method the energy band gap (E g ) was calculated. The Raman spectra only reveal the presence of Si-Si, Ge-Ge, and Si-Ge bonds. Nevertheless, infrared spectra demonstrate the existence of Si-N and Ge-N bonds. The forbidden energy band gap (E g ) as a function of x in the entire range 0 ≤ x ≤ 1 shows two well defined regions: 0 ≤ x ≤ 0.67 and 0.67 ≤ x ≤ 1, due to two different behaviors of the band gap, where for x > 0.67 exists an abruptly change of E g (x). In this case E g (x) versus x is different to the variation of E g in a-Ge 1−x Si x and a-Ge 1−x Si x :H. This fact can be related to the formation of Ge 3 N 4 and GeSi 2 N 4 when x ≤ 0.67, and to the formation of Si 3 N 4 and GeSi 2 N 4 for 0.67 ≤ x. - Highlights: ► Nitrogen doped amorphous Ge 1-x Si x thin films are grown by electron gun technique. ► Nitrogen atoms on E g of the a-Ge 1-x Si x films in the 0 £ x £ 1 range are analyzed. ► Variation in 0 £ x £ 1 range shows a warped change of E g in 1.0 – 3.6 eV range. ► The change in E g (x) behavior when x ∼ 0.67 was associated with Ge 2 SiN 4 presence.

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

Science.gov (United States)

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

2015-10-01

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

Diagnostic and prognostic value of non-invasive imaging in known or suspected coronary artery disease

International Nuclear Information System (INIS)

Schuijf, J.D.; Poldermans, D.; Shaw, L.J.; Jukema, J.W.; Wall, E.E. van der; Lamb, H.J.; Roos, A. de; Wijns, W.; Bax, J.J.

2006-01-01

The role of non-invasive imaging techniques in the evaluation of patients with suspected or known coronary artery disease (CAD) has increased exponentially over the past decade. The traditionally available imaging modalities, including nuclear imaging, stress echocardiography and magnetic resonance imaging (MRI), have relied on detection of CAD by visualisation of its functional consequences (i.e. ischaemia). However, extensive research is being invested in the development of non-invasive anatomical imaging using computed tomography or MRI to allow detection of (significant) atherosclerosis, eventually at a preclinical stage. In addition to establishing the presence of or excluding CAD, identification of patients at high risk for cardiac events is of paramount importance to determine post-test management, and the majority of non-invasive imaging tests can also be used for this purpose. The aim of this review is to provide an overview of the available non-invasive imaging modalities and their merits for the diagnostic and prognostic work-up in patients with suspected or known CAD. (orig.)

Suspected adverse drug reactions in elderly patients reported to the Committee on Safety of Medicines.

Science.gov (United States)

Castleden, C M; Pickles, H

1988-10-01

1. Spontaneous reports of suspected adverse drug reactions (ADRs) reported to the Committee on Safety of Medicines (CSM) have been studied in relation to patient age. 2. The proportion of reports received for the elderly increased between 1965 and 1983. 3. There was a correlation between the use of drugs and the number of ADR reports. Thus age-related prescription figures for two non-steroidal anti-inflammatory drugs (NSAI) and co-trimoxazole matched ADR reports for each drug in each age group. 4. The reported ADR was more likely to be serious or fatal in the elderly. 5. The commonest ADRs reported for the elderly affected the gastrointestinal (GIT) and haemopoietic systems, where more reports were received than would be expected from prescription figures. 6. The drug suspected of causing a GIT reaction was a NSAI in 75% of the reports. 7. Ninety-one per cent of fatal reports of GIT bleeds and perforations associated with NSAI drugs were in patients over 60 years of age.

A simple MRI protocol in patients with clinically suspected appendicitis: results in 138 patients and effect on outcome of appendectomy

International Nuclear Information System (INIS)

Cobben, Lodewijk; Groot, Ingrid; Kingma, Lucas; Coerkamp, Emile; Puylaert, Julien; Blickman, Johan

2009-01-01

To establish the value of breathhold magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis. Over a 14-month period, 138 patients clinically suspected of having appendicitis were evaluated prospectively with MRI and comprised the study group. Fast turbo spin-echo breathhold T1, T2 and T2 fat suppression sequences were used in coronal and axial planes. The imaging results were recorded separately and subsequently correlated with clinical, radiological and histopathological follow-up. The effect of imaging strategies in patients suspected of appendicitis on hospital resources was calculated. Sixty-two of the 138 patients had a histopathologically proven appendicitis. MRI determined appendicitis in 63 patients, with one examination being false positive. The resulting sensitivity and specificity were 100% and 99%, respectively. MRI showed an alternative diagnosis in 41 of the 75 remaining patients. In 22 of the remaining 34 patients, a normal appendix was depicted with MRI. In two patients, where MRI showed no appendicitis, an alternative diagnosis or normal appendix, an unnecessary appendectomy was performed. The overall effect of using MRI in patients suspected of appendicitis on the use of hospital resources could have been a net saving between EUR 55,746 and EUR 72,534. MRI has a high accuracy in detecting and excluding appendicitis, an alternative diagnosis or showing the normal appendix, and can be a valuable and cost-effective tool in the workup of patients clinically suspected of having appendicitis. (orig.)

A simple MRI protocol in patients with clinically suspected appendicitis: results in 138 patients and effect on outcome of appendectomy

Energy Technology Data Exchange (ETDEWEB)

Cobben, Lodewijk [Medisch Centrum Haaglanden, Department of Radiology, Leidschendam (Netherlands); Groot, Ingrid [Medisch Centrum Haaglanden, Department of Surgery, Leidschendam (Netherlands); Kingma, Lucas; Coerkamp, Emile; Puylaert, Julien [Medisch Centrum Haaglanden, Department of Radiology, Den Haag (Netherlands); Blickman, Johan [Universitair Medisch Centrum St Radboud, Department of Radiology, Geert Grooteplein 10, GA, Nijmegen (Netherlands)

2009-05-15

To establish the value of breathhold magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis. Over a 14-month period, 138 patients clinically suspected of having appendicitis were evaluated prospectively with MRI and comprised the study group. Fast turbo spin-echo breathhold T1, T2 and T2 fat suppression sequences were used in coronal and axial planes. The imaging results were recorded separately and subsequently correlated with clinical, radiological and histopathological follow-up. The effect of imaging strategies in patients suspected of appendicitis on hospital resources was calculated. Sixty-two of the 138 patients had a histopathologically proven appendicitis. MRI determined appendicitis in 63 patients, with one examination being false positive. The resulting sensitivity and specificity were 100% and 99%, respectively. MRI showed an alternative diagnosis in 41 of the 75 remaining patients. In 22 of the remaining 34 patients, a normal appendix was depicted with MRI. In two patients, where MRI showed no appendicitis, an alternative diagnosis or normal appendix, an unnecessary appendectomy was performed. The overall effect of using MRI in patients suspected of appendicitis on the use of hospital resources could have been a net saving between EUR 55,746 and EUR 72,534. MRI has a high accuracy in detecting and excluding appendicitis, an alternative diagnosis or showing the normal appendix, and can be a valuable and cost-effective tool in the workup of patients clinically suspected of having appendicitis. (orig.)

Effect of cooler electrons on a compressive ion acoustic solitary wave in a warm ion plasma — Forbidden regions, double layers, and supersolitons

International Nuclear Information System (INIS)

Ghosh, S. S.; Sekar Iyengar, A. N.

2014-01-01

It is observed that the presence of a minority component of cooler electrons in a three component plasma plays a deterministic role in the evolution of solitary waves, double layers, or the newly discovered structures called supersolitons. The inclusion of the cooler component of electrons in a single electron plasma produces sharp increase in nonlinearity in spite of a decrease in the overall energy of the system. The effect maximizes at certain critical value of the number density of the cooler component (typically 15%–20%) giving rise to a hump in the amplitude variation profile. For larger amplitudes, the hump leads to a forbidden region in the ambient cooler electron concentration which dissociates the overall existence domain of solitary wave solutions in two distinct parameter regime. It is observed that an inclusion of the cooler component of electrons as low as < 1% affects the plasma system significantly resulting in compressive double layers. The solution is further affected by the cold to hot electron temperature ratio. In an adequately hotter bulk plasma (i.e., moderately low cold to hot electron temperature ratio), the parameter domain of compressive double layers is bounded by a sharp discontinuity in the corresponding amplitude variation profile which may lead to supersolitons

Effect of cooler electrons on a compressive ion acoustic solitary wave in a warm ion plasma — Forbidden regions, double layers, and supersolitons

Energy Technology Data Exchange (ETDEWEB)

Ghosh, S. S., E-mail: sukti@iigs.iigm.res.in [Indian Institute of Geomagnetism, New Panvel, Navi Mumbai 410218 (India); Sekar Iyengar, A. N. [Plasma Physics Division, Saha Institute of Nuclear Physics, Kolkata 700064 (India)

2014-08-15

It is observed that the presence of a minority component of cooler electrons in a three component plasma plays a deterministic role in the evolution of solitary waves, double layers, or the newly discovered structures called supersolitons. The inclusion of the cooler component of electrons in a single electron plasma produces sharp increase in nonlinearity in spite of a decrease in the overall energy of the system. The effect maximizes at certain critical value of the number density of the cooler component (typically 15%–20%) giving rise to a hump in the amplitude variation profile. For larger amplitudes, the hump leads to a forbidden region in the ambient cooler electron concentration which dissociates the overall existence domain of solitary wave solutions in two distinct parameter regime. It is observed that an inclusion of the cooler component of electrons as low as < 1% affects the plasma system significantly resulting in compressive double layers. The solution is further affected by the cold to hot electron temperature ratio. In an adequately hotter bulk plasma (i.e., moderately low cold to hot electron temperature ratio), the parameter domain of compressive double layers is bounded by a sharp discontinuity in the corresponding amplitude variation profile which may lead to supersolitons.

Amnioinfusion for potential or suspected umbilical cord compression in labour.

Science.gov (United States)

Hofmeyr, G Justus; Lawrie, Theresa A

2012-01-18

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

Diagnostic accuracy of 18F-FDG PET/CT for detection of suspected recurrence in patients with oesophageal carcinoma

International Nuclear Information System (INIS)

Sharma, Punit; Jain, Sachin; Karunanithi, Sellam; Malhotra, Arun; Bal, Chandrasekhar; Kumar, Rakesh; Pal, Sujoy; Julka, Pramod Kumar; Thulkar, Sanjay

2014-01-01

To evaluate the role of 18 F-FDG PET/CT in the detection of recurrence in patients with oesophageal carcinoma, suspected clinically or following conventional investigations. This was a retrospective study. Data from 180 patients (age 56.3 ± 10.4 years; 126 men, 54 women) with histopathologically proven oesophageal carcinoma (squamous cell 115, adenocarcinoma 59, neuroendocrine carcinoma 4, small cell 1, poorly differentiated 1) who had undergone 227 18 F-FDG PET/CT studies for suspected recurrence were analysed. Recurrence was suspected clinically or following conventional investigations. PET/CT images were revaluated by two nuclear medicine physicians in consensus. Findings were grouped into local, nodal and distant recurrence. Results were compared to those from contrast-enhanced (CE) CT when available (109 patients). Clinical/imaging follow-up (minimum 6 months) with histopathology (when available) was taken as the reference standard. Of the 227 18 F-FDG PET/CT studies,166 were positive and 61 were negative for recurrent disease. PET/CT showed local recurrence in 134, nodal recurrence in 115 and distant recurrence in 47, with more than one site of recurrence in 34. The PET/CT findings were true-positive in 153 studies, true-negative in 54, false-positive in 13 and false-negative in 7. The sensitivity of 18 F-FDG PET/CT was 96 %, the specificity was 81 %, the positive and negative predictive values were 92 % and 89 %, respectively, and the accuracy was 91 %. PET/CT showed similar accuracy in patients with squamous cell carcinoma and in those with adenocarcinoma (P = 0.181). 18 F-FDG PET/CT was more specific than CECT (67 % vs. 21 %; P 18 F-FDG PET/CT shows high accuracy in the detection of suspected recurrence in patients with oesophageal carcinoma. It is more specific than and is superior to CECT in the detection of nodal recurrence. (orig.)

The impact of failing to identify suspect effort in patients undergoing adult attention-deficit/hyperactivity disorder (ADHD) assessment.

Science.gov (United States)

Marshall, Paul S; Hoelzle, James B; Heyerdahl, Danielle; Nelson, Nathaniel W

2016-10-01

[Correction Notice: An Erratum for this article was reported in Vol 28(10) of Psychological Assessment (see record 2016-22725-001). In the article, the penultimate sentence of the abstract should read “These results suggest that a significant percentage of those making a suspect effort will be diagnosed with ADHD using the most commonly employed assessment methods: an interview alone (71%); an interview and ADHD behavior rating scales combined (65%); and an interview, behavior rating scales, and most continuous performance tests combined (62%).” All versions of this article have been corrected.] This retrospective study examines how many adult patients would plausibly receive a diagnosis of attention-deficit/hyperactivity disorder (ADHD) if performance and symptom validity measures were not administered during neuropsychological evaluations. Five hundred fifty-four patients were extracted from an archival clinical dataset. A total of 102 were diagnosed with ADHD based on cognitive testing, behavior rating scales, effort testing, and clinical interview; 115 were identified as putting forth suspect effort in accordance with the Slick, Sherman, and Iverson (1999) criteria. From a clinical decision-making perspective, suspect effort and ADHD groups were nearly indistinguishable on ADHD behavior, executive function, and functional impairment rating scales, as well as on cognitive testing and key clinical interview questions. These results suggest that a significant percentage of those making a suspect effort will be diagnosed with ADHD using the most commonly employed assessment methods: an interview alone (71%); an interview and ADHD behavior rating scales combined (65%); and an interview, behavior rating scales, and most continuous performance tests combined (62%) [corrected]. This research makes clear that it is essential to evaluate task engagement and possible symptom amplification during clinical evaluations. PsycINFO Database Record (c) 2016 APA, all rights

The incidence of suspected myocardial infarction in Dutch general practice in the period 1978-1994.

NARCIS (Netherlands)

Pal-de Bruin, K.M. van der; Verkleij, H.; Jansen, J.; Bartelds, A.; Kromhout, D.

1998-01-01

Aim: To evaluate how the incidence of suspected myocardial infarction has developed from 1978 to 1994 and to study the incidence of confirmed acute myocardial infarction in Dutch general practices during the period 1991-1994. Methods: In three periods (1978, 1983-1985 and 1991-1994) the incidence of

The evaluation of the patients who admitted to a regional hospital emergency service with suspect of rabies

Directory of Open Access Journals (Sweden)

Nurettin Tunç

2012-09-01

Full Text Available Objectives: Rabies is one of the highest mortality ratesinfectious disease. The aim was the evaluation of the patientswho admitted to The Batman Regional State HospitalEmergency Service with suspect of rabies in the datesbetween June 2011 and November 2011.Materials and methods: Totally, 166 cases who admittedto our center was recorded according to the followingdata: place of residence (rural/urban, contact type andwound information, time after the contact, whether vaccineor immunoglobulin is applied or not and also the species,breed and being owned of suspected animal.Results: Our study population consisted of a total of 166cases including 38 women (23%, 128 men (77% withthe mean age of 22.01 ± 17.90 years. Of all subjects, 105(63% lived in urban and 61 (37% lived in rural areas.Eighty-five percent of suspicious animals (51% had anowner, while 81 animals were unattended.Conclusions: Our results showed that all admitted patientswere vaccinated and the ones contacted with petsor had a surface wound were vaccinated with 3 doses.Moreover, since the 49% of our cases were contactedwith animals which cannot be follow-up, our study obviouslyreveals that in our country deficiencies in the controlof waifs still is a public health problem and increases thecost of vaccination. J Clin Exp Invest 2012; 3 (3: 383-386Key words: Rabies, suspected bite, rabies prophylaxis

Abdominal and pelvic CT in cases of suspected abuse: can clinical and laboratory findings guide its use?

International Nuclear Information System (INIS)

Trout, Andrew T.; Strouse, Peter J.; Mohr, Bethany A.; Khalatbari, S.; Myles, Jamie D.

2011-01-01

Incomplete history and concern for occult injury in suspected child abuse occasionally results in CT screenings of the abdomen and pelvis. At our institution, we noted that these exams were infrequently positive. To identify clinical or laboratory criteria that may predict intra-abdominal injury and guide the use of abdominal and pelvic CT in this population. This retrospective review involved 68 children older than 36 months who had a CT of the abdomen/pelvis for suspected abuse. CT results and patient charts were reviewed for physical exam and historical and laboratory variables. CTs were positive in 16% of patients (11/68). Hypoactive/absent bowel sounds (P = 0.01, specificity = 94.7%) and AST and ALT values greater than twice normal (P = 0.004 and P = 0.003 respectively, NPV = 93.6%) were significantly associated with positive CTs. Multiple abnormal physical exam or laboratory findings were also significantly associated with positive CTs (P = 0.03 and P = 0.002 respectively, specificity = 91.3% and NPV = 93.6% respectively). CTs of the abdomen and pelvis are infrequently positive in cases of suspected abuse. To reduce radiation exposure, CTs should only be ordered if there are findings indicating that they may be positive. In our population, these findings include absent/hypoactive bowel sounds, LFTs greater than twice normal and ≥2 abnormal labs or physical exam findings. (orig.)

Abdominal and pelvic CT in cases of suspected abuse: can clinical and laboratory findings guide its use?

Energy Technology Data Exchange (ETDEWEB)

Trout, Andrew T.; Strouse, Peter J. [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Mohr, Bethany A. [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Pediatrics, Ann Arbor, MI (United States); Khalatbari, S.; Myles, Jamie D. [University of Michigan, Michigan Institute for Clinical and Health Research, Ann Arbor, MI (United States)

2011-01-15

Incomplete history and concern for occult injury in suspected child abuse occasionally results in CT screenings of the abdomen and pelvis. At our institution, we noted that these exams were infrequently positive. To identify clinical or laboratory criteria that may predict intra-abdominal injury and guide the use of abdominal and pelvic CT in this population. This retrospective review involved 68 children older than 36 months who had a CT of the abdomen/pelvis for suspected abuse. CT results and patient charts were reviewed for physical exam and historical and laboratory variables. CTs were positive in 16% of patients (11/68). Hypoactive/absent bowel sounds (P = 0.01, specificity = 94.7%) and AST and ALT values greater than twice normal (P = 0.004 and P = 0.003 respectively, NPV = 93.6%) were significantly associated with positive CTs. Multiple abnormal physical exam or laboratory findings were also significantly associated with positive CTs (P = 0.03 and P = 0.002 respectively, specificity = 91.3% and NPV = 93.6% respectively). CTs of the abdomen and pelvis are infrequently positive in cases of suspected abuse. To reduce radiation exposure, CTs should only be ordered if there are findings indicating that they may be positive. In our population, these findings include absent/hypoactive bowel sounds, LFTs greater than twice normal and {>=}2 abnormal labs or physical exam findings. (orig.)

Clinical problems of colorectal cancer and endometrial cancer cases with unknown cause of tumor mismatch repair deficiency (suspected Lynch syndrome).

Science.gov (United States)

Buchanan, Daniel D; Rosty, Christophe; Clendenning, Mark; Spurdle, Amanda B; Win, Aung Ko

2014-01-01

Carriers of a germline mutation in one of the DNA mismatch repair (MMR) genes have a high risk of developing numerous different cancers, predominantly colorectal cancer and endometrial cancer (known as Lynch syndrome). MMR gene mutation carriers develop tumors with MMR deficiency identified by tumor microsatellite instability or immunohistochemical loss of MMR protein expression. Tumor MMR deficiency is used to identify individuals most likely to carry an MMR gene mutation. However, MMR deficiency can also result from somatic inactivation, most commonly methylation of the MLH1 gene promoter. As tumor MMR testing of all incident colorectal and endometrial cancers (universal screening) is becoming increasingly adopted, a growing clinical problem is emerging for individuals who have tumors that show MMR deficiency who are subsequently found not to carry an MMR gene mutation after genetic testing using the current diagnostic approaches (Sanger sequencing and multiplex ligation-dependent probe amplification) and who also show no evidence of MLH1 methylation. The inability to determine the underlying cause of tumor MMR deficiency in these "Lynch-like" or "suspected Lynch syndrome" cases has significant implications on the clinical management of these individuals and their relatives. When the data from published studies are combined, 59% (95% confidence interval [CI]: 55% to 64%) of colorectal cancers and 52% (95% CI: 41% to 62%) of endometrial cancers with MMR deficiency were identified as suspected Lynch syndrome. Recent studies estimated that colorectal cancer risk for relatives of suspected Lynch syndrome cases is lower than for relatives of those with MMR gene mutations, but higher than for relatives of those with tumor MMR deficiency resulting from methylation of the MLH1 gene promoter. The cause of tumor MMR deficiency in suspected Lynch syndrome cases is likely due to either unidentified germline MMR gene mutations, somatic cell mosaicism, or biallelic somatic

Optical spectroscopy of known and suspected Herbig-Haro objects

International Nuclear Information System (INIS)

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

1985-01-01

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

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

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

2013-10-01

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

Treatment with epinephrine (adrenaline) in suspected anaphylaxis during anesthesia in Denmark.

Science.gov (United States)

Garvey, Lene H; Belhage, Bo; Krøigaard, Mogens; Husum, Bent; Malling, Hans-Jørgen; Mosbech, Holger

2011-07-01

Literature on the use of epinephrine in the treatment of anaphylaxis during anesthesia is very limited. The objective of this study was to investigate how often epinephrine is used in the treatment of suspected anaphylaxis during anesthesia in Denmark and whether timing of treatment is important. A retrospective study of 270 patients investigated at the Danish Anaesthesia Allergy Centre after referral due to suspected anaphylaxis during anesthesia was performed. Reactions had been graded by severity: C1, mild reactions; C2, moderate reactions; C3, anaphylactic shock with circulatory instability; C4, cardiac arrest. Use of epinephrine, dosage, route of administration, and time between onset of circulatory instability and epinephrine administration were noted. A total of 122 (45.2%) of referred patients had C3 or C4 reactions; of those, 101 (82.8%) received epinephrine. Route of administration was intravenous in 95 (94%) patients. Median time from onset of reported hypotension to treatment with epinephrine was 10 min (range, 1-70 min). Defining epinephrine treatment less than or equal to 10 min after onset of hypotension as early, and more than 10 min as late, infusion was needed in 12 of 60 patients (20%) treated early versus 12 of 35 patients (34%) treated late (odds ratio, 2.09) (95% confidence interval, 0.81-5.35). Anaphylaxis may be difficult to diagnose during anesthesia, and treatment with epinephrine can be delayed as a consequence. Anaphylaxis should be considered and treated in patients with circulatory instability during anesthesia of no apparent cause who do not respond to the usual treatments.

Spinal diffusion tensor tractography for differentiation of intramedullary tumor-suspected lesions

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Egger, K., E-mail: karl.egger@uniklinik-freiburg.de [Department of Neuroradiology, University Medical Center Freiburg, Breisacher Straße 64, 79106 Freiburg (Germany); Hohenhaus, M. [Department of Neurosurgery, University Medical Center Freiburg, Breisacher Straße 64, 79106 Freiburg (Germany); Van Velthoven, V. [Department of Neurosurgery, UZ Brussel, Laarbeeklaan 101, 1090 Brussel (Belgium); Heil, S.; Urbach, H. [Department of Neuroradiology, University Medical Center Freiburg, Breisacher Straße 64, 79106 Freiburg (Germany)

2016-12-15

Background and purpose: Primary MRI diagnosis of spinal intramedullary tumor-suspected lesions can be challenging and often requires spinal biopsy or resection with a substantial risk of neurological deficits. We evaluated whether Diffusion Tensor Imaging (DTI) tractography can facilitate the differential diagnosis. Materials and methods: Twenty-five consecutive patients with an intramedullary tumor-suspected lesion considered for spinal surgery were studied with a Diffusion-weighted multi-shot read out segmented EPI sequence (RESOLVE). White matter tracts (“streamlines”) were calculated using the FACT algorithm and visually co-registered to a T2-weighted 3D sequence. The fused images were assessed concerning spinal streamline appearance as normal, displaced or terminated. Definite diagnosis was verified by histological analysis or further clinical work-up. Results: All patients with normal appearing streamlines (n = 6) showed an acute inflammatory demyelinating pathology in the further clinical work-up. In 10 patients streamline displacing lesions were found from which 5 patients underwent a surgical treatment with histologically confirmed low-grade tumors like ependymomas and pilocytic astrocytomas. In nine patients streamlines were terminated, from which 6 patients received a histology proven diagnoses with a more heterogenous spectrum (3 cases of high grade tumor, 1 case of low grade tumor with intralesional hemorrhage and 2 cases with gliosis but no tumor cells). Conclusion: Using multi-shot DTI spinal tractography acute inflammatory lesions can be differentiated from other tumorous intramedullary lesions. The entity diagnosis of spinal tumors seems to be more challenging, primarily due to the variety of factors like invasivity, expansion or intralesional hemorrhage.

Investigating suspected acute pulmonary embolism - what are hospital clinicians thinking?

International Nuclear Information System (INIS)

McQueen, A.S.; Worthy, S.; Keir, M.J.

2008-01-01

Aims: To assess local clinical knowledge of the appropriate investigation of suspected acute pulmonary embolism (PE) and this compare with the 2003 British Thoracic Society (BTS) guidelines as a national reference standard. Methods: A clinical questionnaire was produced based on the BTS guidelines. One hundred and eight-six participants completed the questionnaires at educational sessions for clinicians of all grades, within a single NHS Trust. The level of experience amongst participants ranged from final year medical students to consultant physicians. Results: The clinicians were divided into four groups based on seniority: Pre-registration, Junior, Middle, and Senior. Forty-six point eight percent of all the clinicians correctly identified three major risk factors for PE and 25.8% recognized the definition of the recommended clinical probability score from two alternatives. Statements regarding the sensitivity of isotope lung imaging and computed tomography pulmonary angiography (CTPA) received correct responses from 41.4 and 43% of participants, respectively, whilst 81.2% recognized that an indeterminate ventilation-perfusion scintigraphy (V/Q) study requires further imaging. The majority of clinicians correctly answered three clinical scenario questions regarding use of D-dimers and imaging (78, 85, and 57.5%). There was no statistically significant difference between the four groups for any of the eight questions. Conclusions: The recommended clinical probability score was unfamiliar to all four groups of clinicians in the present study, and the majority of doctors did not agree that a negative CTPA or isotope lung scintigraphy reliably excluded PE. However, questions based on clinical scenarios received considerably higher rates of correct responses. The results indicate that various aspects of the national guidelines on suspected acute pulmonary embolism are unfamiliar to many UK hospital clinicians. Further research is needed to identify methods to improve

Bile acid aspiration in suspected ventilator-associated pneumonia.

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Wu, Yu-Chung; Hsu, Po-Kuei; Su, Kang-Cheng; Liu, Lung-Yu; Tsai, Cheng-Chien; Tsai, Shu-Ho; Hsu, Wen-Hu; Lee, Yu-Chin; Perng, Diahn-Warng

2009-07-01

The aims of this study were to measure the levels of bile acids in patients with suspected ventilator-associated pneumonia (VAP) and provide a possible pathway for neutrophilic inflammation to explain its proinflammatory effect on the airway. Bile acid levels were measured by spectrophotometric enzymatic assay, and liquid chromatography mass spectrometry was used to quantify the major bile acids. Alveolar cells were grown on modified air-liquid interface culture inserts, and bile acids were then employed to stimulate the cells. Reverse transcriptase polymerase chain reaction and Western blots were used to determine the involved gene expression and protein levels. The mean (+/- SE) concentration of total bile acids in tracheal aspirates was 6.2 +/- 2.1 and 1.1 +/- 0.4 mumol/L/g sputum, respectively, for patients with and without VAP (p VAP group (p aspiration may reduce the intensity of neutrophilic inflammation in intubated and mechanically ventilated patients in the ICU.

Complementary roles of m-mode echocardiography and scintigraphy in the evaluation of adults wih suspected left-to-right shunts

International Nuclear Information System (INIS)

Botvinick, E.H.; Schiller, N.B.

1980-01-01

We sought to determine the relative clinical abilities and roles of echocardiography and scintigraphy in left-to-right shunt diagnosis. M-mode echocardiographic and scintigraphic studies were analyzed in 37 adults presenting diagnostic difficulties with suspected left-to-right shunts. An enlarged right ventricle on M-mode echocardiography was a sensitive (100%) but not specific (55%) indicator of atrial septal defect (ASD). M-mode lacked sensitivity for ventricular eptal defect (VSD) and patent ductus arteriosus (PDA). In a few studies, two-dimensional echocardiography provided additional specific and clinically important anatomic information. Scintigraphic analysis demonstrated complete diagnostic accuracy and excellent localizing and quantitative abilities in all patients studied. Because it is extremely sensitie to ASD, free of any exposure to radioactivity, entirely noninvasive and may by simply and visually analyzed, echocardiography is the study of choice in the preliminary evaluation of patients presenting, diagnostic difficulty with suspected ASD. Scintigraphy is the study of choice in the preliminary evaluation of patients presenting diagnostic difficulty with suspected VSD and PDA and is the logical response to the finding of echocardiographic right ventricular enlargement when the diagnosis remains in doubt

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

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Zhang, Wenhua; Sun, Hongjun; Luo, Fangqiong

2017-10-01

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

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

LENUS (Irish Health Repository)

Quinn, Edel Marie

2012-07-01

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

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

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Dobashi A

2016-04-01

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

The value of chest X-ray in the Scottish Referral Guidelines for suspected head and neck cancer in 2144 patients.

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Fingland, P; Carswell, V; Tikka, T; Douglas, C M; Montgomery, J

2018-04-30

In Scotland, patients with suspected head and neck cancer are referred on the basis of the Scottish Referral Guidelines for Suspected Cancer, rather than the National Institute for Health and Care Excellence guidelines. A chest X-ray should be requested by the general practitioner at the same time as referral for persistent hoarseness. The evidence for this is level 4. This audit identified adherence to this recommendation and X-ray results. All 'urgent suspicion of cancer' referrals to the ENT department in the National Health Service Greater Glasgow and Clyde for 2015-2016 were audited. Persistent hoarseness for more than 3 weeks instigated referral in 318 patients (15.7 per cent). Chest X-ray was performed in 120 patients (38 per cent), which showed: no abnormality in 116 (96.7 per cent), features of infection in 2 (1.7 per cent) and something else in 2 patients (1.7 per cent). No chest X-ray altered the management of a patient. Performance of chest X-ray does not alter management and its removal from the Scottish Referral Guidelines for Suspected Cancer is recommended.

The Shetland Islands scrapie monitoring and control programme: analysis of the clinical data collected from 772 scrapie suspects 1985-1997.

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Cockcroft, P D; Clark, A M

2006-02-01

There were 574 scrapie positive suspects (histopathological scrapie lesions present) and 198 scrapie negative suspects (histopathological scrapie lesions absent). The greatest number of scrapie cases were recorded in sheep of 2, 3 and 4 years of age which represented 17%, 36% and 23% of the scrapie positive suspects, respectively. The sign sensitivities and specificities for the ten recorded signs were, respectively: pruritus (62%, 42%), ataxia (23%, 74%), hyperaesthesia (32%, 74%), wool loss (25%, 73%), fleece discolouration (29%, 85%), bruxism (23%, 69%), nibbling reflex (17%, 58%), head rubbing (47%, 78%), poll rubbing (25%, 83%). These single signs had poor discriminatory values with likelihood ratios close to one (range 0.89-1.21); combinations of the four signs, pruritus, wool loss, ataxia, hyperaesthesia and emaciation were more discriminatory (range 0.30-4.3). This study covered a time period when bovine spongiform encephalopathy (BSE) might have been introduced into the sheep population on the Shetland Islands via contaminated feed. No temporal changes could be detected in the age structure of the affected animals.

Cohort profile: prevalence of valvular heart disease in community patients with suspected heart failure in UK.

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Marciniak, Anna; Glover, Keli; Sharma, Rajan

2017-01-27

The aim of this study was to evaluate the proportion of suspected heart failure patients with significant valvular heart disease. Early diagnosis of valve disease is essential as delay can limit treatment and negatively affect prognosis for undiagnosed patients. The prevalence of unsuspected valve disease in the community is uncertain. We prospectively evaluated 79 043 patients, between 2001 and 2011, who were referred to a community open access echocardiography service for suspected heart failure. All patients underwent a standard transthoracic echocardiogram according to British Society of Echocardiography guidelines. Of the total number, 29 682 patients (37.5%) were diagnosed with mild valve disease, 8983 patients (11.3%) had moderate valve disease and 2134 (2.7%) had severe valve disease. Of the total number of patients scanned, the prevalence of aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation was 10%, 8.4%, 1%, and 12.5% respectively. 18% had tricuspid regurgitation. 5% had disease involving one or more valves. Of patients with suspected heart failure in the primary care setting, a significant proportion have important valvular heart disease. These patients are at high risk of future cardiac events and will require onward referral for further evaluation. We recommend that readily available community echocardiography services should be provided for general practitioners as this will result in early detection of valve disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Imaging Algorithms for Evaluating Suspected Rotator Cuff Disease: Society of Radiologists in Ultrasound Consensus Conference Statement

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Jacobson, Jon A.; Benson, Carol B.; Bancroft, Laura W.; Bedi, Asheesh; McShane, John M.; Miller, Theodore T.; Parker, Laurence; Smith, Jay; Steinbach, Lynne S.; Teefey, Sharlene A.; Thiele, Ralf G.; Tuite, Michael J.; Wise, James N.; Yamaguchi, Ken

2013-01-01

The Society of Radiologists in Ultrasound convened a panel of specialists from a variety of medical disciplines to reach a consensus about the recommended imaging evaluation of painful shoulders with clinically suspected rotator cuff disease. The panel met in Chicago, Ill, on October 18 and 19, 2011, and created this consensus statement regarding the roles of radiography, ultrasonography (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography. The consensus panel consisted of two co-moderators, a facilitator, a statistician and health care economist, and 10 physicians who have specialty expertise in shoulder pain evaluation and/or treatment. Of the 13 physicians on the panel, nine were radiologists who were chosen to represent a broad range of skill sets in diagnostic imaging, different practice types (private and academic), and different geographical regions of the United States. Five of the radiologists routinely performed musculoskeletal US as part of their practice and four did not. There was also one representative from each of the following clinical specialties: rheumatology, physical medicine and rehabilitation, orthopedic surgery, and nonoperative sports medicine. The goal of this conference was to construct several algorithms with which to guide the imaging evaluation of suspected rotator cuff disease in patients with a native rotator cuff, patients with a repaired rotator cuff, and patients who have undergone shoulder replacement. The panel hopes that these recommendations will lead to greater uniformity in rotator cuff imaging and more cost-effective care for patients suspected of having rotator cuff abnormality. © RSNA, 2013 PMID:23401583

Utility of urine cytology in evaluating hematuria with sonographically suspected bladder lesion in patients older than 50 years

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Hussam Eldin Helmy Mady

2014-01-01

Conclusion: Hematuria in patients older than 50 years with sonographically suspected bladder lesion mandates cystoscopy and biopsy. UC does not add more significant information in this group of patients.

ANAMNESIS AND CLINIC FINDINGS OF THE PATIENTS SUSPECTED OF HAVING ECTOPIC PREGNANCY

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Stanoje Pesic

2000-09-01

Full Text Available An analysis has been done of a series of 573 patients suffering from extrauterinepregnancy, namely those found suspect upon entering the hospital. Thediagnosis of extra-uterine pregnancy was confirmed in 322 (56% patients. Theleading symptom of extra-uterine pregnancy is metrorrhagia (63,41%. As for theoperation time, 3 1% of them were immediately operated. The ultrasound techniqueadds to the diagnostic certainty. Our results show that carefully taken anamnesis inaddition to symptom recording and a careful clinic examination can make possiblethe extra-uterine pregnancy diagnosis.

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

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

2015-01-01

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

Suspected Lynch syndrome associated MSH6 variants: A functional assay to determine their pathogenicity.

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Hellen Houlleberghs

2017-05-01

Full Text Available Lynch syndrome (LS is a hereditary cancer predisposition caused by inactivating mutations in DNA mismatch repair (MMR genes. Mutations in the MSH6 DNA MMR gene account for approximately 18% of LS cases. Many LS-associated sequence variants are nonsense and frameshift mutations that clearly abrogate MMR activity. However, missense mutations whose functional implications are unclear are also frequently seen in suspected-LS patients. To conclusively diagnose LS and enroll patients in appropriate surveillance programs to reduce morbidity as well as mortality, the functional consequences of these variants of uncertain clinical significance (VUS must be defined. We present an oligonucleotide-directed mutagenesis screen for the identification of pathogenic MSH6 VUS. In the screen, the MSH6 variant of interest is introduced into mouse embryonic stem cells by site-directed mutagenesis. Subsequent selection for MMR-deficient cells using the DNA damaging agent 6-thioguanine (6TG allows the identification of MMR abrogating VUS because solely MMR-deficient cells survive 6TG exposure. We demonstrate the efficacy of the genetic screen, investigate the phenotype of 26 MSH6 VUS and compare our screening results to clinical data from suspected-LS patients carrying these variant alleles.

Overview of suspected adverse reactions to veterinary medicinal products reported in South Africa (March 2004 - February 2006 : report

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V. Naidoo

2006-06-01

Full Text Available The Veterinary Pharmacovigilance and Medicines Information Centre is responsible for the monitoring of veterinary adverse drug reactions in South Africa. An overview of reports of suspected adverse drug reactions received by the centre during the period March 2004 to February 2006 is presented. A total of 21 reports was received in the 2-year period, continuing the decline in the number of reports to a lower figure than in any previous year. This is surprising considering the legal obligation of the veterinary professionals to report all adverse drug reactions. Once again the majority of reports involved suspected adverse reactions that occurred in dogs and cats. Most of the products implicated were stock remedies. Veterinarians predominantly administered these products.

Improving the Yield of Histological Sampling in Patients With Suspected Colorectal Cancer During Colonoscopy by Introducing a Colonoscopy Quality Assurance Program.

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Gado, Ahmed; Ebeid, Basel; Abdelmohsen, Aida; Axon, Anthony

2011-08-01

Masses discovered by clinical examination, imaging or endoscopic studies that are suspicious for malignancy typically require biopsy confirmation before treatment is initiated. Biopsy specimens may fail to yield a definitive diagnosis if the lesion is extensively ulcerated or otherwise necrotic and viable tumor tissue is not obtained on sampling. The diagnostic yield is improved when multiple biopsy samples (BSs) are taken. A colonoscopy quality-assurance program (CQAP) was instituted in 2003 in our institution. The aim of this study was to determine the effect of instituting a CQAP on the yield of histological sampling in patients with suspected colorectal cancer (CRC) during colonoscopy. Initial assessment of colonoscopy practice was performed in 2003. A total of five patients with suspected CRC during colonoscopy were documented in 2003. BSs confirmed CRC in three (60%) patients and were nondiagnostic in two (40%). A quality-improvement process was instituted which required a minimum six BSs with adequate size of the samples from any suspected CRC during colonoscopy. A total of 37 patients for the period 2004-2010 were prospectively assessed. The diagnosis of CRC was confirmed with histological examination of BSs obtained during colonoscopy in 63% of patients in 2004, 60% in 2005, 50% in 2006, 67% in 2007, 100% in 2008, 67% in 2009 and 100% in 2010. The yield of histological sampling increased significantly ( p quality assurance and improvement program increased the yield of histological sampling in patients with suspected CRC during colonoscopy.

Low-Dose CT for Evaluation of Suspected Urolithiasis: Diagnostic Yield for Assessment of Alternative Diagnoses.

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Weinrich, Julius Matthias; Bannas, Peter; Regier, Marc; Keller, Sarah; Kluth, Luis; Adam, Gerhard; Henes, Frank Oliver

2018-03-01

The purpose of this study is to assess the diagnostic yield of low-dose (LD) CT for alternative diagnoses in patients with suspected urolithiasis. In this retrospective study, we included 776 consecutive patients who underwent unenhanced abdominal CT for evaluation of suspected urolithiasis. All examinations were performed with an LD CT protocol; images were reconstructed using iterative reconstruction. The leading LD CT diagnosis was recorded for each patient and compared with the final clinical diagnosis, which served as the reference standard. The mean (± SD) effective dose of CT was 1.9 ± 0.6 mSv. The frequency of urolithiasis was 82.5% (640/776). LD CT reached a sensitivity of 94.1% (602/640), a specificity of 100.0% (136/136), and an accuracy of 95.1% (738/776) for the detection of urolithiasis. In 93 of 136 patients (68.4%) without urolithiasis, alternative diagnoses were established as the final clinical diagnoses. Alternative diagnoses were most commonly located in the genitourinary (n = 53) and gastrointestinal (n = 18) tracts. LD CT correctly provided alternative diagnoses for 57 patients (61.3%) and was false-negative for five patients (5.4%). The most common clinical alternative diagnoses were urinary tract infections (n = 22). Seven diagnoses missed at LD CT were located outside the FOV. For 43 of all 776 patients (5.5%), neither LD CT nor clinical workup could establish a final diagnosis. The sensitivity, specificity, and accuracy of LD CT for the detection of alternative diagnoses were 91.9% (57/62), 95.6% (43/45), and 93.5% (100/107), respectively. LD CT enables the diagnosis of most alternative diagnoses in the setting of suspected urolithiasis. The most frequent alternative diagnoses missed by LD CT are urinary tract infections or diagnoses located outside the FOV of the abdominopelvic CT scan.

Alternative diagnoses based on CT angiography of the chest in patients with suspected pulmonary thromboembolism

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Ferreira, Eleci Vaz; Gazzana, Marcelo Basso; Seligman, Renato; Knorst, Marli Maria, E-mail: mknorst@gmail.com [Hospital de Clinicas de Porto Alegre, Porto Alegre, RS (Brazil); Guerra, Vinicius Andre [Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre, RS (Brazil). Faculdade de Medicina. Programa de Pos-Graduacao em Ciencias Pneumologicas; Sarmento, Muriel Bossle; Guazzelli, Pedro Arends; Hoffmeister, Mariana Costa [Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre (Brazil). Faculdade de Medicina

2016-01-15

Objective: To determine the prevalence of alternative diagnoses based on chest CT angiography (CTA) in patients with suspected pulmonary thromboembolism (PTE) who tested negative for PTE, as well as whether those alternative diagnoses had been considered prior to the CTA. Methods: This was a cross-sectional, retrospective study involving 191 adult patients undergoing CTA for suspected PTE between September of 2009 and May of 2012. Chest X-rays and CTAs were reviewed to determine whether the findings suggested an alternative diagnosis in the cases not diagnosed as PTE. Data on symptoms, risk factors, comorbidities, length of hospital stay, and mortality were collected. Results: On the basis of the CTA findings, PTE was diagnosed in 47 cases (24.6%). Among the 144 patients not diagnosed with PTE via CTA, the findings were abnormal in 120 (83.3%). Such findings were consistent with an alternative diagnosis that explained the symptoms in 75 patients (39.3%). Among those 75 cases, there were only 39 (20.4%) in which the same alterations had not been previously detected on chest X-rays. The most common alternative diagnosis, made solely on the basis of the CTA findings, was pneumonia (identified in 20 cases). Symptoms, risk factors, comorbidities, and the in-hospital mortality rate did not differ significantly between the patients with and without PTE. However, the median hospital stay was significantly longer in the patients with PTE than in those without (18.0 and 9.5 days, respectively; p = 0.001). Conclusions: Our results indicate that chest CTA is useful in cases of suspected PTE, because it can confirm the diagnosis and reveal findings consistent with an alternative diagnosis in a significant number of patients. (author)

Head Injury Secondary to Suspected Child Maltreatment: Results of a Prospective Canadian National Surveillance Program

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Bennett, Susan; Ward, Michelle; Moreau, Katherine; Fortin, Gilles; King, Jim; MacKay, Morag; Plint, Amy

2011-01-01

Objective: We sought to determine the incidence, clinical features, and demographic profile of head injury secondary to suspected child maltreatment (abuse or neglect) in Canada to help inform the development and evaluation of prevention programs for abusive head injuries. Methods: From March 1, 2005 to February 28, 2008, an average of 2,545…

Suspected seminal vesiculitis in an Asian elephant (Elephas maximus).

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Kilburn, Jennifer J; Velguth, Karen E; Backues, Kay A

2011-09-01

A 32-year-old male Asian elephant (Elephas maximus) underwent routine transrectal stimulation for semen collection as part of an artificial insemination program. The procedure consisted of a preinsemination semen collection followed by two consecutive days of semen collections for artificial insemination. The second day's sample contained large numbers of inflammatory cells, intracellular bacteria, and phagocytized sperm. Semen was submitted for culture and sensitivity. Culture revealed Acinetobacter lwoffii, Staphylococcus intermedius, Kocuria roseus, and an unidentified gram-positive organism. Empirical antibiotic therapy with trimethoprim sulfa was initiated and then changed to enrofloxacin based on sensitivity panel results for a total of 28 days of treatment. Diagnostic semen collections were performed during treatment and 2 wk posttreatment to determine the success of therapy. Posttreatment collections revealed resolution of the inflammation. The origin of the infection was suspected to be the seminal vesicles.

Total quality management for addressing suspect parts at the Oak Ridge High Flux Isotope Reactor

International Nuclear Information System (INIS)

Hendrix, K.A.; Tulay, M.P.

1993-01-01

Martin Marietta Energy System (MMES) Research Reactors Division (RRD), operator of the High Flux Isotope Reactor (HFIR) recently embarked on an aggressive Program to address the issue of suspect Parts and to enhance their procurement process. Through the application of TQM process improvement, RRD has already achieved improved efficiency in specifying, procuring, and accepting replacement items for its largest research reactor. These process improvements have significantly decreased the risk of installing suspect parts in the HFIR safety systems. To date, a systematic plan has been implemented, which includes the following elements: Process assessment and procedure review; Procedural enhancements; On-site training and technology transfer; Enhanced receiving inspections; Performance supplier evaluations and source verifications integrated processes for utilizing commercial grade products in nuclear safety-related applications. This paper will describe the above elements, how a partnership between MMES and Gilbert/Commonwealth facilitated the execution of the plan, and how process enhancements were applied. We will also present measures for improved efficiency and productivity, that MMES intends to continually address with Quality Action Teams

Evaluation of genotype-phenotype relationships in patients referred for endocrine assessment in suspected Pendred syndrome.

Science.gov (United States)

Soh, Lip Min; Druce, Maralyn; Grossman, Ashley B; Differ, Ann-Marie; Rajput, Liala; Bitner-Glindzicz, Maria; Korbonits, Márta

2015-02-01

Patients with Pendred syndrome have genotypic and phenotypic variability, leading to challenges in definitive diagnosis. Deaf children with enlarged vestibular aqueducts are often subjected to repeated investigations when tests for mutations in SLC26A4 are abnormal. This study provides genotype and phenotype information from patients with suspected Pendred syndrome referred to a single clinical endocrinology unit. A retrospective analysis of 50 patients with suspected Pendred syndrome to investigate the correlation between genetic, perchlorate discharge test (PDT) and endocrine status. Eight patients with monoallelic SLC26A4 mutations had normal PDT. Of the 33 patients with biallelic mutations, ten of 12 patients with >30% discharge developed hypothyroidism. In our cohort, c.626G>T and c.3-2A>G result in milder clinical presentations with lower median perchlorate discharge of 9.3% (interquartile range 4-15%) compared with 40% (interquartile range 21-60%) for the remaining mutations. Eight novel mutations were detected. All patients with PDT 30% have a high risk of developing goitre and hypothyroidism, and should have lifelong monitoring. © 2015 European Society of Endocrinology.

Radioimmune imaging of bone marrow in patients with suspected bone metastases from primary breast cancer

International Nuclear Information System (INIS)

Duncker, C.M.; Carrio, I.; Berna, L.; Estorch, M.; Alonso, C.; Ojeda, B.; Blanco, R.; Germa, J.R.; Ortega, V.

1990-01-01

Radioimmune imaging of bone marrow was performed by technetium-99m- (99mTc) labeled antigranulocyte monoclonal antibody BW 250/183 (AGMoAb) scans in 32 patients with suspected bone metastases from primary breast cancer. AGMoAb scans showed bone marrow defects in 25/32 (78%) patients; bone invasion was subsequently confirmed in 23 (72%) patients. Conventional bone scans performed within the same week detected bone metastases in 17/32 (53%) patients (p less than 0.001). AGMoAb scans detected more sites indicating metastatic disease than bone scans in 12 of these 17 patients (71%). All patients with bone metastases in the axial skeleton had bone marrow defects at least at the sites of bone metastases. Of 15 patients with normal, or indicative of, benign disease bone scans, 8 patients (53%) presented with bone marrow defects in the AGMoAb scans. Bone invasion was confirmed in six of them. AGMoAb bone marrow scans provide a method for the early detection of bone metastatic invasion in patients with breast cancer and suspected bone metastases

Validity of total leucocytes count and neutrophil count (differential leucocytes) in diagnosing suspected acute appendicitis

International Nuclear Information System (INIS)

Anwar, M.W.; Abid, I.

2012-01-01

Objective: To compare the diagnostic accuracy of Total Leucocytes Count (TLC) with Neutrophil count; Differential Leucocytes Count (DLC) in diagnosing cases of suspected acute appendicitis. Study design: Validation study. Place and duration of the study: Department of Surgery, Combined Military Hospital (CMH) Rawalpindi, from April 2008 to October 2008. Method: A total of 100 patients of Pain right iliac fossae who underwent appendicectomy were included. Detailed history of all the patients was taken for pain in right lower abdomen, its severity, its nature, relieving or provoking factors. Clinical examination was done in detail. Total and Differential Leucocytes Count was done. Every patient's appendix was examined grossly after appendicectomy for evidence of appendicitis. Diagnostic measures of TLC and DLC were calculated by standard formulas. Results: Sensitivity and specificity of TLC is 86.9% and 81.25% respectively and that of DLC is 82% and 68.75% respectively. Accuracy was 86% for TLC and 80% for DLC. Conclusion: TLC is more sensitive, specific and accurate test as compared to DLC and it should be used as diagnostic aid for suspected acute appendicitis cases. (author)

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

Energy Technology Data Exchange (ETDEWEB)

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

2017-05-15

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

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

International Nuclear Information System (INIS)

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

2017-01-01

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

Management of a Dog with Poorly Regulated Diabetes Mellitus, Chronic Pancreatitis, and Suspected Atopy with Cyclosporine

Directory of Open Access Journals (Sweden)

Jörg M. Steiner

2012-01-01

Full Text Available A 3-year-and-9-months old male neutered Bichon Frise was presented for a second opinion for diabetes mellitus, weight loss, pruritus, and loss of hair. During further work-up, the dog was diagnosed with uncontrolled diabetes mellitus and concurrent diagnoses of pancreatitis and atopy were also suspected. Multiple adjustments of insulin therapy did not improve control of diabetes mellitus. Also, a variety of different treatments failed to improve pruritus. The dog was seen by a veterinary dermatologist who further suspected atopy and started treatment with cyclosporine. Pruritus improved and coincidentally serum Spec cPL and fructosamine concentrations normalized after therapy, suggesting the possibility that cyclosporine may have controlled pancreatic inflammation and improved control of diabetes mellitus. This case report would suggest that further research into autoimmunity in dogs with chronic pancreatitis is warranted. Also, a controlled study is needed and in progress before the use of cyclosporine in dogs with chronic pancreatitis or a subgroup thereof can be advocated.

Unenhanced multidetector CT (CT KUB) in the initial imaging of suspected acute renal colic: evaluating a new service

International Nuclear Information System (INIS)

Chowdhury, F.U.; Kotwal, S.; Raghunathan, G.; Wah, T.M.; Joyce, A.; Irving, H.C.

2007-01-01

Aim: To evaluate a new imaging pathway for the investigation of patients presenting with suspected acute renal colic. Materials and methods: A retrospective review of 500 consecutive cases of suspected acute renal colic was undertaken to evaluate the initial results of a new imaging pathway introduced at our institution, which completely replaced the intravenous urogram (IVU) with unenhanced multidetector CT (CT KUB). Results: The positive rate for urolithiasis was 44% (221/500), the negative rate 46% (229/500) and the rate of other significant findings was 12% (59/500). Female patients had a low positive rate compared with male patients (27.5 versus 57.5%; p < 0.001). Urological intervention was required in 28% (61/221) and these patients had a larger average stone size (6.6 versus 3.7 mm; p < 0.001) and the stone was located more proximally. Out-of-hours imaging was performed in 37% (186/500), and these patients had a higher positive rate (52 versus 40%; p < 0.001). Other findings included a wide range of acute non-urological conditions. Conclusion: The feasibility of replacing the acute IVU with CT KUB in the initial assessment of suspected acute renal colic was demonstrated in the present study. The technique enables rapid diagnosis of urolithiasis, stratification of patients likely to proceed to urological intervention, and prompt diagnosis of a variety of other acute pathological conditions

Molecular screening of 980 cases of suspected hereditary optic neuropathy with a report on 77 novel OPA1 mutations

DEFF Research Database (Denmark)

Ferré, Marc; Bonneau, Dominique; Milea, Dan

2009-01-01

We report the results of molecular screening in 980 patients carried out as part of their work-up for suspected hereditary optic neuropathies. All the patients were investigated for Leber's hereditary optic neuropathy (LHON) and autosomal dominant optic atrophy (ADOA), by searching for the ten...... and OPA3 mutations in cases of suspected hereditary optic neuropathy, even in absence of a family history of the disease....... novel OPA1 mutations reported here. The statistical analysis of this large set of mutations has led us to propose a diagnostic strategy that should help with the molecular work-up of optic neuropathies. Our results highlight the importance of investigating LHON-causing mtDNA mutations as well as OPA1...

Management of suspected monogenic lung fibrosis in a specialised centre

Directory of Open Access Journals (Sweden)

Raphael Borie

2017-04-01

Full Text Available At least 10% of patients with interstitial lung disease present monogenic lung fibrosis suspected on familial aggregation of pulmonary fibrosis, specific syndromes or early age of diagnosis. Approximately 25% of families have an identified mutation in genes mostly involved in telomere homeostasis, and more rarely in surfactant homeostasis. Beyond pathophysiological knowledge, detection of these mutations has practical consequence for patients. For instance, mutations involved in telomere homeostasis are associated with haematological complications after lung transplantation and may require adapted immunosuppression. Moreover, relatives may benefit from a clinical and genetic evaluation that should be specifically managed. The field of genetics of pulmonary fibrosis has made great progress in the last 10 years, raising specific problems that should be addressed by a specialised team.

EuroClonality/BIOMED-2 guidelines for interpretation and reporting of Ig/TCR clonality testing in suspected lymphoproliferations

NARCIS (Netherlands)

Langerak, A. W.; Groenen, P. J. T. A.; Brüggemann, M.; Beldjord, K.; Bellan, C.; Bonello, L.; Boone, E.; Carter, G. I.; Catherwood, M.; Davi, F.; Delfau-Larue, M.-H.; Diss, T.; Evans, P. A. S.; Gameiro, P.; Garcia Sanz, R.; Gonzalez, D.; Grand, D.; Håkansson, A.; Hummel, M.; Liu, H.; Lombardia, L.; Macintyre, E. A.; Milner, B. J.; Montes-Moreno, S.; Schuuring, E.; Spaargaren, M.; Hodges, E.; van Dongen, J. J. M.

2012-01-01

PCR-based immunoglobulin (Ig)/T-cell receptor (TCR) clonality testing in suspected lymphoproliferations has largely been standardized and has consequently become technically feasible in a routine diagnostic setting. Standardization of the pre-analytical and post-analytical phases is now essential to

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

International Nuclear Information System (INIS)

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

1984-01-01

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

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...

Therapeutic effect of epidural steroid injection in patients suspected of having an internal disc disruption: a prospective case study

International Nuclear Information System (INIS)

Kim, Na Ra; Lee, Joon Woo; Chung, Sang Gi

2007-01-01

To assess the effect of the epidural steroid injection for patients suspected of having an internal disc disruption. Thirteen patients at the pain intervention clinic that received a lumbar interlaminar epidural steroid injection and were suspected of having an internal disc disruption were prospectively enrolled in this study. The treatment outcome was assessed using a 5-point patient satisfaction scale (no pain, much improved, slightly improved, no effects, aggravated) two weeks after injection. A successful outcome required a patient satisfaction scale of 'much improved' or 'no pain'. All patients received follow-up for two months. Two radiologists evaluated the presence of HIZ (high intensity zone), a dark disc by MR (n 10) and a diffuse bulging disc by CT (n = 3). Nine (69%) of the 13 patients achieved a successful outcome two weeks after injection. These nine patients showed no recurrence during the two months months follow-up. Of the 22 abnormal discs demonstrated by MRI and CT, MRI showed a dark disc in six patients and HIZ in 13 patients. CT showed diffuse bulging in three discs. Nine of 10 patients showed at least one HIZ. An lumbar interlaminar epidural steroid injection might be an effective tool for managing patients suspected of having an internal disc disruption

Therapeutic effect of epidural steroid injection in patients suspected of having an internal disc disruption: a prospective case study

Energy Technology Data Exchange (ETDEWEB)

Kim, Na Ra; Lee, Joon Woo; Chung, Sang Gi [Seoul National University Bundang Hospital, Seoul (Korea, Republic of)] (and others)

2007-09-15

To assess the effect of the epidural steroid injection for patients suspected of having an internal disc disruption. Thirteen patients at the pain intervention clinic that received a lumbar interlaminar epidural steroid injection and were suspected of having an internal disc disruption were prospectively enrolled in this study. The treatment outcome was assessed using a 5-point patient satisfaction scale (no pain, much improved, slightly improved, no effects, aggravated) two weeks after injection. A successful outcome required a patient satisfaction scale of 'much improved' or 'no pain'. All patients received follow-up for two months. Two radiologists evaluated the presence of HIZ (high intensity zone), a dark disc by MR (n 10) and a diffuse bulging disc by CT (n = 3). Nine (69%) of the 13 patients achieved a successful outcome two weeks after injection. These nine patients showed no recurrence during the two months months follow-up. Of the 22 abnormal discs demonstrated by MRI and CT, MRI showed a dark disc in six patients and HIZ in 13 patients. CT showed diffuse bulging in three discs. Nine of 10 patients showed at least one HIZ. An lumbar interlaminar epidural steroid injection might be an effective tool for managing patients suspected of having an internal disc disruption.

Investigation of Suspected Pulmonary Embolism at Hutt Valley Hospital with CT Pulmonary Angiography: Current Practice and Opportunities for Improvement

Directory of Open Access Journals (Sweden)

Nick Kennedy

2015-01-01

Full Text Available Aims. To study the use of CT pulmonary angiography (CTPA at Hutt Hospital and investigate the use of pretest probability scoring in the assessment of patients with suspected pulmonary embolism (PE. Methods. We studied patients with suspected PE that underwent CTPA between January and May 2012 and collected data on demographics, use of pretest probability scoring, and use of D Dimer and compared our practice with the British Thoracic Society (BTS guideline. Results. 105 patients underwent CTPA and 15% of patients had PE. 13% of patients had a Wells score prior to their scan. Wells score calculated by researchers revealed 54%, 36%, and 8% patients had low, medium, and high risk pretest probabilities and 8%, 20%, and 50% of these patients had positive scans. D Dimer was performed in 58% of patients and no patients with a negative D Dimer had a PE. Conclusion. The CTPA positive rate was similar to other contemporary studies but lower than previous New Zealand studies and some international guidelines. Risk stratification of suspected PE using Wells score and D Dimer was underutilised. A number of scans could have been safely avoided by using accepted guidelines reducing resources use and improving patient safety.

A review of suspected cases of driving under the influence of drugs (DUID) involved in traffic accidents in Istanbul (Turkey).

Science.gov (United States)

Acar, Fatih; Asirdizer, Mahmut; Aker, Rezzan Gulhan; Kucukibrahimoglu, E Esra; Ates, Ismail; Erol, Yeter; Sahin, Aysegul

2013-08-01

Nowadays traffic accidents, which have high mortality and morbidity, are an important public health problem. The association between the use of alcohol and/or drugs by drivers and the increased risk of traffic accidents with a high risk of death and injury has been well described in the literature. This study aimed to review the incidence of cases of driving under the influence of drugs (DUID) among all cases of driving under the influence (DUI) of alcohol and/or other drugs involved in traffic accidents and to evaluate the type of the psychoactive drugs (with or without alcohol) detected in blood samples in Istanbul and its surrounding area. This study is the first investigation on the subject of DUID cases in Turkey. The reports of the Istanbul Toxicology Department of the Council of Forensic Medicine (Turkey) on suspected DUID cases involved in traffic accidents between 1 July 2010 and 30 June 2011 were retrospectively reviewed for alcohol and/or drug use. Alcohol analysis was requested in 4274 suspected DUI cases, whereas drug along with alcohol analysis was requested in only 91. The rate of suspected DUID cases (n = 91) among the suspected DUI cases (n = 4274) was only 2.1% and in this study, we evaluated only the DUID cases in detail. Alcohol was present in 44% of suspected DUID cases. Psychoactive drugs were present in 15.4% of cases. The incidence among 46 confirmed DUID cases was found to be 17.4% for cannabis, 8.7% for benzodiazepines, 4.3% for barbiturates, 4.3% for antidepressants, 2.2% for cocaine and 2.2% for amphetamines. Although there is a zero-tolerance approach for DUID in the Turkish regulations, it is not well recognised and not inspected by police and legal authorities who are responsible for taking measures in traffic accidents and for routine traffic controls in Turkey. It is concluded that psychoactive drugs should be checked as well as alcohol in all traffic accident cases and roadside controls. Copyright © 2013 Elsevier Ltd and Faculty

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

Directory of Open Access Journals (Sweden)

Suzy Duckworth

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

F-FDG PET/CT (PET/CT) influences management in patients with known or suspected pancreatic cancer

International Nuclear Information System (INIS)

Barber, Thomas W.; Kalff, Victor; Cherk, Martin H.; Yap, Kenneth SK.; Evans, Peter; Kelly, Michael J.

2009-01-01

Full text: Objective: To assess the impact on clinical management of PET/CT in patients with known or suspected pancreatic cancer. Methods: Between April 2006 and September 2008,25 PET/CT scans were performed using a dedicated PET/CT (22 scans) or a coincidence hybrid PET/CT camera (3 scans) in 23 patients with known or suspected pancreatic cancer. 17 scans were performed for initial evaluation and 8 for restaging of disease. The pre-PET/CT management plan and for intent were prospectively recorded in all cases. The post-PET/CT management plan was determined from the medical record and for discussions with treating clinicians. The impact of PET/CT on management was classified as High, Medium, Low or None, defined using ANZAPNM PET data collection project criteria. Follow-up was used to reconcile any discordance between PET/CT and conventional imaging. Results: Overall, PET/CT management impact was classified as high (n equal 7), medium (n equal 4), low (n equal 10) or none (n equal 4). Impact was either high or medium in l l/25 patients (44%) (95% confidence interval; 24 - 64%). Impact was high in 4/17 patients imaged for initial evaluation, predominantly by clarifying equivocal lesions on conventional imaging. In restaged patients, PET/CT impact was high in 3/8, and it correctly modified disease extent in 5/8. In the 16 discordant studies, PET/CT assessment was correct in 10, conventional imaging in 4 and there was insufficient information in 2. Conclusion: PET/CT has high or medium management impact in 44% of patients imaged for known or suspected pancreatic cancer, more commonly during restaging. Discordant PET/CT results were usually correct.

Associating a prototypical forbidden food item with guilt or celebration: relationships with indicators of (un)healthy eating and the moderating role of stress and depressive symptoms.

Science.gov (United States)

Kuijer, Roeline G; Boyce, Jessica A; Marshall, Emma M

2015-01-01

The increase in obesity and the many educational messages prompting us to eat a healthy diet have heightened people's concerns about the effects of food choice on health and weight. An unintended side effect may be that such awareness fuels feelings of guilt and worry about food. Although guilt has the potential to motivate behaviour change, it may also lead to feelings of helplessness and loss of control. The current study examined the relationship between a default association of either 'guilt' or 'celebration' with a prototypical forbidden food item (chocolate cake), indicators of healthy eating and choosing food for mood regulation reasons. Following a 'diathesis-stress' perspective, the moderating roles of depressive symptoms and stress were examined. Although a default association of guilt was found to be harmless under some circumstances (i.e. under low stress), those who associated chocolate cake with guilt (vs. celebration) reported unhealthier eating habits and lower levels of perceived behavioural control over healthy eating when under stress, rated mood regulation reasons for food choice as important irrespective of their current affective state, and did not have more positive attitudes towards healthy eating. Implications for public health messages and interventions will be discussed.

Frequency of suspected cases of neurocysticercosis detected by computed skull tomography in Santa Maria, Rio Grande do Sul State, Brazil

International Nuclear Information System (INIS)

Silva, Jose Edson Paz da

2000-01-01

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

Frequency of suspected cases of neurocysticercosis detected by computed skull tomography in Santa Maria, Rio Grande do Sul State, Brazil

Energy Technology Data Exchange (ETDEWEB)

Silva, Jose Edson Paz da [Santa Maria Univ., RS (Brazil). Dept. de Analises Clinicas e Toxicologicas; Diefenthaeler, Ana Paula [Santa Maria Univ., RS (Brazil). Curso de Farmacia e Bioquimica; Palma, Jose Knoll [Hospital de Caridade Astrogildo de Azevedo, Santa Maria, RS (Brazil)

2000-02-01

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

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.

The impact of Einstein observations on our understanding of low mass star formation

International Nuclear Information System (INIS)

Walter, F.M.

1990-01-01

Prior to 1980, the world of pre-main sequence stars, if not well understood, was at least well defined. The Herbig and Rao (1972) catalog listed 69 pre-main sequence stars in Tau-Aur, with the vast majority clearly being T Tauri stars. The characteristics of the classical T Tauri stars include strong Hα emission, with W λ (Hα)>5-10A; forbidden line emission; continuum ultraviolet and IR excesses; veiling of the absorption line spectrum; significant stellar variability; Li I λ6707A absorption; and association with dark clouds and/or emission nebulosities. Star forming regions were observed extensively with the Einstein Observatory, and showed the abundance of stellar X-ray sources in the Orion Nebula. About 1/3 of the known T Tauri stars were detected as X-ray sources, yet the vast majority of the X-ray sources detected were coincident with anonymous stars not suspected to be pre-main sequence stars. In the grand tradition of X-ray astronomy, X-ray astronomers trooped to telescopes to identify the optical counterparts. It was shown that 5 of the counterparts were K7-M0 stars, above the main sequence, with strong Li I absorption and that these stars were kinematic members of the Tau-Aur star formation complex. Since then, additional members of this class of naked T Tauri Stars (NTTS) have been studied, and charts provided for X-ray selected pre-main sequence star candidates in the general vicinity of Tau-Aur. Thirty five X-ray sources have been selected and optically confirmed as NTTS in Tau-Aur

Three suspected cases of sugammadex-induced anaphylactic shock.

Science.gov (United States)

Takazawa, Tomonori; Tomita, Yukinari; Yoshida, Nagahide; Tomioka, Akihiro; Horiuchi, Tatsuo; Nagata, Chie; Orihara, Masaki; Yamada, Makiko Hardy; Saito, Shigeru

2014-01-01

Sugammadex has a unique mechanism of action and is widely used because of its safety and efficacy. A few recent reports have described allergic reactions to clinical doses of sugammadex. We hereby describe another series of cases of possible anaphylaxis to sugammadex. We present three suspected cases of sugammadex-induced anaphylactic shock, including a 13-year-old boy who underwent laparoscopic appendectomy, a 75-year-old woman who underwent left knee arthroplasty, and a 34-year-old man who underwent left pansinectomy for sinobronchitis. All three patients received general anesthesia with rocuronium and their tracheas were intubated. Shortly after injection of sugammadex for reversal of rocuronium, all of them experienced a decrease in blood pressure along with mucocutaneous erythema. In the most severe case, reintubation after extubation was required due to difficulty in manual ventilation. All patients recovered with anti-allergic therapy. On later investigation, all three patients had a positive skin reaction to sugammadex. Our results suggest that physicians using sugammadex should be aware of the possibility of sugammadex-induced anaphylaxis.

Strong-back safety latch

International Nuclear Information System (INIS)

DeSantis, G.N.

1995-01-01

The calculation decides the integrity of the safety latch that will hold the strong-back to the pump during lifting. The safety latch will be welded to the strong-back and will latch to a 1.5-in. dia cantilever rod welded to the pump baseplate. The static and dynamic analysis shows that the safety latch will hold the strong-back to the pump if the friction clamps fail and the pump become free from the strong-back. Thus, the safety latch will meet the requirements of the Lifting and Rigging Manual for under the hook lifting for static loading; it can withstand shock loads from the strong-back falling 0.25 inch

Adjusted scaling of FDG positron emission tomography images for statistical evaluation in patients with suspected Alzheimer's disease.

Science.gov (United States)

Buchert, Ralph; Wilke, Florian; Chakrabarti, Bhismadev; Martin, Brigitte; Brenner, Winfried; Mester, Janos; Clausen, Malte

2005-10-01

Statistical parametric mapping (SPM) gained increasing acceptance for the voxel-based statistical evaluation of brain positron emission tomography (PET) with the glucose analog 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) in patients with suspected Alzheimer's disease (AD). To increase the sensitivity for detection of local changes, individual differences of total brain FDG uptake are usually compensated for by proportional scaling. However, in cases of extensive hypometabolic areas, proportional scaling overestimates scaled uptake. This may cause significant underestimation of the extent of hypometabolic areas by the statistical test. To detect this problem, the authors tested for hypermetabolism. In patients with no visual evidence of true focal hypermetabolism, significant clusters of hypermetabolism in the presence of extended hypometabolism were interpreted as false-positive findings, indicating relevant overestimation of scaled uptake. In this case, scaled uptake was reduced step by step until there were no more significant clusters of hypermetabolism. In 22 consecutive patients with suspected AD, proportional scaling resulted in relevant overestimation of scaled uptake in 9 patients. Scaled uptake had to be reduced by 11.1% +/- 5.3% in these cases to eliminate the artifacts. Adjusted scaling resulted in extension of existing and appearance of new clusters of hypometabolism. Total volume of the additional voxels with significant hypometabolism depended linearly on the extent of the additional scaling and was 202 +/- 118 mL on average. Adjusted scaling helps to identify characteristic metabolic patterns in patients with suspected AD. It is expected to increase specificity of FDGPET in this group of patients.

Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study

International Nuclear Information System (INIS)

Ajaj, Waleed; Lauenstein, Thomas; Goehde, Susanne; Kuehle, Christiane; Herborn, Christoph U.; Ruehm, Stefan G.; Langhorst, Jost; Zoepf, Thomas; Gerken, Guido; Goyen, Mathias

2005-01-01

To assess dark-lumen magnetic resonance colonography (MRC) for the evaluation of patients with suspected sigmoid diverticulitis. Forty patients with suspected sigmoid diverticulitis underwent MRC within 72 h prior to conventional colonoscopy (CC). A three-dimensional T1-weighted volumetric interpolated breath-hold examination sequence was acquired after an aqueous enema and intravenous administration of gadolinium-based contrast agents. All MRC data were evaluated by two radiologists. Based on wall thickness and focal uptake of contrast material and pericolic reaction including mesenteric infiltration on T1-weighted sequence the sigmoid colon was assessed for the presence of diverticulitis. MRC classified 17 of the 40 patients as normal with regard to sigmoid diverticulitis. However, CC confirmed the presence of light inflammatory signs in four patients which were missed in MRC. MRC correctly identified wall thickness and contrast uptake of the sigmoid colon in the other 23 patients. In three of these patients false-positive findings were observed, and MRC classified the inflammation of the sigmoid colon as diverticulitis whereas CC and histopathology confirmed invasive carcinoma. MRC detected additionally relevant pathologies of the entire colon and could be performed in cases where CC was incomplete. MRC may be considered a promising alternative to CC for the detection of sigmoid diverticulitis. (orig.)

Homocysteine plasma levels in patients suspected coronary artery disease: Relation to myocardial perfusion image

International Nuclear Information System (INIS)

Yao, Z.Y.; He, Q.; Qu, W.

2002-01-01

Purpose: Although there is considerable epidemiologic evidence for a relationship between plasma homocysteine (Hcy) levels and coronary artery disease (CAD), not all studies, especially prospective ones have shown such a relationship. The purpose of this study was to investigate a possible association between Hcy plasma levels and myocardial perfusion defect by SPECT in patients suspected CAD. Methods and Materials: A cohort of 238 patients suspected CAD (age: 60.65±10.43, male to female: 172: 66) was examined for Hcy, tetrahydrofolic acid (FH4), vitamine B12 and coronary angiography (CAG). Furthermore, 42 patients also underwent 99m Tc-MIBI myocardial perfusion images (MPI) to assess the myocardial perfusion. Results: There were 69 patients with normal CAG and 63, 60, 42 and 4 patients with 1 vessel, two vessel, 3 vessel and left main coronary stenosis. The plasma Hcy of this group was significantly increased, p 0.05. In patients with >=3 segments myocardial perfusion defect, 10 of them had normal Hcy, and 7 with hyperhomocysteinemia, in patients with 0.05). Conclusion: Our data may indicate that hyperhomocysteinemia represents an independent risk factor in patients with high possibility of CAD rather than a mark of myocardial ischemia or coronary stenosis

MR findings in cases of suspected impacted fracture of the femoral neck

International Nuclear Information System (INIS)

Stiris, M.G.; Lilleaas, F.G.

1997-01-01

Purpose: To evaluate MR imaging of the hip in patients with a clinically suspected impacted fracture of the femoral neck in cases where conventional plain films show negative or equivocal findings. Material and Methods: Twenty-seven such patients were prospectively examined by MR imaging with a 1.0 T unit, within 24 hours of admittance to hospital. A coronal T1-weighted turbo spin-echo sequence (n=27), and a coronal STIR sequence (n=25) or a coronal T2-weighted turbo spin-echo fast saturation sequence (n=2) were used. The evaluations were made by 2 radiologists with experience in musculoskeletal radiology. Results: There were 6 patients with a petrochanteric fracture, 2 without and 4 with slight displacement. Five patients had an impacted fracture of the femoral neck, and 3 had a fracture of the superior pubic bone. Of 2 patients with advanced arthrosis, i had an impacted femoral neck fracture and the other a nondisplaced intertrochanteric fracture. There was 1 patient who had sustained a nondisplaced acetabular fracture with increased joint fluid and muscle contusions. Three patients had muscle contusions only. Two patients had bone marrow contusions only, while 2 others with advanced coxarthrosis had increased joint fluid only. Three patients showed normal findings. Our findings led to emergency surgery in 13 cases, and conservative measures directed to the specific MR findings in 14 patients. Conclusion: MR imaging should be the first modality of choice in examining patients with a clinically suspected impacted fracture of the femoral neck where conventional films show negative or equivocal findings. (orig.)

MR findings in cases of suspected impacted fracture of the femoral neck

Energy Technology Data Exchange (ETDEWEB)

Stiris, M.G.; Lilleaas, F.G. [Aker Hospital, Oslo (Norway). Dept. of Diagnostic Radiology

1997-09-01

Purpose: To evaluate MR imaging of the hip in patients with a clinically suspected impacted fracture of the femoral neck in cases where conventional plain films show negative or equivocal findings. Material and Methods: Twenty-seven such patients were prospectively examined by MR imaging with a 1.0 T unit, within 24 hours of admittance to hospital. A coronal T1-weighted turbo spin-echo sequence (n=27), and a coronal STIR sequence (n=25) or a coronal T2-weighted turbo spin-echo fast saturation sequence (n=2) were used. The evaluations were made by 2 radiologists with experience in musculoskeletal radiology. Results: There were 6 patients with a petrochanteric fracture, 2 without and 4 with slight displacement. Five patients had an impacted fracture of the femoral neck, and 3 had a fracture of the superior pubic bone. Of 2 patients with advanced arthrosis, i had an impacted femoral neck fracture and the other a nondisplaced intertrochanteric fracture. There was 1 patient who had sustained a nondisplaced acetabular fracture with increased joint fluid and muscle contusions. Three patients had muscle contusions only. Two patients had bone marrow contusions only, while 2 others with advanced coxarthrosis had increased joint fluid only. Three patients showed normal findings. Our findings led to emergency surgery in 13 cases, and conservative measures directed to the specific MR findings in 14 patients. Conclusion: MR imaging should be the first modality of choice in examining patients with a clinically suspected impacted fracture of the femoral neck where conventional films show negative or equivocal findings. (orig.).

Population pharmacokinetic characteristics of amikacin in suspected cases of neonatal sepsis in a low-resource African setting

DEFF Research Database (Denmark)

Amponsah, Seth K; Adjei, George O; Enweronu-Laryea, Christabel C

2017-01-01

of amikacin, and explore the influence of selected covariates, including coadministration with aminophylline, on amikacin disposition in neonates of African origin. METHODS: Neonates with suspected sepsis admitted to an intensive care unit in Accra, Ghana, and treated with amikacin (15 mg/kg loading followed...

Audit of a policy of magnetic resonance imaging with diffusion-weighted imaging as first-line neuroimaging for in-patients with clinically suspected acute stroke

International Nuclear Information System (INIS)

Buckley, B.T.; Wainwright, A.; Meagher, T.; Briley, D.

2003-01-01

AIM: To audit the feasibility and use of diffusion-weighted (DW) magnetic resonance imaging (MRI) as initial neuroimaging for in-patients with clinically suspected acute stroke. MATERIALS AND METHODS: In April 2000, MRI with DW and T2-weighted sequence was locally instituted as initial neuroimaging for patients with clinically suspected acute stroke. This retrospective study reviewed imaging performed for in-patients with suspected acute stroke over a 9-month period. Data were collected on image type, result and need for repeat imaging. RESULTS: During the study period, 124 patients had neuroimaging for suspected cerebrovascular accident, and 119 were MRI safe. Eighty-eight (73.9%) patients underwent DW MRI as first-line investigation. Five patients were not MRI safe and 31 had computed tomography (CT) as first-line imaging due to lack of available MRI capacity. Repeat neuroimaging was performed in 16 (12.9%) patients. Study times were comparable for both types of neuroimaging: a mean of 13 min for MRI and 11 min for CT. CONCLUSION: The audit standard was achieved in 88 (73.9%) patients. The use of DW MRI as a first-line investigation for patients with a clinical diagnosis of acute stroke is achievable in a district general hospital setting

Audit of a policy of magnetic resonance imaging with diffusion-weighted imaging as first-line neuroimaging for in-patients with clinically suspected acute stroke

Energy Technology Data Exchange (ETDEWEB)

Buckley, B.T.; Wainwright, A.; Meagher, T.; Briley, D

2003-03-01

AIM: To audit the feasibility and use of diffusion-weighted (DW) magnetic resonance imaging (MRI) as initial neuroimaging for in-patients with clinically suspected acute stroke. MATERIALS AND METHODS: In April 2000, MRI with DW and T2-weighted sequence was locally instituted as initial neuroimaging for patients with clinically suspected acute stroke. This retrospective study reviewed imaging performed for in-patients with suspected acute stroke over a 9-month period. Data were collected on image type, result and need for repeat imaging. RESULTS: During the study period, 124 patients had neuroimaging for suspected cerebrovascular accident, and 119 were MRI safe. Eighty-eight (73.9%) patients underwent DW MRI as first-line investigation. Five patients were not MRI safe and 31 had computed tomography (CT) as first-line imaging due to lack of available MRI capacity. Repeat neuroimaging was performed in 16 (12.9%) patients. Study times were comparable for both types of neuroimaging: a mean of 13 min for MRI and 11 min for CT. CONCLUSION: The audit standard was achieved in 88 (73.9%) patients. The use of DW MRI as a first-line investigation for patients with a clinical diagnosis of acute stroke is achievable in a district general hospital setting.

Using vignettes to study nurse practitioners' performance in suspected domestic violence situations.

Science.gov (United States)

Gagan, M J

2000-01-01

Vignettes have often been used to evaluate students or collect data in nursing research. The format is familiar to most nursing students as well as nurses and nurse researchers. This article presents the development and testing of the Nurse Practitioner Performance Tool (NPPT) which used vignettes as an approach to nurse practitioner performance evaluation. In this example, vignettes were used in a quasi-experimental design to collect data from Adult and Family Nurse Practitioners (A/FNP). The focus was on the diagnosis and intervention performance of the A/FNPs when addressing suspected cases of domestic violence.

First prediction of the direct effect of a confined atom on photoionization of the confining fullerene

International Nuclear Information System (INIS)

McCune, Matthew A; De, Ruma; Chakraborty, Himadri S; Madjet, Mohamed E

2010-01-01

We predict that the confined atom can qualitatively modify the energetic photoionization of some cage levels, even though these levels are of very dominant fullerene character. The effect imposes strong new oscillations in the cross sections which are forbidden to the ionization of empty fullerenes. Results are presented for the AratC 60 endofullerene compound. (fast track communication)

First prediction of the direct effect of a confined atom on photoionization of the confining fullerene

Energy Technology Data Exchange (ETDEWEB)

McCune, Matthew A; De, Ruma; Chakraborty, Himadri S [Center for Innovation and Entrepreneurship, Department of Chemistry and Physics, Northwest Missouri State University, Maryville, MO 64468 (United States); Madjet, Mohamed E, E-mail: himadri@nwmissouri.ed [Institute of Chemistry and Biochemistry, Free University, Fabeckstrasse 36a, D-14195 Berlin (Germany)

2010-09-28

We predict that the confined atom can qualitatively modify the energetic photoionization of some cage levels, even though these levels are of very dominant fullerene character. The effect imposes strong new oscillations in the cross sections which are forbidden to the ionization of empty fullerenes. Results are presented for the AratC{sub 60} endofullerene compound. (fast track communication)

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,

iPad-based primary 2D reading of CT angiography examinations of patients with suspected acute gastrointestinal bleeding: preliminary experience.

Science.gov (United States)

Faggioni, L; Neri, E; Bargellini, I; Scalise, P; Calcagni, F; Mantarro, A; D'Ippolito, G; Bartolozzi, C

2015-03-01

To evaluate the effectiveness of the iPad (Apple Inc., Cupertino, CA) for two-dimensional (2D) reading of CT angiography (CTA) studies performed for suspected acute non-variceal gastrointestinal bleeding. 24 CTA examinations of patients with suspected acute gastrointestinal bleeding confirmed (19/24, 79.2%) or ruled out (5/24, 20.8%) by digital subtraction angiography (DSA) were retrospectively reviewed by three independent readers on a commercial picture archiving communication system (PACS) workstation and on an iPad with Retina Display® 64 GB (Apple Inc.). The time needed to complete reading of every CTA examination was recorded, as well as the rate of detection of arterial bleeding and identification of suspected bleeding arteries on both devices. Overall, the area under the receiver operating characteristic curve, sensitivity, specificity, positive- and negative-predictive values for bleeding detection were not significantly different while using the iPad and workstation (0.774 vs 0.847, 0.947 vs 0.895, 0.6 vs 0.8, 0.9 vs 0.944 and 0.750 vs 0.667, respectively; p > 0.05). In DSA-positive cases, the iPad and workstation allowed correct identification of the bleeding source in 17/19 cases (89.5%) and 15/19 cases (78.9%), respectively (p > 0.05). Finally, the time needed to complete reading of every CTA study was significantly shorter using the iPad (169 ± 74 vs 222 ± 70 s, respectively; p < 0.01). Compared with a conventional PACS workstation, iPad-based preliminary 2D reading of CTA studies has comparable diagnostic accuracy for detection of acute gastrointestinal bleeding and can be significantly faster. The iPad could be used by on-call interventional radiologists for immediate decision on percutaneous embolization in patients with suspected acute gastrointestinal bleeding.

Diagnostic impact of digital tomosynthesis in oncologic patients with suspected pulmonary lesions on chest radiography.

Science.gov (United States)

Quaia, Emilio; Baratella, Elisa; Poillucci, Gabriele; Gennari, Antonio Giulio; Cova, Maria Assunta

2016-08-01

To assess the actual diagnostic impact of digital tomosynthesis (DTS) in oncologic patients with suspected pulmonary lesions on chest radiography (CXR). A total of 237 patients (135 male, 102 female; age, 70.8 ± 10.4 years) with a known primary malignancy and suspected pulmonary lesion(s) on CXR and who underwent DTS were retrospectively identified. Two radiologists (experience, 10 and 15 years) analysed in consensus CXR and DTS images and proposed a diagnosis according to a confidence score: 1 or 2 = definitely or probably benign pulmonary or extrapulmonary lesion, or pseudolesion; 3 = indeterminate; 4 or 5 = probably or definitely pulmonary lesion. DTS findings were proven by CT (n = 114 patients), CXR during follow-up (n = 105) or histology (n = 18). Final diagnoses included 77 pulmonary opacities, 26 pulmonary scars, 12 pleural lesions and 122 pulmonary pseudolesions. DTS vs CXR presented a higher (P chest radiography (CXR) in oncologic patients. • DTS improves confidence of CXR in oncologic patients. • DTS allowed avoidance of CT in about 50 % of oncologic patients.

Diagnostic efficacy and therapeutic impact of computed tomography in the evaluation of clinically suspected otosclerosis

International Nuclear Information System (INIS)

Dudau, Cristina; Salim, Fakhruddin; Jiang, Dan; Connor, Steve E.J.

2017-01-01

To assess the diagnostic efficacy and therapeutic impact of CT in evaluating patients with clinically suspected otosclerosis. CT scans performed over a 5-year period for clinically suspected otosclerosis were retrospectively reviewed. CT diagnoses were correlated with subsequent surgical management. For otosclerosis positive cases, clinically significant extensions of otosclerosis were correlated with audiometry and the diagnosis was correlated with surgical findings. Of 259 CT studies, 46 % of patients were positive, 49 % negative and 5 % equivocal for otosclerosis. A relevant alternative CT diagnosis was evident in 33 % of the negative studies. One targeted surgery was performed for every four CT studies. CT outcome influenced the decision to perform stapedectomy in 41 % CT-positive versus 4 % CT-negative patients. CT-positive ears for otosclerosis could not be predicted from baseline clinical or audiometric criteria. Those with endosteal extension demonstrated lower bone conduction thresholds presurgically. The positive predictive value of CT diagnosis of otosclerosis was 100 %. CT demonstrated a high rate of clinically relevant diagnoses in both CT-positive and -negative for otosclerosis patients, and this frequently influenced surgical management. CT also added value by demonstrating relevant extensions of the otosclerotic foci, some of which were predictive of audiometric parameters. (orig.)