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Sample records for adequate diagnostic quality

  1. Looking for an adequate quality criterion for depth coding

    NASA Astrophysics Data System (ADS)

    Kerbiriou, Paul; Boisson, Guillaume

    2010-02-01

    This paper deals with 3DTV, more especially with 3D content transmission using disparity-based format. In 3DTV, the problem of measuring the stereoscopic quality of a 3D content remains open. Depth signal degradations due to 3DTV transmission will induce new types of artifacts in the final rendered views. Whereas we have some experience regarding the issue of texture coding, the issue of depth coding consequences is rather unknown. In this paper we focus on that particular issue. For that purpose we considered LDV contents (Layered Depth Video) and performed various encoding of their depth information - i.e. depth maps plus depth occlusions layers - using MPEG-4 Part 10 AVC/H.264 MVC. We investigate the impact of depth coding artifacts on the quality of the final views. To this end, we compute the correlation between depth coding errors with the quality of the synthesized views. The criteria used for synthesized views include MSE and structural criteria such as SSIM. The criteria used for depth maps include also a topological measure in the 3D space (the Hausdorff distance). Correlations between the two criteria sets are presented. Trends in function of quantization are also discussed.

  2. [Quality of Mesorectal Excision ("Plane of Surgery") - Which Quality Targets are Adequate?].

    PubMed

    Hermanek, P; Merkel, S; Ptok, H; Hohenberger, W

    2015-12-01

    Today, the examination of rectal cancer specimens includes the obligate macroscopic assessment of the quality of mesorectal excision by the pathologist reporting the plane of surgery. The frequency of operations in the muscularis propria plane of surgery (earlier described as incomplete mesorectal excision) is essential. The quality of mesorectal excision is important for the prognosis, especially as local recurrences are observed more frequently after operations in the muscularis propria plane of surgery. For the definition of quality targets, data of 13 studies published between 2006 and 2012, each with more than 100 patients and adequate specialisation and experience of the surgeons (5413 patients), data of the prospective multicentric observation study "Quality Assurance - Rectal Cancer" (at the Institute for Quality Assurance in Operative Medicine at the Otto-von-Guericke University at Magdeburg) from 2005 to 2010 (8044 patients) and data of the Department of Surgery, University Hospital Erlangen, from 1998 to 2011 (991 patients) were analysed. The total incidence of operations in the muscularis propria plane of surgery was 5.0 % (721/14 448). Even with adequate specialisation and experience of the surgeon, the frequency of operations in the muscularis propria plane of surgery is higher in abdominoperineal excisions than in sphincter-preserving surgery (8.4 vs. 2.8 %, p < 0.001). Thus, the quality target for the frequency of operations in the muscularis propria plane should be defined as < 5 % for sphincter-preserving procedures and as < 10 % for abdominoperineal excisions.

  3. Are image quality metrics adequate to evaluate the quality of geometric objects?

    NASA Astrophysics Data System (ADS)

    Rogowitz, Bernice E.; Rushmeier, Holly E.

    2001-06-01

    Geometric objects are often represented by many millions of triangles or polygons, which limits the ease with which they can be transmitted and displayed electronically. This has lead to the development of many algorithms for simplifying geometric models, and to the recognition that metrics are required to evaluate their success. The goal is to create computer graphic renderings of the object that do not appear to be degraded to a human observer. The perceptual evaluation of simplified objects is a new topic. One approach has been to sue image-based metrics to predict the perceived degradation of simplified 3D models. Since that 2D images of 3D objects can have significantly different perceived quality, depending on the direction of the illumination, 2D measures of image quality may not adequately capture the perceived quality of 3D objects. To address this question, we conducted experiments in which we explicitly compared the perceived quality of animated 3D objects and their corresponding 2D still image projections. Our results suggest that 2D judgements do not provide a good predictor of 3D image quality, and identify a need to develop 'object quality metrics.'

  4. Radiation dose reduction in invasive cardiology by restriction to adequate instead of optimized picture quality.

    PubMed

    Kuon, Eberhard; Dorn, Christian; Schmitt, Moritz; Dahm, Johannes B

    2003-05-01

    In this study, the cinegraphic image intensifier entrance dose level for coronary angiography was changed in four steps from dose level A (0.041 microGy frame(-1)), allowing high contrast, but coarse mottled background, to level D (0.164 microGy frame(-1)), affording high transparency and sharpness. Using this new approach throughout the course of 404 consecutive cardiac catheterizations, we reduced patient radiation exposures down to 11 to 16% of currently typical values: i.e., mean dose area products of 5.97 Gy cm2 (n = 91), 6.73 (n = 113), 8.11 (n = 91), and 8.90 (n = 109); cinegraphic dose area products of 2.34, 3.64, 4.56, and 5.49; and cinegraphic dose area products frame(-1) of 13.3, 19.8, 27.0, and 30.2 mGy cm2, for levels A, B, C, and D, respectively. The number of cinegraphic frames ranged within 168 to 182 per case. Our results show that during catheterization interventionalists should vary image intensifier entrance dose levels in accordance with documented structure, angulation, and body mass index. With the exception of cases with special requirements, lower dose levels typically guarantee an adequate image quality.

  5. Validation of Three Early Ejaculation Diagnostic Tools: A Composite Measure Is Accurate and More Adequate for Diagnosis by Updated Diagnostic Criteria

    PubMed Central

    Jern, Patrick; Piha, Juhana; Santtila, Pekka

    2013-01-01

    Purpose To validate three early ejaculation diagnostic tools, and propose a new tool for diagnosis in line with proposed changes to diagnostic criteria. Significant changes to diagnostic criteria are expected in the near future. Available screening tools do not necessarily reflect proposed changes. Materials and Methods Data from 148 diagnosed early ejaculation patients (Mage = 42.8) and 892 controls (Mage = 33.1 years) from a population-based sample were used. Participants responded to three different questionnaires (Premature Ejaculation Profile; Premature Ejaculation Diagnostic Tool; Multiple Indicators of Premature Ejaculation). Stopwatch measured ejaculation latency times were collected from a subsample of early ejaculation patients. We used two types of responses to the questionnaires depending on the treatment status of the patients 1) responses regarding the situation before starting pharmacological treatment and 2) responses regarding current situation. Logistic regressions and Receiver Operating Characteristics were used to assess ability of both the instruments and individual items to differentiate between patients and controls. Results All instruments had very good precision (Areas under the Curve ranging from .93-.98). A new five-item instrument (named CHecklist for Early Ejaculation Symptoms – CHEES) consisting of high-performance variables selected from the three instruments had validity (Nagelkerke R2 range .51-.79 for backwards/forwards logistic regression) equal to or slightly better than any individual instrument (i.e., had slightly higher validity statistics, but these differences did not achieve statistical significance). Importantly, however, this instrument was more in line with proposed changes to diagnostic criteria. Conclusions All three screening tools had good validity. A new 5-item diagnostic tool (CHEES) based on the three instruments had equal or somewhat more favorable validity statistics compared to the other three tools, but is

  6. Diet quality of Italian yogurt consumers: an application of the probability of adequate nutrient intake score (PANDiet).

    PubMed

    Mistura, Lorenza; D'Addezio, Laura; Sette, Stefania; Piccinelli, Raffaela; Turrini, Aida

    2016-01-01

    The diet quality in yogurt consumers and non-consumers was evaluated by applying the probability of adequate nutrient intake (PANDiet) index to a sample of adults and elderly from the Italian food consumption survey INRAN SCAI 2005-06. Overall, yogurt consumers had a significantly higher mean intake of energy, calcium and percentage of energy from total sugars whereas the mean percentage of energy from total fat, saturated fatty acid and total carbohydrate were significantly (p < 0.01) lower than in non-consumers. The PANDiet index was significantly higher in yogurt consumers than in non-consumers, (60.58 ± 0.33 vs. 58.58 ± 0.19, p < 0.001). The adequacy sub-score for 17 nutrients for which usual intake should be above the reference value was significantly higher among yogurt consumers. The items of calcium, potassium and riboflavin showed the major percentage variation between consumers and non-consumers. Yogurt consumers were more likely to have adequate intakes of vitamins and minerals, and a higher quality score of the diet.

  7. Improved method for collection of sputum for tuberculosis testing to ensure adequate sample volumes for molecular diagnostic testing.

    PubMed

    Fisher, Mark; Dolby, Tania; Surtie, Shireen; Omar, Gaironesa; Hapeela, Nchimunya; Basu, Debby; DeWalt, Abby; Kelso, David; Nicol, Mark; McFall, Sally

    2017-04-01

    The quality and quantity of sputum collected has an important impact on the laboratory diagnosis of pulmonary TB. We conducted a pilot study to assess a new collection cups for the collection of sputum for the diagnosis of pulmonary tuberculosis. The pilot study utilized the standard collection cup in South Africa demonstrating a mean collection volume of 2.86±2.36SDml for 198 samples; 19% of the specimens contained <1ml and 12% contained >5ml. We designed and tested two novel sputum cups with a narrow bottom section and clear minimum and maximum markings to allow patients and clinicians to know whether sufficient sputum volume has been produced. The cups differed in their shape and manufacturing approach. The two options also support different mixing approaches being considered for a highly sensitive companion TB-screening assay being developed at Northwestern University (XtracTB assay). Sputum was collected from 102 patients at Nolungile Youth Centre, Khayelitsha, Cape Town, South Africa for a total of 204 samples. The mean volumes collected from the two cups were 2.70±0.88SDml and 2.88±0.89SDml. While the mean volumes of current and novel cups are similar, the volume ranges collected with the novel cups were narrower, and 98% of the specimen volumes were within the target range. Only 4 samples contained >5ml, but none were >6ml, and none of the specimens contained <1ml. The number of coughs that produced the samples, patient HIV and TB status plus qualitative descriptions of the sputum specimens were also evaluated.

  8. Regulation and quality evaluation system for HIV diagnostics in China.

    PubMed

    Xu, Sihong; Huang, Weijin; Zhang, Li; An, Juanjuan; Li, Xiuhua; Song, Aijing; Nie, Jianhui; Zhang, Chuntao; Wang, Youchun

    2016-03-01

    A sophisticated regulatory framework has been constructed for Human immunodeficiency virus (HIV) diagnostics in China, which have developed over the past 30 years. China National Institutes for Food and Drug Control acts as the legal institution in this regulatory framework, launching important activities to ensure the quality of HIV diagnostics. These include the analysis of the main problems faced in developing domestic HIV diagnostics, by investigating the quality of HIV diagnostics and their development; exploring the key factors affecting the quality of HIV diagnostics, to determine the criteria for screening national reference samples; the development of new technologies and methods for preparing reference samples; and the establishment of nine types of national reference panels and nine national standards to evaluate the quality of HIV diagnostics. Based on these researches, a quality evaluation system was established, including nine types of national reference panels, nine national standards for HIV diagnostics, and five sample banks (HIV-positive sample bank, HIV-negative sample bank, common international genotype sample bank, seroconversion series sample bank, HIV virus bank) to evaluate the quality of HIV diagnostics in China. The regulatory framework and the quality evaluation system are pivotal in ensuring the quality of the HIV diagnostics licensed in China.

  9. Laboratory Diagnostics and Quality of Blood Collection

    PubMed Central

    Lima-Oliveira, Gabriel; Lippi, Giuseppe; Salvagno, Gian Luca; Picheth, Geraldo; Guidi, Gian Cesare

    2015-01-01

    Summary Diagnostic blood samples collected by phlebotomy are the most common type of biological specimens drawn and sent to laboratory medicine facilities for being analyzed, thus supporting caring physicians in patient diagnosis, follow-up and/or therapeutic monitoring. Phlebotomy, a relatively invasive medical procedure, is indeed critical for the downstream procedures accomplished either in the analytical phase made in the laboratory or in the interpretive process done by the physicians. Diagnosis, management, treatment of patients and ultimately patient safety itself can be compromised by poor phlebotomy quality. We have read with interest a recent article where the authors addressed important aspects of venous blood collection for laboratory medicine analysis. The authors conducted a phlebotomy survey based on the Clinical and Laboratory Standard Institute (CLSI) H03-A6 document (presently replaced by the GP41-A6 document) in three government hospitals in Ethiopia to evaluate 120 professionals (101 non-laboratory professionals vs. 19 laboratory professionals) as regards the venous blood collection practice. The aim of this mini (non-systematic) review is to both take a cue from the above article and from current practices we had already observed in other laboratory settings, and discuss four questionable activities performed by health care professionals during venous blood collection. We refer to: i) diet restriction assessment; ii) puncture site cleansing; iii) timing of tourniquet removal and; iv) mixing specimen with additives. PMID:28356839

  10. Delivering Diagnostic Quality Video over Mobile Wireless Networks for Telemedicine.

    PubMed

    Rao, Sira P; Jayant, Nikil S; Stachura, Max E; Astapova, Elena; Pearson-Shaver, Anthony

    2009-01-01

    In real-time remote diagnosis of emergency medical events, mobility can be enabled by wireless video communications. However, clinical use of this potential advance will depend on definitive and compelling demonstrations of the reliability of diagnostic quality video. Because the medical domain has its own fidelity criteria, it is important to incorporate diagnostic video quality criteria into any video compression system design. To this end, we used flexible algorithms for region-of-interest (ROI) video compression and obtained feedback from medical experts to develop criteria for diagnostically lossless (DL) quality. The design of the system occurred in three steps-measurement of bit rate at which DL quality is achieved through evaluation of videos by medical experts, incorporation of that information into a flexible video encoder through the notion of encoder states, and an encoder state update option based on a built-in quality criterion. Medical experts then evaluated our system for the diagnostic quality of the video, allowing us to verify that it is possible to realize DL quality in the ROI at practical communication data transfer rates, enabling mobile medical assessment over bit-rate limited wireless channels. This work lays the scientific foundation for additional validation through prototyped technology, field testing, and clinical trials.

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

    NASA Astrophysics Data System (ADS)

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

    2011-03-01

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

  12. Current management of the hemophilic child: a demanding interlocutor. Quality of life and adequate cost-efficacy analysis.

    PubMed

    Giordano, Paola; Lassandro, Giuseppe; Valente, Michele; Molinari, Angelo Claudio; Ieranò, Paola; Coppola, Antonio

    2014-11-01

    Hemophilias are the most known inherited bleeding disorders. The challenges in the management of hemophilic children are different from those in adults: prophylaxis regimen removed the hallmark of crippling disease with lifelong disabilities; individualized regimens are being implemented in order to overcome venous access problems. Presently, at least in high-income countries, advances in treatment of hemophilia resulted in continuous improvement of the patients' quality of life and life expectancy. Inhibitors remain the most severe complication of hemophilia therapy. The treatment' compliance is the key to achieve a successful management. The patient, his family, the medical and psychological team are the players of a comprehensive care system. The current management of hemophilic children is the example of huge resource investments enabling long-term benefits in particular quality of life as a primary objective of the healthcare process.

  13. Are the defined substrate-based methods adequate to determine the microbiological quality of natural recreational waters?

    PubMed

    Valente, Marta Sofia; Pedro, Paulo; Alonso, M Carmen; Borrego, Juan J; Dionísio, Lídia

    2010-03-01

    Monitoring the microbiological quality of water used for recreational activities is very important to human public health. Although the sanitary quality of recreational marine waters could be evaluated by standard methods, they are time-consuming and need confirmation. For these reasons, faster and more sensitive methods, such as the defined substrate-based technology, have been developed. In the present work, we have compared the standard method of membrane filtration using Tergitol-TTC agar for total coliforms and Escherichia coli, and Slanetz and Bartley agar for enterococci, and the IDEXX defined substrate technology for these faecal pollution indicators to determine the microbiological quality of natural recreational waters. ISO 17994:2004 standard was used to compare these methods. The IDEXX for total coliforms and E. coli, Colilert, showed higher values than those obtained by the standard method. Enterolert test, for the enumeration of enterococci, showed lower values when compared with the standard method. It may be concluded that more studies to evaluate the precision and accuracy of the rapid tests are required in order to apply them for routine monitoring of marine and freshwater recreational bathing areas. The main advantages of these methods are that they are more specific, feasible and simpler than the standard methodology.

  14. Quality control for diagnostic oral microbiology laboratories in European countries.

    PubMed

    Rautemaa-Richardson, Riina; der Reijden Wa, Wil A Van; Dahlen, Gunnar; Smith, Andrew J

    2011-01-01

    Participation in diagnostic microbiology internal and external quality control (QC) processes is good laboratory practice and an essential component of a quality management system. However, no QC scheme for diagnostic oral microbiology existed until 2009 when the Clinical Oral Microbiology (COMB) Network was created. At the European Oral Microbiology Workshop in 2008, 12 laboratories processing clinical oral microbiological samples were identified. All these were recruited to participate into the study and six laboratories from six European countries completed both the online survey and the first QC round. Three additional laboratories participated in the second round. Based on the survey, European oral microbiology laboratories process a significant (mean per laboratory 4,135) number of diagnostic samples from the oral cavity annually. A majority of the laboratories did not participate in any internal or external QC programme and nearly half of the laboratories did not have standard operating procedures for the tests they performed. In both QC rounds, there was a large variation in the results, interpretation and reporting of antibiotic susceptibility testing among the laboratories. In conclusion, the results of this study demonstrate the need for harmonisation of laboratory processing methods and interpretation of results for oral microbiology specimens. The QC rounds highlighted the value of external QC in evaluating the efficacy and safety of processes, materials and methods used in the laboratory. The use of standardised methods is also a prerequisite for multi-centre epidemiological studies that can provide important information on emerging microbes and trends in anti-microbial susceptibility for empirical prescribing in oro-facial infections.

  15. [Development of Standards for Baseline Quality in Quality Management of Molecular-Diagnostic Testing].

    PubMed

    Miyachi, Hayato

    2015-07-01

    As molecular-diagnostic testing is expanding in clinical use, the demand for its quality assurance is increasing. To this end, efforts towards quality management have been made regionally and globally. An entire testing procedure needs to be properly performed from the preanalytic, analytic, and postanalytic processes. Particularly, the preanalytic process largely affects the measurement and, thus, the result. The Japanese Committee for Clinical Laboratory and Standard developed the standard documents, such as that for the quality management of clinical specimens and best-practice guideline for quality assurance of molecular-genetic testing. These standard documents would provide not only the requirements as the best practice for testing, but also the basis of baseline quality and reliability. They can be used as the basis for assessment of the quality of practice in reimbursement coverage by payers and in certification or accreditation by a third party.

  16. A new diagnostic tool for masked hypertension: impaired sleep quality

    PubMed Central

    Erdem, Fatma; Cakır, Ugur; Yıldırım, Osman; Alcelik, Aytekin; Donmez, Ibrahim; Tuman, Taha Can; Caglar, Sabri Onur; Yazıcı, Mehmet

    2016-01-01

    Introduction The aim of this study was to evaluate the relationship between masked hypertension and impaired sleep quality. Additionally, we evaluated the diagnostic role and prevalence of poor sleep quality among patients with newly diagnosed masked hypertension. Material and methods A total of 112 individuals, 72 patients with newly diagnosed masked hypertension and 40 normotensive healthy volunteers, were included in this study. All patients underwent evaluation comprising 12-lead electrocardiography, transthoracic echocardiography, 24-hour Holter ECG, and basic laboratory tests. Additionally, all participants completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI). Results The total PSQI score was significantly higher in the masked hypertension group than in the normotensive healthy volunteers (4.13 ±2.43 vs. 2.33 ±1.67, p < 0.001). A PSQI score > 5 was found in 45.8% (n = 33) of patients in the masked hypertension group and 15% (n = 6) of patients in the normotensive group (p < 0.001). The non-dipper pattern was found in 17.5% of the healthy volunteer group and 59.94% (n = 41) of the masked hypertension group (p < 0.001). When we compared the dipping pattern of the masked hypertension groups, there was a significant difference in PSQI score between the dipper and non-dipper groups (4.87 ±3.21 vs. 3.58 ±2.33, p < 0.001). Multiple logistic regression analyses showed that masked hypertension, LV mass, and LV mass index score were independent predictors of poor PSQI. Conclusions This study demonstrates impaired sleep quality in subjects with masked hypertension, particularly those with a non-dipper pattern. Additionally, this study indicates that impaired sleep quality may help diagnose masked hypertension, particularly in the non-dipper group. PMID:27904509

  17. Transcranial sonography (TCS) of brain parenchyma in movement disorders: quality standards, diagnostic applications and novel technologies.

    PubMed

    Walter, U; Školoudík, D

    2014-08-01

    Transcranial B-mode sonography (TCS) of brain parenchyma is being increasingly used as a diagnostic tool in movement disorders. Compared to other neuroimaging modalities such as magnetic resonance imaging (MRI) and computed tomography, TCS can be performed today with portable machines and has the advantages of noninvasiveness and high resistance to movement artifacts. In distinct brain disorders TCS detects abnormalities that cannot be visualized or can only be visualized with significant effort with other imaging methods. In the field of movement disorders, TCS has been established mainly as a tool for the early and differential diagnosis of Parkinson's disease. The postoperative position control of deep brain stimulation electrodes, especially in the subthalamic nucleus, can reliably and safely be performed with TCS.  The present update review summarizes the current methodological standards and defines quality criteria of adequate TCS imaging and assessment of diagnostically relevant deep brain structures such as substantia nigra, brainstem raphe, basal ganglia and ventricles. Finally, an overview is given on recent technological advances including TCS-MRI fusion imaging and upcoming technologies of digitized image analysis aiming at a more investigator-independent assessment of deep brain structures on TCS.

  18. Diagnostic Air Quality Model Evaluation of Source-Specific ...

    EPA Pesticide Factsheets

    Ambient measurements of 78 source-specific tracers of primary and secondary carbonaceous fine particulate matter collected at four midwestern United States locations over a full year (March 2004–February 2005) provided an unprecedented opportunity to diagnostically evaluate the results of a numerical air quality model. Previous analyses of these measurements demonstrated excellent mass closure for the variety of contributing sources. In this study, a carbon-apportionment version of the Community Multiscale Air Quality (CMAQ) model was used to track primary organic and elemental carbon emissions from 15 independent sources such as mobile sources and biomass burning in addition to four precursor-specific classes of secondary organic aerosol (SOA) originating from isoprene, terpenes, aromatics, and sesquiterpenes. Conversion of the source-resolved model output into organic tracer concentrations yielded a total of 2416 data pairs for comparison with observations. While emission source contributions to the total model bias varied by season and measurement location, the largest absolute bias of −0.55 μgC/m3 was attributed to insufficient isoprene SOA in the summertime CMAQ simulation. Biomass combustion was responsible for the second largest summertime model bias (−0.46 μgC/m3 on average). Several instances of compensating errors were also evident; model underpredictions in some sectors were masked by overpredictions in others. The National Exposure Research L

  19. Diagnostic quality versus patient exposure with five panoramic screen-film combinations

    SciTech Connect

    D'Ambrosio, J.A.; Schiff, T.G.; McDavid, W.D.; Langland, O.E.

    1986-04-01

    Five film-screen combinations were used to make five density-matched panoramic radiographs of a tissue-equivalent phantom skull using the Midwest/Morita Panoral x-ray machine. The radiographs were evaluated as to their diagnostic quality by twenty dental radiologists. The results demonstrate that proper screen-film selection can significantly reduce patient exposure without compromising diagnostic quality.

  20. Endorsing good quality assurance practices in molecular pathology: risks and recommendations for diagnostic laboratories and external quality assessment providers.

    PubMed

    Tembuyser, Lien; Dequeker, Elisabeth M C

    2016-01-01

    Quality assurance is an indispensable element in a molecular diagnostic laboratory. The ultimate goal is to warrant patient safety. Several risks that can compromise high quality procedures are at stake, from sample collection to the test performed by the laboratory, the reporting of test results to clinicians, and the organization of effective external quality assessment schemes. Quality assurance should therefore be safeguarded at each level and should imply a holistic multidisciplinary approach. This review aims to provide an overview of good quality assurance practices and discusses certain risks and recommendations to promote and improve quality assurance for both diagnostic laboratories and for external quality assessment providers. The number of molecular targets is continuously rising, and new technologies are evolving. As this poses challenges for clinical implementation and increases the demand for external quality assessment, the formation of an international association for improving quality assurance in molecular pathology is called for.

  1. [Improved quality of coronary diagnostics and interventions by virtual reality simulation].

    PubMed

    Voelker, W; Maier, S; Lengenfelder, B; Schöbel, W; Petersen, J; Bonz, A; Ertl, G

    2011-08-01

    Currently, more than 800,000 diagnostic procedures and 300,000 percutaneous coronary interventions are performed annually in 556 catheter laboratories in Germany. These numbers document the importance of training programs in interventional cardiology. However, this need is in sharp contrast to the time constraints for continuing medical education in Germany due to personnel and financial restrictions. A possible solution for this dilemma could be new training programs which partially supplement conventional clinical training by simulation-based medical education. Currently five virtual reality simulators for diagnostic procedures and percutaneous coronary interventions are available. These simulators provide a realistic hands-on training comparable to flight simulation in aviation.The simulator of choice for a defined training program depending on the underlying learning objectives could either be a simple mechanical model (for puncture training) or even a combination of virtual reality simulator and a full-scale mannequin (for team training and crisis resource management). For the selection of the adequate training program the basic skills of the trainee, the learning objectives and the underlying curriculum have to be taken into account. Absolutely mandatory for the success of simulation-based training is a dedicated teacher providing feedback and guidance. This teacher should be an experienced interventional cardiologist who knows both the simulator and the selected training cases which serve as a vehicle for transferring knowledge and skills.In this paper the potential of virtual reality simulation in cardiology will be discussed and the conditions which must be fulfilled to achieve quality improvement by simulation-based training will be defined.

  2. Assessment of adequate quality and collocation of reference measurements with space borne hyperspectral infrared instruments to validate retrievals of temperature and water vapour

    NASA Astrophysics Data System (ADS)

    Calbet, X.

    2015-06-01

    A method is presented to assess whether a given reference ground based point observation, typically a radiosonde measurement, is adequately collocated and sufficiently representative of space borne hyperspectral infrared instrument measurements. Once this assessment is made, the ground based data can be used to validate and potentially calibrate, with a high degree of accuracy, the hyperspectral retrievals of temperature and water vapour.

  3. Assessment of adequate quality and collocation of reference measurements with space-borne hyperspectral infrared instruments to validate retrievals of temperature and water vapour

    NASA Astrophysics Data System (ADS)

    Calbet, X.

    2016-01-01

    A method is presented to assess whether a given reference ground-based point observation, typically a radiosonde measurement, is adequately collocated and sufficiently representative of space-borne hyperspectral infrared instrument measurements. Once this assessment is made, the ground-based data can be used to validate and potentially calibrate, with a high degree of accuracy, the hyperspectral retrievals of temperature and water vapour.

  4. Diagnostics of organic compounds in water quality monitoring

    SciTech Connect

    Poryvkina, L.; Leeben, A.

    1997-08-01

    The application of two-dimensional fluorescent technique for automatic monitoring of organic compounds in a water is discussed. For recognition and quantitative estimation of water organics the spectra were systematized and arranged into the calibrated catalogues of spectral signatures. The catalogue compilation and training of expert system for diagnostics of natural organics, oils and chemical pollution are considered. The two-dimensional fluorescent method was applied for the investigation of the environmental effects of the power plants on the river`s water in the north area of Estonia.

  5. Towards Quality Assurance and an Adequate Risk Management in Geotechnical Engineering - Application of Eurocode 7 and DIN 4020 in Engineering Geology

    NASA Astrophysics Data System (ADS)

    Schetelig, Kurt; Heitfeld, Michael; von Soos, Paul; Stocker, Manfred; Mainz, Mark

    A key issue of engineering geology is the extreme variety of soil and rock, their heterogeneity and at places anisotropy, the fabric of rockmasses, the influence of water, the primary stresses and their change into a secondary stress field by loading or unloading. Changeable properties of some kinds of soil and rock, the effect of different scales of laboratory tests, field tests and the size of the structure create further questions. Considering the difficulties of investigation of the underground, size and complexity of the structure and its construction procedure Eurocode 7 and DIN 4020 have introduced geotechnical categories. The design concept in geotechnical category 3 is mostly combined with the observational method. This requires the establishment of an adequate monitoring system and a permanent comparison of the design assumptions (pre-calculated displacements or stresses) with the recorded values. The goals and handling of Eurocode 7 and DIN 4020 are demonstrated by means of site examples.

  6. WE-AB-206-01: Diagnostic Ultrasound Imaging Quality Assurance.

    PubMed

    Zagzebski, J

    2016-06-01

    The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. The goal of this ultrasound hands-on workshop is to demonstrate quality control (QC) testing in diagnostic ultrasound and to provide updates in ACR ultrasound accreditation requirements. The first half of this workshop will include two presentations reviewing diagnostic ultrasound QA/QC and ACR ultrasound accreditation requirements. The second half of the workshop will include live demonstrations of basic QC tests. An array of ultrasound testing phantoms and ultrasound scanners will be available for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations and on-site instructors. The targeted attendees are medical physicists in diagnostic imaging.

  7. Quality Assessment of Comparative Diagnostic Accuracy Studies: Our Experience Using a Modified Version of the QUADAS-2 Tool

    ERIC Educational Resources Information Center

    Wade, Ros; Corbett, Mark; Eastwood, Alison

    2013-01-01

    Assessing the quality of included studies is a vital step in undertaking a systematic review. The recently revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool (QUADAS-2), which is the only validated quality assessment tool for diagnostic accuracy studies, does not include specific criteria for assessing comparative studies. As…

  8. A diagnostic model for studying daytime urban air quality trends

    NASA Technical Reports Server (NTRS)

    Brewer, D. A.; Remsberg, E. E.; Woodbury, G. E.

    1981-01-01

    A single cell Eulerian photochemical air quality simulation model was developed and validated for selected days of the 1976 St. Louis Regional Air Pollution Study (RAPS) data sets; parameterizations of variables in the model and validation studies using the model are discussed. Good agreement was obtained between measured and modeled concentrations of NO, CO, and NO2 for all days simulated. The maximum concentration of O3 was also predicted well. Predicted species concentrations were relatively insensitive to small variations in CO and NOx emissions and to the concentrations of species which are entrained as the mixed layer rises.

  9. Evaluating radiographers' diagnostic accuracy in screen-reading mammograms: what constitutes a quality study?

    SciTech Connect

    Debono, Josephine C; Poulos, Ann E

    2015-03-15

    The aim of this study was to first evaluate the quality of studies investigating the diagnostic accuracy of radiographers as mammogram screen-readers and then to develop an adapted tool for determining the quality of screen-reading studies. A literature search was used to identify relevant studies and a quality evaluation tool constructed by combining the criteria for quality of Whiting, Rutjes, Dinnes et al. and Brealey and Westwood. This constructed tool was then applied to the studies and subsequently adapted specifically for use in evaluating quality in studies investigating diagnostic accuracy of screen-readers. Eleven studies were identified and the constructed tool applied to evaluate quality. This evaluation resulted in the identification of quality issues with the studies such as potential for bias, applicability of results, study conduct, reporting of the study and observer characteristics. An assessment of the applicability and relevance of the tool for this area of research resulted in adaptations to the criteria and the development of a tool specifically for evaluating diagnostic accuracy in screen-reading. This tool, with further refinement and rigorous validation can make a significant contribution to promoting well-designed studies in this important area of research and practice.

  10. A Methodology for Anatomic Ultrasound Image Diagnostic Quality Assessment.

    PubMed

    Hemmsen, Martin Christian; Lange, Theis; Brandt, Andreas Hjelm; Nielsen, Michael Bachmann; Jensen, Jorgen Arendt

    2017-01-01

    This paper discusses the methods for the assessment of ultrasound image quality based on our experiences with evaluating new methods for anatomic imaging. It presents a methodology to ensure a fair assessment between competing imaging methods using clinically relevant evaluations. The methodology is valuable in the continuing process of method optimization and guided development of new imaging methods. It includes a three phased study plan covering from initial prototype development to clinical assessment. Recommendations to the clinical assessment protocol, software, and statistical analysis are presented. Earlier uses of the methodology has shown that it ensures validity of the assessment, as it separates the influences between developer, investigator, and assessor once a research protocol has been established. This separation reduces confounding influences on the result from the developer to properly reveal the clinical value. This paper exemplifies the methodology using recent studies of synthetic aperture sequential beamforming tissue harmonic imaging.

  11. Staffing in postnatal units: is it adequate for the provision of quality care? Staff perspectives from a state-wide review of postnatal care in Victoria, Australia

    PubMed Central

    Forster, Della A; McLachlan, Helen L; Yelland, Jane; Rayner, Jo; Lumley, Judith; Davey, Mary-Ann

    2006-01-01

    Background State-wide surveys of recent mothers conducted over the past decade in Victoria, one state of Australia, have identified that women are consistently less satisfied with the care they received in hospital following birth compared with other aspects of maternity care. Little is known of caregivers' perspectives on the provision ofhospital postnatal care: how care is organised and provided in different hospitals; what constrains the provision of postnatal care (apart from funding) and what initiatives are being undertaken to improve service delivery. A state-widereview of organisational structures and processes in relation to the provision of hospital postnatal care in Victoria was undertaken. This paper focuses on the impact of staffing issues on the provision of quality postnatal care from the perspective of care providers. Methods A study of care providers from Victorian public hospitals that provide maternity services was undertaken. Datawere collected in two stages. Stage one: a structured questionnaire was sent to all public hospitals in Victoria that provided postnatal care (n = 73), exploring the structure and organisation of care (e.g. staffing, routine observations, policy framework and discharge planning). Stage two: 14 maternity units were selected and invited to participate in a more in-depth exploration of postnatal care. Thirty-eight key informant interviews were undertaken with midwives (including unit managers, associate unit managers and clinical midwives) and a medical practitioner from eachselected hospital. Results Staffing was highlighted as a major factor impacting on the provision of quality postnatal care. There were significant issues associated with inadequate staff/patient ratios; staffing mix; patient mix; prioritisation of birth suites over postnatal units; and the use of non-permanent staff. Forty-three percent of hospitals reported having only midwives (i.e. no non-midwives) providing postnatal care. Staffing issues impact on

  12. How does study quality affect the results of a diagnostic meta-analysis?

    PubMed Central

    Westwood, Marie E; Whiting, Penny F; Kleijnen, Jos

    2005-01-01

    Background The use of systematic literature review to inform evidence based practice in diagnostics is rapidly expanding. Although the primary diagnostic literature is extensive, studies are often of low methodological quality or poorly reported. There has been no rigorously evaluated, evidence based tool to assess the methodological quality of diagnostic studies. The primary objective of this study was to determine the extent to which variations in the quality of primary studies impact the results of a diagnostic meta-analysis and whether this differs with diagnostic test type. A secondary objective was to contribute to the evaluation of QUADAS, an evidence-based tool for the assessment of quality in diagnostic accuracy studies. Methods This study was conducted as part of large systematic review of tests used in the diagnosis and further investigation of urinary tract infection (UTI) in children. All studies included in this review were assessed using QUADAS, an evidence-based tool for the assessment of quality in systematic reviews of diagnostic accuracy studies. The impact of individual components of QUADAS on a summary measure of diagnostic accuracy was investigated using regression analysis. The review divided the diagnosis and further investigation of UTI into the following three clinical stages: diagnosis of UTI, localisation of infection, and further investigation of the UTI. Each stage used different types of diagnostic test, which were considered to involve different quality concerns. Results Many of the studies included in our review were poorly reported. The proportion of QUADAS items fulfilled was similar for studies in different sections of the review. However, as might be expected, the individual items fulfilled differed between the three clinical stages. Regression analysis found that different items showed a strong association with test performance for the different tests evaluated. These differences were observed both within and between the three

  13. The Quality Assurance in Diagnostic Radiology and their Effect in the Quality Image and Radiological Protection of the Patient

    NASA Astrophysics Data System (ADS)

    Gaona, Enrique

    2002-08-01

    The quality assurance in diagnostic radiology in Mexico before 1997 was virtually nonexistent except in few academic institutions and hospitals. The purpose of this study was to carry out an exploratory survey of the issue of quality control parameters of general and fluoroscopy x-ray systems in the Mexican Republic and their effects in the quality image and radiological protection of the patient. A general result of the survey is that there is not significant difference in the observed frequencies among public and private radiology departments for α = 0.05, then the results are valid for both departments. 37% of x-ray systems belong to public radiology departments. In the radiology departments that didn't agree with the Mexican regulations in: light field to mach the x-ray field, light field intensity, kV, time and output. In those cases, we found a repeat rate of radiography studies >30% with non necessary dose to patient, low quality image and high operating costs of the radiology service. We found in x-ray fiuoroscopy systems that 62% had a low quality image due to electronic noise in the television chain. In general the x-ray systems that didn't agree with Mexican regulations are 35% and they can affect in a way or other the quality image and the dose to patient.

  14. Influence of plasma diagnostics and constraints on the quality of equilibrium reconstructions on Joint European Torus

    SciTech Connect

    Gelfusa, M.; Gaudio, P.; Peluso, E.; Murari, A.; Baruzzo, M.; Lupelli, I.; Hawkes, N.; Brix, M.; Drozdov, V.; Meigs, A.; Romanelli, M.; Schmuck, S.; Sieglin, B.; Collaboration: JET-EFDA Contributors

    2013-10-15

    One of the main approaches to thermonuclear fusion relies on confining high temperature plasmas with properly shaped magnetic fields. The determination of the magnetic topology is, therefore, essential for controlling the experiments and for achieving the required performance. In Tokamaks, the reconstruction of the fields is typically formulated as a free boundary equilibrium problem, described by the Grad-Shafranov equation in toroidal geometry and axisymmetric configurations. Unfortunately, this results in mathematically very ill posed problems and, therefore, the quality of the equilibrium reconstructions depends sensitively on the measurements used as inputs and on the imposed constraints. In this paper, it is shown how the different diagnostics (Magnetics Measurements, Polarimetry and Motional Stark Effect), together with the edge current density and plasma pressure constraints, can have a significant impact on the quality of the equilibrium on JET. Results show that both the Polarimetry and Motional Stark Effect internal diagnostics are crucial in order to obtain reasonable safety factor profiles. The impact of the edge current density constraint is significant when the plasma is in the H-mode of confinement. In this plasma scenario the strike point positions and the plasma last closed flux surface can change even by centimetres, depending on the edge constraints, with a significant impact on the remapping of the equilibrium-dependent diagnostics and of pedestal physics studies. On the other hand and quite counter intuitively, the pressure constraint can severely affect the quality of the magnetic reconstructions in the core. These trends have been verified with several JET discharges and consistent results have been found. An interpretation of these results, as interplay between degrees of freedom and available measurements, is provided. The systematic analysis described in the paper emphasizes the importance of having sufficient diagnostic inputs and of

  15. Influence of plasma diagnostics and constraints on the quality of equilibrium reconstructions on Joint European Torus

    NASA Astrophysics Data System (ADS)

    Gelfusa, M.; Murari, A.; Lupelli, I.; Hawkes, N.; Gaudio, P.; Baruzzo, M.; Brix, M.; Craciunescu, T.; Drozdov, V.; Meigs, A.; Peluso, E.; Romanelli, M.; Schmuck, S.; Sieglin, B.; JET-EFDA Contributors

    2013-10-01

    One of the main approaches to thermonuclear fusion relies on confining high temperature plasmas with properly shaped magnetic fields. The determination of the magnetic topology is, therefore, essential for controlling the experiments and for achieving the required performance. In Tokamaks, the reconstruction of the fields is typically formulated as a free boundary equilibrium problem, described by the Grad-Shafranov equation in toroidal geometry and axisymmetric configurations. Unfortunately, this results in mathematically very ill posed problems and, therefore, the quality of the equilibrium reconstructions depends sensitively on the measurements used as inputs and on the imposed constraints. In this paper, it is shown how the different diagnostics (Magnetics Measurements, Polarimetry and Motional Stark Effect), together with the edge current density and plasma pressure constraints, can have a significant impact on the quality of the equilibrium on JET. Results show that both the Polarimetry and Motional Stark Effect internal diagnostics are crucial in order to obtain reasonable safety factor profiles. The impact of the edge current density constraint is significant when the plasma is in the H-mode of confinement. In this plasma scenario the strike point positions and the plasma last closed flux surface can change even by centimetres, depending on the edge constraints, with a significant impact on the remapping of the equilibrium-dependent diagnostics and of pedestal physics studies. On the other hand and quite counter intuitively, the pressure constraint can severely affect the quality of the magnetic reconstructions in the core. These trends have been verified with several JET discharges and consistent results have been found. An interpretation of these results, as interplay between degrees of freedom and available measurements, is provided. The systematic analysis described in the paper emphasizes the importance of having sufficient diagnostic inputs and of

  16. Diagnostic image quality in gynaecological ultrasound: Who should measure it, what should we measure and how?

    PubMed

    Cantin, Peter; Knapp, Karen

    2014-02-01

    Assessment of diagnostic image quality in gynaecological ultrasound is an important aspect of imaging department quality assurance. This may be addressed through audit, but who should undertake the audit, what should be measured and how, remains contentious. The aim of this study was to identify whether peer audit is a suitable method of assessing the diagnostic quality of gynaecological ultrasound images. Nineteen gynaecological ultrasound studies were independently assessed by six sonographers utilising a pilot version of an audit tool. Outcome measures were levels of inter-rater agreement using different data collection methods (binary scores, Likert scale, continuous scale), effect of ultrasound study difficulty on study score and whether systematic differences were present between reviewers of different clinical grades and length of experience. Inter-rater agreement ranged from moderate to good depending on the data collection method. A continuous scale gave the highest level of inter-rater agreement with an intra-class correlation coefficient of 0.73. A strong correlation (r = 0.89) between study difficulty and study score was yielded. Length of clinical experience between reviewers had no effect on the audit scores, but individuals of a higher clinical grade gave significantly lower scores than those of a lower grade (p = 0.04). Peer audit is a promising tool in the assessment of ultrasound image quality. Continuous scales seem to be the best method of data collection implying a strong element of heuristically driven decision making by reviewing ultrasound practitioners.

  17. Optical coherence tomography: influence of contrast concentration on image quality and diagnostic confidence.

    PubMed

    Blachutzik, Florian; Achenbach, Stephan; Nef, Holger; Hamm, Christian; Dörr, Oliver; Boeder, Niklas; Marwan, Mohamed; Tröbs, Monique; Schneider, Reinhard; Röther, Jens; Schlundt, Christian

    2016-11-09

    OCT requires intracoronary injection of contrast agent to remove blood from the coronary lumen during data acquisition, which is a possible limitation of this method. Aim of this study was to analyze the influence of iodine concentration on image quality and diagnostic certainty of optical coherence tomography (OCT). OCT sequences acquired using contrast agent with a reduced concentration of 150 mg iodine/ml and a standard concentration of 350 mg iodine/ml were analyzed. Cross-sectional images with a spacing of 10 mm were evaluated regarding image quality and diagnostic confidence. A total of 67 OCT sequences acquired in 24 patients were analyzed. 31 sequences were acquired using contrast agent with a concentration of 150 mg iodine/ml and 36 sequences with a concentration of 350 mg iodine/ml. The percentage of remaining blood streaks in the cross sections was significantly lower for 350 mg iodine/ml compared to 150 mg iodine/ml (19 ± 21 vs. 34 ± 26%, p = 0.013). Contrast with 350 mg iodine/ml showed a significantly higher percentage of completely flushed pullback length as compared to 150 mg iodine/ml (78 ± 24 vs. 58 ± 27%, p = 0.004). Diagnostic certainty was significantly higher for 350 mg iodine/ml than for 150 mg iodine/ml (Likert scale average 1.4 ± 0.7 vs. 2.1 ± 1.2, p < 0.001; Likert scale: 1 = absolutely confident, 2 = confident with slight doubts, 3 = doubtful/not confident, 4 = non-diagnostic). Regarding image quality and diagnostic certainty, contrast agent with a concentration of 350 mg iodine/ml is superior to 150 mg iodine/ml.

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

    SciTech Connect

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

    1983-11-30

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

  19. Investigation of diagnostic and image quality attributes: comparison of screen-film to CR mammography

    NASA Astrophysics Data System (ADS)

    Fletcher-Heath, Lynn; Richards, Anne; Ryan-Kron, Susan

    2006-03-01

    Digital mammography is advancing into an arena where analog has long been the gold standard. Direct digital systems may not be the favored solution for a particular site while computed radiography (CR) mammography, remains unproven worldwide. This pilot study responds to the growing desire to acquire and display digital mammographic images by exploring the acceptability of CR mammography. Images representing a range of breast tissue types were collected from 49 subjects (17 screening; 32 diagnostic) at four clinical sites. Comparison views were collected on the same breast, under the same compression, using automatic exposure control on state-of-the-art film systems followed by CR. CR images were processed and printed to a mammography printer for hard copy feature comparison. Each image pair in the study was evaluated according to 13 image quality attributes covering noise, contrast, sharpness, and image quality in the overall captured images as well as in each of several particular breast regions (periphery and skin-line, parenchyma and fatty tissue). A rating scale from 1 to 5 was used (strong preference for film=1, strong preference for CR=5). Twelve experienced mammographers at four clinical sites scored a subset of the 49 cases for a total of 64 image pair readings. There were 64 ratings for each of 13 image quality attributes for all cases and, an additional series of scores (four or five attribute ratings) for each abnormality in the category of mass, architectural distortion and microcalcification, for a total of 1069 scores. Based on the pilot study results, it was suggested that CR was equivalent or preferred to conventional screen-film for overall image quality (38% scored 3; 46% scored >3), image contrast (27% scored 3; 59% scored >3) and sharpness (28% scored 3; 50% scored >3). No preference was found when assessing noise. This pilot study also suggested that diagnostic quality was maintained in assessing abnormalities for attributes necessary to

  20. A Diagnostic System for Improving Biomass Quality Based on a Sensor Network

    PubMed Central

    Bochtis, Dionysis D.; Sørensen, Claus G.; Green, Ole; Bartzanas, Thomas

    2011-01-01

    Losses during storage of biomass are the main parameter that defines the profitability of using preserved biomass as feed for animal husbandry. In order to minimize storage losses, potential changes in specific physicochemical properties must be identified to subsequently act as indicators of silage decomposition and form the basis for preventive measures. This study presents a framework for a diagnostic system capable of detecting potential changes in specific physicochemical properties, i.e., temperature and the oxygen content, during the biomass storage process. The diagnostic system comprises a monitoring tool based on a wireless sensors network and a prediction tool based on a validated computation fluid dynamics model. It is shown that the system can provide the manager (end-user) with continuously updated information about specific biomass quality parameters. The system encompasses graphical visualization of the information to the end-user as a first step and, as a second step, the system identifies alerts depicting real differences between actual and predicted values of the monitored properties. The perspective is that this diagnostic system will provide managers with a solid basis for necessary preventive measures. PMID:22163886

  1. Measuring the quality-of-life effects of diagnostic and screening tests.

    PubMed

    Swan, J Shannon; Miksad, Rebecca A

    2009-08-01

    Health-related quality of life (HRQL) is a central concept for understanding the outcomes of medical care. When used in cost-effectiveness analysis, HRQL is typically measured for conditions persisting over long time frames (years), and quality-adjusted life year (QALY) values are generated. Consequently, years are the basic unit of time for cost-effectiveness analysis results: dollars spent per QALY gained. However, shorter term components of health care may also affect HRQL, and there is increased interest in measuring and accounting for these events. In radiology, the short-term HRQL effects of screening and diagnostic testing may affect a test's cost-effectiveness, even though they may only last for days. The unique challenge in radiology HRQL assessment is to realistically tap into the testing and screening experience while remaining consistent with QALY theory. The authors review HRQL assessment and highlight methods developed to specifically address the short-term effects of radiologic screening and testing.

  2. Does the Reporting Quality of Diagnostic Test Accuracy Studies, as Defined by STARD 2015, Affect Citation?

    PubMed Central

    Choi, Young Jun; Chung, Mi Sun; Koo, Hyun Jung; Park, Ji Eun; Yoon, Hee Mang

    2016-01-01

    Objective To determine the rate with which diagnostic test accuracy studies that are published in a general radiology journal adhere to the Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015, and to explore the relationship between adherence rate and citation rate while avoiding confounding by journal factors. Materials and Methods All eligible diagnostic test accuracy studies that were published in the Korean Journal of Radiology in 2011–2015 were identified. Five reviewers assessed each article for yes/no compliance with 27 of the 30 STARD 2015 checklist items (items 28, 29, and 30 were excluded). The total STARD score (number of fulfilled STARD items) was calculated. The score of the 15 STARD items that related directly to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 was also calculated. The number of times each article was cited (as indicated by the Web of Science) after publication until March 2016 and the article exposure time (time in months between publication and March 2016) were extracted. Results Sixty-three articles were analyzed. The mean (range) total and QUADAS-2-related STARD scores were 20.0 (14.5–25) and 11.4 (7–15), respectively. The mean citation number was 4 (0–21). Citation number did not associate significantly with either STARD score after accounting for exposure time (total score: correlation coefficient = 0.154, p = 0.232; QUADAS-2-related score: correlation coefficient = 0.143, p = 0.266). Conclusion The degree of adherence to STARD 2015 was moderate for this journal, indicating that there is room for improvement. When adjusted for exposure time, the degree of adherence did not affect the citation rate. PMID:27587959

  3. Quality control agent: Self-adaptive laser vibrometry for on-line diagnostics

    NASA Astrophysics Data System (ADS)

    Serafini, S.; Paone, N.; Castellini, P.

    2012-06-01

    It is presented the development of a self-adaptive diagnostic system based on laser vibrometry for production line quality control. The vibration measurement system consists of a laser Doppler vibrometer, equipped with scanning mirrors and a smart camera, which implements self-adaptivity for compensating target mis-positioning under guidance by a vision system and for the achievement of the best condition for measurement by optimizing the Doppler signal level. This system is designed as a Quality Control Agent (QCA) and it is part of a Multi Agent System (MAS) that supervises all the production line. The QCA behavior is defined so to perform a minimization of measurement uncertainty during the on line tests; for this purpose the QCA exhibits a self-adaptive behavior. Best measurement conditions are defined in terms of amplitude of the optical Doppler beat signal (signal quality - SQ). In this paper, the optimization strategy for measurement enhancement achieved by the down-hill algorithm (Nelder-Mead algorithm) and its effect on signal quality improvement is discussed. Tests on a washing machine in controlled operating conditions allow to evaluate the efficacy of the method; significant reduction of noise on vibration velocity spectra is observed.

  4. Improving the diagnostic quality and adequacy of shoulder radiographs in a District General Hospital

    PubMed Central

    Richards, Bethany; Riley, James; Saithna, Adnan

    2016-01-01

    A high rate of suboptimal shoulder radiographs was identified during a service evaluation exercise in our orthopaedic outpatient clinics. Inadequate radiographs require a return to the radiology department for further imaging, a resultant increased workload, delays in the clinic, increased radiation for patients, and inconvenience and decreased patient satisfaction. Furthermore, if a sub-optimal radiograph is accepted there is concern that diagnoses may be missed. The aim of this project was to decrease the rate of suboptimal radiographs by delivering a teaching package directed towards quality improvement. Evaluation criteria were set for standard orthopaedic shoulder radiographs (Anterior-posterior, axillary, and Velpeau views). Baseline data collection was performed over three, two-week periods and included all patients attending the shoulder clinic. The percentage of x-rays which were deemed adequate was only 19.4% for anterior-posterior views and 57.9% for axillary views. A comprehensive educational package was delivered to radiographers. This included a formal PowerPoint based teaching session, hands on training with practice using a skeleton, posters with step-by step instructions on how to obtain an adequate image, and PDF aide memoires suitable for viewing on a smartphone. Two subsequent two-week periods of data collection were performed to evaluate the benefit of this intervention. Delivery of focussed training and provision of easily accessible aide memoires to facilitate improved quality of radiographs resulted in a significant (p<0.05) reduction in the rate of inadequate images. There was also a significant decreases in the rate of return to the radiology department for repeat imaging. PMID:27559473

  5. Pre-diagnostic Sleep Duration and Sleep Quality in Relation to Subsequent Cancer Survival

    PubMed Central

    Phipps, Amanda I.; Bhatti, Parveen; Neuhouser, Marian L.; Chen, Chu; Crane, Tracy E.; Kroenke, Candyce H.; Ochs-Balcom, Heather; Rissling, Michelle; Snively, Beverly M.; Stefanick, Marcia L.; Treggiari, Miriam M.; Watson, Nathaniel F.

    2016-01-01

    Study Objectives: Poor sleep quality and short sleep duration have been associated with elevated risk for several cancer types; however, the relationship between sleep and cancer outcomes has not been well characterized. We assessed the association between pre-diagnostic sleep attributes and subsequent cancer survival within the Women's Health Initiative (WHI). Methods: We identified WHI participants in whom a first primary invasive cancer had been diagnosed during follow-up (n = 21,230). Participants provided information on sleep characteristics at enrollment. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between these pre-diagnostic sleep characteristics and cancer-specific survival for all cancers combined and separately for common cancers. Analyses were adjusted for age, study arm, cancer site, marital status, income, smoking, physical activity, and time to diagnosis. Results: No individual pre-diagnostic sleep characteristics were found to be significantly associated with cancer survival in analyses of all cancer sites combined; however, women who reported short sleep duration (≤ 6 h sleep/night) combined with frequent snoring (≥ 5 nights/w experienced significantly poorer cancer-specific survival than those who reported 7–8 h of sleep/night and no snoring (HR = 1.32, 95% CI: 1.14–1.54). Short sleep duration (HR = 1.46, 95% CI: 1.07–1.99) and frequent snoring (HR = 1.34, 95% CI: 0.98–1.85) were each associated with poorer breast cancer survival; those reporting short sleep combined with frequent snoring combined had substantially poorer breast cancer survival than those reporting neither (HR = 2.14, 95% CI: 1.47–3.13). Conclusions: Short sleep duration combined with frequent snoring reported prior to cancer diagnosis may influence subsequent cancer survival, particularly breast cancer survival. Citation: Phipps AI, Bhatti P, Neuhouser ML, Chen C, Crane TE, Kroenke CH, Ochs-Balcom H

  6. Quality assessment of comparative diagnostic accuracy studies: our experience using a modified version of the QUADAS-2 tool.

    PubMed

    Wade, Ros; Corbett, Mark; Eastwood, Alison

    2013-09-01

    Assessing the quality of included studies is a vital step in undertaking a systematic review. The recently revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool (QUADAS-2), which is the only validated quality assessment tool for diagnostic accuracy studies, does not include specific criteria for assessing comparative studies. As part of an assessment that included comparative diagnostic accuracy studies, we used a modified version of QUADAS-2 to assess study quality. We modified QUADAS-2 by duplicating questions relating to the index test, to assess the relevant potential sources of bias for both the index test and comparator test. We also added review-specific questions. We have presented our modified version of QUADAS-2 and outlined some key issues for consideration when assessing the quality of comparative diagnostic accuracy studies, to help guide other systematic reviewers conducting comparative diagnostic reviews. Until QUADAS is updated to incorporate assessment of comparative studies, QUADAS-2 can be used, although modification and careful thought is required. It is important to reflect upon whether aspects of study design and methodology favour one of the tests over another.

  7. Impact of iterative metal artifact reduction on diagnostic image quality in patients with dental hardware.

    PubMed

    Weiß, Jakob; Schabel, Christoph; Bongers, Malte; Raupach, Rainer; Clasen, Stephan; Notohamiprodjo, Mike; Nikolaou, Konstantin; Bamberg, Fabian

    2017-03-01

    Background Metal artifacts often impair diagnostic accuracy in computed tomography (CT) imaging. Therefore, effective and workflow implemented metal artifact reduction algorithms are crucial to gain higher diagnostic image quality in patients with metallic hardware. Purpose To assess the clinical performance of a novel iterative metal artifact reduction (iMAR) algorithm for CT in patients with dental fillings. Material and Methods Thirty consecutive patients scheduled for CT imaging and dental fillings were included in the analysis. All patients underwent CT imaging using a second generation dual-source CT scanner (120 kV single-energy; 100/Sn140 kV in dual-energy, 219 mAs, gantry rotation time 0.28-1/s, collimation 0.6 mm) as part of their clinical work-up. Post-processing included standard kernel (B49) and an iterative MAR algorithm. Image quality and diagnostic value were assessed qualitatively (Likert scale) and quantitatively (HU ± SD) by two reviewers independently. Results All 30 patients were included in the analysis, with equal reconstruction times for iMAR and standard reconstruction (17 s ± 0.5 vs. 19 s ± 0.5; P > 0.05). Visual image quality was significantly higher for iMAR as compared with standard reconstruction (3.8 ± 0.5 vs. 2.6 ± 0.5; P < 0.0001, respectively) and showed improved evaluation of adjacent anatomical structures. Similarly, HU-based measurements of degree of artifacts were significantly lower in the iMAR reconstructions as compared with the standard reconstruction (0.9 ± 1.6 vs. -20 ± 47; P < 0.05, respectively). Conclusion The tested iterative, raw-data based reconstruction MAR algorithm allows for a significant reduction of metal artifacts and improved evaluation of adjacent anatomical structures in the head and neck area in patients with dental hardware.

  8. Diagnostic ultrasound estimates of muscle mass and muscle quality discriminate between women with and without sarcopenia

    PubMed Central

    Ismail, Catheeja; Zabal, Johannah; Hernandez, Haniel J.; Woletz, Paula; Manning, Heather; Teixeira, Carla; DiPietro, Loretta; Blackman, Marc R.; Harris-Love, Michael O.

    2015-01-01

    Introduction: Age-related changes in muscle mass and muscle tissue composition contribute to diminished strength in older adults. The objectives of this study are to examine if an assessment method using mobile diagnostic ultrasound augments well-known determinants of lean body mass (LBM) to aid sarcopenia staging, and if a sonographic measure of muscle quality is associated with muscle performance. Methods: Twenty community-dwelling female subjects participated in the study (age = 43.4 ± 20.9 years; BMI: 23.8, interquartile range: 8.5). Dual energy X-ray absorptiometry (DXA) and diagnostic ultrasound morphometry were used to estimate LBM. Muscle tissue quality was estimated via the echogenicity using grayscale histogram analysis. Peak force was measured with grip dynamometry and scaled for body size. Bivariate and multiple regression analyses were used to determine the association of the predictor variables with appendicular lean mass (aLM/ht2), and examine the relationship between scaled peak force values and muscle echogenicity. The sarcopenia LBM cut point value of 6.75 kg/m2 determined participant assignment into the Normal LBM and Low LBM subgroups. Results: The selected LBM predictor variables were body mass index (BMI), ultrasound morphometry, and age. Although BMI exhibited a significant positive relationship with aLM/ht2 (adj. R2 = 0.61, p < 0.001), the strength of association improved with the addition of ultrasound morphometry and age as predictor variables (adj. R2 = 0.85, p < 0.001). Scaled peak force was associated with age and echogenicity (adj. R2 = 0.53, p < 0.001), but not LBM. The Low LBM subgroup of women (n = 10) had higher scaled peak force, lower BMI, and lower echogenicity values in comparison to the Normal LBM subgroup (n = 10; p < 0.05). Conclusions: Diagnostic ultrasound morphometry values are associated with LBM, and improve the BMI predictive model for aLM/ht2 in women. In addition, ultrasound proxy measures of muscle quality are more

  9. Image Quality Analysis of Various Gastrointestinal Endoscopes: Why Image Quality Is a Prerequisite for Proper Diagnostic and Therapeutic Endoscopy

    PubMed Central

    Ko, Weon Jin; An, Pyeong; Ko, Kwang Hyun; Hahm, Ki Baik; Hong, Sung Pyo

    2015-01-01

    Arising from human curiosity in terms of the desire to look within the human body, endoscopy has undergone significant advances in modern medicine. Direct visualization of the gastrointestinal (GI) tract by traditional endoscopy was first introduced over 50 years ago, after which fairly rapid advancement from rigid esophagogastric scopes to flexible scopes and high definition videoscopes has occurred. In an effort towards early detection of precancerous lesions in the GI tract, several high-technology imaging scopes have been developed, including narrow band imaging, autofocus imaging, magnified endoscopy, and confocal microendoscopy. However, these modern developments have resulted in fundamental imaging technology being skewed towards red-green-blue and this technology has obscured the advantages of other endoscope techniques. In this review article, we have described the importance of image quality analysis using a survey to consider the diversity of endoscope system selection in order to better achieve diagnostic and therapeutic goals. The ultimate aims can be achieved through the adoption of modern endoscopy systems that obtain high image quality. PMID:26473119

  10. Systematic review and quality analysis of emerging diagnostic measures for calcium pyrophosphate crystal deposition disease

    PubMed Central

    Wu, Y; Chen, K; Terkeltaub, R

    2016-01-01

    Objectives Calcium pyrophosphate crystal deposition disease (CPPD) is common, yet prevalence and overall clinical impact remain unclear. Sensitivity and specificity of CPPD reference standards (conventional crystal analysis (CCA) and radiography (CR)) were meta-analysed by EULAR (published 2011). Since then, new diagnostic modalities are emerging. Hence, we updated 2009–2016 literature findings by systematic review and evidence grading, and assessed unmet needs. Methods We performed systematic search of full papers (PubMed, Scopus/EMBASE, Cochrane 2009–2016 databases). Search terms included CPPD, chondrocalcinosis, pseudogout, ultrasound, MRI, dual energy CT (DECT). Paper selection, data abstraction, EULAR evidence level, and Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 bias and applicability grading were performed independently by 3 authors. Results We included 26 of 111 eligible papers, which showed emergence in CPPD diagnosis of ultrasound (U/S), and to lesser degree, DECT and Raman spectroscopy. U/S detected CPPD crystals in peripheral joints with sensitivity >80%, superior to CR. However, most study designs, though analytical, yielded low EULAR evidence level. DECT was marginally explored for CPPD, compared with 35 published DECT studies in gout. QUADAS-2 grading indicated strong applicability of U/S, DECT and Raman spectroscopy, but high study bias risk (in ∼30% of papers) due to non-controlled designs, and non-randomised subject selection. Conclusions Though CCA and CR remain reference standards for CPPD diagnosis, U/S, DECT and Raman spectroscopy are emerging U/S sensitivity appears to be superior to CR. We identified major unmet needs, including for randomised, blinded, controlled studies of CPPD diagnostic performance and rigorous analyses of 4 T MRI and other emerging modalities. PMID:27933211

  11. Radiological safety status and quality assurance audit of medical X-ray diagnostic installations in India.

    PubMed

    Sonawane, A U; Singh, Meghraj; Sunil Kumar, J V K; Kulkarni, Arti; Shirva, V K; Pradhan, A S

    2010-10-01

    We conducted a radiological safety and quality assurance (QA) audit of 118 medical X-ray diagnostic machines installed in 45 major hospitals in India. The main objective of the audit was to verify compliance with the regulatory requirements stipulated by the national regulatory body. The audit mainly covered accuracy check of accelerating potential (kVp), linearity of tube current (mA station) and timer, congruence of radiation and optical field, and total filtration; in addition, we also reviewed medical X-ray diagnostic installations with reference to room layout of X-ray machines and conduct of radiological protection survey. A QA kit consisting of a kVp Test-O-Meter (ToM) (Model RAD/FLU-9001), dose Test-O-Meter (ToM) (Model 6001), ionization chamber-based radiation survey meter model Gun Monitor and other standard accessories were used for the required measurements. The important areas where there was noncompliance with the national safety code were: inaccuracy of kVp calibration (23%), lack of congruence of radiation and optical field (23%), nonlinearity of mA station (16%) and timer (9%), improper collimator/diaphragm (19.6%), faulty adjustor knob for alignment of field size (4%), nonavailability of warning light (red light) at the entrance of the X-ray room (29%), and use of mobile protective barriers without lead glass viewing window (14%). The present study on the radiological safety status of diagnostic X-ray installations may be a reasonably good representation of the situation in the country as a whole. The study contributes significantly to the improvement of radiological safety by the way of the steps already taken and by providing a vital feed back to the national regulatory body.

  12. Development of distance accuracy measurement program for quality control of diagnostic ultrasound system

    NASA Astrophysics Data System (ADS)

    Kim, Yon-Min; Kim, Moon-Chan; Han, Dong-Kyoon; Cho, Jae-Hwan; Kim, Sang-Hyun

    2013-12-01

    Evaluating the performance of a diagnostic ultrasound system is important. Above all, establishing standards for such evaluations in an objective and systematic way is critical. However, quality control is currently measured based on subjective judgment of an observer. Against this background, this study intended to suggest quantified and objective data that would enable inter-observer variation to be overcome. Five radiological technologists used an ATS-539 multi-purpose ultrasound phantom to conduct measurements in the predetermined method. A digital imaging and communications in medicine (DICOM) standard image was obtained in an ultrasound system by using a self-developed software to measure the accuracy of the distance before the 95% confidence interval was calculated. In order to examine the accuracy of the distance in longitudinal and transverse measurements, we conducted t-tests to evaluate the significance for the results of quality control that was performed manually for the past one year and for the results of quality control that was performed by using software with the same equipment. For the longitudinal and the transverse measurements, the 95% confidence intervals were 100.96-101.29 mm and 83.18-84.26 mm, respectively. The computerized longitudinal measurement showed no significant difference from the manual measurement ( p > 0.05). The results of measurements using of software showed a higher reproducibility.

  13. Effects of motion-JPEG compression on the diagnostic quality of pediatric echocardiograms

    NASA Astrophysics Data System (ADS)

    Chimiak, William J.; Kuehl, Karen S.; Hayes, Wendelin S.; Khanafer, Nassib; Lo, Shih-Chung B.; Karr, Sharon; Cockerham, John E.; Schratz, Lorraine; Baffa, Jeanne M.; Tohme, Walid G.; Rainer, Robert O.; Mun, Seong K.

    1997-05-01

    Congenital heart disease is infrequent and often is apparent in the immediate newborn period. Accurate diagnosis delivered in real-time or near-real-time is important to provide appropriate care to avoid patient morbidity and mortality. Color-flow Doppler echocardiograms are an essential part of the diagnostic assessment of the newborn, however, few hospitals have the staff to interpret these studies appropriately. Transmission of these studies to a regional center with subspecialists will allow interpretation of the studies by physicians with expertise in this subspecialty. Transmission of these studies to a regional center with subspecialists will allow interpretation of the studies by physicians to appropriately and rapidly triage neonates with high-risk congenital heart disease. To make a teleradiology service affordable in the near future, the 73 million bit per second transmission speed must be reduced to affordable bandwidths using compression. The purpose of this study is to evaluate the impact of motion JPEG on the diagnostic quality of pediatric echocardiograms.

  14. Region 6: Texas Adequate Letter (4/16/2010)

    EPA Pesticide Factsheets

    This letter from EPA to Texas Commission on Environmental Quality determined 2021 motor vehicle emission budgets for nitrogen oxides (NOx) and volatile organic compounds (VOCs) for Beaumont/Port Arthur area adequate for transportation conformity purposes

  15. Region 8: Utah Adequate Letter (6/10/2005)

    EPA Pesticide Factsheets

    This letter from EPA to Utah Department of Environmental Quality determined Salt Lake Citys' and Ogdens' Carbon Monoxide (CO) maintenance plan for Motor Vehicle Emissions Budgets adequate for transportation conformity purposes.

  16. Web-based tools for quality assurance and radiation protection in diagnostic radiology.

    PubMed

    Moores, B M; Charnock, P; Ward, M

    2010-01-01

    Practical and philosophical aspects of radiation protection in diagnostic radiology have changed very little over the past 50 y even though patient doses have continued to rise significantly in this period. This rise has been driven by technological developments, such as multi-slice computed tomography, that have been able to improve diagnostic accuracy but not necessarily provide the same level of risk-benefit to all patients or groups of patients given the dose levels involved. Can practical radiation protection strategies hope to keep abreast of these ongoing developments? A project was started in 1992 in Liverpool that aimed to develop IT driven quality assurance (QA)/radiation protection software tools based upon a modular quality assurance dose data system. One of the modules involved the assessment of the patient entrance surface air kerma (ESAK) for an X-ray examination that was based upon the use of calibrated X-ray tube exposure factors to calculate ESAK as well as collecting appropriate patient details (age, sex, weight, thickness etc). The package also contained modules for logging all necessary equipment performance QA data. This paper will outline the experience gained with this system through its transition from a local application on a stand alone PC within the department to the current web-based approach. Advantages of a web-based approach to delivering such an application as well as centrally storing data originating on many hospital sites will be discussed together with the scientific support processes that can be developed with such a system. This will include local, national and international considerations. The advantages of importing radiographic examination details directly from other electronic storage systems such as a hospital's radiology information system will be presented together with practical outcomes already achieved. This will include the application of statistical techniques to the very large data sets generated. The development

  17. Diagnostic air quality model evaluation of source-specific primary and secondary fine particulate carbon.

    PubMed

    Napelenok, Sergey L; Simon, Heather; Bhave, Prakash V; Pye, Havala O T; Pouliot, George A; Sheesley, Rebecca J; Schauer, James J

    2014-01-01

    Ambient measurements of 78 source-specific tracers of primary and secondary carbonaceous fine particulate matter collected at four midwestern United States locations over a full year (March 2004-February 2005) provided an unprecedented opportunity to diagnostically evaluate the results of a numerical air quality model. Previous analyses of these measurements demonstrated excellent mass closure for the variety of contributing sources. In this study, a carbon-apportionment version of the Community Multiscale Air Quality (CMAQ) model was used to track primary organic and elemental carbon emissions from 15 independent sources such as mobile sources and biomass burning in addition to four precursor-specific classes of secondary organic aerosol (SOA) originating from isoprene, terpenes, aromatics, and sesquiterpenes. Conversion of the source-resolved model output into organic tracer concentrations yielded a total of 2416 data pairs for comparison with observations. While emission source contributions to the total model bias varied by season and measurement location, the largest absolute bias of -0.55 μgC/m(3) was attributed to insufficient isoprene SOA in the summertime CMAQ simulation. Biomass combustion was responsible for the second largest summertime model bias (-0.46 μgC/m(3) on average). Several instances of compensating errors were also evident; model underpredictions in some sectors were masked by overpredictions in others.

  18. Statistical diagnostics emerging from external quality control of real-time PCR.

    PubMed

    Marubini, E; Verderio, P; Raggi, Casini C; Pazzagli, M; Orlando, C

    2004-01-01

    Besides the application of conventional qualitative PCR as a valuable tool to enrich or identify specific sequences of nucleic acids, a new revolutionary technique for quantitative PCR determination has been introduced recently. It is based on real-time detection of PCR products revealed as a homogeneous accumulating signal generated by specific dyes. However, as far as we know, the influence of the variability of this technique on the reliability of the quantitative assay has not been thoroughly investigated. A national program of external quality assurance (EQA) for real-time PCR determination involving 42 Italian laboratories has been developed to assess the analytical performance of real-time PCR procedures. Participants were asked to perform a conventional experiment based on the use of an external reference curve (standard curve) for real-time detection of three cDNA samples with different concentrations of a specific target. In this paper the main analytical features of the standard curve have been investigated in an attempt to produce statistical diagnostics emerging from external quality control. Specific control charts were drawn to help biochemists take technical decisions aimed at improving the performance of their laboratories. Overall, our results indicated a subset of seven laboratories whose performance appeared to be markedly outside the limits for at least one of the standard curve features investigated. Our findings suggest the usefulness of the approach presented here for monitoring the heterogeneity of results produced by different laboratories and for selecting those laboratories that need technical advice on their performance.

  19. The importance of quality assurance/quality control of diagnostics to increase the confidence in global foot-and-mouth disease control.

    PubMed

    De Clercq, K; Goris, N; Barnett, P V; MacKay, D K

    2008-01-01

    The last decade international trade in animals and animal products was liberated and confidence in this global trade can increase only if appropriate control measures are applied. As foot-and-mouth disease (FMD) diagnostics will play an essential role in this respect, the Food and Agriculture Organization European Commission for the Control of Foot-and-Mouth Disease (EUFMD) co-ordinates, in collaboration with the European Commission, several programmes to increase the quality of FMD diagnostics. A quality assurance (QA) system is deemed essential for laboratories involved in certifying absence of FMDV or antibodies against the virus. Therefore, laboratories are encouraged to validate their diagnostic tests fully and to install a continuous quality control (QC) monitoring system. Knowledge of performance characteristics of diagnostics is essential to interpret results correctly and to calculate sample rates in regional surveillance campaigns. Different aspects of QA/QC of classical and new FMD virological and serological diagnostics are discussed in respect to the EU FMD directive (2003/85/EC). We recommended accepting trade certificates only from laboratories participating in international proficiency testing on a regular basis.

  20. Daily dose monitoring with atlas-based auto-segmentation on diagnostic quality CT for prostate cancer

    SciTech Connect

    Li, Wen; Vassil, Andrew; Xia, Ping; Zhong, Yahua

    2013-11-15

    Purpose: To evaluate the feasibility of daily dose monitoring using a patient specific atlas-based autosegmentation method on diagnostic quality verification images.Methods: Seven patients, who were treated for prostate cancer with intensity modulated radiotherapy under daily imaging guidance of a CT-on-rails system, were selected for this study. The prostate, rectum, and bladder were manually contoured on the first six and last seven sets of daily verification images. For each patient, three patient specific atlases were constructed using manual contours from planning CT alone (1-image atlas), planning CT plus first three verification CTs (4-image atlas), and planning CT plus first six verification CTs (7-image atlas). These atlases were subsequently applied to the last seven verification image sets of the same patient to generate the auto-contours. Daily dose was calculated by applying the original treatment plans to the daily beam isocenters. The autocontours and manual contours were compared geometrically using the dice similarity coefficient (DSC), and dosimetrically using the dose to 99% of the prostate CTV (D99) and the D5 of rectum and bladder.Results: The DSC of the autocontours obtained with the 4-image atlases were 87.0%± 3.3%, 84.7%± 8.6%, and 93.6%± 4.3% for the prostate, rectum, and bladder, respectively. These indices were higher than those from the 1-image atlases (p < 0.01) and comparable to those from the 7-image atlases (p > 0.05). Daily prostate D99 of the autocontours was comparable to those of the manual contours (p= 0.55). For the bladder and rectum, the daily D5 were 95.5%± 5.9% and 99.1%± 2.6% of the planned D5 for the autocontours compared to 95.3%± 6.7% (p= 0.58) and 99.8%± 2.3% (p < 0.01) for the manual contours.Conclusions: With patient specific 4-image atlases, atlas-based autosegmentation can adequately facilitate daily dose monitoring for prostate cancer.

  1. Diagnostic and quality-assurance tools for low-contrast images obtained from array detectors

    NASA Technical Reports Server (NTRS)

    Hatfield, D. B.; Sandel, Bill R.

    1993-01-01

    We investigate methods of estimating a background image frame for subtraction from a data frame for use when a more suitable measured background frame is not available. We define background as any signal component that is not attributable to the phenomenon currently under investigation. We describe a technique that is based on pixel-by-pixel least-squares regression of images for computing a background frame from available data. We argue that the same technique can be a useful quality-assurance tool for evaluating instrument performance. For example, it can help to separate image structure resulting from the reading process from structure resulting from the characteristics of the detector itself. We demonstrate that background estimation can be nontrivial by comparing the results of different background estimation procedures by using data obtained from a CCD array detector. We investigate the temperature-dependent contributions of the detector and readout electronics to the total signal as a demonstration of the diagnostic capabilities of least-squares image regression.

  2. In situ process diagnostics of silane plasma for device-quality a-Si:H deposition

    NASA Astrophysics Data System (ADS)

    Shing, Y. H.; Perry, J. W.; Hermann, A. M.

    Coherent anti-Stokes Raman spectroscopy (CARS) and mass spectrometry (MS) have been applied to in situ process diagnostics of a silane plasma for device-quality a-Si:H film deposition. Silane depletion was directly measured by CARS and is linearly dependent on RF power in the region of 4-12 W with a slope of 0.5 percent/mW-sq cm. The depletion is also dependent on SiH4 flow rate starting with a 50 percent depletion at a low flow rate of 5.6 sccm and asymptotically approaching an 8 percent depletion at a flow rate of 80 sccm. The mass spectral line signal intensity of disilane increases with RF power and shows an apparent transition at 6 W. Disilane formation in silane plasma, film deposition rate, and silane depletion ratio as a function of the RF power indicate that the film growth mechanism in the low-power region of 3.5-6.5 W is substantially different from that in the high-power region of 6.5-12 W.

  3. Improving the Quality of Diagnostic Studies Evaluating Point of Care Tests for Acute HIV Infections: Problems and Recommendations.

    PubMed

    Smallwood, Megan; Pant Pai, Nitika

    2017-03-04

    The diagnosis of acute human immunodeficiency virus (HIV) infection (AHI) plays a unique role in preventing the spread of HIV and ending the epidemic. Acutely infected individuals are thought to contribute substantially to forward transmissions of HIV; however, diagnosing AHI in resource-limited settings has proven to be a challenge. While fourth generation antigen-antibody combination assays have been successful in high-resource settings, rapid point of care (POC) versions of these assays have yet to demonstrate high sensitivity to detect AHI. Newer RNA/DNA based POC technologies are being validated, but the challenge to understand the additional value of these devices depends on the quality of study evaluations, in particular choice of study designs and case mix of included populations. In this commentary, we aimed to review the quality of studies evaluating a new fourth generation rapid test for detecting AHI, to identify general methodological limitations and biases in diagnostic accuracy studies, and to recommend strategies for avoiding them in future evaluations. The new studies that were evaluated continued to report the same weaknesses and biases that were seen in previous evaluations of fourth generation rapid tests. We recommend that investigators design future studies carefully, keeping in mind how diagnostic performance may be influenced by prevalence, population, patient case mixes, and reference standards. Care must be taken to avoid biases specific to diagnostic accuracy studies (spectrum, verification, incorporation and reference standard biases). To improve on quality, reporting checklists and guidelines such as Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) and Standards for Reporting Diagnostic accuracy studies (STARD) should be reviewed prior to conducting studies.

  4. Improving the Quality of Diagnostic Studies Evaluating Point of Care Tests for Acute HIV Infections: Problems and Recommendations

    PubMed Central

    Smallwood, Megan; Pant Pai, Nitika

    2017-01-01

    The diagnosis of acute human immunodeficiency virus (HIV) infection (AHI) plays a unique role in preventing the spread of HIV and ending the epidemic. Acutely infected individuals are thought to contribute substantially to forward transmissions of HIV; however, diagnosing AHI in resource-limited settings has proven to be a challenge. While fourth generation antigen-antibody combination assays have been successful in high-resource settings, rapid point of care (POC) versions of these assays have yet to demonstrate high sensitivity to detect AHI. Newer RNA/DNA based POC technologies are being validated, but the challenge to understand the additional value of these devices depends on the quality of study evaluations, in particular choice of study designs and case mix of included populations. In this commentary, we aimed to review the quality of studies evaluating a new fourth generation rapid test for detecting AHI, to identify general methodological limitations and biases in diagnostic accuracy studies, and to recommend strategies for avoiding them in future evaluations. The new studies that were evaluated continued to report the same weaknesses and biases that were seen in previous evaluations of fourth generation rapid tests. We recommend that investigators design future studies carefully, keeping in mind how diagnostic performance may be influenced by prevalence, population, patient case mixes, and reference standards. Care must be taken to avoid biases specific to diagnostic accuracy studies (spectrum, verification, incorporation and reference standard biases). To improve on quality, reporting checklists and guidelines such as Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) and Standards for Reporting Diagnostic accuracy studies (STARD) should be reviewed prior to conducting studies. PMID:28273857

  5. Diagnostic quality of time-averaged ECG-gated CT data

    NASA Astrophysics Data System (ADS)

    Klein, Almar; Oostveen, Luuk J.; Greuter, Marcel J. W.; Hoogeveen, Yvonne; Schultze Kool, Leo J.; Slump, Cornelis H.; Renema, W. Klaas Jan

    2009-02-01

    Purpose: ECG-gated CTA allows visualization of the aneurysm and stentgraft during the different phases of the cardiac cycle, although with a lower SNR per cardiac phase than without ECG gating using the same dose. In our institution, abdominal aortic aneurysm (AAA) is evaluated using non-ECG-gated CTA. Some common CT scanners cannot reconstruct a non-gated volume from ECG-gated acquired data. In order to obtain the same diagnostic image quality, we propose offline temporal averaging of the ECG-gated data. This process, though straightforward, is fundamentally different from taking a non-gated scan, and its result will certainly differ as well. The purpose of this study is to quantitatively investigate how good off-line averaging approximates a non-gated scan. Method: Non-gated and ECG-gated CT scans have been performed on a phantom (Catphan 500). Afterwards the phases of the ECG-gated CTA data were averaged to create a third dataset. The three sets are compared with respect to noise properties (NPS) and frequency response (MTF). To study motion artifacts identical scans were acquired on a programmable dynamic phantom. Results and Conclusions: The experiments show that the spatial frequency content is not affected by the averaging process. The minor differences observed for the noise properties and motion artifacts are in favor of the averaged data. Therefore the averaged ECG-gated phases can be used for diagnosis. This enables the use of ECG-gating for research on stentgrafts in AAA, without impairing clinical patient care.

  6. 21 CFR 1404.900 - Adequate evidence.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Adequate evidence. 1404.900 Section 1404.900 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 1404.900 Adequate evidence. Adequate evidence means information sufficient...

  7. 21 CFR 1404.900 - Adequate evidence.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Adequate evidence. 1404.900 Section 1404.900 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 1404.900 Adequate evidence. Adequate evidence means information sufficient...

  8. The quest for 'diagnostically lossless' medical image compression: a comparative study of objective quality metrics for compressed medical images

    NASA Astrophysics Data System (ADS)

    Kowalik-Urbaniak, Ilona; Brunet, Dominique; Wang, Jiheng; Koff, David; Smolarski-Koff, Nadine; Vrscay, Edward R.; Wallace, Bill; Wang, Zhou

    2014-03-01

    Our study, involving a collaboration with radiologists (DK,NSK) as well as a leading international developer of medical imaging software (AGFA), is primarily concerned with improved methods of assessing the diagnostic quality of compressed medical images and the investigation of compression artifacts resulting from JPEG and JPEG2000. In this work, we compare the performances of the Structural Similarity quality measure (SSIM), MSE/PSNR, compression ratio CR and JPEG quality factor Q, based on experimental data collected in two experiments involving radiologists. An ROC and Kolmogorov-Smirnov analysis indicates that compression ratio is not always a good indicator of visual quality. Moreover, SSIM demonstrates the best performance, i.e., it provides the closest match to the radiologists' assessments. We also show that a weighted Youden index1 and curve tting method can provide SSIM and MSE thresholds for acceptable compression ratios.

  9. A diagnostic tool for basic daily quality assurance of a Tomotherapy Hi*Art machine.

    PubMed

    Van de Vondel, Iwein; Tournel, Koen; Verellen, Dirk; Duchateau, Michael; Lelie, Steven; Storme, Guy

    2009-10-15

    To investigate and evaluate the use of an in-house developed diagnostic software tool using the imaging detector data for a quick daily quality assurance check of the output (dose) and lateral profile (cone) of a tomotherapy Hi*Art system. The Hi*Art treatment system is a radiation therapy machine for delivering intensity modulated radiation therapy (IMRT) in a helical fashion with an integrated CT scanner used for improved patient positioning before treatment. Since the system was developed specifically for IMRT, flat fields can be obtained by modulating the beam and therefore the flattening filter could be omitted. Because of this, the field has a cone-like profile in both lateral and transversal directions. Patients are treated in a helical fashion with a tight pitch and a constant gantry rotation speed, while modulation is performed by a binary MLC. Consequently dose output per time-unit (dose rate) as well as the shape of the cone-profile are very important for correct patient treatment and should be closely monitored. However, using the company-provided initial tools and conventional dosimetry, this can be a time consuming daily procedure. The aim of this work is to develop a fast, automated method of quality assurance based on the detector signal. A software tool called "tomocheck" running on the operation station has been developed to evaluate the output (dose rate) and the lateral cone profile (energy) of the Hi*Art system, comparing actual output and cone profile with a reference (previously approved against ionization chamber measurements). This is done by using the data of the 640 on-board detector array that are directly retrieved and processed after a specific QA procedure. The detector file consists of the CT detector data and the three monitoring dose chamber readings over a time period of 200 sec. To evaluate the method, the system was benchmarked against ionization chamber measurements and classical IMRT QA methods. Action levels (final status

  10. Diagnostic Air Quality Model Evaluation of Source-Specific Primary and Secondary Fine Particulate Carbon

    EPA Science Inventory

    Ambient measurements of 78 source-specific tracers of primary and secondary carbonaceous fine particulate matter collected at four midwestern United States locations over a full year (March 2004–February 2005) provided an unprecedented opportunity to diagnostically evaluate...

  11. 21 CFR 1000.55 - Recommendation for quality assurance programs in diagnostic radiology facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... and continuing education to keep the personnel up-to-date. Practical experience with the techniques... producing the images. Quality assurance actions include both “quality control” techniques and “quality... control techniques are those techniques used in the monitoring (or testing) and maintenance of...

  12. 5 CFR 919.900 - Adequate evidence.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Adequate evidence. 919.900 Section 919.900 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 919.900 Adequate...

  13. Quality and Safety in Health Care, Part XIV: The External Environment and Research for Diagnostic Processes.

    PubMed

    Harolds, Jay A

    2016-09-01

    The work system in which diagnosis takes place is affected by the external environment, which includes requirements such as certification, accreditation, and regulations. How errors are reported, malpractice, and the system for payment are some other aspects of the external environment. Improving the external environment is expected to decrease errors in diagnosis. More research on improving the diagnostic process is needed.

  14. Psychometric Qualities of the German Version of the Posttraumatic Diagnostic Scale (PTDS)

    ERIC Educational Resources Information Center

    Griesel, Dorothee; Wessa, Michele; Flor, Herta

    2006-01-01

    In the present study, the psychometric properties of the German version of the Posttraumatic Diagnostic Scale (PTDS; A. Ehlers, R. Steil, H. Winter, & E. B. Foa, 1996) were evaluated in a sample of 143 trauma survivors. To investigate convergent and discriminant validity of this questionnaire, the authors assessed posttraumatic stress disorder…

  15. Diagnostic Evaluation of Ozone Production and Horizontal Transport in a Regional Photochemical Air Quality Modeling System

    EPA Science Inventory

    A diagnostic model evaluation effort has been performed to focus on photochemical ozone formation and the horizontal transport process since they strongly impact the temporal evolution and spatial distribution of ozone (O3) within the lower troposphere. Results from th...

  16. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies.

    PubMed

    Whiting, Penny F; Rutjes, Anne W S; Westwood, Marie E; Mallett, Susan; Deeks, Jonathan J; Reitsma, Johannes B; Leeflang, Mariska M G; Sterne, Jonathan A C; Bossuyt, Patrick M M

    2011-10-18

    In 2003, the QUADAS tool for systematic reviews of diagnostic accuracy studies was developed. Experience, anecdotal reports, and feedback suggested areas for improvement; therefore, QUADAS-2 was developed. This tool comprises 4 domains: patient selection, index test, reference standard, and flow and timing. Each domain is assessed in terms of risk of bias, and the first 3 domains are also assessed in terms of concerns regarding applicability. Signalling questions are included to help judge risk of bias. The QUADAS-2 tool is applied in 4 phases: summarize the review question, tailor the tool and produce review-specific guidance, construct a flow diagram for the primary study, and judge bias and applicability. This tool will allow for more transparent rating of bias and applicability of primary diagnostic accuracy studies.

  17. Diagnostic Analysis of Ozone Concentrations Simulated by Two Regional-Scale Air Quality Models

    EPA Science Inventory

    Since the Community Multiscale Air Quality modeling system (CMAQ) and the Weather Research and Forecasting with Chemistry model (WRF/Chem) use different approaches to simulate the interaction of meteorology and chemistry, this study compares the CMAQ and WRF/Chem air quality simu...

  18. Quality Assessment in Dobutamine Stress Echocardiography: What are the Clinical Predictors Associated With a Non-Diagnostic Test?

    PubMed Central

    Hawthorne, Katie M.; Johri, Amer M.; Malhotra, Rajeev; Hung, Judy; Baggish, Aaron; Picard, Michael H.

    2012-01-01

    Background Non-diagnostic dobutamine stress echocardiography (ndDSE, failure to achieve 85% of maximal predicted heart rate (HR) without evidence of inducible ischemia) is an important limitation affecting quality of DSE testing. The objectives of this study were to identify the clinical variables associated with a non-diagnostic Dobutamine Stress Echocardiogram (ndDSE) and further evaluate the patterns of subsequent testing for myocardial ischemia. Methods Consecutive DSE’s over a 17 month period (January 2008 to June 2009) were studied. Baseline demographics, medical history, and vital signs were collected. Subsequent testing was determined for up to 6 months after the initial DSE. Univariate and multivariate logistic regression analysis was performed to identify clinical factors associated with ndDSE. Results Of 467 total DSE, 314 (67%) were negative for ischemia, 69 (15%) were positive, and 84 (18%) were ndDSE. Of those recommended for further nuclear MPI testing 12 (14%) had an ndDSE compared to 16 (4%) patients with a diagnostic DSE (P = 0.001). Fifty percent of the ndDSE nuclear MPI tests were positive for ischemia. In the univariate analysis, Diabetes Mellitus (DM; P = 0.003), calcium channel antagonist (CCA) use (P = 0.047), Hypertension (HTN; P = 0.06), low baseline HR (P < 0.001), and younger age group (P = 0.02) were predictive of ndDSE. Of these, all except CCA use remained independent predictors of ndDSE in multivariate analysis. A 4 variable model for predicting ndDSE was developed from the multivariate logistic regression displayed in Table 1 (age and baseline HR were categorized and scored 0-2; DM and HTN were scored as 0 (absent) or 1 (present)). Figure 2 demonstrates how risk of ndDSE correlated with a higher score, with each increment having an odds ratio of 2.1 (P < 0.001). Conclusions DM, HTN, younger age, and lower baseline HR affect the quality of DSE testing, resulting in non-diagnostic tests. A model combining these factors can identify

  19. Diagnostic and treatment delay, quality of life and satisfaction with care in colorectal cancer patients: a study protocol

    PubMed Central

    2013-01-01

    Background Due to recent improvements in colorectal cancer survival, patient-reported outcomes, including health-related quality of life and satisfaction with care, have become well-established endpoints to determine the impact of the disease on the lives of patients. The aim of this study is to determine prospectively, in a cohort of colorectal cancer incident cases: a) health-related quality of life, b) satisfaction with hospital-based care, and c) functional status. A secondary objective is to determine whether diagnostic/therapeutic delay influence quality of life or patients’ satisfaction levels. Methods/design Single-centre prospective follow-up study of colorectal cancer patients diagnosed during the period 2011–2012 (n = 375). This project was approved by the corresponding ethics review board, and informed consent is obtained from each patient. After diagnosis, patients are interviewed by a trained nurse, obtaining information on sociodemographic characteristics, family history of cancer, first symptoms, symptom perception and reaction to early symptoms. Quality of life is assessed with the EORTC QLQ-C30 and QLQ-CR29 questionnaires, and patients’ satisfaction with care is determined using the EORTC IN-PATSAT32. Functional status is measured with the Karnofsky Performance Status Scale. Clinical records are also reviewed to collect information on comorbidity, tumour characteristics, treatment, hospital consultations and exploratory procedures. Symptoms-to-diagnosis interval is defined as the time from the date of first symptoms until the cytohistological confirmation of cancer. Treatment delay is defined as the time between diagnosis and surgical treatment. All the patients will be followed-up for a maximum of 2 years. For survivors, assessments will be re-evaluated at one and two years after the diagnosis. Multiple linear/logistic regression models will be used to identify variables associated with the patients’ functional status, quality of life

  20. Developing a Standards-Based Information Model for Representing Computable Diagnostic Criteria: A Feasibility Study of the NQF Quality Data Model.

    PubMed

    Jiang, Guoqian; Solbrig, Harold R; Pathak, Jyotishman; Chute, Christopher G

    2015-01-01

    The lack of a standards-based information model has been recognized as a major barrier for representing computable diagnostic criteria. In this paper we describe our efforts in examining the feasibility of the Quality Data Model (QDM)-developed by the National Quality Forum (NQF)-for representing computable diagnostic criteria. We collected the diagnostic criteria for a number of diseases and disorders (n=12) from textbooks and profiled the data elements of the criteria using the QDM data elements. We identified a number of common patterns informed by the QDM. In conclusion, the common patterns informed by the QDM are useful and feasible in building a standards-based information model for computable diagnostic criteria.

  1. Health-related quality of life: The impact of diagnostic angiography

    PubMed Central

    Eastwood, Jo-Ann; Doering, Lynn V.; Dracup, Kathleen; Evangelista, Lorraine; Hays, Ron D.

    2011-01-01

    Background Little is known regarding the effects of index angiograms on health-related quality of life related to angiographic outcome, that is, positive or negative for coronary heart disease (CHD). Methods A longitudinal, comparative design was used. Ninety-three patients underwent initial angiography and completed questionnaires (Cardiac-Quality of Life Index, Short Form-36 mental and physical, and Cardiac Attitudes Index) before, 1 week and 1 year after angiography. Data were evaluated with linear regression and analysis of variance. Results Fifty-five patients were CHD positive (age 65.3 ± 10.7 years, 49% were female), and 38 patients were CHD negative (age 59.5 ± 12 years, 53% were female). Compared with CHD-positive patients over 1 year, CHD-negative patients reported lower scores on the Cardiac-Quality of Life Index (P < .008), Short Form-36 mental and physical measures (P = .004), and Cardiac Attitudes Index (P = .05). Conclusion CHD-negative patients experienced lower health-related quality of life and lower perceived control than CHD-positive patients. After an index angiogram, a negative finding may not be sufficient to relieve negative emotions. PMID:20691477

  2. Asbestos/NESHAP adequately wet guidance

    SciTech Connect

    Shafer, R.; Throwe, S.; Salgado, O.; Garlow, C.; Hoerath, E.

    1990-12-01

    The Asbestos NESHAP requires facility owners and/or operators involved in demolition and renovation activities to control emissions of particulate asbestos to the outside air because no safe concentration of airborne asbestos has ever been established. The primary method used to control asbestos emissions is to adequately wet the Asbestos Containing Material (ACM) with a wetting agent prior to, during and after demolition/renovation activities. The purpose of the document is to provide guidance to asbestos inspectors and the regulated community on how to determine if friable ACM is adequately wet as required by the Asbestos NESHAP.

  3. Funding the Formula Adequately in Oklahoma

    ERIC Educational Resources Information Center

    Hancock, Kenneth

    2015-01-01

    This report is a longevity, simulational study that looks at how the ratio of state support to local support effects the number of school districts that breaks the common school's funding formula which in turns effects the equity of distribution to the common schools. After nearly two decades of adequately supporting the funding formula, Oklahoma…

  4. A diagnostic for determining the quality of single-reference electron correlation methods

    NASA Technical Reports Server (NTRS)

    Lee, Timothy J.; Taylor, Peter R.

    1989-01-01

    It was recently proposed that the Euclidian norm of the t(sub 1) vector of the coupled cluster wave function (normalized by the number of electrons included in the correlation procedure) could be used to determine whether a single-reference-based electron correlation procedure is appopriate. This diagnostic, T(sub 1) is defined for use with self-consistent-field molecular orbitals and is invariant to the same orbital rotations as the coupled cluster energy. T(sub 1) is investigated for several different chemical systems which exhibit a range of multireference behavior, and is shown to be an excellent measure of the importance of non-dynamical electron correlation and is far superior to C(sub 0) from a singles and doubles configuration interaction wave function. It is further suggested that when the aim is to recover a large fraction of the dynamical electron correlation energy, a large T(sub 1) (i.e., greater than 0.02) probably indicates the need for a multireference electron correlation procedure.

  5. A diagnostic for determining the quality of single-reference electron correlation methods

    NASA Technical Reports Server (NTRS)

    Lee, Timothy J.; Taylor, Peter R.

    1989-01-01

    It was recently proposed that the Euclidian norm of the t sub 1 vector of the coupled cluster wave function (normalized by the number of electrons included in the correlation procedure) could be used to determine whether a single-reference-based electron correlation procedure is appropriate. This diagnostic, T sub 1, is defined for use with self consistent field molecular orbitals and is invariant to the same orbital rotations as the coupled cluster energy. T sub 1 is investigated for several different chemical systems which exhibit a range of multireference behavior, and is shown to be an excellent measure of the importance of nondynamical electron correlation and is far superior to C sub 0 from a singles and doubles configuration interaction wave function. It is further suggested that when the aim is to recover a large fraction of the dynamical electron correlation energy, a large T sub 1 (i.e., greater than 0.02) probably indicates the need for a multireference electron correlation procedure.

  6. Tuberculosis diagnostics: innovating to make an impact.

    PubMed

    Ghanashyam, Bharathi

    2011-04-01

    The 'International Symposium on TB Diagnostics: Innovating to Make an Impact' was organized by the International Centre for Genetic Engineering & Biotechnology, New Delhi, India, on December 16-17, 2010, with sponsorship support from the Bill & Melinda Gates Foundation, Foundation for Innovative New Diagnostics and AERAS Global TB Vaccine Foundation. This highly successful symposium attracted more than 300 participants from India and several other countries and covered several aspects of TB diagnostics, including recent scientific advances in TB diagnostics, progress made in expanding the TB diagnostics pipeline including a portfolio of WHO-endorsed, validated new tools and improved technologies, the successful development of newer molecular assays that have the potential to be used at the point of treatment and the growing contributions of emerging economies such as India. In addition to highlighting the positive aspects of TB diagnostics, the symposium speakers also highlighted the need to focus on worrisome aspects of TB diagnosis, including widespread abuse of inappropriate tests that can prevent the use of good diagnostics, lack of quality assurance in laboratories, lack of adequate regulation of diagnostics and how these can pose a major challenge for roll-out and implementation of new tools. The symposium ended with a very stimulating discussion on how India can become a global leader in TB innovations.

  7. Quality Control Performance in a Provincial Veterinary Diagnostic Microbiology Laboratory System

    PubMed Central

    Lynch, John A.; Kierstead, Marsha E.

    1986-01-01

    A quality control exercise was carried out in a provincial laboratory system to assess the performance of nine bacteriology technologists working in six laboratories. A group of ten mock specimens were distributed to each participant. Identification of all organisms and antibiotic susceptibility testing of pathogens was requested. Of the 117 organisms distributed, 104 were correctly identified, five were incorrectly identified and eight were not reported. Overall less than 1% very major errors, less than 5% major errors and less than 10% minor errors were observed in the antibiotic susceptibility testing. Most frequent errors were associated with penicillins, aminoglycosides, polymyxin, tetracycline and fastidious organisms. PMID:17422640

  8. Spectra Transmitted by Mortar Barite in x-ray Qualities Applied in Diagnostic Radiology as Shielding

    NASA Astrophysics Data System (ADS)

    Almeida, A. T., Jr.; Araújo, F. G. S.; Nogueira, M. S.; Santos, M. A. P.

    2016-07-01

    Concrete which contains water, cement and aggregate, is widely used in building construction such as medical hospitals. The CdZnTe spectrometry system was used to acquire the transmitted spectra in the RQR qualities and the stripping procedure was performed by taking into account both the contributions of efficiency and x-ray escape fraction, experimentally determined. The samples were prepared in rectangular plate format with dimensions of (5 x 5) cm with thicknesses varying from 0.2cm to 2cm and exposed to x-ray beams generated. The HVL and the mean energy in this energy range was determined.

  9. Algorithm design for automated transportation photo enforcement camera image and video quality diagnostic check modules

    NASA Astrophysics Data System (ADS)

    Raghavan, Ajay; Saha, Bhaskar

    2013-03-01

    Photo enforcement devices for traffic rules such as red lights, toll, stops, and speed limits are increasingly being deployed in cities and counties around the world to ensure smooth traffic flow and public safety. These are typically unattended fielded systems, and so it is important to periodically check them for potential image/video quality problems that might interfere with their intended functionality. There is interest in automating such checks to reduce the operational overhead and human error involved in manually checking large camera device fleets. Examples of problems affecting such camera devices include exposure issues, focus drifts, obstructions, misalignment, download errors, and motion blur. Furthermore, in some cases, in addition to the sub-algorithms for individual problems, one also has to carefully design the overall algorithm and logic to check for and accurately classifying these individual problems. Some of these issues can occur in tandem or have the potential to be confused for each other by automated algorithms. Examples include camera misalignment that can cause some scene elements to go out of focus for wide-area scenes or download errors that can be misinterpreted as an obstruction. Therefore, the sequence in which the sub-algorithms are utilized is also important. This paper presents an overview of these problems along with no-reference and reduced reference image and video quality solutions to detect and classify such faults.

  10. SveDem, the Swedish Dementia Registry – A Tool for Improving the Quality of Diagnostics, Treatment and Care of Dementia Patients in Clinical Practice

    PubMed Central

    Religa, Dorota; Fereshtehnejad, Seyed-Mohammad; Cermakova, Pavla; Edlund, Ann-Katrin; Garcia-Ptacek, Sara; Granqvist, Nicklas; Hallbäck, Anne; Kåwe, Kerstin; Farahmand, Bahman; Kilander, Lena; Mattsson, Ulla-Britt; Nägga, Katarina; Nordström, Peter; Wijk, Helle; Wimo, Anders; Winblad, Bengt; Eriksdotter, Maria

    2015-01-01

    Background The Swedish Dementia Registry (SveDem) was developed with the aim to improve the quality of diagnostic work-up, treatment and care of patients with dementia disorders in Sweden. Methods SveDem is an internet based quality registry where several indicators can be followed over time. It includes information about the diagnostic work-up, medical treatment and community support (www.svedem.se). The patients are diagnosed and followed-up yearly in specialist units, primary care centres or in nursing homes. Results The database was initiated in May 2007 and covers almost all of Sweden. There were 28 722 patients registered with a mean age of 79.3 years during 2007–2012. Each participating unit obtains continuous online statistics from its own registrations and they can be compared with regional and national data. A report from SveDem is published yearly to inform medical and care professionals as well as political and administrative decision-makers about the current quality of diagnostics, treatment and care of patients with dementia disorders in Sweden. Conclusion SveDem provides knowledge about current dementia care in Sweden and serves as a framework for ensuring the quality of diagnostics, treatment and care across the country. It also reflects changes in quality dementia care over time. Data from SveDem can be used to further develop the national guidelines for dementia and to generate new research hypotheses. PMID:25695768

  11. Improved image quality and diagnostic potential using ultra-high-resolution computed tomography of the lung with small scan FOV: A prospective study

    PubMed Central

    Wang, Yali; Hamal, Preeti; You, Xiaofang; Mao, Haixia; Li, Fei; Sun, Xiwen

    2017-01-01

    The aim of this study was to assess whether CT imaging using an ultra-high-resolution CT (UHRCT) scan with a small scan field of view (FOV) provides higher image quality and helps to reduce the follow-up period compared with a conventional high-resolution CT (CHRCT) scan. We identified patients with at least one pulmonary nodule at our hospital from July 2015 to November 2015. CHRCT and UHRCT scans were conducted in all enrolled patients. Three experienced radiologists evaluated the image quality using a 5-point score and made diagnoses. The paired images were displayed side by side in a random manner and annotations of scan information were removed. The following parameters including image quality, diagnostic confidence of radiologists, follow-up recommendations and diagnostic accuracy were assessed. A total of 52 patients (62 nodules) were included in this study. UHRCT scan provides a better image quality regarding the margin of nodules and solid internal component compared to that of CHRCT (P < 0.05). Readers have higher diagnostic confidence based on the UHRCT images than of CHRCT images (P<0.05). The follow-up recommendations were significantly different between UHRCT and CHRCT images (P<0.05). Compared with the surgical pathological findings, UHRCT had a relative higher diagnostic accuracy than CHRCT (P > 0.05). These findings suggest that the UHRCT prototype scanner provides a better image quality of subsolid nodules compared to CHRCT and contributes significantly to reduce the patients' follow-up period. PMID:28231320

  12. Diagnostic tools to determine the quality of "transparent" regression-based QSARs: the "modelling power" plot.

    PubMed

    Sagrado, Salvador; Cronin, Mark T D

    2006-01-01

    A bivariate plot is presented for comparing two or more QSAR models. It is based on two new statistics associated with a regression model, the "descriptive power" (Dp), which is estimated through the relative uncertainty of model coefficients, and the "predictive power" (Pp), which is estimated through both the fitted and cross-validated explained variance of the response variable (i.e., biological activity). An algorithm was developed for performing equivalent multiple linear regression and partial-least-squares calculations. The results were validated by comparison with widely accepted commercial software. Dp and Pp statistics are defined to vary from 0 to 100%, so the modeler has a intuitive impression of the descriptive (i.e., global importance of the selected descriptors) and predictive (i.e., possibility of performing QSAR or just SAR estimations) power. These statistics represent a point in the Dp versus Pp "modelling power" plot, which facilitates visual multiple models comparison, but also could be used to substitute classical statistics and could even be combined to obtain a unique parameter to define (or compare) the model's quality.

  13. Optical reflectivity as a simple diagnostic method for testing structural quality of icosahedral quasicrystals

    SciTech Connect

    Brien, Valerie; Dauscher, Anne; Machizaud, Francis

    2006-08-15

    The optical reflectivity of Al-based and Ti-based quasicrystalline and approximant samples were investigated versus the quality of their structural morphology using optical reflectometry, x-ray diffraction, and transmission electron microscopy. The different structural morphologies were obtained using three different preparation processes: sintering, pulsed laser deposition, and reactive cathodic magnetron sputtering. The work demonstrates that the canonical behavior of icosahedral state in specular reflectivity is extremely sensitive to different and very fine aspects of the microstructure: sizes of grains smaller than 50 nm, slight local diffuse disorder, and shifts away from the icosahedral crystallographic structure (approximants). The work explains why the optical properties of the same kind of quasicrystals found in literature sometimes reveal a different behavior from one author to another. The study then confirms the work of some authors and definitely shows that the canonical behavior of icosahedral state in specular reflectivity over the 30 000-50 000 cm{sup -1} domain is characterized by a decreasing function made of steps. It also shows that this behavior can be interpreted thanks to the cluster hierarchy of the model of Janot [Phys. Rev. B 53, 181 (1996)].

  14. Free magnetic energy and relative magnetic helicity diagnostics for the quality of NLFF field extrapolations

    NASA Astrophysics Data System (ADS)

    Moraitis, Kostas; Archontis, Vasilis; Tziotziou, Konstantinos; Georgoulis, Manolis K.

    We calculate the instantaneous free magnetic energy and relative magnetic helicity of solar active regions using two independent approaches: a) a non-linear force-free (NLFF) method that requires only a single photospheric vector magnetogram, and b) well known semi-analytical formulas that require the full three-dimensional (3D) magnetic field structure. The 3D field is obtained either from MHD simulations, or from observed magnetograms via respective NLFF field extrapolations. We find qualitative agreement between the two methods and, quantitatively, a discrepancy not exceeding a factor of 4. The comparison of the two methods reveals, as a byproduct, two independent tests for the quality of a given force-free field extrapolation. We find that not all extrapolations manage to achieve the force-free condition in a valid, divergence-free, magnetic configuration. This research has been co-financed by the European Union (European Social Fund - ESF) and Greek national funds through the Operational Program "Education and Lifelong Learning" of the National Strategic Reference Framework (NSRF) - Research Funding Program: Thales. Investing in knowledge society through the European Social Fund.

  15. MO-AB-210-00: Diagnostic Ultrasound Imaging Quality Control and High Intensity Focused Ultrasound Therapy Hands-On Workshop

    SciTech Connect

    2015-06-15

    The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrations with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS

  16. Comparison of Image Quality, Diagnostic Accuracy and Radiation Dose Between Flash Model and Retrospective ECG-Triggered Protocols in Dual Source Computed Tomography (DSCT) in Congenital Heart Diseases

    PubMed Central

    Wang, Rong; Xu, Xiang-Jiu; Huang, Gang; Zhou, Xing; Zhang, Wen-Wen; Ma, Ya-Qiong; Zuo, Xiao-na

    2017-01-01

    Summary Background Dual source computed tomography (DSCT) plays an important role in the diagnosis of congenital heart diseases (CHD). However, the issue of radiation-related side effects constitutes a wide public concern. The aim of the study was to explore the differences in diagnostic accuracy, radiation dose and image quality between a prospectively ECG – triggered high – pitch spiral acquisition (flash model) and a retrospective ECG-gated protocol of DSCT used for the detection of CHD. Material/Methods The study included 58 patients with CHD who underwent a DSCT examination, including two groups of 29 patients in each protocol. Then, both subjective and objective image quality, diagnostic accuracy and radiation dose were compared between the two protocols. Results The image quality and the total as well as partial diagnostic accuracy did not differ significantly between the protocols. The radiation dose in the flash model was obviously lower than that in the retrospective model (P<0.05). Conclusions Compared to the retrospective protocol, the flash model can significantly reduce the dose of radiation, while maintaining both diagnostic accuracy and image quality. PMID:28344686

  17. Online NIR diagnostic of laser welding processes and its potential for quality assuring sensor systems

    NASA Astrophysics Data System (ADS)

    Dorsch, Friedhelm; Braun, Holger; Keβler, Steffen; Pfitzner, Dieter; Rominger, Volker

    2014-02-01

    We have integrated an imaging thermographic sensor into commercial welding optics for observation of the weld zone. Key element of the sensor is an InGaAs-camera that detects the thermal radiation of the welding process in the wavelength range of 1,200 to 1,700 nm. This is well suited to record images of the keyhole, the melt pool and the thermal trace. The sensor was integrated to the welding heads for on-axis observation to minimize the interfering contour to ensure easy adaption to industrial processes. The welding heads used were established industrial-grade TRUMPF optics: a BEO fixed optics with 280 mm focal length, or a TRUMPF PFO-3D scanner optics with 450 mm focal length. We used a TRUMPF TruDisk 16002 16kW-thin disk laser that transmits its power through a 200 μm core diameter light cable. The images were recorded and features of the various process zones were evaluated by image processing. It turns out that almost all weld faults can be clearly detected in the NIR images. Quantitative features like the dimension of the melt pool and the thermal trace can be derived from the captured images. They are correlated to process input parameters as well as to process results. In contrast to observation in the visible spectrum the NIR camera records the melt pool without auxiliary illumination. As an unrivaled attribute of the NIR sensor it supports an online heat flow thermography of the seam and allows identifying missing fusion ("false friends") of lap joints virtually during the welding process. Automated weld fault detection and documentation is possible by online image processing which sets the basis for comprehensive data documentation for quality assurance and traceability.

  18. External quality assessment of tumour marker analysis: state of the art and consequences for estimating diagnostic sensitivity and specificity.

    PubMed

    Reinauer, Hans; Wood, William Graham

    2005-05-30

    This review shows the current analytical quality for the following analytes used as tumour markers in the external quality assessment (EQA)-programmes of Instand e.V., a national EQA-organiser in Germany: Corticotropin (ACTH), growth hormone (GH, hGH), prolactin (PRL), chorionic gonadotropin (CG, hCG), calcitonin (CT, hCT), thyroglobulin (Tg), carcinoembryonic antigen (CEA), CA-Antigens 125, 72-4, 15-3 and 19-9, alpha foetoprotein (AFP) and prostate-specific antigen (PSA). The results from the participants show a large variation in the precision of the methods used as well as in the comparability of results between methods for the same analyte. In general, the hormones used as tumour markers show better performance than the "CA-markers", which are often inadequately standardised and defined. In the case of one CA-marker (CA 72-4/TAG 72-4), the differences between the lowest kit median concentration and highest kit median concentration for one sample pair were 440% and 580%. The corresponding figures for ACTH were 123% and 156% and for CEA 180% and 184%. The classical tumour markers such as carcinoembryonic antigen (CEA) and alpha foetoprotein (AFP) performed markedly better than the CA-markers and PSA with regards to both inter- and intra-method comparability. The inter-laboratory precision for a given kit and marker was acceptable in many cases. The results show that only results from the same kit/method for each tumour marker can be used for cumulative or time-dependent comparison of results - for example pre-operative and post-operative follow up. In the case of prostate specific antigen (PSA), the kits used for free and total PSA must come from the same producer, if the generally accepted ratios are to have any diagnostic value. The need for kit- and laboratory-specific reference ranges and cut-off values for setting diagnostic specificity and sensitivity is highlighted from the EQA-results. The situation for inter-method comparability for the CA-Markers has

  19. Can a revised paediatric radiation dose reduction CT protocol be applied and still maintain anatomical delineation, diagnostic confidence and overall imaging quality?

    PubMed Central

    Siriwanarangsun, P; Tanaanantarak, P; Krisanachinda, A

    2014-01-01

    Objective: To compare multidetector CT (MDCT) radiation doses between default settings and a revised dose reduction protocol and to determine whether the diagnostic confidence can be maintained with imaging quality made under the revised protocol in paediatric head, chest and abdominal CT studies. Methods: The study retrospectively reviewed head, chest, abdominal and thoracoabdominal MDCT studies, comparing 231 CT studies taken before (Phase 1) and 195 CT studies taken after (Phase 2) the implemented revised protocol. Image quality was assessed using a five-point grading scale based on anatomical criteria, diagnostic confidence and overall quality. Image noise and dose–length product (DLP) were collected and compared. Results: The relative dose reductions between Phase 1 and Phase 2 were statistically significant in 35%, 51% and 54% (p < 0.001) of head, chest and abdominal CT studies, respectively. There were no statistically significant differences in overall image quality score comparisons in the head (p = 0.3), chest (p = 0.7), abdominal (p = 0.7) and contiguous thoracic (p = 0.1) and abdominal (p = 0.2) CT studies, with the exception of anatomical quality in definition of bronchial walls and delineation of intrahepatic portal branches in thoracoabdominal CTs, and diagnostic confidence in mass lesion in head CTs, liver lesion (>1 cm), splanchnic venous thrombosis, pancreatitis in abdominal CTs, and emphysema and aortic dissection in thoracoabdominal CTs. Conclusion: Paediatric CT radiation doses can be significantly reduced from manufacturer's default protocol while still maintaining anatomical delineation, diagnostic confidence and overall imaging quality. Advances in knowledge: Revised paediatric CT protocol can provide a half DLP reduction while preserving overall imaging quality. PMID:24959737

  20. A New Full-Field Digital Mammography System with and without the Use of an Advanced Post-Processing Algorithm: Comparison of Image Quality and Diagnostic Performance

    PubMed Central

    Ahn, Hye Shin; Jang, Mijung; Yun, Bo La; Kim, Bohyoung; Ko, Eun Sook; Han, Boo-Kyung; Chang, Jung Min; Yi, Ann; Cho, Nariya; Moon, Woo Kyung; Choi, Hye Young

    2014-01-01

    Objective To compare new full-field digital mammography (FFDM) with and without use of an advanced post-processing algorithm to improve image quality, lesion detection, diagnostic performance, and priority rank. Materials and Methods During a 22-month period, we prospectively enrolled 100 cases of specimen FFDM mammography (Brestige®), which was performed alone or in combination with a post-processing algorithm developed by the manufacturer: group A (SMA), specimen mammography without application of "Mammogram enhancement ver. 2.0"; group B (SMB), specimen mammography with application of "Mammogram enhancement ver. 2.0". Two sets of specimen mammographies were randomly reviewed by five experienced radiologists. Image quality, lesion detection, diagnostic performance, and priority rank with regard to image preference were evaluated. Results Three aspects of image quality (overall quality, contrast, and noise) of the SMB were significantly superior to those of SMA (p < 0.05). SMB was significantly superior to SMA for visualizing calcifications (p < 0.05). Diagnostic performance, as evaluated by cancer score, was similar between SMA and SMB. SMB was preferred to SMA by four of the five reviewers. Conclusion The post-processing algorithm may improve image quality with better image preference in FFDM than without use of the software. PMID:24843234

  1. Improvement of diagnostic agreement among pathologists in resolving an "atypical glands suspicious for cancer" diagnosis in prostate biopsies using a novel "Disease-Focused Diagnostic Review" quality improvement process.

    PubMed

    Shah, Rajal B; Leandro, Gioacchino; Romerocaces, Gloria; Bentley, James; Yoon, Jiyoon; Mendrinos, Savvas; Tadros, Yousef; Tian, Wei; Lash, Richard

    2016-10-01

    One of the major goals of an anatomic pathology laboratory quality program is to minimize unwarranted diagnostic variability and equivocal reporting. This study evaluated the utility of Miraca Life Sciences' "Disease-Focused Diagnostic Review" (DFDR) quality program in improving interobserver diagnostic reproducibility associated with classification of "atypical glands suspicious for adenocarcinoma" (ATYP) in prostate biopsies. Seventy-one selected prostate biopsies with a focus of ATYP were reviewed by 8 pathologists. Participants were blinded to the original diagnosis and were first asked to classify the ATYP as benign, atypical, or limited adenocarcinoma. DFDR comprised a "theoretical consensus" (in which pathologists first reached consensus on the morphological features they considered relevant for the diagnosis of limited prostatic adenocarcinoma), a didactic review including relevant literature, and "practical consensus" (pathologists performed joint microscopic sessions, reconciling each other's observations and positions evaluating a separate unique slide set). Participants were finally asked to reclassify the original 71 ATYP cases based on knowledge gleaned from DFDR. Pre- and post-DFDR interobserver reproducibility of overall diagnostic agreement was assessed. Interobserver reproducibility measured by Fleiss κ values of pre- and post-DFDR was 0.36 and 0.59, respectively (P=.006). Post-DFDR, there were significant improvement for "100% concordance" (P=.011) and reduction for "no consensus" (P=.0004) categories. Despite a lower pre-DFDR reproducibility for non-uropathology fellowship-trained (n=3, κ=0.38) versus uropathology fellowship-trained (n=5, κ=0.43) pathologists, both groups achieved similarly high post-DFDR κ levels (κ=0.58 and 0.56, respectively). DFDR represents an effective tool to formally achieve diagnostic consensus and reduce variability associated with critical diagnoses in an anatomic pathology practice.

  2. Serum thyroglobulin reference intervals in regions with adequate and more than adequate iodine intake.

    PubMed

    Wang, Zhaojun; Zhang, Hanyi; Zhang, Xiaowen; Sun, Jie; Han, Cheng; Li, Chenyan; Li, Yongze; Teng, Xiaochun; Fan, Chenling; Liu, Aihua; Shan, Zhongyan; Liu, Chao; Weng, Jianping; Teng, Weiping

    2016-11-01

    The purpose of this study was to establish normal thyroglobulin (Tg) reference intervals (RIs) in regions with adequate and more than adequate iodine intake according to the National Academy of Clinical Biochemistry (NACB) guidelines and to investigate the relationships between Tg and other factors.A total of 1317 thyroid disease-free adult subjects (578 men, 739 nonpregnant women) from 2 cities (Guangzhou and Nanjing) were enrolled in this retrospective, observational study. Each subject completed a questionnaire and underwent physical and ultrasonic examination. Serum Tg, thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), Tg antibody (TgAb), and urinary iodine concentration (UIC) were measured. Reference groups were established on the basis of TSH levels: 0.5 to 2.0 and 0.27 to 4.2 mIU/L.The Tg RIs for Guangzhou and Nanjing were 1.6 to 30.0 and 1.9 to 25.8 ng/mL, respectively. No significant differences in Tg were found between genders or among different reference groups. Stepwise linear regression analyses showed that TgAb, thyroid volume, goiter, gender, age, and TSH levels were correlated with Tg.In adults from regions with adequate and more than adequate iodine intake, we found that Tg may be a suitable marker of iodine status; gender-specific Tg RI was unnecessary; there was no difference between Tg RIs in regions with adequate and more than adequate iodine intake; and the TSH criterion for selecting the Tg reference population could follow the local TSH reference rather than 0.5 to 2.0 mIU/L.

  3. Serum thyroglobulin reference intervals in regions with adequate and more than adequate iodine intake

    PubMed Central

    Wang, Zhaojun; Zhang, Hanyi; Zhang, Xiaowen; Sun, Jie; Han, Cheng; Li, Chenyan; Li, Yongze; Teng, Xiaochun; Fan, Chenling; Liu, Aihua; Shan, Zhongyan; Liu, Chao; Weng, Jianping; Teng, Weiping

    2016-01-01

    Abstract The purpose of this study was to establish normal thyroglobulin (Tg) reference intervals (RIs) in regions with adequate and more than adequate iodine intake according to the National Academy of Clinical Biochemistry (NACB) guidelines and to investigate the relationships between Tg and other factors. A total of 1317 thyroid disease-free adult subjects (578 men, 739 nonpregnant women) from 2 cities (Guangzhou and Nanjing) were enrolled in this retrospective, observational study. Each subject completed a questionnaire and underwent physical and ultrasonic examination. Serum Tg, thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), Tg antibody (TgAb), and urinary iodine concentration (UIC) were measured. Reference groups were established on the basis of TSH levels: 0.5 to 2.0 and 0.27 to 4.2 mIU/L. The Tg RIs for Guangzhou and Nanjing were 1.6 to 30.0 and 1.9 to 25.8 ng/mL, respectively. No significant differences in Tg were found between genders or among different reference groups. Stepwise linear regression analyses showed that TgAb, thyroid volume, goiter, gender, age, and TSH levels were correlated with Tg. In adults from regions with adequate and more than adequate iodine intake, we found that Tg may be a suitable marker of iodine status; gender-specific Tg RI was unnecessary; there was no difference between Tg RIs in regions with adequate and more than adequate iodine intake; and the TSH criterion for selecting the Tg reference population could follow the local TSH reference rather than 0.5 to 2.0 mIU/L. PMID:27902589

  4. Improvement of Image Quality and Diagnostic Performance by an Innovative Motion-Correction Algorithm for Prospectively ECG Triggered Coronary CT Angiography

    PubMed Central

    Lu, Bin; Yan, Hong-Bing; Mu, Chao-Wei; Gao, Yang; Hou, Zhi-Hui; Wang, Zhi-Qiang; Liu, Kun; Parinella, Ashley H.; Leipsic, Jonathon A.

    2015-01-01

    Objective To investigate the effect of a novel motion-correction algorithm (Snap-short Freeze, SSF) on image quality and diagnostic accuracy in patients undergoing prospectively ECG-triggered CCTA without administering rate-lowering medications. Materials and Methods Forty-six consecutive patients suspected of CAD prospectively underwent CCTA using prospective ECG-triggering without rate control and invasive coronary angiography (ICA). Image quality, interpretability, and diagnostic performance of SSF were compared with conventional multisegment reconstruction without SSF, using ICA as the reference standard. Results All subjects (35 men, 57.6 ± 8.9 years) successfully underwent ICA and CCTA. Mean heart rate was 68.8±8.4 (range: 50–88 beats/min) beats/min without rate controlling medications during CT scanning. Overall median image quality score (graded 1–4) was significantly increased from 3.0 to 4.0 by the new algorithm in comparison to conventional reconstruction. Overall interpretability was significantly improved, with a significant reduction in the number of non-diagnostic segments (690 of 694, 99.4% vs 659 of 694, 94.9%; P<0.001). However, only the right coronary artery (RCA) showed a statistically significant difference (45 of 46, 97.8% vs 35 of 46, 76.1%; P = 0.004) on a per-vessel basis in this regard. Diagnostic accuracy for detecting ≥50% stenosis was improved using the motion-correction algorithm on per-vessel [96.2% (177/184) vs 87.0% (160/184); P = 0.002] and per-segment [96.1% (667/694) vs 86.6% (601/694); P <0.001] levels, but there was not a statistically significant improvement on a per-patient level [97.8 (45/46) vs 89.1 (41/46); P = 0.203]. By artery analysis, diagnostic accuracy was improved only for the RCA [97.8% (45/46) vs 78.3% (36/46); P = 0.007]. Conclusion The intracycle motion correction algorithm significantly improved image quality and diagnostic interpretability in patients undergoing CCTA with prospective ECG triggering and

  5. Rotorcraft Diagnostics

    NASA Technical Reports Server (NTRS)

    Haste, Deepak; Azam, Mohammad; Ghoshal, Sudipto; Monte, James

    2012-01-01

    Health management (HM) in any engineering systems requires adequate understanding about the system s functioning; a sufficient amount of monitored data; the capability to extract, analyze, and collate information; and the capability to combine understanding and information for HM-related estimation and decision-making. Rotorcraft systems are, in general, highly complex. Obtaining adequate understanding about functioning of such systems is quite difficult, because of the proprietary (restricted access) nature of their designs and dynamic models. Development of an EIM (exact inverse map) solution for rotorcraft requires a process that can overcome the abovementioned difficulties and maximally utilize monitored information for HM facilitation via employing advanced analytic techniques. The goal was to develop a versatile HM solution for rotorcraft for facilitation of the Condition Based Maintenance Plus (CBM+) capabilities. The effort was geared towards developing analytic and reasoning techniques, and proving the ability to embed the required capabilities on a rotorcraft platform, paving the way for implementing the solution on an aircraft-level system for consolidation and reporting. The solution for rotorcraft can he used offboard or embedded directly onto a rotorcraft system. The envisioned solution utilizes available monitored and archived data for real-time fault detection and identification, failure precursor identification, and offline fault detection and diagnostics, health condition forecasting, optimal guided troubleshooting, and maintenance decision support. A variant of the onboard version is a self-contained hardware and software (HW+SW) package that can be embedded on rotorcraft systems. The HM solution comprises components that gather/ingest data and information, perform information/feature extraction, analyze information in conjunction with the dependency/diagnostic model of the target system, facilitate optimal guided troubleshooting, and offer

  6. Adequate mathematical modelling of environmental processes

    NASA Astrophysics Data System (ADS)

    Chashechkin, Yu. D.

    2012-04-01

    In environmental observations and laboratory visualization both large scale flow components like currents, jets, vortices, waves and a fine structure are registered (different examples are given). The conventional mathematical modeling both analytical and numerical is directed mostly on description of energetically important flow components. The role of a fine structures is still remains obscured. A variety of existing models makes it difficult to choose the most adequate and to estimate mutual assessment of their degree of correspondence. The goal of the talk is to give scrutiny analysis of kinematics and dynamics of flows. A difference between the concept of "motion" as transformation of vector space into itself with a distance conservation and the concept of "flow" as displacement and rotation of deformable "fluid particles" is underlined. Basic physical quantities of the flow that are density, momentum, energy (entropy) and admixture concentration are selected as physical parameters defined by the fundamental set which includes differential D'Alembert, Navier-Stokes, Fourier's and/or Fick's equations and closing equation of state. All of them are observable and independent. Calculations of continuous Lie groups shown that only the fundamental set is characterized by the ten-parametric Galilelian groups reflecting based principles of mechanics. Presented analysis demonstrates that conventionally used approximations dramatically change the symmetries of the governing equations sets which leads to their incompatibility or even degeneration. The fundamental set is analyzed taking into account condition of compatibility. A high order of the set indicated on complex structure of complete solutions corresponding to physical structure of real flows. Analytical solutions of a number problems including flows induced by diffusion on topography, generation of the periodic internal waves a compact sources in week-dissipative media as well as numerical solutions of the same

  7. Assessment and management of interfractional variations in daily diagnostic-quality-CT guided prostate-bed irradiation after prostatectomy

    SciTech Connect

    Liu, Feng; Ahunbay, Ergun; Lawton, Colleen; Allen Li, X.

    2014-03-15

    Purpose: To quantify interfractional anatomic variations and limitations of the current practice of image-guided radiation therapy (IGRT) for prostate-bed patients and to study dosimetric benefits of an online adaptive replanning scheme that addresses the interfractional variations. Methods: Contours for the targets and organs at risk (OARs) from daily diagnostic-quality CTs acquired with in-room CT (CTVision, Siemens) were generated by populating the planning contours using an autosegmentation tool based on deformable registration (ABAS, Elekta) with manual editing for ten prostate-bed patients treated with postoperative daily CT-guided IMRT. Dice similarity coefficient (DSC) obtained by maximizing the overlap of contours for a structure between the daily and plan contours was used to quantify the organ deformation between the plan and daily CTs. Three interfractional-variation-correction schemes, the current standard practice of IGRT repositioning, a previously developed online adaptive RT (ART), and the full reoptimization, were applied to these daily CTs and a number of dose-volume quantities for the targets and organs at risk were compared for their effectiveness to account for the interfractional variations. Results: Large interfractional organ deformations in prostate-bed irradiation were seen. The mean DSCs for CTV, rectum, and bladder were 86.6 ± 5.1% (range from 61% to 97%), 77.3% ± 7.4% (range from 55% to 90%), and 75.4% ± 11.2% (range from 46% to 96%), respectively. The fractional and cumulative dose-volume quantities for CTV and PTV: V100 (volume received at least 100% prescription dose), and rectum and bladder: V{sub 45Gy} and V{sub 60Gy} (volume received at least 45 or 60 Gy), were compared for the repositioning, adaptive, reoptimization, and original plans. The fractional and cumulative dosimetric results were nearly the same. The average cumulative CTV V100 were 88.0%, 98.4%, 99.2%, and 99.3% for the IGRT, ART, reoptimization, and original plans

  8. Melioidosis Diagnostic Workshop, 20131

    PubMed Central

    AuCoin, David; Baccam, Prasith; Baggett, Henry C.; Baird, Rob; Bhengsri, Saithip; Blaney, David D.; Brett, Paul J.; Brooks, Timothy J.G.; Brown, Katherine A.; Chantratita, Narisara; Cheng, Allen C.; Dance, David A.B.; Decuypere, Saskia; Defenbaugh, Dawn; Gee, Jay E.; Houghton, Raymond; Jorakate, Possawat; Lertmemongkolchai, Ganjana; Limmathurotsakul, Direk; Merlin, Toby L.; Mukhopadhyay, Chiranjay; Norton, Robert; Peacock, Sharon J.; Rolim, Dionne B.; Simpson, Andrew J.; Steinmetz, Ivo; Stoddard, Robyn A.; Stokes, Martha M.; Sue, David; Tuanyok, Apichai; Whistler, Toni; Wuthiekanun, Vanaporn; Walke, Henry T.

    2015-01-01

    Melioidosis is a severe disease that can be difficult to diagnose because of its diverse clinical manifestations and a lack of adequate diagnostic capabilities for suspected cases. There is broad interest in improving detection and diagnosis of this disease not only in melioidosis-endemic regions but also outside these regions because melioidosis may be underreported and poses a potential bioterrorism challenge for public health authorities. Therefore, a workshop of academic, government, and private sector personnel from around the world was convened to discuss the current state of melioidosis diagnostics, diagnostic needs, and future directions. PMID:25626057

  9. Fundamentals of quality assessment of molecular amplification methods in clinical diagnostics. International Federation of Clinical Chemistry Scientific Division Committee on Molecular Biology Techniques.

    PubMed

    Neumaier, M; Braun, A; Wagener, C

    1998-01-01

    The increasing interest in molecular biology diagnostics is a result of the tremendous gain of scientific knowledge in genetics, made possible especially since the introduction of amplification techniques. High expectations have been placed on genetic testing, and the number of laboratories now using the relevant technology is rapidly increasing--resulting in an obvious need for standardization and definition of laboratory organization. This communication is an effort towards that end. We address aspects that should be considered when structuring a new molecular diagnostic laboratory, and we discuss individual preanalytical and analytical procedures, from sampling to evaluation of assay results. In addition, different means of controlling contamination are discussed. Because the methodology is in constant change, no general standards can be defined. Accordingly, this publication is intended to serve as a recommendation for good laboratory practice and internal quality control and as a guide to troubleshooting, primarily in amplification techniques.

  10. Emergency CT brain: preliminary interpretation with a tablet device: image quality and diagnostic performance of the Apple iPad.

    PubMed

    Mc Laughlin, Patrick; Neill, Siobhan O; Fanning, Noel; Mc Garrigle, Anne Marie; Connor, Owen J O; Wyse, Gerry; Maher, Michael M

    2012-04-01

    Tablet devices have recently been used in radiological image interpretation because they have a display resolution comparable to desktop LCD monitors. We identified a need to examine tablet display performance prior to their use in preliminary interpretation of radiological images. We compared the spatial and contrast resolution of a commercially available tablet display with a diagnostic grade 2 megapixel monochrome LCD using a contrast detail phantom. We also recorded reporting discrepancies, using the ACR RADPEER system, between preliminary interpretation of 100 emergency CT brain examinations on the tablet display and formal review on a diagnostic LCD. The iPad display performed inferiorly to the diagnostic monochrome display without the ability to zoom. When the software zoom function was enabled on the tablet device, comparable contrast detail phantom scores of 163 vs 165 points were achieved. No reporting discrepancies were encountered during the interpretation of 43 normal examinations and five cases of acute intracranial hemorrhage. There were seven RADPEER2 (understandable) misses when using the iPad display and 12 with the diagnostic LCD. Use of software zoom in the tablet device improved its contrast detail phantom score. The tablet allowed satisfactory identification of acute CT brain findings, but additional research will be required to examine the cause of "understandable" reporting discrepancies that occur when using tablet devices.

  11. Quality of referral: What information should be included in a request for diagnostic imaging when a patient is referred to a clinical radiologist?

    PubMed

    G Pitman, Alexander

    2017-01-31

    Referral to a clinical radiologist is the prime means of communication between the referrer and the radiologist. Current Australian and New Zealand government regulations do not prescribe what clinical information should be included in a referral. This work presents a qualitative compilation of clinical radiologist opinion, relevant professional recommendations, governmental regulatory positions and prior work on diagnostic error to synthesise recommendations on what clinical information should be included in a referral. Recommended requirements on what clinical information should be included in a referral to a clinical radiologist are as follows: an unambiguous referral; identity of the patient; identity of the referrer; and sufficient clinical detail to justify performance of the diagnostic imaging examination and to confirm appropriate choice of the examination and modality. Recommended guideline on the content of clinical detail clarifies when the information provided in a referral meets these requirements. High-quality information provided in a referral allows the clinical radiologist to ensure that exposure of patients to medical radiation is justified. It also minimises the incidence of perceptual and interpretational diagnostic error. Recommended requirements and guideline on the clinical detail to be provided in a referral to a clinical radiologist have been formulated for professional debate and adoption.

  12. Diagnostic Lumbar Puncture

    PubMed Central

    Doherty, Carolynne M; Forbes, Raeburn B

    2014-01-01

    Diagnostic Lumbar Puncture is one of the most commonly performed invasive tests in clinical medicine. Evaluation of an acute headache and investigation of inflammatory or infectious disease of the nervous system are the most common indications. Serious complications are rare, and correct technique will minimise diagnostic error and maximise patient comfort. We review the technique of diagnostic Lumbar Puncture including anatomy, needle selection, needle insertion, measurement of opening pressure, Cerebrospinal Fluid (CSF) specimen handling and after care. We also make some quality improvement suggestions for those designing services incorporating diagnostic Lumbar Puncture. PMID:25075138

  13. 42 CFR 438.207 - Assurances of adequate capacity and services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Assurances of adequate capacity and services. 438.207 Section 438.207 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and...

  14. 40 CFR 716.25 - Adequate file search.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Adequate file search. 716.25 Section 716.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of...

  15. 40 CFR 716.25 - Adequate file search.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Adequate file search. 716.25 Section 716.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of...

  16. "Something Adequate"? In Memoriam Seamus Heaney, Sister Quinlan, Nirbhaya

    ERIC Educational Resources Information Center

    Parker, Jan

    2014-01-01

    Seamus Heaney talked of poetry's responsibility to represent the "bloody miracle", the "terrible beauty" of atrocity; to create "something adequate". This article asks, what is adequate to the burning and eating of a nun and the murderous gang rape and evisceration of a medical student? It considers Njabulo Ndebele's…

  17. 40 CFR 716.25 - Adequate file search.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Adequate file search. 716.25 Section... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a person's responsibility to search records is limited to records in the location(s) where the...

  18. 40 CFR 51.354 - Adequate tools and resources.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 2 2013-07-01 2013-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain the administrative resources necessary to perform all of the program functions including...

  19. 40 CFR 51.354 - Adequate tools and resources.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 2 2014-07-01 2014-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain the administrative resources necessary to perform all of the program functions including...

  20. 40 CFR 51.354 - Adequate tools and resources.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain the administrative resources necessary to perform all of the program functions including...

  1. 40 CFR 51.354 - Adequate tools and resources.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 2 2011-07-01 2011-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain the administrative resources necessary to perform all of the program functions including...

  2. 40 CFR 51.354 - Adequate tools and resources.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 2 2012-07-01 2012-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain the administrative resources necessary to perform all of the program functions including...

  3. 9 CFR 305.3 - Sanitation and adequate facilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Sanitation and adequate facilities. 305.3 Section 305.3 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... OF VIOLATION § 305.3 Sanitation and adequate facilities. Inspection shall not be inaugurated if...

  4. 9 CFR 305.3 - Sanitation and adequate facilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Sanitation and adequate facilities. 305.3 Section 305.3 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... OF VIOLATION § 305.3 Sanitation and adequate facilities. Inspection shall not be inaugurated if...

  5. 9 CFR 305.3 - Sanitation and adequate facilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Sanitation and adequate facilities. 305.3 Section 305.3 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... OF VIOLATION § 305.3 Sanitation and adequate facilities. Inspection shall not be inaugurated if...

  6. 9 CFR 305.3 - Sanitation and adequate facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Sanitation and adequate facilities. 305.3 Section 305.3 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... OF VIOLATION § 305.3 Sanitation and adequate facilities. Inspection shall not be inaugurated if...

  7. 9 CFR 305.3 - Sanitation and adequate facilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Sanitation and adequate facilities. 305.3 Section 305.3 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... OF VIOLATION § 305.3 Sanitation and adequate facilities. Inspection shall not be inaugurated if...

  8. 21 CFR 201.5 - Drugs; adequate directions for use.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Drugs; adequate directions for use. 201.5 Section 201.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL LABELING General Labeling Provisions § 201.5 Drugs; adequate directions for use....

  9. PERFORMANCE AND DIAGNOSTIC EVALUATION OF OZONE PREDICTIONS BY THE ETA-COMMUNITY MULTISCALE AIR QUALITY FORECAST SYSTEM DURING THE 2002 NEW ENGLAND AIR QUALITY STUDY

    EPA Science Inventory

    A real-time air quality forecasting system (Eta-CMAQ model suite) has been developed by linking the NCEP Eta model to the U.S. EPA CMAQ model. This work presents results from the application of the Eta-CMAQ modeling system for forecasting O3 over the northeastern U.S d...

  10. Comparison of the Diagnostic Image Quality of the Canine Maxillary Dentoalveolar Structures Obtained by Cone Beam Computed Tomography and 64-Multidetector Row Computed Tomography.

    PubMed

    Soukup, Jason W; Drees, Randi; Koenig, Lisa J; Snyder, Christopher J; Hetzel, Scott; Miles, Chanda R; Schwarz, Tobias

    2015-01-01

    The objective of this blinded study was to validate the use of cone beam computed tomography (C) for imaging of the canine maxillary dentoalveolar structures by comparing its diagnostic image quality with that of 64-multidetector row CT Sagittal slices of a tooth-bearing segment of the maxilla of a commercially purchased dog skull embedded in methylmethacrylate were obtained along a line parallel with the dental arch using a commercial histology diamond saw. The slice of tooth-bearing bone that best depicted the dentoalveolar structures was chosen and photographed. The maxillary segment was imaged with cone beam CT and 64-multidetector row CT. Four blinded evaluators compared the cone beam CT and 64-multidetector row CT images and image quality was scored as it related to the anatomy of dentoalveolar structures. Trabecular bone, enamel, dentin, pulp cavity, periodontal ligament space, and lamina dura were scored In addition, a score depicting the evaluators overall impression of the image was recorded. Images acquired with cone beam CT were found to be significantly superior in image quality to images acquired with 64-multidetector row CT overall, and in all scored categories. In our study setting cone beam CT was found to be a valid and clinically superior imaging modality for the canine maxillary dentoalveolar structures when compared to 64-multidetector row CT.

  11. [The experience of implementation of system of quality management in the Department of Laboratory Diagnostic of the N.V. Sklifosofskiy Research Institute of Emergency Care of Moscow Health Department: a lecture].

    PubMed

    Zenina, L P; Godkov, M A

    2013-08-01

    The article presents the experience of implementation of system of quality management into the practice of multi-field laboratory of emergency medical care hospital. The analysis of laboratory errors is applied and the modes of their prevention are demonstrated. The ratings of department of laboratory diagnostic of the N. V. Sklifosofskiy research institute of emergency care in the program EQAS (USA) Monthly Clinical Chemistry from 2007 are presented. The implementation of the system of quality management of laboratory analysis into department of laboratory diagnostic made it possible to support physicians of clinical departments with reliable information. The confidence of clinicians to received results increased. The effectiveness of laboratory diagnostic increased due to lowering costs of analysis without negative impact to quality of curative process.

  12. Region 9: Arizona Adequate Letter (10/14/2003)

    EPA Pesticide Factsheets

    This is a letter from Jack P. Broadben,. Director, to Nancy Wrona and Dennis Smith informing them that Maricopa County's motor vehicle emissions budgets in the 2003 MAGCO Maintenance Plan are adequate for transportation conformity purposes.

  13. Region 2: New Jersey Adequate Letter (5/23/2002)

    EPA Pesticide Factsheets

    This April 22, 2002 letter from EPA to the New Jersey Department of Environmental Protection determined 2007 and 2014 Carbon Monoxide (CO) Mobile Source Emissions Budgets adequate for transportation conformity purposes and will be announced in the Federal

  14. Region 8: Colorado Adequate Letter (10/29/2001)

    EPA Pesticide Factsheets

    This letter from EPA to Colorado Department of Public Health and Environment determined Denvers' particulate matter (PM10) maintenance plan for Motor Vehicle Emissions Budgets adequate for transportation conformity purposes.

  15. Region 1: New Hampshire Adequate Letter (8/12/2008)

    EPA Pesticide Factsheets

    This July 9, 2008 letter from EPA to the New Hampshire Department of Environmental Services, determined the 2009 Motor Vehicle Emissions Budgets (MVEBs) are adequate for transportation conformity purposes and will be announced in the Federal Register (FR).

  16. Region 8: Colorado Adequate Letter (1/20/2004)

    EPA Pesticide Factsheets

    This letter from EPA to Colorado Department of Public Health and Environment determined Greeleys' Carbon Monoxide (CO) maintenance plan for Motor Vehicle Emissions Budgets adequate for transportation conformity purposes and will be announced in the FR.

  17. 15 CFR 970.404 - Adequate exploration plan.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Certification of Applications § 970.404 Adequate exploration plan. Before he may certify an application, the Administrator must...

  18. 15 CFR 970.404 - Adequate exploration plan.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Certification of Applications § 970.404 Adequate exploration plan. Before he may certify an application, the Administrator must...

  19. 15 CFR 970.404 - Adequate exploration plan.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Certification of Applications § 970.404 Adequate exploration plan. Before he may certify an application, the Administrator must...

  20. 15 CFR 970.404 - Adequate exploration plan.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Certification of Applications § 970.404 Adequate exploration plan. Before he may certify an application, the Administrator must...

  1. 15 CFR 970.404 - Adequate exploration plan.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Certification of Applications § 970.404 Adequate exploration plan. Before he may certify an application, the Administrator must...

  2. Region 6: New Mexico Adequate Letter (8/21/2003)

    EPA Pesticide Factsheets

    This is a letter from Carl Edlund, Director, to Alfredo Santistevan regarding MVEB's contained in the latest revision to the Albuquerque Carbon Monoxide State Implementation Plan (SIP) are adequate for transportation conformity purposes.

  3. 10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... contained in a system of records are adequately trained to protect the security and privacy of such records..., by degaussing or by overwriting with the appropriate security software, in accordance...

  4. 4 CFR 200.14 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... require access to and use of records contained in a system of records are adequately trained to protect... with the appropriate security software, in accordance with regulations of the Archivist of the...

  5. 10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... contained in a system of records are adequately trained to protect the security and privacy of such records..., by degaussing or by overwriting with the appropriate security software, in accordance...

  6. 4 CFR 200.14 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... require access to and use of records contained in a system of records are adequately trained to protect... with the appropriate security software, in accordance with regulations of the Archivist of the...

  7. 10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... contained in a system of records are adequately trained to protect the security and privacy of such records..., by degaussing or by overwriting with the appropriate security software, in accordance...

  8. 10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... contained in a system of records are adequately trained to protect the security and privacy of such records..., by degaussing or by overwriting with the appropriate security software, in accordance...

  9. 4 CFR 200.14 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... require access to and use of records contained in a system of records are adequately trained to protect... with the appropriate security software, in accordance with regulations of the Archivist of the...

  10. Region 9: Nevada Adequate Letter (3/30/2006)

    EPA Pesticide Factsheets

    This is a letter from Deborah Jordan, Director, to Leo M. Drozdoff regarding Nevada's motor vehicle emissions budgets in the 2005 Truckee Meadows CO Redesignation Request and Maintenance Plan are adequate for transportation conformity decisions.

  11. Performance and diagnostic evaluation of ozone predictions by the Eta-Community Multiscale Air Quality Forecast System during the 2002 New England Air Quality Study.

    PubMed

    Yu, Shaocai; Mathur, Rohit; Kang, Daiwen; Schere, Kenneth; Eder, Brian; Pleim, Jonathan

    2006-10-01

    A real-time air quality forecasting system (Eta-Community Multiscale Air Quality [CMAQ] model suite) has been developed by linking the National Centers for Environmental Estimation Eta model to the U.S. Environmental Protection Agency (EPA) CMAQ model. This work presents results from the application of the Eta-CMAQ modeling system for forecasting ozone (O3) over the Northeastern United States during the 2002 New England Air Quality Study (NEAQS). Spatial and temporal performance of the Eta-CMAQ model for O3 was evaluated by comparison with observations from the EPA Air Quality System (AQS) network. This study also examines the ability of the model to simulate the processes governing the distributions of tropospheric O3 on the basis of the intensive datasets obtained at the four Atmospheric Investigation, Regional Modeling, Analysis, and Estimation (AIRMAP) and Harvard Forest (HF) surface sites. The episode analysis reveals that the model captured the buildup of O3 concentrations over the northeastern domain from August 11 and reproduced the spatial distributions of observed O3 very well for the daytime (8:00 p.m.) of both August 8 and 12 with most of normalized mean bias (NMB) within +/- 20%. The model reproduced 53.3% of the observed hourly O3 within a factor of 1.5 with NMB of 29.7% and normalized mean error of 46.9% at the 342 AQS sites. The comparison of modeled and observed lidar O3 vertical profiles shows that whereas the model reproduced the observed vertical structure, it tended to overestimate at higher altitude. The model reproduced 64-77% of observed NO2 photolysis rate values within a factor of 1.5 at the AIRMAP sites. At the HF site, comparison of modeled and observed O3/nitrogen oxide (NOx) ratios suggests that the site is mainly under strongly NOx-sensitive conditions (>53%). It was found that the modeled lower limits of the O3 production efficiency values (inferred from O3-CO correlation) are close to the observations.

  12. Total quality management in dermato-mycology in Germany.

    PubMed

    Korting, H C

    2003-02-01

    Mycoses of the skin are extremely frequent. The clinical presentation often resembles the one of other frequent inflammatory skin diseases not caused by fungi. Adequate diagnostics are critical for the establishment of proper treatment. A total quality management system has been devised in Germany during the last 5 years. There are several guidelines addressing various aspects of the management of various types of disease as well as structure quality of laboratory diagnostics. Continuous medical education and so-called ring trials are major aspects of implementation.

  13. On Adequate Comparisons of Antenna Phase Center Variations

    NASA Astrophysics Data System (ADS)

    Schoen, S.; Kersten, T.

    2013-12-01

    One important part for ensuring the high quality of the International GNSS Service's (IGS) products is the collection and publication of receiver - and satellite antenna phase center variations (PCV). The PCV are crucial for global and regional networks, since they introduce a global scale factor of up to 16ppb or changes in the height component with an amount of up to 10cm, respectively. Furthermore, antenna phase center variations are also important for precise orbit determination, navigation and positioning of mobile platforms, like e.g. the GOCE and GRACE gravity missions, or for the accurate Precise Point Positioning (PPP) processing. Using the EUREF Permanent Network (EPN), Baire et al. (2012) showed that individual PCV values have a significant impact on the geodetic positioning. The statements are further supported by studies of Steigenberger et al. (2013) where the impact of PCV for local-ties are analysed. Currently, there are five calibration institutions including the Institut für Erdmessung (IfE) contributing to the IGS PCV file. Different approaches like field calibrations and anechoic chamber measurements are in use. Additionally, the computation and parameterization of the PCV are completely different within the methods. Therefore, every new approach has to pass a benchmark test in order to ensure that variations of PCV values of an identical antenna obtained from different methods are as consistent as possible. Since the number of approaches to obtain these PCV values rises with the number of calibration institutions, there is the necessity for an adequate comparison concept, taking into account not only the numerical values but also stochastic information and computational issues of the determined PCVs. This is of special importance, since the majority of calibrated receiver antennas published by the IGS origin from absolute field calibrations based on the Hannover Concept, Wübbena et al. (2000). In this contribution, a concept for the adequate

  14. Integrated diagnostics

    NASA Technical Reports Server (NTRS)

    Hunthausen, Roger J.

    1988-01-01

    Recently completed projects in which advanced diagnostic concepts were explored and/or demonstrated are summarized. The projects begin with the design of integrated diagnostics for the Army's new gas turbine engines, and advance to the application of integrated diagnostics to other aircraft subsystems. Finally, a recent project is discussed which ties together subsystem fault monitoring and diagnostics with a more complete picture of flight domain knowledge.

  15. Readout-segmented echo-planar diffusion-weighted imaging in the assessment of orbital tumors: comparison with conventional single-shot echo-planar imaging in image quality and diagnostic performance.

    PubMed

    Xu, Xiaoquan; Wang, Yanjun; Hu, Hao; Su, Guoyi; Liu, Hu; Shi, Haibin; Wu, Feiyun

    2017-01-01

    Background Readout-segmented echo-planar imaging (RS-EPI) could improve the imaging quality of diffusion-weighted imaging (DWI) in various organs. However, whether it could improve the imaging quality and diagnostic performance for the patients with orbital tumors is still unknown. Purpose To compare the image quality and diagnostic performance of RS-EPI DWI with that of conventional single-shot EPI (SS-EPI) DWI in patients with orbital tumors. Material and Methods SS-EPI and RS-EPI DW images of 32 patients with pathologically diagnosed orbital tumors were retrospectively analyzed. Qualitative imaging parameters (imaging sharpness, geometric distortion, ghosting artifacts, and overall imaging quality) and quantitative imaging parameters (apparent diffusion coefficient [ADC], signal-to-noise ratio [SNR], contrast, and contrast-to-noise ratio [CNR]) were assessed by two independent radiologists, and compared between SS-EPI and RS-EPI DWI. Receiver operating characteristic curves were used to determine the diagnostic value of ADC in differentiating malignant from benign orbital tumors. Results RS-EPI DW imaging produced less geometric distortion and ghosting artifacts, and better imaging sharpness and overall imaging quality than SS-EPI DWI (for all, P < 0.001). Meanwhile, RS-EPI DWI produced significantly lower SNR ( P < 0.001) and ADC ( P < 0.001), and higher contrast ( P < 0.001) than SS-EPI DWI, while producing no difference in CNR ( P = 0.137). There was no significant difference on the diagnostic performance between SS-EPI and RS-EPI DWI, when using ADC as the differentiating index ( P = 0.529). Conclusion Compared with SS-EPI, RS-EPI DWI provided significantly better imaging quality and comparable diagnostic performance in differentiating malignant from benign orbital tumors.

  16. Regulatory requirements for providing adequate veterinary care to research animals.

    PubMed

    Pinson, David M

    2013-09-01

    Provision of adequate veterinary care is a required component of animal care and use programs in the United States. Program participants other than veterinarians, including non-medically trained research personnel and technicians, also provide veterinary care to animals, and administrators are responsible for assuring compliance with federal mandates regarding adequate veterinary care. All program participants therefore should understand the regulatory requirements for providing such care. The author provides a training primer on the US regulatory requirements for the provision of veterinary care to research animals. Understanding the legal basis and conditions of a program of veterinary care will help program participants to meet the requirements advanced in the laws and policies.

  17. Comparability and Reliability Considerations of Adequate Yearly Progress

    ERIC Educational Resources Information Center

    Maier, Kimberly S.; Maiti, Tapabrata; Dass, Sarat C.; Lim, Chae Young

    2012-01-01

    The purpose of this study is to develop an estimate of Adequate Yearly Progress (AYP) that will allow for reliable and valid comparisons among student subgroups, schools, and districts. A shrinkage-type estimator of AYP using the Bayesian framework is described. Using simulated data, the performance of the Bayes estimator will be compared to…

  18. 13 CFR 107.200 - Adequate capital for Licensees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... operate actively in accordance with your Articles and within the context of your business plan, as... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Adequate capital for Licensees. 107.200 Section 107.200 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL...

  19. 13 CFR 107.200 - Adequate capital for Licensees.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... operate actively in accordance with your Articles and within the context of your business plan, as... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Adequate capital for Licensees. 107.200 Section 107.200 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL...

  20. Is the Stock of VET Skills Adequate? Assessment Methodologies.

    ERIC Educational Resources Information Center

    Blandy, Richard; Freeland, Brett

    In Australia and elsewhere, four approaches have been used to determine whether stocks of vocational education and training (VET) skills are adequate to meet industry needs. The four methods are as follows: (1) the manpower requirements approach; (2) the international, national, and industry comparisons approach; (3) the labor market analysis…

  1. Do Beginning Teachers Receive Adequate Support from Their Headteachers?

    ERIC Educational Resources Information Center

    Menon, Maria Eliophotou

    2012-01-01

    The article examines the problems faced by beginning teachers in Cyprus and the extent to which headteachers are considered to provide adequate guidance and support to them. Data were collected through interviews with 25 school teachers in Cyprus, who had recently entered teaching (within 1-5 years) in public primary schools. According to the…

  2. 13 CFR 108.200 - Adequate capital for NMVC Companies.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Companies. 108.200 Section 108.200 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Qualifications for the NMVC Program Capitalizing A Nmvc Company § 108.200 Adequate capital for NMVC Companies. You must meet the requirements of §§ 108.200-108.230 in order...

  3. 13 CFR 108.200 - Adequate capital for NMVC Companies.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Companies. 108.200 Section 108.200 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Qualifications for the NMVC Program Capitalizing A Nmvc Company § 108.200 Adequate capital for NMVC Companies. You must meet the requirements of §§ 108.200-108.230 in order...

  4. 13 CFR 108.200 - Adequate capital for NMVC Companies.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Companies. 108.200 Section 108.200 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Qualifications for the NMVC Program Capitalizing A Nmvc Company § 108.200 Adequate capital for NMVC Companies. You must meet the requirements of §§ 108.200-108.230 in order...

  5. 13 CFR 108.200 - Adequate capital for NMVC Companies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Companies. 108.200 Section 108.200 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Qualifications for the NMVC Program Capitalizing A Nmvc Company § 108.200 Adequate capital for NMVC Companies. You must meet the requirements of §§ 108.200-108.230 in order...

  6. 13 CFR 108.200 - Adequate capital for NMVC Companies.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Companies. 108.200 Section 108.200 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Qualifications for the NMVC Program Capitalizing A Nmvc Company § 108.200 Adequate capital for NMVC Companies. You must meet the requirements of §§ 108.200-108.230 in order...

  7. Understanding Your Adequate Yearly Progress (AYP), 2011-2012

    ERIC Educational Resources Information Center

    Missouri Department of Elementary and Secondary Education, 2011

    2011-01-01

    The "No Child Left Behind Act (NCLB) of 2001" requires all schools, districts/local education agencies (LEAs) and states to show that students are making Adequate Yearly Progress (AYP). NCLB requires states to establish targets in the following ways: (1) Annual Proficiency Target; (2) Attendance/Graduation Rates; and (3) Participation…

  8. 34 CFR 200.13 - Adequate yearly progress in general.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Adequate yearly progress in general. 200.13 Section 200.13 Education Regulations of the Offices of the Department of Education OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE...

  9. 34 CFR 200.13 - Adequate yearly progress in general.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false Adequate yearly progress in general. 200.13 Section 200.13 Education Regulations of the Offices of the Department of Education OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE...

  10. Region 9: Arizona Adequate Letter (11/1/2001)

    EPA Pesticide Factsheets

    This is a letter from Jack P. Broadbent, Director, Air Division to Nancy Wrona and James Bourney informing them of the adequacy of Revised MAG 1999 Serious Area Carbon Monoxide Plan and that the MAG CO Plan is adequate for Maricopa County.

  11. Diagnostic analysis of the Lake Uluabat in Turkey.

    PubMed

    Degirminci, Hasan; Alp, Ahmet; Buyukcangaz, Hakan

    2006-05-01

    Diagnostic analysis of wetlands is an ordered/structured method of examining wetland systems to identify their values and constraints for the solution of the environmental problems. This study focuses on the diagnostic analysis of Lake Uluabat on the feasibility of "Objective Oriented Project Planning (OOPP)" approach, created by the United States Agency for International Development (USAID) and further improved by the Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ). Negative changes both in water quality and quantity were determined as the core problems. The main results were summarized as the water pollution and fluctuation in the water level caused by the urban and agricultural waste disposals, sedimentation, and overfishing. These negative effects cause loss of biodiversity and damage to crops. Disposal control, training, adequate regulations, and a centralized control and monitoring authority have been proposed to cope with the determined problems.

  12. Which Food Security Determinants Predict Adequate Vegetable Consumption among Rural Western Australian Children?

    PubMed

    Godrich, Stephanie L; Lo, Johnny; Davies, Christina R; Darby, Jill; Devine, Amanda

    2017-01-03

    Improving the suboptimal vegetable consumption among the majority of Australian children is imperative in reducing chronic disease risk. The objective of this research was to determine whether there was a relationship between food security determinants (FSD) (i.e., food availability, access, and utilisation dimensions) and adequate vegetable consumption among children living in regional and remote Western Australia (WA). Caregiver-child dyads (n = 256) living in non-metropolitan/rural WA completed cross-sectional surveys that included questions on FSD, demographics and usual vegetable intake. A total of 187 dyads were included in analyses, which included descriptive and logistic regression analyses via IBM SPSS (version 23). A total of 13.4% of children in this sample had adequate vegetable intake. FSD that met inclusion criteria (p ≤ 0.20) for multivariable regression analyses included price; promotion; quality; location of food outlets; variety of vegetable types; financial resources; and transport to outlets. After adjustment for potential demographic confounders, the FSD that predicted adequate vegetable consumption were, variety of vegetable types consumed (p = 0.007), promotion (p = 0.017), location of food outlets (p = 0.027), and price (p = 0.043). Food retail outlets should ensure that adequate varieties of vegetable types (i.e., fresh, frozen, tinned) are available, vegetable messages should be promoted through food retail outlets and in community settings, towns should include a range of vegetable purchasing options, increase their reliance on a local food supply and increase transport options to enable affordable vegetable purchasing.

  13. Diagnostics on Z (invited)

    NASA Astrophysics Data System (ADS)

    Nash, T. J.; Derzon, M. S.; Chandler, G. A.; Fehl, D. L.; Leeper, R. J.; Porter, J. L.; Spielman, R. B.; Ruiz, C.; Cooper, G.; McGurn, J.; Hurst, M.; Jobe, D.; Torres, J.; Seaman, J.; Struve, K.; Lazier, S.; Gilliland, T.; Ruggles, L. A.; Simpson, W. A.; Adams, R.; Seaman, J. A.; Wenger, D.; Nielsen, D.; Riley, P.; French, R.; Stygar, B.; Wagoner, T.; Sanford, T. W. L.; Mock, R.; Asay, J.; Hall, C.; Knudson, M.; Armijo, J.; McKenney, J.; Hawn, R.; Schroen-Carey, D.; Hebron, D.; Cutler, T.; Dropinski, S.; Deeney, C.; LePell, P. D.; Coverdale, C. A.; Douglas, M.; Cuneo, M.; Hanson, D.; Bailey, J. E.; Lake, P.; Carlson, A.; Wakefield, C.; Mills, J.; Slopek, J.; Dinwoodie, T.; Idzorek, G.

    2001-01-01

    The 100 ns, 20 MA pinch-driver Z is surrounded by an extensive set of diagnostics. There are nine radial lines of sight set at 12° above horizontal and each of these may be equipped with up to five diagnostic ports. Instruments routinely fielded viewing the pinch from the side with these ports include x-ray diode arrays, photoconducting detector arrays, bolometers, transmission grating spectrometers, time-resolved x-ray pinhole cameras, x-ray crystal spectrometers, calorimeters, silicon photodiodes, and neutron detectors. A diagnostic package fielded on axis for viewing internal pinch radiation consists of nine lines of sight. This package accommodates virtually the same diagnostics as the radial ports. Other diagnostics not fielded on the axial or radial ports include current B-dot monitors, filtered x-ray scintillators coupled by fiber optics to streak cameras, streaked visible spectroscopy, velocity interferometric system for any reflector, bremsstrahlung cameras, and active shock breakout measurement of hohlraum temperature. The data acquisition system is capable of recording up to 500 channels and the data from each shot is available on the Internet. A major new diagnostic presently under construction is the BEAMLET backlighter. We will briefly describe each of these diagnostics and present some of the highest-quality data from them.

  14. Malaria rapid diagnostic kits: quality of packaging, design and labelling of boxes and components and readability and accuracy of information inserts

    PubMed Central

    2011-01-01

    Background The present study assessed malaria RDT kits for adequate and correct packaging, design and labelling of boxes and components. Information inserts were studied for readability and accuracy of information. Methods Criteria for packaging, design, labelling and information were compiled from Directive 98/79 of the European Community (EC), relevant World Health Organization (WHO) documents and studies on end-users' performance of RDTs. Typography and readability level (Flesch-Kincaid grade level) were assessed. Results Forty-two RDT kits from 22 manufacturers were assessed, 35 of which had evidence of good manufacturing practice according to available information (i.e. CE-label affixed or inclusion in the WHO list of ISO13485:2003 certified manufacturers). Shortcomings in devices were (i) insufficient place for writing sample identification (n = 40) and (ii) ambiguous labelling of the reading window (n = 6). Buffer vial labels were lacking essential information (n = 24) or were of poor quality (n = 16). Information inserts had elevated readability levels (median Flesch Kincaid grade 8.9, range 7.1 - 12.9) and user-unfriendly typography (median font size 8, range 5 - 10). Inadequacies included (i) no referral to biosafety (n = 18), (ii) critical differences between depicted and real devices (n = 8), (iii) figures with unrealistic colours (n = 4), (iv) incomplete information about RDT line interpretations (n = 31) and no data on test characteristics (n = 8). Other problems included (i) kit names that referred to Plasmodium vivax although targeting a pan-species Plasmodium antigen (n = 4), (ii) not stating the identity of the pan-species antigen (n = 2) and (iii) slight but numerous differences in names displayed on boxes, device packages and information inserts. Three CE labelled RDT kits produced outside the EC had no authorized representative affixed and the shape and relative dimensions of the CE symbol affixed did not comply with the Directive 98/79/EC

  15. Army General Fund Adjustments Not Adequately Documented or Supported

    DTIC Science & Technology

    2016-07-26

    statements were unreliable and lacked an adequate audit trail. Furthermore, DoD and Army managers could not rely on the data in their accounting...risk that AGF financial statements will be materially misstated and the Army will not achieve audit readiness by the congressionally mandated...and $6.5 trillion in yearend adjustments made to Army General Fund data during FY 2015 financial statement compilation. We conducted this audit in

  16. Computed Tomography is Diagnostic in the Cervical Imaging of Helmeted Football Players With Shoulder Pads

    PubMed Central

    Rothman, Michael; Foley, Jack; Heller, Michael

    2004-01-01

    Objective: Prospective, observational case series evaluating the value of cervical spine computed tomography (CT) scans in the initial evaluation of a helmeted football player with suspected cervical spine injury. Subjects: Five asymptomatic male football players, fully equipped and immobilized on a backboard. Design: Multiple 3.0-mm, helically acquired, axially displayed CT images of the cervical spine were obtained from the skull base inferiorly through T1, with images filmed at soft tissue and bone windows. Sagittal and coronal reformatted images were performed. Software was used to minimize metallic artifact. Measurements: All series were reviewed by a Board-certified neuroradiologist for image clarity and diagnostic capability. Results: Lateral scout films demonstrated mild segmental degradation, depending on the location of the metallic snaps overlying the spine. Anteroposterior scout films and bone window images were of diagnostic quality. The soft tissue windows showed minimal localized artifact occurring at the same levels as in the lateral scout views. This minimal beam-hardening streak artifact did not affect the diagnostic quality of the soft tissue windows. Reconstructed images were uniformly of clinical diagnostic quality. Discussion: When CT scans were reviewed as a unit, sufficient information was available to allow reliable clinical decisions about the helmeted football player. In light of recent publications demonstrating the difficulty of obtaining adequate radiographs to evaluate cervical spine injury in equipped football players, helmeted athletes may undergo CT scanning without any significant diagnostic limitations. PMID:15496989

  17. Status of US ITER Diagnostics

    NASA Astrophysics Data System (ADS)

    Stratton, B.; Delgado-Aparicio, L.; Hill, K.; Johnson, D.; Pablant, N.; Barnsley, R.; Bertschinger, G.; de Bock, M. F. M.; Reichle, R.; Udintsev, V. S.; Watts, C.; Austin, M.; Phillips, P.; Beiersdorfer, P.; Biewer, T. M.; Hanson, G.; Klepper, C. C.; Carlstrom, T.; van Zeeland, M. A.; Brower, D.; Doyle, E.; Peebles, A.; Ellis, R.; Levinton, F.; Yuh, H.

    2013-10-01

    The US is providing 7 diagnostics to ITER: the Upper Visible/IR cameras, the Low Field Side Reflectometer, the Motional Stark Effect diagnostic, the Electron Cyclotron Emission diagnostic, the Toroidal Interferometer/Polarimeter, the Core Imaging X-Ray Spectrometer, and the Diagnostic Residual Gas Analyzer. The front-end components of these systems must operate with high reliability in conditions of long pulse operation, high neutron and gamma fluxes, very high neutron fluence, significant neutron heating (up to 7 MW/m3) , large radiant and charge exchange heat flux (0.35 MW/m2) , and high electromagnetic loads. Opportunities for repair and maintenance of these components will be limited. These conditions lead to significant challenges for the design of the diagnostics. Space constraints, provision of adequate radiation shielding, and development of repair and maintenance strategies are challenges for diagnostic integration into the port plugs that also affect diagnostic design. The current status of design of the US ITER diagnostics is presented and R&D needs are identified. Supported by DOE contracts DE-AC02-09CH11466 (PPPL) and DE-AC05-00OR22725 (UT-Battelle, LLC).

  18. [Diagnostic Management of Exophthalmos].

    PubMed

    Klingenstein, A; Hintschich, C

    2017-01-01

    Exophthalmos is a common and important symptom in orbital consultation. It can be either uni- or bilateral. A wide spectrum of benign and malignant diseases has to be considered and evaluated for differential diagnosis, in order to maintain complete ocular function and to lead the patient to adequate therapy. Exophthalmos can be accompanied by variable symptoms, ranging from neurogenic or myogenic to corneal alterations. Symptoms at presentation depend on the underlying disease and may manifest systemically. Interdisciplinary teamwork is essential for diagnostics and therapy of exophthalmos. In addition to ophthalmological routine diagnostics, various supplementary examinations are available which are of importance for disease monitoring. Exact radiological imaging is important for the detailed visualisation of the pathology, surgery as well as treatment planning. Magnetic resonance imaging (MRI) and computed tomography (CT) are the standard imaging techniques used. Contrast enhancement and specific sequences can answer specific problems in detail. Combined positron emission tomography (PET) with CT permits evaluation of metabolic and morphological data and is employed in diagnosis of meningioma, lymphoma and metastases. In summary, the reader should learn important differential diagnoses and accompanying symptoms of exophthalmos, thus enabling essential clinical examinations and adequate imaging.

  19. Potential clinical utility of a fibre optic-coupled dosemeter for dose measurements in diagnostic radiology.

    PubMed

    Jones, A Kyle; Hintenlang, David

    2008-01-01

    Many types of dosemeters have been investigated for absorbed dose measurements in diagnostic radiology, including ionisation chambers, metal-oxide semiconductor field-effect transistor dosemeters, thermoluminescent dosemeters, optically stimulated luminescence detectors, film and diodes. Each of the aforementioned dosemeters suffers from a critical limitation, either the need to interrogate, or read, the dosemeter to retrieve dose information or large size to achieve adequate sensitivity. This work presents an evaluation of a fibre optic-coupled dosemeter (FOCD) for use in diagnostic radiology dose measurement. This dosemeter is small, tissue-equivalent and capable of providing true real-time dose information. The FOCD has been evaluated for dose linearity, angular dependence, sensitivity and energy dependence at energies, beam qualities and beam quantities relevant to diagnostic radiology. The FOCD displayed excellent dose linearity and high sensitivity, while exhibiting minimal angular dependence of response. However, the dosemeter does exhibit positive energy dependence, and is subject to attenuation of response when bent.

  20. Genetic modification of preimplantation embryos: toward adequate human research policies.

    PubMed

    Dresser, Rebecca

    2004-01-01

    Citing advances in transgenic animal research and setbacks in human trials of somatic cell genetic interventions, some scientists and others want to begin planning for research involving the genetic modification of human embryos. Because this form of genetic modification could affect later-born children and their offspring, the protection of human subjects should be a priority in decisions about whether to proceed with such research. Yet because of gaps in existing federal policies, embryo modification proposals might not receive adequate scientific and ethical scrutiny. This article describes current policy shortcomings and recommends policy actions designed to ensure that the investigational genetic modification of embryos meets accepted standards for research on human subjects.

  1. Elements for adequate informed consent in the surgical context.

    PubMed

    Abaunza, Hernando; Romero, Klaus

    2014-07-01

    Given a history of atrocities and violations of ethical principles, several documents and regulations have been issued by a wide variety of organizations. They aim at ensuring that health care and clinical research adhere to defined ethical principles. A fundamental component was devised to ensure that the individual has been provided the necessary information to make an informed decision regarding health care or participation in clinical research. This article summarizes the history and regulations for informed consent and discusses suggested components for adequate consent forms for daily clinical practice in surgery as well as clinical research.

  2. [Thalassaemia diagnostics].

    PubMed

    Kusters, Elske; Kerkhoffs, Jean-Louis H; van Rossum, André P

    2014-01-01

    The thalassaemias are characterised by quantitative aberrations in the production of the globin chains that make up haemoglobin, and are a subgroup of the haemoglobinopathies. In this LabQuiz we show how thalassaemia carrier status can be indicated in the results of regular laboratory tests, and discuss the laboratory diagnostics that can confirm or rule out thalassaemia. In these two cases we will present a man of Moroccan descent, and two brothers of Filipino descent, all with anaemia and microcytosis. We show it is possible to differentiate between iron-deficiency anaemia and thalassaemia carrier status on the basis of a complete blood count and measurement of ferritin levels, and which laboratory diagnostics can be subsequently performed in order to confirm a suspicion of thalassaemia. The background section discusses the properties and pitfalls of routine laboratory diagnostics for the thalassaemias, and thalassaemia diagnostics in the Dutch newborn screening programme.

  3. Quantifying dose to the reconstructed breast: Can we adequately treat?

    SciTech Connect

    Chung, Eugene; Marsh, Robin B.; Griffith, Kent A.; Moran, Jean M.; Pierce, Lori J.

    2013-04-01

    To evaluate how immediate reconstruction (IR) impacts postmastectomy radiotherapy (PMRT) dose distributions to the reconstructed breast (RB), internal mammary nodes (IMN), heart, and lungs using quantifiable dosimetric end points. 3D conformal plans were developed for 20 IR patients, 10 autologous reconstruction (AR), and 10 expander-implant (EI) reconstruction. For each reconstruction type, 5 right- and 5 left-sided reconstructions were selected. Two plans were created for each patient, 1 with RB coverage alone and 1 with RB + IMN coverage. Left-sided EI plans without IMN coverage had higher heart Dmean than left-sided AR plans (2.97 and 0.84 Gy, p = 0.03). Otherwise, results did not vary by reconstruction type and all remaining metrics were evaluated using a combined AR and EI dataset. RB coverage was adequate regardless of laterality or IMN coverage (Dmean 50.61 Gy, D95 45.76 Gy). When included, IMN Dmean and D95 were 49.57 and 40.96 Gy, respectively. Mean heart doses increased with left-sided treatment plans and IMN inclusion. Right-sided treatment plans and IMN inclusion increased mean lung V{sub 20}. Using standard field arrangements and 3D planning, we observed excellent coverage of the RB and IMN, regardless of laterality or reconstruction type. Our results demonstrate that adequate doses can be delivered to the RB with or without IMN coverage.

  4. Virtual Guidance Ultrasound: A Tool to Obtain Diagnostic Ultrasound for Remote Environments

    NASA Technical Reports Server (NTRS)

    Caine,Timothy L.; Martin David S.; Matz, Timothy; Lee, Stuart M. C.; Stenger, Michael B.; Platts, Steven H.

    2012-01-01

    Astronauts currently acquire ultrasound images on the International Space Station with the assistance of real-time remote guidance from an ultrasound expert in Mission Control. Remote guidance will not be feasible when significant communication delays exist during exploration missions beyond low-Earth orbit. For example, there may be as much as a 20- minute delay in communications between the Earth and Mars. Virtual-guidance, a pre-recorded audio-visual tutorial viewed in real-time, is a viable modality for minimally trained scanners to obtain diagnostically-adequate images of clinically relevant anatomical structures in an autonomous manner. METHODS: Inexperienced ultrasound operators were recruited to perform carotid artery (n = 10) and ophthalmic (n = 9) ultrasound examinations using virtual guidance as their only instructional tool. In the carotid group, each each untrained operator acquired two-dimensional, pulsed, and color Doppler of the carotid artery. In the ophthalmic group, operators acquired representative images of the anterior chamber of the eye, retina, optic nerve, and nerve sheath. Ultrasound image quality was evaluated by independent imaging experts. RESULTS: Eight of the 10 carotid studies were judged to be diagnostically adequate. With one exception the quality of all the ophthalmic images were adequate to excellent. CONCLUSION: Diagnostically-adequate carotid and ophthalmic ultrasound examinations can be obtained by untrained operators with instruction only from an audio/video tutorial viewed in real time while scanning. This form of quick-response-guidance, can be developed for other ultrasound examinations, represents an opportunity to acquire important medical and scientific information for NASA flight surgeons and researchers when trained medical personnel are not present. Further, virtual guidance will allow untrained personnel to autonomously obtain important medical information in remote locations on Earth where communication is

  5. [Phenomenology of craving: from differentiation to adequate therapy].

    PubMed

    Mendelevich, V D

    2010-01-01

    The author analyzes a phenomenon of addiction from the psychological/psychiatric position and differentiates it from psychopathological disorders, including parabulia, hyperbulia, paraphylia, commonly used for the definition of drive disorders. It has been concluded that addition is a specific complex of clinical symptoms which is not similar to other drive disorders. To avoid diagnostic and therapeutic errors, the author suggests to revise definitions by assigning the biological sense to the conception of addiction within psychoactive substance dependence and sexual addiction, some forms of eating dependence and to use the definition of paraaddictive drives in cases of over-valued drives (gambling, Internet dependence, fanaticism etc).

  6. Region 1: Rhode Island Adequate Letter (7/15/2008)

    EPA Pesticide Factsheets

    This is a letter from Anne E. Arnold, Manager Air Quality Planning Unit, to Stephen Majkut regarding Rhode Islands Adequacy Status of Transportation Conformity Motor Vehicle Emissions budgets 8-hour ozone nonattainment area.

  7. Prostate cancer between prognosis and adequate/proper therapy

    PubMed Central

    Grozescu, T; Popa, F

    2017-01-01

    Knowing the indolent, non-invasive nature of most types of prostate cancer, as well as the simple fact that the disease seems more likely to be associated with age rather than with other factors (50% of men at the age of 50 and 80% at the age of 80 have it [1], with or without presenting any symptom), the big challenge of this clinical entity was to determine severity indicators (so far insufficient) to guide the physician towards an adequate attitude in the clinical setting. The risk of over-diagnosing and over-treating many prostate cancer cases (indicated by all the major European and American studies) is real and poses many question marks. The present paper was meant to deliver new research data and to reset the clinical approach in prostate cancer cases. PMID:28255369

  8. The cerebellopontine angle: does the translabyrinthine approach give adequate access?

    PubMed

    Fagan, P A; Sheehy, J P; Chang, P; Doust, B D; Coakley, D; Atlas, M D

    1998-05-01

    A long-standing but unfounded criticism of the translabyrinthine approach is the misperception that this approach does not give adequate access to the cerebellopontine angle. Because of what is perceived as limited visualization and operating space within the cerebellopontine angle, some surgeons still believe that the translabyrinthine approach is inappropriate for large acoustic tumors. In this study, the surgical access to the cerebellopontine angle by virtue of the translabyrinthine approach is measured and analyzed. The parameters are compared with those measured for the retrosigmoid approach. This series objectively confirms that the translabyrinthine approach offers the neurotologic surgeon a shorter operative depth to the tumor, via a similar-sized craniotomy. This permits superior visualization by virtue of a wider angle of surgical access. Such access is achieved with the merit of minimal cerebellar retraction.

  9. Which Food Security Determinants Predict Adequate Vegetable Consumption among Rural Western Australian Children?

    PubMed Central

    Godrich, Stephanie L.; Lo, Johnny; Davies, Christina R.; Darby, Jill; Devine, Amanda

    2017-01-01

    Improving the suboptimal vegetable consumption among the majority of Australian children is imperative in reducing chronic disease risk. The objective of this research was to determine whether there was a relationship between food security determinants (FSD) (i.e., food availability, access, and utilisation dimensions) and adequate vegetable consumption among children living in regional and remote Western Australia (WA). Caregiver-child dyads (n = 256) living in non-metropolitan/rural WA completed cross-sectional surveys that included questions on FSD, demographics and usual vegetable intake. A total of 187 dyads were included in analyses, which included descriptive and logistic regression analyses via IBM SPSS (version 23). A total of 13.4% of children in this sample had adequate vegetable intake. FSD that met inclusion criteria (p ≤ 0.20) for multivariable regression analyses included price; promotion; quality; location of food outlets; variety of vegetable types; financial resources; and transport to outlets. After adjustment for potential demographic confounders, the FSD that predicted adequate vegetable consumption were, variety of vegetable types consumed (p = 0.007), promotion (p = 0.017), location of food outlets (p = 0.027), and price (p = 0.043). Food retail outlets should ensure that adequate varieties of vegetable types (i.e., fresh, frozen, tinned) are available, vegetable messages should be promoted through food retail outlets and in community settings, towns should include a range of vegetable purchasing options, increase their reliance on a local food supply and increase transport options to enable affordable vegetable purchasing. PMID:28054955

  10. Barriers to adequate prenatal care utilization in American Samoa

    PubMed Central

    Hawley, Nicola L; Brown, Carolyn; Nu’usolia, Ofeira; Ah-Ching, John; Muasau-Howard, Bethel; McGarvey, Stephen T

    2013-01-01

    Objective To describe the utilization of prenatal care in American Samoan women and to identify socio-demographic predictors of inadequate prenatal care utilization. Methods Using data from prenatal clinic records, women (n=692) were categorized according to the Adequacy of Prenatal Care Utilization Index as having received adequate plus, adequate, intermediate or inadequate prenatal care during their pregnancy. Categorical socio-demographic predictors of the timing of initiation of prenatal care (week of gestation) and the adequacy of received services were identified using one way Analysis of Variance (ANOVA) and independent samples t-tests. Results Between 2001 and 2008 85.4% of women received inadequate prenatal care. Parity (P=0.02), maternal unemployment (P=0.03), and both parents being unemployed (P=0.03) were negatively associated with the timing of prenatal care initation. Giving birth in 2007–2008, after a prenatal care incentive scheme had been introduced in the major hospital, was associated with earlier initiation of prenatal care (20.75 versus 25.12 weeks; P<0.01) and improved adequacy of received services (95.04% versus 83.8%; P=0.02). Conclusion The poor prenatal care utilization in American Samoa is a major concern. Improving healthcare accessibility will be key in encouraging women to attend prenatal care. The significant improvements in the adequacy of prenatal care seen in 2007–2008 suggest that the prenatal care incentive program implemented in 2006 may be a very positive step toward addressing issues of prenatal care utilization in this population. PMID:24045912

  11. Astrovirus Diagnostics

    PubMed Central

    Pérot, Philippe; Lecuit, Marc; Eloit, Marc

    2017-01-01

    Various methods exist to detect an astrovirus infection. Current methods include electron microscopy (EM), cell culture, immunoassays, polymerase chain reaction (PCR) and various other molecular approaches that can be applied in the context of diagnostic or in surveillance studies. With the advent of metagenomics, novel human astrovirus (HAstV) strains have been found in immunocompromised individuals in association with central nervous system (CNS) infections. This work reviews the past and current methods for astrovirus detection and their uses in both research laboratories and for medical diagnostic purposes. PMID:28085120

  12. The quality of life of children and adolescents with ADHD undergoing outpatient psychiatric treatment: simple disorders of activity and attention and hyperkinetic conduct disorders in comparison with each other and with other diagnostic groups.

    PubMed

    Remschmidt, Helmut; Mattejat, Fritz

    2010-12-01

    (1) How does the quality of life of patients with ADHD treated in an ambulatory care setting compare to that of other patient groups in child and adolescent psychiatry? (2) Can differences in the quality of life be demonstrated between patients with simple disorders of activity and attention and those with hyperkinetic conduct disorders? (3) How does the quality of life in these patient groups change over one year of treatment? The Inventory for the Assessment of Life Quality in Children and Adolescents (Inventar zur Untersuchung der Lebensqualität von Kindern und Jugendlichen, ILK) was applied to a sample of 726 patients derived from nine different outpatient practices for child and adolescent psychiatry. Among them were 196 patients with a simple disorder of activity and attention and 64 with a hyperkinetic conduct disorder. A comparison between these two groups was the main aim of the study. The mean age of the patients in the sample (all diagnoses) was 8.7 ± 3 years. The two groups of hyperkinetic patients made up 35% of the overall sample, and both of them showed a marked male predominance. The hyperkinetic patients tended to have lower quality-of-life scores than patients in the other diagnostic groups. Longitudinal observation revealed improvements in the quality of life across all patient groups, but the patients with hyperkinetic disorders (both groups) improved the least. The parents of the hyperkinetic patients, too, reported suffering greater stress because of their children's condition than the parents of children with other types of disorders. The ILK instrument has test-metrical qualities that render it usable and capable of holding its own among other, comparable instruments. It can be used to assess the quality of life of children with various diagnoses. Children with ADHD tend to have the least favorable quality-of-life scores, yet they do show some degree of improvement in their quality of life after a year of treatment.

  13. Region 9: California Adequate Letter (4/9/2004)

    EPA Pesticide Factsheets

    This is a letter from Deborah Jordan, Acting Director, to Catherine Witherspoon regarding the motor vehicle emission budgets in the South Coast 2003 Air Quality Management Plan (2003 AQMP) for the 1-hour ozone, PM-10. carbon monoxide (CO), and nitrogen

  14. Systemic Crisis of Civilization: In Search for Adequate Solution

    NASA Astrophysics Data System (ADS)

    Khozin, Grigori

    In December 1972 a jumbo jet crashed in the Florida Everglades with the loss of 101 lives. The pilot, distracted by a minor malfunction, failed to note until too late the warning signal that - correctly - indicated an impending disaster. His sudden, astonished cry of Hey, what happening here? were his last words 1. Three decades after this tragic episode, as the Humankind approaches the threshold of the third Millennium, the problem of adequate reaction to warning signals of different nature and of distinguishing minor malfunctions in everyday life of society, in economy and technology as well as in evolution of biosphere from grave threats to the world community and the phenomenon of life on our planet remains crucial to human survival and the future of Civilization. Rational use of knowledge and technology available to the world community remains in this context the corner stone of discussions on the destiny of the intelligent life both on the planet Earth and in the Universe (the fact of intelligent life in the Universe is to be detected by the Humankind)…

  15. ENSURING ADEQUATE SAFETY WHEN USING HYDROGEN AS A FUEL

    SciTech Connect

    Coutts, D

    2007-01-22

    Demonstration projects using hydrogen as a fuel are becoming very common. Often these projects rely on project-specific risk evaluations to support project safety decisions. This is necessary because regulations, codes, and standards (hereafter referred to as standards) are just being developed. This paper will review some of the approaches being used in these evolving standards, and techniques which demonstration projects can implement to bridge the gap between current requirements and stakeholder desires. Many of the evolving standards for hydrogen-fuel use performance-based language, which establishes minimum performance and safety objectives, as compared with prescriptive-based language that prescribes specific design solutions. This is being done for several reasons including: (1) concern that establishing specific design solutions too early will stifle invention, (2) sparse performance data necessary to support selection of design approaches, and (3) a risk-adverse public which is unwilling to accept losses that were incurred in developing previous prescriptive design standards. The evolving standards often contain words such as: ''The manufacturer shall implement the measures and provide the information necessary to minimize the risk of endangering a person's safety or health''. This typically implies that the manufacturer or project manager must produce and document an acceptable level of risk. If accomplished using comprehensive and systematic process the demonstration project risk assessment can ease the transition to widespread commercialization. An approach to adequately evaluate and document the safety risk will be presented.

  16. DARHT -- an adequate EIS: A NEPA case study

    SciTech Connect

    Webb, M.D.

    1997-08-01

    In April 1996 the US District Court in Albuquerque ruled that the Dual Axis Radiographic Hydrodynamic Test (DARHT) Facility Environmental Impact Statement (EIS), prepared by the Los Alamos Area Office, US Department of Energy (DOE), was adequate. The DARHT EIS had been prepared in the face of a lawsuit in only 10 months, a third of the time usually allotted for a DOE EIS, and for only a small fraction of the cost of a typical DOE EIS, and for only a small fraction of the cost of a typical DOE EIS. It subject was the first major facility to be built in decades for the DOE nuclear weapons stockpile stewardship program. It was the first EIS to be prepared for a proposal at DOE`s Los Alamos National Laboratory since 1979, and the first ever prepared by the Los Alamos Area Office. Much of the subject matter was classified. The facility had been specially designed to minimize impacts to a nearby prehistoric Native American ruin, and extensive consultation with American Indian Pueblos was required. The week that the draft EIS was published Laboratory biologists identified a previously unknown pair of Mexican spotted owls in the immediate vicinity of the project, bringing into play the consultation requirements of the Endangered Species Act. In spite of these obstacles, the resultant DARHT EIS was reviewed by the court and found to meet all statutory and regulatory requirements; the court praised the treatment of the classified material which served as a basis for the environmental analysis.

  17. Dose Limits for Man do not Adequately Protect the Ecosystem

    SciTech Connect

    Higley, Kathryn A.; Alexakhin, Rudolf M.; McDonald, Joseph C.

    2004-08-01

    It has been known for quite some time that different organisms display differing degrees of sensitivity to the effects of ionizing radiations. Some microorganisms such as the bacterium Micrococcus radiodurans, along with many species of invertebrates, are extremely radio-resistant. Humans might be categorized as being relatively sensitive to radiation, and are a bit more resistant than some pine trees. Therefore, it could be argued that maintaining the dose limits necessary to protect humans will also result in the protection of most other species of flora and fauna. This concept is usually referred to as the anthropocentric approach. In other words, if man is protected then the environment is also adequately protected. The ecocentric approach might be stated as; the health of humans is effectively protected only when the environment is not unduly exposed to radiation. The ICRP is working on new recommendations dealing with the protection of the environment, and this debate should help to highlight a number of relevant issues concerning that topic.

  18. Are Vancomycin Trough Concentrations Adequate for Optimal Dosing?

    PubMed Central

    Youn, Gilmer; Jones, Brenda; Jelliffe, Roger W.; Drusano, George L.; Rodvold, Keith A.; Lodise, Thomas P.

    2014-01-01

    The current vancomycin therapeutic guidelines recommend the use of only trough concentrations to manage the dosing of adults with Staphylococcus aureus infections. Both vancomycin efficacy and toxicity are likely to be related to the area under the plasma concentration-time curve (AUC). We assembled richly sampled vancomycin pharmacokinetic data from three studies comprising 47 adults with various levels of renal function. With Pmetrics, the nonparametric population modeling package for R, we compared AUCs estimated from models derived from trough-only and peak-trough depleted versions of the full data set and characterized the relationship between the vancomycin trough concentration and AUC. The trough-only and peak-trough depleted data sets underestimated the true AUCs compared to the full model by a mean (95% confidence interval) of 23% (11 to 33%; P = 0.0001) and 14% (7 to 19%; P < 0.0001), respectively. In contrast, using the full model as a Bayesian prior with trough-only data allowed 97% (93 to 102%; P = 0.23) accurate AUC estimation. On the basis of 5,000 profiles simulated from the full model, among adults with normal renal function and a therapeutic AUC of ≥400 mg · h/liter for an organism for which the vancomycin MIC is 1 mg/liter, approximately 60% are expected to have a trough concentration below the suggested minimum target of 15 mg/liter for serious infections, which could result in needlessly increased doses and a risk of toxicity. Our data indicate that adjustment of vancomycin doses on the basis of trough concentrations without a Bayesian tool results in poor achievement of maximally safe and effective drug exposures in plasma and that many adults can have an adequate vancomycin AUC with a trough concentration of <15 mg/liter. PMID:24165176

  19. Is clinical measurement of anatomic axis of the femur adequate?

    PubMed

    Wu, Chi-Chuan

    2017-03-23

    Background and purpose - The accuracy of using clinical measurement from the anterior superior iliac spine (ASIS) to the center of the knee to determine an anatomic axis of the femur has rarely been studied. A radiographic technique with a full-length standing scanogram (FLSS) was used to assess the adequacy of the clinical measurement. Patients and methods - 100 consecutive young adult patients (mean age 34 (20-40) years) with chronic unilateral lower extremity injuries were studied. The pelvis and intact contralateral lower extremity images in the FLSS were selected for study. The angles between the tibial axis and the femoral shaft anatomic axis (S-AA), the piriformis anatomic axis (P-AA), the clinical anatomic axis (C-AA), and the mechanical axis (MA) were compared between sexes. Results - Only the S-AA and C-AA angles were statistically significantly different in the 100 patients (3.6° vs. 2.8°; p = 0.03). There was a strong correlation between S-AA, P-AA, and C-AA angles (r > 0.9). The average intersecting angle between MA and S-AA in the femur in the 100 patients was 5.5°, and it was 4.8° between MA and C-AA. Interpretation - Clinical measurement of an anatomic axis from the ASIS to the center of the knee may be an adequate and acceptable method to determine lower extremity alignment. The optimal inlet for antegrade femoral intramedullary nailing may be the lateral edge of the piriformis fossa.

  20. Multiformat video and laser cameras: history, design considerations, acceptance testing, and quality control. Report of AAPM Diagnostic X-Ray Imaging Committee Task Group No. 1.

    PubMed

    Gray, J E; Anderson, W F; Shaw, C C; Shepard, S J; Zeremba, L A; Lin, P J

    1993-01-01

    Acceptance testing and quality control of video and laser cameras is relatively simple, especially with the use of the SMPTE test pattern. Photographic quality control is essential if one wishes to be able to maintain the quality of video and laser cameras. In addition, photographic quality control must be carried out with the film used clinically in the video and laser cameras, and with a sensitometer producing a light spectrum similar to that of the video or laser camera. Before the end of the warranty period a second acceptance test should be carried out. At this time the camera should produce the same results as noted during the initial acceptance test. With the appropriate acceptance and quality control the video and laser cameras should produce quality images throughout the life of the equipment.

  1. Diagnostic tolerance for missing sensor data

    NASA Technical Reports Server (NTRS)

    Scarl, Ethan A.

    1989-01-01

    For practical automated diagnostic systems to continue functioning after failure, they must not only be able to diagnose sensor failures but also be able to tolerate the absence of data from the faulty sensors. It is shown that conventional (associational) diagnostic methods will have combinatoric problems when trying to isolate faulty sensors, even if they adequately diagnose other components. Moreover, attempts to extend the operation of diagnostic capability past sensor failure will necessarily compound those difficulties. Model-based reasoning offers a structured alternative that has no special problems diagnosing faulty sensors and can operate gracefully when sensor data is missing.

  2. Diagnostic errors in interactive telepathology.

    PubMed

    Stauch, G; Schweppe, K W; Kayser, K

    2000-01-01

    Telepathology (TP) as a service in pathology at a distance is now widely used. It is integrated in the daily workflow of numerous pathologists. Meanwhile, in Germany 15 departments of pathology are using the telepathology technique for frozen section service; however, a common recognised quality standard in diagnostic accuracy is still missing. In a first step, the working group Aurich uses a TP system for frozen section service in order to analyse the frequency and sources of errors in TP frozen section diagnoses for evaluating the quality of frozen section slides, the important components of image quality and their influences an diagnostic accuracy. The authors point to the necessity of an optimal training program for all participants in this service in order to reduce the risk of diagnostic errors. In addition, there is need for optimal cooperation of all partners involved in TP service.

  3. Accuracy in contouring of small and low contrast lesions: Comparison between diagnostic quality computed tomography scanner and computed tomography simulation scanner-A phantom study

    SciTech Connect

    Ho, Yick Wing; Wong, Wing Kei Rebecca; Yu, Siu Ki; Lam, Wai Wang; Geng Hui

    2012-01-01

    To evaluate the accuracy in detection of small and low-contrast regions using a high-definition diagnostic computed tomography (CT) scanner compared with a radiotherapy CT simulation scanner. A custom-made phantom with cylindrical holes of diameters ranging from 2-9 mm was filled with 9 different concentrations of contrast solution. The phantom was scanned using a 16-slice multidetector CT simulation scanner (LightSpeed RT16, General Electric Healthcare, Milwaukee, WI) and a 64-slice high-definition diagnostic CT scanner (Discovery CT750 HD, General Electric Healthcare). The low-contrast regions of interest (ROIs) were delineated automatically upon their full width at half maximum of the CT number profile in Hounsfield units on a treatment planning workstation. Two conformal indexes, CI{sub in}, and CI{sub out}, were calculated to represent the percentage errors of underestimation and overestimation in the automated contours compared with their actual sizes. Summarizing the conformal indexes of different sizes and contrast concentration, the means of CI{sub in} and CI{sub out} for the CT simulation scanner were 33.7% and 60.9%, respectively, and 10.5% and 41.5% were found for the diagnostic CT scanner. The mean differences between the 2 scanners' CI{sub in} and CI{sub out} were shown to be significant with p < 0.001. A descending trend of the index values was observed as the ROI size increases for both scanners, which indicates an improved accuracy when the ROI size increases, whereas no observable trend was found in the contouring accuracy with respect to the contrast levels in this study. Images acquired by the diagnostic CT scanner allow higher accuracy on size estimation compared with the CT simulation scanner in this study. We recommend using a diagnostic CT scanner to scan patients with small lesions (<1 cm in diameter) for radiotherapy treatment planning, especially for those pending for stereotactic radiosurgery in which accurate delineation of small

  4. Salivary diagnostics

    PubMed Central

    Lee, J.M.; Garon, E.; Wong, D.T.

    2010-01-01

    The ability to monitor health status, disease onset and progression, and treatment outcome through non-invasive means is a most desirable goal in the health care promotion and delivery. There are three prerequisites to materialize this goal: specific biomarkers associated with a health or disease state; a non-invasive approach to detect and monitor the biomarkers; and the technologies to discriminate the biomarkers. A national initiative catalyzed by the National Institute of Dental & Craniofacial Research (NIDCR) has created a roadmap to achieve these goals through the use of oral fluids as the diagnostic medium to scrutinize the health and/or disease status of individuals. Progress has shown this is an ideal opportunity to bridge state of the art saliva-based biosensors, optimized to disease discriminatory salivary biomarkers, for diagnostic applications. Oral fluid being the ‘mirror of body’ is a perfect medium to be explored for health and disease surveillance. The translational applications and opportunities are enormous. PMID:19627522

  5. Methods for selection of adequate neural network structures with application to early assessment of chest pain patients by biochemical monitoring.

    PubMed

    Ellenius, J; Groth, T

    2000-07-01

    A methodology for selecting, training and estimating the performance of adequate artificial neural network (ANN) structures and incorporating them with algorithms that are optimized for clinical decision making is presented. The methodology was applied to the problem of early ruling-in/ruling-out of patients with suspected acute myocardial infarction using frequent biochemical monitoring. The selection of adequate ANN structures from a set of candidates was based on criteria for model compatibility, parameter identifiability and diagnostic performance. The candidate ANN structures evaluated were the single-layer perceptron (SLP), the fuzzified SLP, the multiple SLP, the gated multiple SLP, the multi-layer perceptron (MLP) and the discrete-time recursive neural network. The identifiability of the ANNs was assessed in terms of the conditioning of the Hessian of the objective function, and variability of parameter estimates and decision boundaries in the trials of leave-one-out cross-validation. The commonly used MLP was shown to be non-identifiable for the present problem and available amount of data, despite artificially reducing the model complexity with use of regularization methods. The investigation is concluded by recommending a number of guidelines in order to obtain an adequate ANN model.

  6. Teaching children with diabetes about adequate dietary choices.

    PubMed

    Maffeis, Claudio; Pinelli, Leonardo

    2008-02-01

    Recent recommendations by the American Diabetes Association suggest that children with type 1 diabetes should follow the recommendations for age, sex and body size of the general population. In the case of being overweight or obese, weight-control strategies should be applied. Adherence to recommendations should be pursued by continuous nutritional education that should start at the onset of diabetes and maintained by means of nutritional counselling to the family. The second main target of nutritional intervention is to encourage a reproducible daily meal plan that can be maintained by acquiring good habits when making nutritional choices. Finally, children and parents should be taught how to count carbohydrates, which would help them manage exceptions in their daily meal plan. Specifically, nutritional recommendations for children with diabetes focus on limiting the intake of foods of animal origin (red meat, cheese, cold cuts), moderating fat intake and promoting the intake of foods that naturally contain fibre (mainly vegetables, legumes, fruit). There are two at-risk periods in the lives of children when nutritional education procedures as well as diabetes care in general are less likely to be effective: early years of life and adolescence. In the case of very young children, new behavioural-based intervention strategies to help parents improve mealtimes could be useful in teaching diabetic children to learn to follow a structured eating schedule, which is desirable for long-lasting efficacy in diabetes care. In adolescents, eating disorders and insulin misuse for weight control purposes are concrete and difficult problems to deal with. A good balance between eating for pleasure and maintaining one's health is a challenge for anyone. Appropriate nutritional education helps children with diabetes to find this balance and enjoy a better quality of life.

  7. Does the World Health Organization criterion adequately define glaucoma blindness?

    PubMed Central

    Mokhles, P; Schouten, JSAG; Beckers, HJM; Webers, CAB

    2017-01-01

    Purpose Blindness in glaucoma is difficult to assess with merely the use of the current World Health Organization (WHO) definition (a visual field restricted to 10° in a radius around central fixation), as this criterion does not cover other types of visual field loss that are encountered in clinical practice and also depict blindness. In this study, a 5-point ordinal scale was developed for the assessment of common visual field defect patterns, with the purpose of comparing blindness as outcome to the findings with the WHO criterion when applied to the same visual fields. The scores with the two methods were compared between two ophthalmologists. In addition, the variability between these assessors in assessing the different visual field types was determined. Methods Two glaucoma specialists randomly assessed a sample of 423 visual fields from 77 glaucoma patients, stripped of all indices and masked for all patient variables. They applied the WHO criterion and a 5-point ordinal scale to all visual fields for the probability of blindness. Results The WHO criterion was mostly found applicable and in good agreement for both assessors to visual fields depicting central island of vision or a temporal crescent. The percentage of blindness scores was higher when using the ordinal scale, 21.7% and 19.6% for assessors A and B, respectively, versus 14.4% and 11.3% for the WHO criterion. However, Kappa was lower, 0.71 versus 0.78 for WHO. Conclusions The WHO criterion is strictly applied and shows good agreement between assessors; however, blindness does not always fit this criterion. More visual fields are labeled as blind when a less stringent criterion is used, but this leads to more interobserver variability. A new criterion that describes the extent, location, and depth of visual field defects together with their consequence for the patient’s quality of life is needed for the classification of glaucoma blindness. PMID:28280297

  8. External quality assessment of platelet disorder investigations: results of international surveys on diagnostic tests for dense granule deficiency and platelet aggregometry interpretation.

    PubMed

    Hayward, Catherine P M; Moffat, Karen A; Plumhoff, Elizabeth; Timleck, Marnie; Hoffman, Suzanne; Spitzer, Ernie; Van Cott, Elizabeth M; Meijer, Piet

    2012-09-01

    The quality of platelet aggregation and dense granule deficiency testing is important for diagnosing platelet function disorders. After a successful pilot exercise on diagnosing platelet dense granule deficiency by electron microscopy (EM), the North American Specialized Coagulation Laboratory Association (NASCOLA) has launched regular external quality assurance (EQA) for dense granule EM, as well as for the interpretation of platelet aggregation findings. EQA records were analyzed to assess performance. For EM EQA, between 2009 and 2011, there was excellent performance in distinguishing normal from dense granule-deficient samples and good (>70%) agreement on classifying most electron dense structures in platelets. For aggregation EQA, some normal variants were misclassified and overall case interpretations were more acceptable for rare disorders than for common findings. NASCOLA experiences with these EQAs indicate that there is a need to improve the quality of platelet disorder evaluations. For aggregometry interpretations, deficits in performance could be addressed by translating guideline recommendations into practice.

  9. Rapid diagnostic tests for malaria.

    PubMed

    Visser, Theodoor; Daily, Jennifer; Hotte, Nora; Dolkart, Caitlin; Cunningham, Jane; Yadav, Prashant

    2015-12-01

    Maintaining quality, competitiveness and innovation in global health technology is a constant challenge for manufacturers, while affordability, access and equity are challenges for governments and international agencies. In this paper we discuss these issues with reference to rapid diagnostic tests for malaria. Strategies to control and eliminate malaria depend on early and accurate diagnosis. Rapid diagnostic tests for malaria require little training and equipment and can be performed by non-specialists in remote settings. Use of these tests has expanded significantly over the last few years, following recommendations to test all suspected malaria cases before treatment and the implementation of an evaluation programme to assess the performance of the malaria rapid diagnostic tests. Despite these gains, challenges exist that, if not addressed, could jeopardize the progress made to date. We discuss recent developments in rapid diagnostic tests for malaria, highlight some of the challenges and provide suggestions to address them.

  10. 21 CFR 801.5 - Medical devices; adequate directions for use.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Medical devices; adequate directions for use. 801... (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.5 Medical devices; adequate directions for use. Adequate directions for use means directions under which the layman can use a device...

  11. 21 CFR 801.5 - Medical devices; adequate directions for use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical devices; adequate directions for use. 801... (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.5 Medical devices; adequate directions for use. Adequate directions for use means directions under which the layman can use a device...

  12. 21 CFR 801.5 - Medical devices; adequate directions for use.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Medical devices; adequate directions for use. 801... (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.5 Medical devices; adequate directions for use. Adequate directions for use means directions under which the layman can use a device...

  13. 21 CFR 801.5 - Medical devices; adequate directions for use.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Medical devices; adequate directions for use. 801... (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.5 Medical devices; adequate directions for use. Adequate directions for use means directions under which the layman can use a device...

  14. 21 CFR 801.5 - Medical devices; adequate directions for use.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Medical devices; adequate directions for use. 801... (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.5 Medical devices; adequate directions for use. Adequate directions for use means directions under which the layman can use a device...

  15. Microgravity Combustion Diagnostics Workshop

    NASA Technical Reports Server (NTRS)

    Santoro, Gilbert J. (Editor); Greenberg, Paul S. (Editor); Piltch, Nancy D. (Editor)

    1988-01-01

    Through the Microgravity Science and Applications Division (MSAD) of the Office of Space Science and Applications (OSSA) at NASA Headquarters, a program entitled, Advanced Technology Development (ATD) was promulgated with the objective of providing advanced technologies that will enable the development of future microgravity science and applications experimental flight hardware. Among the ATD projects one, Microgravity Combustion Diagnostics (MCD), has the objective of developing advanced diagnostic techniques and technologies to provide nonperturbing measurements of combustion characteristics and parameters that will enhance the scientific integrity and quality of microgravity combustion experiments. As part of the approach to this project, a workshop was held on July 28 and 29, 1987, at the NASA Lewis Research Center. A small group of laser combustion diagnosticians met with a group of microgravity combustion experimenters to discuss the science requirements, the state-of-the-art of laser diagnostic technology, and plan the direction for near-, intermediate-, and long-term programs. This publication describes the proceedings of that workshop.

  16. OPERATIONAL AND DIAGNOSTIC EVALUATION OF THE OZONE FORECASTS BY THE ETA-CMAQ MODEL SUITE DURING THE 2002 NEW ENGLAND AIR QUALITY STUDY (NEAQS)

    EPA Science Inventory

    Ozone (O3), a secondary pollutant, is created in part by emissions from anthropogenic and biogenic sources. It is necessary for local air quality agencies to accurately forecast ozone concentrations to warn the public of unhealthy air and to encourage people to volunta...

  17. Quality of Diagnosis and Treatment Plans after Using the "Diagnostic Guideline for Anxiety and Challenging Behaviours" in People with Intellectual Disabilities: A Comparative Multiple Case Study Design

    ERIC Educational Resources Information Center

    Pruijssers, Addy; van Meijel, Berno; Maaskant, Marian; Keeman, Noortje; van Achterberg, Theo

    2016-01-01

    Background: People with intellectual disabilities often have a multitude of concurrent problems due to the combination of cognitive impairments, psychiatric disorders (particularly anxiety) and related challenging behaviours. Diagnoses in people with intellectual disabilities are complicated. This study evaluates the quality of the diagnoses and…

  18. Evaluation of Commercial Diagnostic Assays for the Specific Detection of Avian Influenza A (H7N9) Virus RNA Using a Quality-Control Panel and Clinical Specimens in China

    PubMed Central

    Chen, Suhong; Wang, Dayan; Li, Changgui; Wu, Xing; Li, Lili; Bai, Dongting; Zhang, Chuntao; Wang, Junzhi

    2015-01-01

    A novel avian influenza A H7N9-subtype virus emerged in China in 2013 and threatened global public health. Commercial kits that specifically detect avian influenza A (H7N9) virus RNA are urgently required to prepare for the emergence and potential pandemic of this novel influenza virus. The safety and effectiveness of three commercial molecular diagnostic assays were evaluated using a quality-control panel and clinical specimens collected from over 90 patients with confirmed avian influenza A (H7N9) virus infections. The analytical performance evaluation showed that diverse influenza H7N9 viruses can be detected with high within- and between-lot reproducibility and without cross-reactivity to other influenza viruses (H1N1 pdm09, seasonal H1N1, H3N2, H5N1 and influenza B). The detection limit of all the commercial assays was 2.83 Log10 copies/μl [0.7 Log10TCID50/mL of avian influenza A (H7N9) virus strain A/Zhejiang/DTID-ZJU01/2013], which is comparable to the method recommended by the World Health Organization (WHO). In addition, using a WHO-Chinese National Influenza Center (CNIC) method as a reference for clinical evaluation, positive agreement of more than 98% was determined for all of the commercial kits, while negative agreement of more than 99% was observed. In conclusion, our findings provide comprehensive evidence for the high performance of three commercial diagnostic assays and suggest the application of these assays as rapid and effective diagnostic tools for avian influenza A (H7N9) virus in the routine clinical practice of medical laboratories. PMID:26361351

  19. Environmental Quality

    ERIC Educational Resources Information Center

    Abelson, Philip H.

    1972-01-01

    Data from the Third Annual Report of the United States Council of Environmental Quality are used in an editorial advocating the use of some of the money committed to cleaning air and water to create a more adequate knowledge base for action. (AL)

  20. THE ESTABLISHMENT OF LOCAL DIAGNOSTIC REFERENCE LEVELS IN ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY: A PRACTICAL TOOL FOR THE OPTIMISATION AND FOR QUALITY ASSURANCE MANAGEMENT.

    PubMed

    Saukko, E; Henner, A; Nieminen, M T; Ahonen, S-M

    2016-02-29

    Fluoroscopic procedures are an area of special concern in relation to radiation protection. The aim of this study was to describe the current level of patient radiation doses in endoscopic retrograde cholangiopancreatography (ERCP) collected from a single centre, as well as to establish and review local diagnostic reference levels (DRLs) in ERCP. A total of 100 patients' radiation doses in ERCP were recorded, and the third-quartile method was adopted to establish local DRLs for ERCP. The mean dose area product (DAP) was 2.05 Gy cm(2), fluoroscopy time (FT) 1.7 min and the number of images was 3. The proposed local DRLs for ERCP were 3.00 Gy cm(2) and 3.0 min. Local DRLs were reviewed in a sample of 25 patients 5 y after they had been established. In reviewing data, the averages of DAP and FT were below the local DRLs. Local DRLs help in the optimisation process of fluoroscopic procedures and guides to a good clinical practice.

  1. New integrated elemental and molecular strategies as a diagnostic tool for the quality of water soluble quantum dots and their bioconjugates

    NASA Astrophysics Data System (ADS)

    Trapiella-Alfonso, Laura; Montoro Bustos, Antonio R.; Encinar, Jorge Ruiz; Costa-Fernández, Jose M.; Pereiro, Rosario; Sanz-Medel, Alfredo

    2011-03-01

    Herein, we demonstrate that both qualitative molecular and quantitative elemental data obtained from size exclusion chromatography coupled online for the first time to both molecular fluorescence and elemental mass spectrometry, respectively, turned out to be critical to evaluate the quality of coatings of quantum dots. Moreover, such an instrumental approach also allowed us to study quantitatively the appropriated bioconjugation of quantum dots to antibodies, a critical step for QDs future use in quantitative fluorescence immunoassays.Herein, we demonstrate that both qualitative molecular and quantitative elemental data obtained from size exclusion chromatography coupled online for the first time to both molecular fluorescence and elemental mass spectrometry, respectively, turned out to be critical to evaluate the quality of coatings of quantum dots. Moreover, such an instrumental approach also allowed us to study quantitatively the appropriated bioconjugation of quantum dots to antibodies, a critical step for QDs future use in quantitative fluorescence immunoassays. Electronic supplementary information (ESI) available: Description of experimental section and Fig. S1 and S2. See DOI: 10.1039/c0nr00822b

  2. Patient satisfaction and quality of care at four diagnostic imaging procedures: mammography, double-contrast barium enema, abdominal ultrasonography and vaginal ultrasonography.

    PubMed

    Loken, K; Steine, S; Laerum, E

    1999-01-01

    The objective of this study was to measure patient satisfaction and to investigate the practical implications of monitoring the quality of care at four radiology procedures. A survey was conducted immediately after the examinations in eight radiology departments: 550 patients attending for mammography, 110 for double-contrast barium enema (DCBE), 97 for abdominal ultrasonography and 90 for vaginal ultrasonography. Outcome measures were seven questionnaire scales: pain, emotional distress, information received, staff's punctuality and technical ability, facilities, and general satisfaction. Response rate was 87 %. Multivariate regression analysis showed significant differences between procedures on all scales (p < 0.001). Differences considered to be of practical importance, i. e. >/= 7 scale points, were detected on five of the scales. Mammography and DCBE caused the most pain, and vaginal US and DCBE caused the most distress. The US procedures entailed dissatisfaction with information about the procedures. The DCBE patients recorded dissatisfaction with the staff's lack of punctuality, and these and the mammography patients recorded dissatisfaction with the facilities. The findings indicate a potential for improving patients' experiences. Several aspects of care, i. e. pain management, attention to the patient's emotional concerns, explanation of procedures, punctuality and quality of the facilities, can be improved.

  3. Diagnosis of West Nile Virus Human Infections: Overview and Proposal of Diagnostic Protocols Considering the Results of External Quality Assessment Studies

    PubMed Central

    Sambri, Vittorio; Capobianchi, Maria R.; Cavrini, Francesca; Charrel, Rémi; Donoso-Mantke, Olivier; Escadafal, Camille; Franco, Leticia; Gaibani, Paolo; Gould, Ernest A.; Niedrig, Matthias; Papa, Anna; Pierro, Anna; Rossini, Giada; Sanchini, Andrea; Tenorio, Antonio; Varani, Stefania; Vázquez, Ana; Vocale, Caterina; Zeller, Herve

    2013-01-01

    West Nile virus, genus Flavivirus, is transmitted between birds and occasionally other animals by ornithophilic mosquitoes. This virus also infects humans causing asymptomatic infections in about 85% of cases and <1% of clinical cases progress to severe neuroinvasive disease. The virus also presents a threat since most infections remain unapparent. However, the virus contained in blood and organs from asymptomatically infected donors can be transmitted to recipients of these infectious tissues. This paper reviews the presently available methods to achieve the laboratory diagnosis of West Nile virus infections in humans, discussing the most prominent advantages and disadvantages of each in light of the results obtained during four different External Quality Assessment studies carried out by the European Network for ‘Imported’ Viral Diseases (ENIVD). PMID:24072061

  4. Adequate nutrient intake can reduce cardiovascular disease risk in African Americans.

    PubMed

    Reusser, Molly E; DiRienzo, Douglas B; Miller, Gregory D; McCarron, David A

    2003-03-01

    Cardiovascular disease kills nearly as many Americans each year as the next seven leading causes of death combined. The prevalence of cardiovascular disease and most of its associated risk factors is markedly higher and increasing more rapidly among African Americans than in any other racial or ethnic group. Improving these statistics may be simply a matter of improving diet quality. In recent years, a substantial and growing body of evidence has revealed that dietary patterns complete in all food groups, including nutrient-rich dairy products, are essential for preventing and reducing cardiovascular disease and the conditions that contribute to it. Several cardiovascular risk factors, including hypertension, insulin resistance syndrome, and obesity, have been shown to be positively influenced by dietary patterns that include adequate intake of dairy products. The benefits of nutrient-rich dietary patterns have been specifically tested in randomized, controlled trials emphasizing African American populations. These studies demonstrated proportionally greater benefits for African Americans without evidence of adverse effects such as symptoms of lactose intolerance. As currently promoted for the prevention of certain cancers and osteoporosis, regular consumption of diets that meet recommended nutrient intake levels might also be the most effective approach for reducing cardiovascular disease risk in African Americans.

  5. The Human Right to Adequate Housing: A Tool for Promoting and Protecting Individual and Community Health

    PubMed Central

    Thiele, Bret

    2002-01-01

    The human right to adequate housing is enshrined in international law. The right to adequate housing can be traced to the Universal Declaration of Human Rights, which was unanimously adopted by the world community in 1948. Since that time, the right to adequate housing has been reaffirmed on numerous occasions and further defined and elaborated. A key component of this right is habitability of housing, which should comply with health and safety standards. Therefore, the right to adequate housing provides an additional tool for advocates and others interested in promoting healthful housing and living conditions and thereby protecting individual and community health. PMID:11988432

  6. 9 CFR 2.40 - Attending veterinarian and adequate veterinary care (dealers and exhibitors).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... veterinary care (dealers and exhibitors). 2.40 Section 2.40 Animals and Animal Products ANIMAL AND PLANT... and Adequate Veterinary Care § 2.40 Attending veterinarian and adequate veterinary care (dealers and... veterinary care to its animals in compliance with this section. (1) Each dealer and exhibitor shall employ...

  7. 9 CFR 2.33 - Attending veterinarian and adequate veterinary care.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... veterinary care. 2.33 Section 2.33 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE... adequate veterinary care. (a) Each research facility shall have an attending veterinarian who shall provide adequate veterinary care to its animals in compliance with this section: (1) Each research facility...

  8. 40 CFR 152.20 - Exemptions for pesticides adequately regulated by another Federal agency.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Exemptions for pesticides adequately... PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS PESTICIDE REGISTRATION AND CLASSIFICATION PROCEDURES Exemptions § 152.20 Exemptions for pesticides adequately regulated by another Federal agency. The...

  9. 40 CFR 152.20 - Exemptions for pesticides adequately regulated by another Federal agency.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Exemptions for pesticides adequately... PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS PESTICIDE REGISTRATION AND CLASSIFICATION PROCEDURES Exemptions § 152.20 Exemptions for pesticides adequately regulated by another Federal agency. The...

  10. 40 CFR 152.20 - Exemptions for pesticides adequately regulated by another Federal agency.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Exemptions for pesticides adequately... PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS PESTICIDE REGISTRATION AND CLASSIFICATION PROCEDURES Exemptions § 152.20 Exemptions for pesticides adequately regulated by another Federal agency. The...

  11. 40 CFR 152.20 - Exemptions for pesticides adequately regulated by another Federal agency.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Exemptions for pesticides adequately... PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS PESTICIDE REGISTRATION AND CLASSIFICATION PROCEDURES Exemptions § 152.20 Exemptions for pesticides adequately regulated by another Federal agency. The...

  12. 40 CFR 152.20 - Exemptions for pesticides adequately regulated by another Federal agency.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Exemptions for pesticides adequately... PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS PESTICIDE REGISTRATION AND CLASSIFICATION PROCEDURES Exemptions § 152.20 Exemptions for pesticides adequately regulated by another Federal agency. The...

  13. 42 CFR 417.568 - Adequate financial records, statistical data, and cost finding.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Adequate financial records, statistical data, and....568 Adequate financial records, statistical data, and cost finding. (a) Maintenance of records. (1) An HMO or CMP must maintain sufficient financial records and statistical data for proper determination...

  14. 42 CFR 417.568 - Adequate financial records, statistical data, and cost finding.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Adequate financial records, statistical data, and....568 Adequate financial records, statistical data, and cost finding. (a) Maintenance of records. (1) An HMO or CMP must maintain sufficient financial records and statistical data for proper determination...

  15. 42 CFR 417.568 - Adequate financial records, statistical data, and cost finding.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Adequate financial records, statistical data, and....568 Adequate financial records, statistical data, and cost finding. (a) Maintenance of records. (1) An HMO or CMP must maintain sufficient financial records and statistical data for proper determination...

  16. 42 CFR 438.207 - Assurances of adequate capacity and services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Assurances of adequate capacity and services. 438... Improvement Access Standards § 438.207 Assurances of adequate capacity and services. (a) Basic rule. The State... provides supporting documentation that demonstrates that it has the capacity to serve the...

  17. 42 CFR 438.207 - Assurances of adequate capacity and services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Assurances of adequate capacity and services. 438... Improvement Access Standards § 438.207 Assurances of adequate capacity and services. (a) Basic rule. The State... provides supporting documentation that demonstrates that it has the capacity to serve the...

  18. 42 CFR 438.207 - Assurances of adequate capacity and services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Assurances of adequate capacity and services. 438... Improvement Access Standards § 438.207 Assurances of adequate capacity and services. (a) Basic rule. The State... provides supporting documentation that demonstrates that it has the capacity to serve the...

  19. 42 CFR 438.207 - Assurances of adequate capacity and services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Assurances of adequate capacity and services. 438... Improvement Access Standards § 438.207 Assurances of adequate capacity and services. (a) Basic rule. The State... provides supporting documentation that demonstrates that it has the capacity to serve the...

  20. 9 CFR 2.33 - Attending veterinarian and adequate veterinary care.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Research Facilities § 2.33 Attending veterinarian and adequate veterinary care. (a) Each research facility shall have an attending veterinarian who shall provide adequate veterinary care to its animals in compliance with this section: (1) Each research facility...

  1. 9 CFR 2.33 - Attending veterinarian and adequate veterinary care.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Research Facilities § 2.33 Attending veterinarian and adequate veterinary care. (a) Each research facility shall have an attending veterinarian who shall provide adequate veterinary care to its animals in compliance with this section: (1) Each research facility...

  2. The Relevance of Surface Roughness Data Qualities in Diagnostic Modeling of Wind Velocity in Complex Terrain: A Case Study from the Śnieżnik Massif (SW Poland)

    NASA Astrophysics Data System (ADS)

    Jancewicz, Kacper; Szymanowski, Mariusz

    2016-04-01

    Numerical modeling of wind velocity above complex terrain has become a subject of numerous contemporary studies. Regardless of the methodical approach (dynamic or diagnostic), it can be observed that information about surface roughness is indispensable to achieve realistic results. In this context, the current state of GIS and remote sensing development allows access to a number of datasets providing information about various properties of land coverage in a broad spectrum of spatial resolution. Hence, the quality of roughness information may vary depending on the properties of primary land coverage data. As a consequence, the results of the wind velocity modeling are affected by the accuracy and spatial resolution of roughness data. This paper describes further attempts to model wind velocity using the following sources of roughness information: LiDAR data (Digital Surface Model and Digital Terrain Model), database of topographical objects (BDOT10k) and both raster and vector versions of Corine Land Cover 2006 (CLC). The modeling was conducted in WindStation 4.0.2 software which is based on the computational fluid dynamics (CFD) diagnostic solver Canyon. Presented experiment concerns three episodes of relatively strong and constant synoptic forcing: 26 November 2011, 25 May 2012 and 26 May 2012. The modeling was performed in the spatial resolution of 50 and 100 m. Input anemological data were collected during field measurements while the atmosphere boundary layer parameters were derived from the meteorological stations closest to the study area. The model's performance was verified using leave-one-out cross-validation and calculation of error indices such as bias error, root mean square error and index of wind speed. Thus, it was possible to compare results of using roughness datasets of different type and resolution. The study demonstrates that the use of LiDAR-based roughness data may result in an improvement of the model's performance in 100 and 50 m resolution

  3. The Relevance of Surface Roughness Data Qualities in Diagnostic Modeling of Wind Velocity in Complex Terrain: A Case Study from the Śnieżnik Massif (SW Poland)

    NASA Astrophysics Data System (ADS)

    Jancewicz, Kacper; Szymanowski, Mariusz

    2017-02-01

    Numerical modeling of wind velocity above complex terrain has become a subject of numerous contemporary studies. Regardless of the methodical approach (dynamic or diagnostic), it can be observed that information about surface roughness is indispensable to achieve realistic results. In this context, the current state of GIS and remote sensing development allows access to a number of datasets providing information about various properties of land coverage in a broad spectrum of spatial resolution. Hence, the quality of roughness information may vary depending on the properties of primary land coverage data. As a consequence, the results of the wind velocity modeling are affected by the accuracy and spatial resolution of roughness data. This paper describes further attempts to model wind velocity using the following sources of roughness information: LiDAR data (Digital Surface Model and Digital Terrain Model), database of topographical objects (BDOT10k) and both raster and vector versions of Corine Land Cover 2006 (CLC). The modeling was conducted in WindStation 4.0.2 software which is based on the computational fluid dynamics (CFD) diagnostic solver Canyon. Presented experiment concerns three episodes of relatively strong and constant synoptic forcing: 26 November 2011, 25 May 2012 and 26 May 2012. The modeling was performed in the spatial resolution of 50 and 100 m. Input anemological data were collected during field measurements while the atmosphere boundary layer parameters were derived from the meteorological stations closest to the study area. The model's performance was verified using leave-one-out cross-validation and calculation of error indices such as bias error, root mean square error and index of wind speed. Thus, it was possible to compare results of using roughness datasets of different type and resolution. The study demonstrates that the use of LiDAR-based roughness data may result in an improvement of the model's performance in 100 and 50 m resolution

  4. [Councelling regarding prenatal diagnostic: a model project to enhance cooperation between medical and psychosocial consultants].

    PubMed

    Kuhn, Rita; Schmidt, Ulrike; Ottomar, Bahrs; Riehl-Emde, Astrid

    2007-01-01

    Although according to section 2 of the Pregnancy Conflicts Law, there is a legal claim to psychosocial counselling and although its benefit has been proven empirically, pregnant women rarely draw upon it in the context of prenatal diagnostics (PND). One of the reasons is probably that physicians are not sufficiently aware of this counselling offer. By means of the model project "Interprofessional quality circles in prenatal diagnostics" an attempt was made to counteract this deficit. For this purpose, interprofessional quality circles have been established in six different places in Germany in order to motivate medical and psychosocial consultants to an increased cooperation. The effects and realization of the quality circle efforts have been evaluated. For this purpose, structural characteristics such as cooperation practice and utilization of psychosocial counselling have been assessed using a questionnaire before and after the introduction of the quality circles. All sessions have been documented; in addition, they have been evaluated by the participants using another shorter questionnaire. The results show that the quality circles led to an improved cooperation between the different professional groups and an increased utilization of psychosocial counselling. The work of the quality circles has been evaluated positively. It was regarded as conductive to cooperation, emotionally exonerative and extremely helpful with respect to the daily counselling work. Most of all, its practicality and case management were appraised. Thus, interprofessional quality circles prove to be an adequate instrument to advance the interprofessional and aim-oriented cooperation in such a way as demanded emphatically by the German Expert Advisory Board of Community Health in its recent experts report.

  5. 45 CFR 1159.15 - Who has the responsibility for maintaining adequate technical, physical, and security safeguards...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... adequate technical, physical, and security safeguards to prevent unauthorized disclosure or destruction of... adequate technical, physical, and security safeguards to prevent unauthorized disclosure or destruction of... of maintaining adequate technical, physical, and security safeguards to prevent...

  6. 45 CFR 1159.15 - Who has the responsibility for maintaining adequate technical, physical, and security safeguards...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... adequate technical, physical, and security safeguards to prevent unauthorized disclosure or destruction of... adequate technical, physical, and security safeguards to prevent unauthorized disclosure or destruction of... of maintaining adequate technical, physical, and security safeguards to prevent...

  7. Diagnostic imaging of child abuse.

    PubMed

    2009-05-01

    The role of imaging in cases of child abuse is to identify the extent of physical injury when abuse is present and to elucidate all imaging findings that point to alternative diagnoses. Effective diagnostic imaging of child abuse rests on high-quality technology as well as a full appreciation of the clinical and pathologic alterations occurring in abused children. This statement is a revision of the previous policy published in 2000.

  8. Malaria Diagnostics in Clinical Trials

    PubMed Central

    Murphy, Sean C.; Shott, Joseph P.; Parikh, Sunil; Etter, Paige; Prescott, William R.; Stewart, V. Ann

    2013-01-01

    Malaria diagnostics are widely used in epidemiologic studies to investigate natural history of disease and in drug and vaccine clinical trials to exclude participants or evaluate efficacy. The Malaria Laboratory Network (MLN), managed by the Office of HIV/AIDS Network Coordination, is an international working group with mutual interests in malaria disease and diagnosis and in human immunodeficiency virus/acquired immunodeficiency syndrome clinical trials. The MLN considered and studied the wide array of available malaria diagnostic tests for their suitability for screening trial participants and/or obtaining study endpoints for malaria clinical trials, including studies of HIV/malaria co-infection and other malaria natural history studies. The MLN provides recommendations on microscopy, rapid diagnostic tests, serologic tests, and molecular assays to guide selection of the most appropriate test(s) for specific research objectives. In addition, this report provides recommendations regarding quality management to ensure reproducibility across sites in clinical trials. Performance evaluation, quality control, and external quality assessment are critical processes that must be implemented in all clinical trials using malaria tests. PMID:24062484

  9. Diagnostic instruments for behavioural addiction: an overview

    PubMed Central

    Albrecht, Ulrike; Kirschner, Nina Ellen; Grüsser, Sabine M.

    2007-01-01

    In non-substance-related addiction, the so-called behavioural addiction, no external psychotropic substances are consumed. The psychotropic effect consists of the body’s own biochemical processes induced only by excessive activities. Until recently, knowledge was limited with respect to clinically relevant excessive reward-seeking behaviour, such as pathological gambling, excessive shopping and working which meet diagnostic criteria of dependent behaviour. To date, there is no consistent concept for diagnosis and treatment of excessive reward-seeking behaviour, and its classification is uncertain. Therefore, a clear conceptualization of the so-called behavioural addictions is of great importance. The use of adequate diagnostic instruments is necessary for successful therapeutical implications. This article provides an overview of the current popular diagnostic instruments assessing the different forms of behavioural addiction. Especially in certain areas there are only few valid and reliable instruments available to assess excessive rewarding behaviours that fulfill the criteria of addiction. PMID:19742294

  10. The Goal of Adequate Nutrition: Can It Be Made Affordable, Sustainable, and Universal?

    PubMed

    McFarlane, Ian

    2016-11-30

    Until about 1900, large proportions of the world population endured hunger and poverty. The 20th century saw world population increase from 1.6 to 6.1 billion, accompanied and to some extent made possible by rapid improvements in health standards and food supply, with associated advances in agricultural and nutrition sciences. In this paper, I use the application of linear programming (LP) in preparation of rations for farm animals to illustrate a method of calculating the lowest cost of a human diet selected from locally available food items, constrained to provide recommended levels of food energy and nutrients; then, to find a realistic minimum cost, I apply the further constraint that the main sources of food energy in the costed diet are weighted in proportion to the actual reported consumption of food items in that area. Worldwide variations in dietary preferences raise the issue as to the sustainability of popular dietary regimes, and the paper reviews the factors associated with satisfying requirements for adequate nutrition within those regimes. The ultimate physical constraints on food supply are described, together with the ways in which climate change may affect those constraints. During the 20th century, food supply increased sufficiently in most areas to keep pace with the rapid increase in world population. Many challenges will need to be overcome if food supply is to continue to meet demand, and those challenges are made more severe by rising expectations of quality of life in the developing world, as well as by the impacts of climate change on agriculture and aquaculture.

  11. The Goal of Adequate Nutrition: Can It Be Made Affordable, Sustainable, and Universal?

    PubMed Central

    McFarlane, Ian

    2016-01-01

    Until about 1900, large proportions of the world population endured hunger and poverty. The 20th century saw world population increase from 1.6 to 6.1 billion, accompanied and to some extent made possible by rapid improvements in health standards and food supply, with associated advances in agricultural and nutrition sciences. In this paper, I use the application of linear programming (LP) in preparation of rations for farm animals to illustrate a method of calculating the lowest cost of a human diet selected from locally available food items, constrained to provide recommended levels of food energy and nutrients; then, to find a realistic minimum cost, I apply the further constraint that the main sources of food energy in the costed diet are weighted in proportion to the actual reported consumption of food items in that area. Worldwide variations in dietary preferences raise the issue as to the sustainability of popular dietary regimes, and the paper reviews the factors associated with satisfying requirements for adequate nutrition within those regimes. The ultimate physical constraints on food supply are described, together with the ways in which climate change may affect those constraints. During the 20th century, food supply increased sufficiently in most areas to keep pace with the rapid increase in world population. Many challenges will need to be overcome if food supply is to continue to meet demand, and those challenges are made more severe by rising expectations of quality of life in the developing world, as well as by the impacts of climate change on agriculture and aquaculture. PMID:28231177

  12. Inferential Processing among Adequate and Struggling Adolescent Comprehenders and Relations to Reading Comprehension

    PubMed Central

    Barth, Amy E.; Barnes, Marcia; Francis, David J.; Vaughn, Sharon; York, Mary

    2015-01-01

    Separate mixed model analyses of variance (ANOVA) were conducted to examine the effect of textual distance on the accuracy and speed of text consistency judgments among adequate and struggling comprehenders across grades 6–12 (n = 1203). Multiple regressions examined whether accuracy in text consistency judgments uniquely accounted for variance in comprehension. Results suggest that there is considerable growth across the middle and high school years, particularly for adequate comprehenders in those text integration processes that maintain local coherence. Accuracy in text consistency judgments accounted for significant unique variance for passage-level, but not sentence-level comprehension, particularly for adequate comprehenders. PMID:26166946

  13. Using Multitheory Model of Health Behavior Change to Predict Adequate Sleep Behavior.

    PubMed

    Knowlden, Adam P; Sharma, Manoj; Nahar, Vinayak K

    The purpose of this article was to use the multitheory model of health behavior change in predicting adequate sleep behavior in college students. A valid and reliable survey was administered in a cross-sectional design (n = 151). For initiation of adequate sleep behavior, the construct of behavioral confidence (P < .001) was found to be significant and accounted for 24.4% of the variance. For sustenance of adequate sleep behavior, changes in social environment (P < .02), emotional transformation (P < .001), and practice for change (P < .001) were significant and accounted for 34.2% of the variance.

  14. Multidisciplinary molecular diagnostics: the 9th European meeting on molecular diagnostics.

    PubMed

    Loonen, Anne J M; Schuurman, Rob; van den Brule, Adriaan J C

    2016-01-01

    This report presents a summary of the 9th European Meeting on Molecular Diagnostics held in Noordwijk, The Netherlands, 14-16 October 2015. This 3-day conference covered many relevant topics in the field of molecular diagnostics in humans, including infectious disease, oncology, outbreak management, population-based cancer screening, standardization and quality control, chronic diseases and pharmacogenetics. Beyond these different areas, shared values are new technologies and novel technical and clinical applications. Approximately 450 participants, the majority coming from European countries, attended the meeting. Besides high quality scientific presentations, more than 35 diagnostic companies presented their latest innovations, altogether in an informal and inspiring scientific ambience.

  15. Region 8: Colorado Lamar and Steamboat Springs Adequate Letter (11/12/2002)

    EPA Pesticide Factsheets

    This letter from EPA to Colorado Department of Public Health and Environment determined Lamar and Steamboat Springs particulate matter (PM10) maintenance plan for Motor Vehicle Emissions Budgets adequate for transportation conformity purposes

  16. 75 FR 5893 - Suspension of Community Eligibility for Failure To Maintain Adequate Floodplain Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-05

    ... To Maintain Adequate Floodplain Management Regulations AGENCY: Federal Emergency Management Agency... floodplain management regulations meeting minimum requirements under the National Flood Insurance Program... they have brought their floodplain management regulations into compliance with the NFIP...

  17. Region 9: California Adequate / Inadequate Letter Attachment (5/30/2008)

    EPA Pesticide Factsheets

    This is a document that states that it has been found adequate for transportation conformitypurposes certain 8-hour ozone and PM2.5 motor vehicleemissions budgets in the 2007 South Coast StateImplementation Plan.

  18. Sensorless, online motor diagnostics

    SciTech Connect

    Kliman, G.B.; Premerlani, W.J.; Yazici, B.; Koegl, R.A.; Mazereeuw, J.

    1997-04-01

    Electric motors play a very important role in the safe and efficient running of any industrial plant. Early detection of abnormalities in the motors will help avoid expensive failures. Motor current signature analysis (MCSA) implemented in a computer-based motor monitor can contribute to such condition-based maintenance functions. Such a system may also detect an abnormality in the process as well as the motor. Extensive online monitoring of the motors can lead to greater plant availability, extended plant life, higher quality product, and smoother plant operation. With advances in digital technology over the last several years, adequate data processing capability is now available on cost-effective, microprocessor-based, protective-relay platforms to monitor motors for a variety of abnormalities in addition to the normal protection functions. Such multifunction monitors, first introduced by Multilin, are displacing the multiplicity of electromechanical devices commonly applied for many years. Following some background information on motor monitoring, this article features recent developments in providing tools for the diagnosis of faults or incipient faults in electric motor drives: Sensorless torque measurement, direct detection of turn-to-turn short circuits, detection of cracked or broken rotor bars, and detection of bearing deterioration.

  19. Diagnostic Algorithm Benchmarking

    NASA Technical Reports Server (NTRS)

    Poll, Scott

    2011-01-01

    A poster for the NASA Aviation Safety Program Annual Technical Meeting. It describes empirical benchmarking on diagnostic algorithms using data from the ADAPT Electrical Power System testbed and a diagnostic software framework.

  20. Prenatal Genetic Diagnostic Tests

    MedlinePlus

    ... Education & Events Advocacy For Patients About ACOG Prenatal Genetic Diagnostic Tests Home For Patients Search FAQs Prenatal ... Pamphlets - Spanish FAQ164, September 2016 PDF Format Prenatal Genetic Diagnostic Tests Pregnancy What is prenatal genetic testing? ...

  1. Diagnostic challenges for multiplexed protein microarrays.

    PubMed

    Master, Stephen R; Bierl, Charlene; Kricka, Larry J

    2006-11-01

    Multiplexed protein analysis using planar microarrays or microbeads is growing in popularity for simultaneous assays of antibodies, cytokines, allergens, drugs and hormones. However, this new assay format presents several new operational issues for the clinical laboratory, such as the quality control of protein-microarray-based assays, the release of unrequested test data and the use of diagnostic algorithms to transform microarray data into diagnostic results.

  2. Individual and contextual determinants of adequate maternal health care services in Kenya.

    PubMed

    Achia, Thomas N O; Mageto, Lillian E

    2015-01-01

    This study aimed to examine individual and community level factors associated with adequate use of maternal antenatal health services in Kenya. Individual and community level factors associated with adequate use of maternal health care (MHC) services were obtained from the 2008-09 Kenya Demographic and Health Survey data set. Multilevel partial-proportional odds logit models were fitted using STATA 13.0 to quantify the relations of the selected covariates to adequate MHC use, defined as a three-category ordinal variable. The sample consisted of 3,621 women who had at least one live birth in the five-year period preceding this survey. Only 18 percent of the women had adequate use of MHC services. Greater educational attainment by the woman or her partner, higher socioeconomic status, access to medical insurance coverage, and greater media exposure were the individual-level factors associated with adequate use of MHC services. Greater community ethnic diversity, higher community-level socioeconomic status, and greater community-level health facility deliveries were the contextual-level factors associated with adequate use of MHC. To improve the use of MHC services in Kenya, the government needs to design and implement programs that target underlying individual and community level factors, providing focused and sustained health education to promote the use of antenatal, delivery, and postnatal care.

  3. Diagnostics for ITER

    SciTech Connect

    Donne, A. J. H.; Hellermann, M. G. von; Barnsley, R.

    2008-10-22

    After an introduction into the specific challenges in the field of diagnostics for ITER (specifically high level of nuclear radiation, long pulses, high fluxes of particles to plasma facing components, need for reliability and robustness), an overview will be given of the spectroscopic diagnostics foreseen for ITER. The paper will describe both active neutral-beam based diagnostics as well as passive spectroscopic diagnostics operating in the visible, ultra-violet and x-ray spectral regions.

  4. Assessment of radiological protection systems among diagnostic radiology facilities in North East India.

    PubMed

    Singh, Thokchom Dewan; Jayaraman, T; Arunkumar Sharma, B

    2017-03-01

    This study aims to assess the adequacy level of radiological protection systems available in the diagnostic radiology facilities located in three capital cities of North East (NE) India. It further attempts to understand, using a multi-disciplinary approach, how the safety codes/standards in diagnostic radiology framed by the Atomic Energy Regulatory Board (AERB) and the International Atomic Energy Agency (IAEA) to achieve adequate radiological protection in facilities, have been perceived, conceptualized, and applied accordingly in these facilities. About 30 diagnostic radiology facilities were randomly selected from three capitals of states in NE India; namely Imphal (Manipur), Shillong (Meghalaya) and Guwahati (Assam). A semi-structured questionnaire developed based on a multi-disciplinary approach was used for this study. It was observed that radiological practices undertaken in these facilities were not exactly in line with safety codes/standards in diagnostic radiology of the AERB and the IAEA. About 50% of the facilities had registered/licensed x-ray equipment with the AERB. More than 80% of the workers did not use radiation protective devices, although these devices were available in the facilities. About 85% of facilities had no institutional risk management system. About 70% of the facilities did not carry out periodic quality assurance testing of their x-ray equipment or surveys of radiation leakage around the x-ray room, and did not display radiation safety indicators in the x-ray rooms. Workers in these facilities exhibited low risk perception about the risks associated with these practices. The majority of diagnostic radiology facilities in NE India did not comply with the radiological safety codes/standards framed by the AERB and IAEA. The study found inadequate levels of radiological protection systems in the majority of facilities. This study suggests a need to establish firm measures that comply with the radiological safety codes/standards of the

  5. BEAM SIMULATIONS USING VIRTUAL DIAGNOSTICS FOR THE DRIVER LINAC

    SciTech Connect

    R. C. York; X. Wu; Q. Zhao

    2011-12-21

    End-to-end beam simulations for the driver linac have shown that the design meets the necessary performance requirements including having adequate transverse and longitudinal acceptances. However, to achieve reliable operational performance, the development of appropriate beam diagnostic systems and control room procedures are crucial. With limited R&D funding, beam simulations provide a cost effective tool to evaluate candidate beam diagnostic systems and to provide a critical basis for developing early commissioning and later operational activities. We propose to perform beam dynamic studies and engineering analyses to define the requisite diagnostic systems of the driver linac and through simulation to develop and test commissioning and operational procedures.

  6. Novette diagnostic support. Final report

    SciTech Connect

    Cirigliano, R.; Franco, E.; Koppel, L.; Rodrigues, B.; Smith, J.

    1985-02-01

    The primary research areas were the following: (1) contribute x-ray diagnostic, experimental, and data reduction and analysis support for the Novette DANTE x-ray spectrometer experiments. This effort was expanded to improve the overall quality of the Novette database; (2) experimental and calculational characterization of the x-ray imaging properties of an ellipsoidal x-ray collection optic serving as a sensitivity enhancing component of the Transmission Grating Streak Spectrometer; (3) performance simulation of the x-ray dispersion properties of candidate x-ray laser cavity, normal incidence end-mirror optics; (4) contribute x-ray diagnostic, experimental, and data reduction and analysis support for the Novette Henway crystal spectrometer and the MCPIGS microchannel plate intensified grazing incident spectrometer experiments; and (5) perform a technical performance vs cost evaluation of commercially available hardware required to perform the NOVA neutron time-of-flight experiments.

  7. Importance of adequate exercise in the detection of coronary heart disease by radionuclide ventriculography

    SciTech Connect

    Brady, T.J.; Thrall, J.H.; Lo, K.; Pitt, B.

    1980-12-01

    Rest and exercise radionuclide ventriculograms were obtained on 77 symptomatic patients without prior documented coronary artery disease (CAD). Coronary artery disease was present by angiograms in 48. Radionuclide ventriculography (RNV) was abnormal in 41 patients (overall sensitivity 85%). In 29 patients with normal coronary arteries, RNV was normal in 24 (specificity 83%). To determine if the exercise level affects sensitivity, the studies were graded for adequacy of exercise. It was considered adequate if patients developed (a) chest pain, or (b) ST segment depression of at least 1 mm, or (c) if they achieved a pressure rate product greater than 250. Among the 48 patients with coronary artery disease, 35 achieved adequate exercise. Thirty-three had an abnormal RNV (sensitivity 94%). In 13 patients who failed to achieve adequate exercise, RNV was abnormal in eight (sensitivity of only 62%). Some patients with coronary artery disease may have a normal ventricular response at inadequate levels of stress.

  8. [Prevention of ocular complications of herpes zoster ophthalmicus by adequate treatment with acyclovir].

    PubMed

    Borruat, F X; Buechi, E R; Piguet, B; Fitting, P; Zografos, L; Herbort, C P

    1991-05-01

    We compared the frequency of severe ocular complications secondary to Herpes Zoster Ophthalmicus (HZO) in 232 patients. They were divided into three groups: 1) patients without treatment (n = 164); 2) patients treated adequately (n = 48) with acyclovir (ACV; 5 x 800 mg/d orally and ophthalmic ointment 5 x /d for a minimum of 7 days, given within three days after skin eruption); and, 3) patients treated inadequately (n = 20) with ACV (only topical treatment, insufficient doses, interrupted treatment, delayed treatment). Patients with no treatment or with inadequate treatments showed the same frequency of severe ocular complications (21% (34/164) and 25% (5/20), respectively). In contrast, when adequate treatment of ACV was given complications occurred in only 4% (2/48) of cases. This study emphasizes the need for prompt (within three days after skin eruption) and adequate (5 x 800 mg/d for at least 7 days) treatment of ACV to prevent the severe complications of HZO.

  9. Broadband inversion of 1J(CC) responses in 1,n-ADEQUATE spectra.

    PubMed

    Reibarkh, Mikhail; Williamson, R Thomas; Martin, Gary E; Bermel, Wolfgang

    2013-11-01

    Establishing the carbon skeleton of a molecule greatly facilitates the process of structure elucidation, both manual and computer-assisted. Recent advances in the family of ADEQUATE experiments demonstrated their potential in this regard. 1,1-ADEQUATE, which provides direct (13)C-(13)C correlation via (1)J(CC), and 1,n-ADEQUATE, which typically yields (3)J(CC) and (1)J(CC) correlations, are more sensitive and more widely applicable experiments than INADEQUATE and PANACEA. A recently reported modified pulse sequence that semi-selectively inverts (1)J(CC) correlations in 1,n-ADEQUATE spectra provided a significant improvement, allowing (1)J(CC) and (n)J(CC) correlations to be discerned in the same spectrum. However, the reported experiment requires a careful matching of the amplitude transfer function with (1)J(CC) coupling constants in order to achieve the inversion, and even then some (1)J(CC) correlations could still have positive intensity due to the oscillatory nature of the transfer function. Both shortcomings limit the practicality of the method. We now report a new, dual-optimized inverted (1)J(CC) 1,n-ADEQUATE experiment, which provides more uniform inversion of (1)J(CC) correlations across the range of 29-82 Hz. Unlike the original method, the dual optimization experiment does not require fine-tuning for the molecule's (1)J(CC) coupling constant values. Even more usefully, the dual-optimized version provides up to two-fold improvement in signal-to-noise for some long-range correlations. Using modern, cryogenically-cooled probes, the experiment can be successfully applied to samples of ~1 mg under favorable circumstances. The improvements afforded by dual optimization inverted (1)J(CC) 1,n-ADEQUATE experiment make it a useful and practical tool for NMR structure elucidation and should facilitate the implementation and utilization of the experiment.

  10. Self-reported segregation experience throughout the life course and its association with adequate health literacy.

    PubMed

    Goodman, Melody S; Gaskin, Darrell J; Si, Xuemei; Stafford, Jewel D; Lachance, Christina; Kaphingst, Kimberly A

    2012-09-01

    Residential segregation has been shown to be associated with health outcomes and health care utilization. We examined the association between racial composition of five physical environments throughout the life course and adequate health literacy among 836 community health center patients in Suffolk County, NY. Respondents who attended a mostly White junior high school or currently lived in a mostly White neighborhood were more likely to have adequate health literacy compared to those educated or living in predominantly minority or diverse environments. This association was independent of the respondent's race, ethnicity, age, education, and country of birth.

  11. Self-reported segregation experience throughout the life course and its association with adequate health literacy

    PubMed Central

    Gaskin, Darrell J.; Si, Xuemei; Stafford, Jewel D.; Lachance, Christina; Kaphingst, Kimberly A.

    2012-01-01

    Residential segregation has been shown to be associated with health outcomes and health care utilization. We examined the association between racial composition of five physical environments throughout the life course and adequate health literacy among 836 community health center patients in Suffolk County, NY. Respondents who attended a mostly White junior high school or currently lived in a mostly White neighborhood were more likely to have adequate health literacy compared to those educated or living in predominantly minority or diverse environments. This association was independent of the respondent’s race, ethnicity, age, education, and country of birth. PMID:22658579

  12. Preliminary evaluation of a high-resolution workstation for diagnostic interpretation of portable radiographs

    NASA Astrophysics Data System (ADS)

    Honeyman-Buck, Janice C.; Huda, Walter; Palmer, Carole K.; Frost, Meryll M.; Moser, Robert; Staab, Edward V.

    1995-04-01

    required to read from the workstation and that the increased time was spent using window/level and magnification/roam functions. This preliminary study suggests that the high resolution workstation developed at the University of Florida has adequate quality and functionality to be used for diagnostic interpretation of portable radiographs if given high resolution images. However, further investigation is indicated before we eliminate film in a CR environment.

  13. A New Diagnostic Test for Endometrial Cancer?

    PubMed Central

    Guralp, Onur; Sheridan, Susan M.; Harter, Josephine; Hinshaw, James Louis; Seo, Songwon; Hartenbach, Ellen M.; Lindheim, Steven; Stewar, Sarah; Kushner, David M.

    2014-01-01

    Objective During saline-infused sonohysterography (SIS), the distension fluid is typically discarded. If cytology analysis could identify those patients with endometrial cancer, many women would be spared from further procedures. Methods Thirty consecutive patients with clinical stage I or II endometrial adenocarcinoma were prospectively recruited preoperatively. Saline-infused sonohysterography was performed by instilling 5 mL of saline, withdrawing and sending for analysis. Saline was reinfused until complete SIS images were obtained and sent separately for cytology. Results Of the 30 women enrolled, SIS was technically successful in 29. Demographics included mean age (60.5 ± 6.99 years), body mass index (35.55 ± 8.18 kg/m2), endometrioid histology (76%), and grade (grade 1, 67%). Prestudy diagnostic method included biopsy (70%), dilatation and curettage (17%), and hysteroscopy (10%). Adequate cytology specimens were obtained in 66% of the 5mL flushes and 72% of the complete SIS collections. Of adequate specimens, the sensitivities to detect endometrial cancer for the 5-mL, complete, and combined fluid samples were 26% (95% confidence interval, 9%–51%), 36% (17%–59%), and 42% (22%–63%). Sensitivity based on the whole study sample (N = 30) was 33% (17%–53%). Statistical significance was not found in the association between a positive test and age, body mass index, grade, diagnostic method, or volume instilled or aspirated. Conclusions Most patients with early endometrial cancer can undergo SIS procedures with adequate cytology specimens obtained from distention media. However, the sensitivity is low, and refinements are necessary before utilizing as a diagnostic test. In cases with positive results, the patient may be able to avoid other costly and painful procedures. PMID:23881100

  14. Laboratory testing for von Willebrand's disease: an assessment of current diagnostic practice and efficacy by means of a multi-laboratory survey. RCPA Quality Assurance Program (QAP) in Haematology Haemostasis Scientific Advisory Panel.

    PubMed

    Favaloro, E J; Smith, J; Petinos, P; Hertzberg, M; Koutts, J

    1999-10-01

    We report an evaluation of current laboratory practice for the diagnosis of von Willebrand's disease (VWD) by means of a multilaboratory survey. This assessment was undertaken with the RCPA Quality Assurance Program (QAP) in Haematology, which covers a wide geographic area encompassing Australia, New Zealand and Asia. A total of 25 laboratories actively involved in testing for VWD were selected to participate in a sample testing assessment exercise. Samples comprised 10 plasmas: (i) a normal plasma pool (in duplicate), (ii) this pool diluted to 50% (in duplicate), (iii) a normal individual (X1), (iv) severe Type 1 VWD (X1), (v) Type 2B VWD (x2 unrelated donors), (vi) Type 3 VWD (x1), (vii) Type 2A VWD (x1). Laboratories were asked to perform all tests available to them in order to establish a laboratory diagnosis of VWD, and then to comment on the possibility or otherwise of VWD. Overall findings indicated a wide variation in test practice, in the effectiveness of various test procedures in detecting VWD, and in the ability of various composite test panels to identify type 2 VWD subtypes. Firstly, while all laboratories (n = 25) performed tests for FVIII:C activity, von Willebrand factor 'antigen' (VWF:Ag) and a functional VWF assay [using the ristocetin cofactor assay (VWF:RCo; n = 23) and/or the collagen binding assay (VWF:CBA; n = 12)], only three laboratories carried out VWF:Multimer analysis. Secondly, for the three quantitative VWF assays, 10/25 (40%) laboratories performed all three, whereas 15/25 (60%) performed only two [VWF:Ag and VWF:RCo (n = 13); VWF:Ag and VWF:CBA (n = 2)]. Thirdly, a variety of assay methodologies were evident for VWF:Ag [ELISA, electro-immuno diffusion (EID), latex immuno-assay (LIA), and VIDAS assay] and VWF:RCo (platelet agglutination/'aggregometry' and a 'functional VWF:RCo-alternative' ELISA assay). Between method analysis for the quantitative VWF assays showed that the VWF:RCo yielded the greatest degree of inter

  15. TFTR diagnostic vacuum controller

    SciTech Connect

    Olsen, D.; Persons, R.

    1981-01-01

    The TFTR diagnostic vacuum controller (DVC) provides in conjunction with the Central Instrumentation Control and Data Acquisition System (CICADA), control and monitoring for the pumps, valves and gauges associated with each individual diagnostic vacuum system. There will be approximately 50 systems on TFTR. Two standard versions of the controller (A and B) wil be provided in order to meet the requirements of two diagnostic manifold arrangements. All pump and valve sequencing, as well as protection features, will be implemented by the controller.

  16. Diagnostic Development on NSTX

    SciTech Connect

    A.L. Roquemore; D. Johnson; R. Kaita; et al

    1999-12-16

    Diagnostics are described which are currently installed or under active development for the newly commissioned NSTX device. The low aspect ratio (R/a less than or equal to 1.3) and low toroidal field (0.1-0.3T) used in this device dictate adaptations in many standard diagnostic techniques. Technical summaries of each diagnostic are given, and adaptations, where significant, are highlighted.

  17. What Is Diagnostic Testing?

    MedlinePlus

    ... Primary care providers Specialists Getting covered Research Basic science research Research in people ... screening Diagnostic testing Direct-to-consumer genetic testing Newborn screening Pharmacogenomic testing ...

  18. 75 FR 69648 - Safety Analysis Requirements for Defining Adequate Protection for the Public and the Workers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

    ... ENERGY Safety Analysis Requirements for Defining Adequate Protection for the Public and the Workers... designed to hold firmly in place. 10 CFR Part 830 imposes a requirement that a documented safety analysis... provide guidance on meeting the requirements imposed by DOE Order 5480.23, Nuclear Safety Analysis...

  19. 42 CFR 413.24 - Adequate cost data and cost finding.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    .... Adequate data capable of being audited is consistent with good business concepts and effective and efficient management of any organization, whether it is operated for profit or on a nonprofit basis. It is a... contract for services (for example, a management contract), directly assigning the costs to the...

  20. Prenatal zinc supplementation of zinc-adequate rats adversely affects immunity in offspring

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We previously showed that zinc (Zn) supplementation of Zn-adequate dams induced immunosuppressive effects that persist in the offspring after weaning. We investigated whether the immunosuppressive effects were due to in utero exposure and/or mediated via milk using a cross-fostering design. Pregnant...

  1. Towards Defining Adequate Lithium Trials for Individuals with Mental Retardation and Mental Illness.

    ERIC Educational Resources Information Center

    Pary, Robert J.

    1991-01-01

    Use of lithium with mentally retarded individuals with psychiatric conditions and/or behavior disturbances is discussed. The paper describes components of an adequate clinical trial and reviews case studies and double-blind cases. The paper concludes that aggression is the best indicator for lithium use, and reviews treatment parameters and…

  2. ADEQUATE SHELTERS AND QUICK REACTIONS TO WARNING: A KEY TO CIVIL DEFENSE.

    PubMed

    LYNCH, F X

    1963-11-08

    Case histories collected by investigators in Japan during 1945 illustrate both the effectiveness of shelters and the dangers inherent in apathy of the population, which suffered needless casualties by ignoring air raid warnintgs. Adequate shelters and immediate response to warnings are essential to survival in nuclear attack.

  3. Perceptions of Teachers in Their First Year of School Restructuring: Failure to Make Adequate Yearly Progress

    ERIC Educational Resources Information Center

    Moser, Sharon

    2010-01-01

    The 2007-2008 school year marked the first year Florida's Title I schools that did not made Adequate Yearly Progress (AYP) for five consecutive years entered into restructuring as mandated by the "No Child Left Behind Act" of 2001. My study examines the perceptions of teacher entering into their first year of school restructuring due to…

  4. 45 CFR 1182.15 - Institute responsibility for maintaining adequate technical, physical, and security safeguards to...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... record systems. These security safeguards shall apply to all systems in which identifiable personal data... data and automated systems shall be adequately trained in the security and privacy of personal data. (4... technical, physical, and security safeguards to prevent unauthorized disclosure or destruction of manual...

  5. 42 CFR 417.568 - Adequate financial records, statistical data, and cost finding.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Adequate financial records, statistical data, and... financial records, statistical data, and cost finding. (a) Maintenance of records. (1) An HMO or CMP must maintain sufficient financial records and statistical data for proper determination of costs payable by...

  6. Effect of tranquilizers on animal resistance to the adequate stimuli of the vestibular apparatus

    NASA Technical Reports Server (NTRS)

    Maksimovich, Y. B.; Khinchikashvili, N. V.

    1980-01-01

    The effect of tranquilizers on vestibulospinal reflexes and motor activity was studied in 900 centrifuged albino mice. Actometric studies have shown that the tranquilizers have a group capacity for increasing animal resistance to the action of adequate stimuli to the vestibular apparatus.

  7. 9 CFR 2.40 - Attending veterinarian and adequate veterinary care (dealers and exhibitors).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Attending veterinarian and adequate veterinary care (dealers and exhibitors). 2.40 Section 2.40 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Attending...

  8. 9 CFR 2.40 - Attending veterinarian and adequate veterinary care (dealers and exhibitors).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Attending veterinarian and adequate veterinary care (dealers and exhibitors). 2.40 Section 2.40 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Attending...

  9. 9 CFR 2.40 - Attending veterinarian and adequate veterinary care (dealers and exhibitors).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Attending veterinarian and adequate veterinary care (dealers and exhibitors). 2.40 Section 2.40 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Attending...

  10. 9 CFR 2.40 - Attending veterinarian and adequate veterinary care (dealers and exhibitors).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Attending veterinarian and adequate veterinary care (dealers and exhibitors). 2.40 Section 2.40 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Attending...

  11. The Relationship between Parental Involvement and Adequate Yearly Progress among Urban, Suburban, and Rural Schools

    ERIC Educational Resources Information Center

    Ma, Xin; Shen, Jianping; Krenn, Huilan Y.

    2014-01-01

    Using national data from the 2007-08 School and Staffing Survey, we compared the relationships between parental involvement and school outcomes related to adequate yearly progress (AYP) in urban, suburban, and rural schools. Parent-initiated parental involvement demonstrated significantly positive relationships with both making AYP and staying off…

  12. 9 CFR 2.33 - Attending veterinarian and adequate veterinary care.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... veterinary care. 2.33 Section 2.33 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Research Facilities § 2.33 Attending veterinarian and adequate veterinary care. (a) Each research facility shall have an attending veterinarian who shall...

  13. 9 CFR 2.33 - Attending veterinarian and adequate veterinary care.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... veterinary care. 2.33 Section 2.33 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Research Facilities § 2.33 Attending veterinarian and adequate veterinary care. (a) Each research facility shall have an attending veterinarian who shall...

  14. Identifying the Factors Impacting the Adequately Yearly Progress Performance in the United States

    ERIC Educational Resources Information Center

    Hsieh, Ju-Shan

    2013-01-01

    The NCLB (No Child Left Behind Act) specifies that states must develop AYP (adequate yearly progress) statewide measurable objectives for improved achievement by all students, including economically disadvantaged students, students from minority races, students with disabilities, and students with limited English proficiency. By the 2013-2014…

  15. 36 CFR 13.960 - Who determines when there is adequate snow cover?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Who determines when there is adequate snow cover? 13.960 Section 13.960 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR NATIONAL PARK SYSTEM UNITS IN ALASKA Special Regulations-Denali National Park...

  16. 36 CFR 13.960 - Who determines when there is adequate snow cover?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Who determines when there is adequate snow cover? 13.960 Section 13.960 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR NATIONAL PARK SYSTEM UNITS IN ALASKA Special Regulations-Denali National Park...

  17. 76 FR 51041 - Hemoglobin Standards and Maintaining Adequate Iron Stores in Blood Donors; Public Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-17

    ... HUMAN SERVICES Food and Drug Administration Hemoglobin Standards and Maintaining Adequate Iron Stores in... workshop. The Food and Drug Administration (FDA) is announcing a public workshop entitled: ``Hemoglobin... discuss blood donor hemoglobin and hematocrit qualification standards in the United States, its impact...

  18. 21 CFR 514.117 - Adequate and well-controlled studies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... adequate and well-controlled studies of a new animal drug is to distinguish the effect of the new animal... with one or more controls to provide a quantitative evaluation of drug effects. The protocol and the... for special circumstances. Examples include studies in which the effect of the new animal drug is...

  19. 21 CFR 514.117 - Adequate and well-controlled studies.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... adequate and well-controlled studies of a new animal drug is to distinguish the effect of the new animal... with one or more controls to provide a quantitative evaluation of drug effects. The protocol and the... for special circumstances. Examples include studies in which the effect of the new animal drug is...

  20. 21 CFR 514.117 - Adequate and well-controlled studies.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... adequate and well-controlled studies of a new animal drug is to distinguish the effect of the new animal... with one or more controls to provide a quantitative evaluation of drug effects. The protocol and the... for special circumstances. Examples include studies in which the effect of the new animal drug is...

  1. 21 CFR 514.117 - Adequate and well-controlled studies.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... adequate and well-controlled studies of a new animal drug is to distinguish the effect of the new animal... with one or more controls to provide a quantitative evaluation of drug effects. The protocol and the... for special circumstances. Examples include studies in which the effect of the new animal drug is...

  2. 21 CFR 514.117 - Adequate and well-controlled studies.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... adequate and well-controlled studies of a new animal drug is to distinguish the effect of the new animal... with one or more controls to provide a quantitative evaluation of drug effects. The protocol and the... for special circumstances. Examples include studies in which the effect of the new animal drug is...

  3. 30 CFR 227.801 - What if a State does not adequately perform a delegated function?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... delegated function? 227.801 Section 227.801 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT DELEGATION TO STATES Performance Review § 227.801 What if a State does not adequately perform a delegated function? If your performance of the delegated function does...

  4. Science Education as a Contributor to Adequate Yearly Progress and Accountability Programs

    ERIC Educational Resources Information Center

    Judson, Eugene

    2010-01-01

    The No Child Left Behind (NCLB) Act requires states to measure the adequate yearly progress (AYP) of each public school and local educational agency (LEA) and to hold schools and LEAs accountable for failing to make AYP. Although it is required that science be assessed in at least three grades, the achievement results from science examinations are…

  5. 42 CFR 417.568 - Adequate financial records, statistical data, and cost finding.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Adequate financial records, statistical data, and... financial records, statistical data, and cost finding. (a) Maintenance of records. (1) An HMO or CMP must maintain sufficient financial records and statistical data for proper determination of costs payable by...

  6. Understanding the pelvic pain mechanism is key to find an adequate therapeutic approach.

    PubMed

    Van Kerrebroeck, Philip

    2016-06-25

    Pain is a natural mechanism to actual or potential tissue damage and involves both a sensory and an emotional experience. In chronic pelvic pain, localisation of pain can be widespread and can cause considerable distress. A multidisciplinary approach is needed in order to fully understand the pelvic pain mechanism and to identify an adequate therapeutic approach.

  7. 36 CFR 13.960 - Who determines when there is adequate snow cover?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Who determines when there is adequate snow cover? 13.960 Section 13.960 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR NATIONAL PARK SYSTEM UNITS IN ALASKA Special Regulations-Denali National Park...

  8. 36 CFR 13.960 - Who determines when there is adequate snow cover?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Who determines when there is adequate snow cover? 13.960 Section 13.960 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR NATIONAL PARK SYSTEM UNITS IN ALASKA Special Regulations-Denali National Park...

  9. 36 CFR 13.960 - Who determines when there is adequate snow cover?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Who determines when there is adequate snow cover? 13.960 Section 13.960 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR NATIONAL PARK SYSTEM UNITS IN ALASKA Special Regulations-Denali National Park...

  10. Human milk feeding supports adequate growth in infants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Despite current nutritional strategies, premature infants remain at high risk for extrauterine growth restriction. The use of an exclusive human milk-based diet is associated with decreased incidence of necrotizing enterocolitis (NEC), but concerns exist about infants achieving adequate growth. The ...

  11. Adequate Yearly Progress for Students with Emotional and Behavioral Disorders through Research-Based Practices

    ERIC Educational Resources Information Center

    Vannest, Kimberly J.; Temple-Harvey, Kimberly K.; Mason, Benjamin A.

    2009-01-01

    Because schools are held accountable for the academic performance of all students, it is important to focus on academics and the need for effective teaching practices. Adequate yearly progress, a method of accountability that is part of the No Child Left Behind Act (2001), profoundly affects the education of students who have emotional and…

  12. Influenza 2005-2006: vaccine supplies adequate, but bird flu looms.

    PubMed

    Mossad, Sherif B

    2005-11-01

    Influenza vaccine supplies appear to be adequate for the 2005-2006 season, though delivery has been somewhat delayed. However, in the event of a pandemic of avian flu-considered inevitable by most experts, although no one knows when it will happen-the United States would be woefully unprepared.

  13. How Much and What Kind? Identifying an Adequate Technology Infrastructure for Early Childhood Education. Policy Brief

    ERIC Educational Resources Information Center

    Daugherty, Lindsay; Dossani, Rafiq; Johnson, Erin-Elizabeth; Wright, Cameron

    2014-01-01

    To realize the potential benefits of technology use in early childhood education (ECE), and to ensure that technology can help to address the digital divide, providers, families of young children, and young children themselves must have access to an adequate technology infrastructure. The goals for technology use in ECE that a technology…

  14. Diagnostic Tools for Onchocerciasis Elimination Programs.

    PubMed

    Vlaminck, Johnny; Fischer, Peter U; Weil, Gary J

    2015-11-01

    Onchocerciasis (river blindness) is a major public health problem in sub-Saharan Africa. Major disease-control programs have greatly reduced both disease and infection prevalence by mass distribution of donated ivermectin. Recent studies have shown that local elimination was achieved in some areas following many years of ivermectin. The global health community has recently decided to build on these successes with a new program that aims to eliminate onchocerciasis. Diagnostic tests that were useful for identifying priority areas for disease prevention may not be adequate tools for elimination programs. This paper reviews available and emerging diagnostic tests for onchocerciasis and considers how they might be best employed during different stages of onchocerciasis elimination programs.

  15. [20-year experience with laserofluorescent diagnostics in clinical microbiology].

    PubMed

    Aleksandrov, M T; Pashkov, E P; Bykov, A S; Gun'ko, V I; Popov, S N; Ivanchenko, O N; Rodionov, A D; Gizatullin, R M

    2011-01-01

    Results of rapid laser-assisted identification of microorganisms for diagnostics of microbial processes based on auto-fluorescence effect in bacteria-containing materials are summarized. It is proposed to use the auto-fluorescence technique for express diagnostics of pyoinflammatory diseases, evaluation of microflora conditions (eubiosis, dysbiosis) and sensitivity to antibiotics, monitoring and prognostication, assessment of the quality of antibiotic therapy. Priority in the development of this medical technology for laserofluorescent diagnostics and its practical application is protected by 15 patents.

  16. Automotive Diagnostic Technologies.

    ERIC Educational Resources Information Center

    Columbus State Community Coll., OH.

    This document contains materials developed for and about the automotive diagnostic technologies tech prep program of the South-Western City Schools in Ohio. Part 1 begins with a map of the program, which begins with an automotive/diagnostic technologies program in grades 11 and 12 that leads to entry-level employment or a 2-year automotive…

  17. The Diagnostic Validity of Clinical Tests in Temporomandibular Internal Derangement: A Systematic Review and Meta-analysis.

    PubMed

    Chaput, Eve; Gross, Anita; Stewart, Ryan; Nadeau, Gordon; Goldsmith, Charlie H

    2012-01-01

    Purpose: To assess the diagnostic validity of clinical tests for temporomandibular internal derangement relative to magnetic resonance imaging (MRI). Methods: MEDLINE and Embase were searched from 1994 through 2009. Independent reviewers conducted study selection; risk of bias was assessed using Quality Assessment of studies of Diagnostic Accuracy included in Systematic reviews (QUADAS); ≥9/14) and data abstraction. Overall quality of evidence was profiled using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Agreement was measured using quadratic weighted kappa (κw). Positive (+) or negative (−) likelihood ratios (LR) with 95% CIs were calculated and pooled using the DerSimonian–Laird method and a random-effects model when homogeneous (I(2)≥0.40, Q-test p≤0.10). Results: We selected 8 of 36 studies identified. There is very low quality evidence that deflection (+LR: 6.37 [95% CI, 2.13–19.03]) and crepitation (LR:5.88 [95% CI, 1.95–17.76]) as single tests and crepitation, deflection, pain, and limited mouth opening as a cluster of tests are the most valuable for ruling in internal derangement without reduction (+LR:6.37 [95% CI, 2.13–19.03]), (−LR:0.27 [95% CI, 0.11–0.64]) while the test cluster click, deviation, and pain rules out internal derangement with reduction (−LR: 0.09 [95% CI, 0.01–0.72]). No single test or cluster of tests was conclusive and of significant value for ruling in internal derangement with reduction. Conclusions: Findings of this review will assist clinicians in deciding which diagnostic tests to use when internal derangement is suspected. The literature search revealed a lack of high-quality studies; further research with adequate description of patient populations, blinded assessments, and both sagittal and coronal MRI planes is therefore recommended.

  18. Fast ion JET diagnostics: confinement and losses

    SciTech Connect

    Kiptily, V. G.; Pinches, S. D.; Sharapov, S. E.; Syme, D. B.; Cecconello, M.; Darrow, D.; Hill, K.; Goloborod'ko, V.; Yavorskij, V.; Johnson, T.; Murari, A.; Reich, M.; Gorini, G.; Zoita, V.

    2008-03-12

    A study of magnetically confined fast ions in tokamaks plays an important role in burning plasma research. To reach ignition and steady burning of a reactor plasma an adequate confinement of energetic ions produced by NBI heating, accelerated with ICRF and born in fusion reactions is essential to provide efficient heating of the bulk plasma. Thus, investigation of the fast ion behaviour is an immediate task for present-day large machines, such as JET, in order to understand the main mechanisms of slowing down, redistribution and losses, and to develop optimal plasma scenarios. Today's JET has an enhanced suite of fast ion diagnostics both of confined and lost ions that enable to significantly contribute to this important area of research. Fast ion populations of p, d, t, {sup 3}He and {sup 4}He, made with ICRF, NBI, and fusion reactions have been investigated in experiments on JET with sophisticated diagnostics in conventional and shear-reversed plasmas, exploring a wide range of effects. This paper will introduce to the JET fast-ion diagnostic techniques and will give an overview of recent observations. A synergy of the unique diagnostic set was utilised in JET, and studies of the response of fast ions to MHD modes (e.g. tornado modes, sawtooth crashes), fast {sup 3}He-ions behaviour in shear-reversed plasmas are impressive examples of that. Some results on fast ion losses in JET experiments with various levels of the toroidal field ripple will be demonstrated.

  19. Diagnostics of Nanodusty Plasma

    NASA Astrophysics Data System (ADS)

    Greiner, Franko; Groth, Sebastian; Tadsen, Bejamin; Piel, Alexander

    2015-11-01

    The diagnostic of nanodusty plasmas, i.e. plasmas including nano-sized dust particles, is a challenging task. For both, the diagnostic of the nanodusty plasma itself, and the in-situ diagnostic of the nanoparticles, no standard diagnostic exist. Nanodust particle size and density can be estimated using light scattering techniques, namely kinetic Mie ellipsometry and extinction measurements. The charge of the nanoparticles can be estimated from the analysis of dust density waves (DDW). Parameters like the electron density, which give information about the plasma itself, may be deduced from the DDW analysis. We present detailed investigations on nanodust in a reactive Argon-Acetylene plasma created in an rf-driven parallel plate reactor at low pressure using the above mentioned portfolio of diagnostic. Funded by DFG under contract SFB TR-24/A2.

  20. Rayleigh Scattering Diagnostics Workshop

    NASA Technical Reports Server (NTRS)

    Seasholtz, Richard (Compiler)

    1996-01-01

    The Rayleigh Scattering Diagnostics Workshop was held July 25-26, 1995 at the NASA Lewis Research Center in Cleveland, Ohio. The purpose of the workshop was to foster timely exchange of information and expertise acquired by researchers and users of laser based Rayleigh scattering diagnostics for aerospace flow facilities and other applications. This Conference Publication includes the 12 technical presentations and transcriptions of the two panel discussions. The first panel was made up of 'users' of optical diagnostics, mainly in aerospace test facilities, and its purpose was to assess areas of potential applications of Rayleigh scattering diagnostics. The second panel was made up of active researchers in Rayleigh scattering diagnostics, and its purpose was to discuss the direction of future work.

  1. 21 CFR 886.1390 - Flexible diagnostic Fresnel lens.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1390 Flexible diagnostic Fresnel lens... to the back of the spectacle lenses of patients with aphakia (absence of the lens of the eye). (b... from the current good manufacturing practice requirements of the quality system regulation in part...

  2. Clinical technique: techniques in the practice diagnostic laboratory: a review.

    PubMed

    Doneley, Bob

    2015-01-01

    The need to rapidly diagnose disease in avian/exotic animal patients has led to the increased use of on-site diagnostic testing by veterinarians treating these animals. This article explores the use of on-site veterinary diagnostic testing: advantages and disadvantages of such testing; tests that are performed; type of equipment available; and the need for quality control.

  3. The concept of adequate causation and Max Weber's comparative sociology of religion.

    PubMed

    Buss, A

    1999-06-01

    Max Weber's The Protestant Ethic and the Spirit of Capitalism, studied in isolation, shows mainly an elective affinity or an adequacy on the level of meaning between the Protestant ethic and the 'spirit' of capitalism. Here it is suggested that Weber's subsequent essays on 'The Economic Ethics of World Religions' are the result of his opinion that adequacy on the level of meaning needs and can be verified by causal adequacy. After some introductory remarks, particularly on elective affinity, the paper tries to develop the concept of adequate causation and the related concept of objective possibility on the basis of the work of v. Kries on whom Weber heavily relied. In the second part, this concept is used to show how the study of the economic ethics of India, China, Rome and orthodox Russia can support the thesis that the 'spirit' of capitalism, although it may not have been caused by the Protestant ethic, was perhaps adequately caused by it.

  4. Ensuring smokers are adequately informed: reflections on consumer rights, manufacturer responsibilities, and policy implications

    PubMed Central

    Chapman, S; Liberman, J

    2005-01-01

    The right to information is a fundamental consumer value. Following the advent of health warnings, the tobacco industry has repeatedly asserted that smokers are fully informed of the risks they take, while evidence demonstrates widespread superficial levels of awareness and understanding. There remains much that tobacco companies could do to fulfil their responsibilities to inform smokers. We explore issues involved in the meaning of "adequately informed" smoking and discuss some of the key policy and regulatory implications. We use the idea of a smoker licensing scheme—under which it would be illegal to sell to smokers who had not demonstrated an adequate level of awareness—as a device to explore some of these issues. We also explore some of the difficulties that addiction poses for the notion that smokers might ever voluntarily assume the risks of smoking. PMID:16046703

  5. Myth 19: Is Advanced Placement an Adequate Program for Gifted Students?

    ERIC Educational Resources Information Center

    Gallagher, Shelagh A.

    2009-01-01

    Is it a myth that Advanced Placement (AP) is an adequate program for gifted students? AP is so covered with myths and assumptions that it is hard to get a clear view of the issues. In this article, the author finds the answer about AP by looking at current realties. First, AP is hard for gifted students to avoid. Second, AP never was a program…

  6. Global risk assessment of aflatoxins in maize and peanuts: are regulatory standards adequately protective?

    PubMed

    Wu, Felicia; Stacy, Shaina L; Kensler, Thomas W

    2013-09-01

    The aflatoxins are a group of fungal metabolites that contaminate a variety of staple crops, including maize and peanuts, and cause an array of acute and chronic human health effects. Aflatoxin B1 in particular is a potent liver carcinogen, and hepatocellular carcinoma (HCC) risk is multiplicatively higher for individuals exposed to both aflatoxin and chronic infection with hepatitis B virus (HBV). In this work, we sought to answer the question: do current aflatoxin regulatory standards around the world adequately protect human health? Depending upon the level of protection desired, the answer to this question varies. Currently, most nations have a maximum tolerable level of total aflatoxins in maize and peanuts ranging from 4 to 20ng/g. If the level of protection desired is that aflatoxin exposures would not increase lifetime HCC risk by more than 1 in 100,000 cases in the population, then most current regulatory standards are not adequately protective even if enforced, especially in low-income countries where large amounts of maize and peanuts are consumed and HBV prevalence is high. At the protection level of 1 in 10,000 lifetime HCC cases in the population, however, almost all aflatoxin regulations worldwide are adequately protective, with the exception of several nations in Africa and Latin America.

  7. Global Risk Assessment of Aflatoxins in Maize and Peanuts: Are Regulatory Standards Adequately Protective?

    PubMed Central

    Wu, Felicia

    2013-01-01

    The aflatoxins are a group of fungal metabolites that contaminate a variety of staple crops, including maize and peanuts, and cause an array of acute and chronic human health effects. Aflatoxin B1 in particular is a potent liver carcinogen, and hepatocellular carcinoma (HCC) risk is multiplicatively higher for individuals exposed to both aflatoxin and chronic infection with hepatitis B virus (HBV). In this work, we sought to answer the question: do current aflatoxin regulatory standards around the world adequately protect human health? Depending upon the level of protection desired, the answer to this question varies. Currently, most nations have a maximum tolerable level of total aflatoxins in maize and peanuts ranging from 4 to 20ng/g. If the level of protection desired is that aflatoxin exposures would not increase lifetime HCC risk by more than 1 in 100,000 cases in the population, then most current regulatory standards are not adequately protective even if enforced, especially in low-income countries where large amounts of maize and peanuts are consumed and HBV prevalence is high. At the protection level of 1 in 10,000 lifetime HCC cases in the population, however, almost all aflatoxin regulations worldwide are adequately protective, with the exception of several nations in Africa and Latin America. PMID:23761295

  8. Current strategies for the restoration of adequate lordosis during lumbar fusion.

    PubMed

    Barrey, Cédric; Darnis, Alice

    2015-01-18

    Not restoring the adequate lumbar lordosis during lumbar fusion surgery may result in mechanical low back pain, sagittal unbalance and adjacent segment degeneration. The objective of this work is to describe the current strategies and concepts for restoration of adequate lordosis during fusion surgery. Theoretical lordosis can be evaluated from the measurement of the pelvic incidence and from the analysis of spatial organization of the lumbar spine with 2/3 of the lordosis given by the L4-S1 segment and 85% by the L3-S1 segment. Technical aspects involve patient positioning on the operating table, release maneuvers, type of instrumentation used (rod, screw-rod connection, interbody cages), surgical sequence and the overall surgical strategy. Spinal osteotomies may be required in case of fixed kyphotic spine. AP combined surgery is particularly efficient in restoring lordosis at L5-S1 level and should be recommended. Finally, not one but several strategies may be used to achieve the need for restoration of adequate lordosis during fusion surgery.

  9. Oil & gas in the 1990`s and beyond: Adequate supplies, growing demand, flat prices

    SciTech Connect

    Kennedy, J.L.

    1995-06-01

    Long term petroleum market fundamentals are clear: supplies are adequate and world demand will continue to grow steadily. Adequate supplies insure that prices will not increase significantly, on average, till the end of the 1990`s, probably much beyond. Despite plentiful supply and modest price increases, there will be peaks and valleys in the price graph as productive capacity is used up, then expanded. Tens of billions of dollars will be needed over the next decade to expand producing capacity. World oil consumption will increase at about 1.5% per year, at least for the next decade. Demand in Asia and Latin America will grow several times faster than this average world rate. World natural gas demand will grow at more then 2% per year well past 2000. Oil and gas companies around the world have changed the way they operate to survive the market realities of the 1990`s. restructuring, outsourcing, and partnering will continue as increasing costs and flat prices squeeze profits. Energy use patterns will change. Fuel and other product specifications will change. Market shares of oil and gas will shift. But opportunities abound in this new market environment. Growing markets always provide opportunities. Technology has helped operators dramatically lower finding, developing, and producing costs. The petroleum age is far from being over. Growing markets, adequate supply, affordable products, and a 60% market share. Those are the signs of an industry with a bright future.

  10. Current strategies for the restoration of adequate lordosis during lumbar fusion

    PubMed Central

    Barrey, Cédric; Darnis, Alice

    2015-01-01

    Not restoring the adequate lumbar lordosis during lumbar fusion surgery may result in mechanical low back pain, sagittal unbalance and adjacent segment degeneration. The objective of this work is to describe the current strategies and concepts for restoration of adequate lordosis during fusion surgery. Theoretical lordosis can be evaluated from the measurement of the pelvic incidence and from the analysis of spatial organization of the lumbar spine with 2/3 of the lordosis given by the L4-S1 segment and 85% by the L3-S1 segment. Technical aspects involve patient positioning on the operating table, release maneuvers, type of instrumentation used (rod, screw-rod connection, interbody cages), surgical sequence and the overall surgical strategy. Spinal osteotomies may be required in case of fixed kyphotic spine. AP combined surgery is particularly efficient in restoring lordosis at L5-S1 level and should be recommended. Finally, not one but several strategies may be used to achieve the need for restoration of adequate lordosis during fusion surgery. PMID:25621216

  11. A test for adequate wastewater treatment based on glutathione S transferase isoenzyme profile.

    PubMed

    Grammou, A; Samaras, P; Papadimitriou, C; Papadopoulos, A I

    2013-04-01

    Discharge to the environment of treated or non-treated municipal wastewater imposes several threats to coastal and estuarine ecosystems which are difficult to assess. In our study we evaluate the use of the isoenzyme profile of glutathione S transferase (GST) in combination with the kinetic characteristics of the whole enzyme and of heme peroxidase, as a test of adequate treatment of municipal wastewater. For this reason, Artemia nauplii were incubated in artificial seawater prepared by wastewater samples, such as secondary municipal effluents produced by a conventional activated sludge unit and advanced treated effluents produced by the employment of coagulation, activated carbon adsorption and chlorination as single processes or as combined ones. Characteristic changes of the isoenzyme pattern and the enzymes' kinetic properties were caused by chlorinated secondary municipal effluent or by secondary non-chlorinated effluent. Advanced treatment by combination of coagulation and/or carbon adsorption resulted to less prominent changes, suggesting more adequate treatment. Our results suggest that GST isoenzyme profile in combination with the kinetic properties of the total enzyme family is a sensitive test for the evaluation of the adequateness of the treatment of reclaimed wastewater and the reduction of potentially harmful compounds. Potentially, it may offer a 'fingerprint' characteristic of a particular effluent and probably of the treatment level it has been subjected.

  12. Cable Diagnostic Focused Initiative

    SciTech Connect

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

    2010-12-30

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

  13. Quantitative analysis of genomic DNA degradation in whole blood under various storage conditions for molecular diagnostic testing.

    PubMed

    Permenter, Jessalyn; Ishwar, Arjun; Rounsavall, Angie; Smith, Maddie; Faske, Jennifer; Sailey, Charles J; Alfaro, Maria P

    2015-12-01

    Proper storage of whole blood is crucial for isolating nucleic acids from leukocytes and to ensure adequate performance of downstream assays in the molecular diagnostic laboratory. Short-term and long-term storage recommendations are lacking for successful isolation of genomic DNA (gDNA). Container type (EDTA or heparin), temperature (4 °C and room temperature) and time (1-130 days) were assessed as criterion for sample acceptance policies. The percentage of integrated area (%Ti) between 150 and 10,000 bp from the 2200 TapeStation electropherogram was calculated to measure gDNA degradation. Refrigerated EDTA samples yielded gDNA with low %Ti (high quality). Heparinized samples stored at room temperature yielded gDNA of worst quality. Downstream analysis demonstrated that the quality of the gDNA correlated with the quality of the data; samples with high %Ti generated significantly lower levels of high molecular weight amplicons. Recommendations from these analyses include storing blood samples intended for nucleic acid isolation in EDTA tubes at 4 °C for long term storage (>10 days). gDNA should be extracted within 3 days when blood is stored at room temperature regardless of the container. Finally, refrigerated heparinized samples should not be stored longer than 9 days if expecting high quality gDNA isolates. Laboratories should consider many factors, in addition to the results obtained herein, to update their policies for sample acceptance for gDNA extraction intended for molecular genetic testing.

  14. Communication skills in diagnostic pathology.

    PubMed

    Lehr, Hans-Anton; Bosman, Fred T

    2016-01-01

    Communication is an essential element of good medical practice also in pathology. In contrast to technical or diagnostic skills, communication skills are not easy to define, teach, or assess. Rules almost do not exist. In this paper, which has a rather personal character and cannot be taken as a set of guidelines, important aspects of communication in pathology are explored. This includes what should be communicated to the pathologist on the pathology request form, communication between pathologists during internal (interpathologist) consultation, communication around frozen section diagnoses, modalities of communication of a final diagnosis, with whom and how critical and unexpected findings should be communicated, (in-)adequate routes of communication for pathology diagnoses, who will (or might) receive pathology reports, and what should be communicated and how in case of an error or a technical problem. An earlier more formal description of what the responsibilities are of a pathologist as communicator and as collaborator in a medical team is added in separate tables. The intention of the paper is to stimulate reflection and discussion rather than to formulate strict rules.

  15. Diagnostic workup for ARDS patients.

    PubMed

    Papazian, Laurent; Calfee, Carolyn S; Chiumello, Davide; Luyt, Charles-Edouard; Meyer, Nuala J; Sekiguchi, Hiroshi; Matthay, Michael A; Meduri, Gianfranco Umberto

    2016-05-01

    Acute respiratory distress syndrome (ARDS) is defined by the association of bilateral infiltrates and hypoxaemia following an initial insult. Although a new definition has been recently proposed (Berlin definition), there are various forms of ARDS with potential differences regarding their management (ventilator settings, prone positioning use, corticosteroids). ARDS can be caused by various aetiologies, and the adequate treatment of the responsible cause is crucial to improve the outcome. It is of paramount importance to characterize the mechanisms causing lung injury to optimize both the aetiological treatment and the symptomatic treatment. If there is no obvious cause of ARDS or if a direct lung injury is suspected, bronchoalveolar lavage (BAL) should be strongly considered to identify microorganisms responsible for pneumonia. Blood samples can also help to identify microorganisms and to evaluate biomarkers of infection. If there is no infectious cause of ARDS or no other apparent aetiology is found, second-line examinations should include markers of immunologic diseases. In selected cases, open lung biopsy remains useful to identify the cause of ARDS when all other examinations remain inconclusive. CT scan is fundamental when there is a suspicion of intra-abdominal sepsis and in some cases of pneumonia. Ultrasonography is important not only in evaluating biventricular function but also in identifying pleural effusions and pneumothorax. The definition of ARDS remains clinical and the main objective of the diagnostic workup should be to be focused on identification of its aetiology, especially a treatable infection.

  16. Radioactive diagnostic agent

    SciTech Connect

    Shigematsu, A.; Aihara, M.; Matsuda, M.; Suzuki, A.; Tsuya, A.

    1984-02-07

    A radioactive diagnostic agent for renal cortex, adrenal cortex, myocardium, brain stem, spinal nerve, etc., which comprises as an essential component monoiodoacetic acid wherein the iodine atom is radioactive.

  17. Fermilab recycler diagnostics

    SciTech Connect

    Martin Hu

    2001-07-24

    The Fermilab Recycler Ring is a permanent magnet storage ring for the storage and cooling of antiprotons. The following note describes the diagnostic tools currently available for commissioning, as well as the improvements and upgrades planned for the near future.

  18. Barriers and facilitators to the introduction of digital pathology for diagnostic work.

    PubMed

    Randell, Rebecca; Ruddle, Roy A; Treanor, Darren

    2015-01-01

    Cellular pathologists are doctors who diagnose disease by using a microscope to examine glass slides containing thin sections of human tissue. These slides can be digitised and viewed on a computer, promising benefits in both efficiency and safety. Despite this, uptake of digital pathology for diagnostic work has been slow, with use largely restricted to second opinions, education, and external quality assessment schemes. To understand the barriers and facilitators to the introduction of digital pathology, we have undertaken an interview study with nine consultant pathologists. Interviewees were able to identify a range of potential benefits of digital pathology, with a particular emphasis on easier access to slides. Amongst the barriers to use, a key concern was lack of familiarity, not only in terms of becoming familiar with the technology but learning how to adjust their diagnostic skills to this new medium. The findings emphasise the need to ensure adequate training and support and the potential benefit of allowing parallel use of glass slides and digital while pathologists are on the learning curve.

  19. Principles of plasma diagnostics

    NASA Astrophysics Data System (ADS)

    Hutchinson, Ian H.

    The physical principles, techniques, and instrumentation of plasma diagnostics are examined in an introduction and reference work for students and practicing scientists. Topics addressed include basic plasma properties, magnetic diagnostics, plasma particle flux, and refractive-index measurements. Consideration is given to EM emission by free and bound electrons, the scattering of EM radiation, and ion processes. Diagrams, drawings, graphs, sample problems, and a glossary of symbols are provided.

  20. Laser fluorescence diagnostics

    NASA Astrophysics Data System (ADS)

    Kozlov, V. K.; Krasilnikov, D. M.; Turkin, V. V.

    1995-01-01

    This paper descsribes the development of an apparatus, method, and practical recommendation on using fluorescence diagnostics in alimentary-intestinal tract surgery and analyses of blood serum and plasma for investigating influence of various drug preparations on a human organism. The report of the firm Israel Aircraft Industries on the high efficiency of using fluorescent analysis in early diagnostics of rectum, lung, and breast cancer has stimulated our publication.

  1. Are the current Australian sun exposure guidelines effective in maintaining adequate levels of 25-hydroxyvitamin D?

    PubMed

    Kimlin, Michael; Sun, Jiandong; Sinclair, Craig; Heward, Sue; Hill, Jane; Dunstone, Kimberley; Brodie, Alison

    2016-01-01

    An adequate vitamin D status, as measured by serum 25-hydroxyvitamin D (25(OH)D) concentration, is important in humans for maintenance of healthy bones and muscle function. Serum 25(OH)D concentration was assessed in participants from Melbourne, Australia (37.81S, 144.96E), who were provided with the current Australian guidelines on sun exposure for 25(OH)D adequacy (25(OH)D ≥50 nmol/L). Participants were interviewed in February (summer, n=104) and August (winter, n=99) of 2013. Serum 25(OH)D concentration was examined as a function of measures of sun exposure and sun protection habits with control of key characteristics such as dietary intake of vitamin D, body mass index (BMI) and skin colour, that may modify this relationship. The mean 25(OH)D concentration in participants who complied with the current sun exposure guidelines was 67.3 nmol/L in summer and 41.9 nmol/L in winter. At the end of the study, 69.3% of participants who complied with the summer sun exposure guidelines were 25(OH)D adequate, while only 27.6% of participants who complied with the winter sun exposure guidelines were 25(OH)D adequate at the end of the study. The results suggest that the current Australian guidelines for sun exposure for 25(OH)D adequacy are effective for most in summer and ineffective for most in winter. This article is part of a Special Issue entitled '17th Vitamin D Workshop'.

  2. Adequate Iodine Status in New Zealand School Children Post-Fortification of Bread with Iodised Salt

    PubMed Central

    Jones, Emma; McLean, Rachael; Davies, Briar; Hawkins, Rochelle; Meiklejohn, Eva; Ma, Zheng Feei; Skeaff, Sheila

    2016-01-01

    Iodine deficiency re-emerged in New Zealand in the 1990s, prompting the mandatory fortification of bread with iodised salt from 2009. This study aimed to determine the iodine status of New Zealand children when the fortification of bread was well established. A cross-sectional survey of children aged 8–10 years was conducted in the cities of Auckland and Christchurch, New Zealand, from March to May 2015. Children provided a spot urine sample for the determination of urinary iodine concentration (UIC), a fingerpick blood sample for Thyroglobulin (Tg) concentration, and completed a questionnaire ascertaining socio-demographic information that also included an iodine-specific food frequency questionnaire (FFQ). The FFQ was used to estimate iodine intake from all main food sources including bread and iodised salt. The median UIC for all children (n = 415) was 116 μg/L (females 106 μg/L, males 131 μg/L) indicative of adequate iodine status according to the World Health Organisation (WHO, i.e., median UIC of 100–199 μg/L). The median Tg concentration was 8.7 μg/L, which was <10 μg/L confirming adequate iodine status. There was a significant difference in UIC by sex (p = 0.001) and ethnicity (p = 0.006). The mean iodine intake from the food-only model was 65 μg/day. Bread contributed 51% of total iodine intake in the food-only model, providing a mean iodine intake of 35 μg/day. The mean iodine intake from the food-plus-iodised salt model was 101 μg/day. In conclusion, the results of this study confirm that the iodine status in New Zealand school children is now adequate. PMID:27196925

  3. The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems

    PubMed Central

    Welcome, Menizibeya Osain

    2011-01-01

    Objectives: As an important element of national security, public health not only functions to provide adequate and timely medical care but also track, monitor, and control disease outbreak. The Nigerian health care had suffered several infectious disease outbreaks year after year. Hence, there is need to tackle the problem. This study aims to review the state of the Nigerian health care system and to provide possible recommendations to the worsening state of health care in the country. To give up-to-date recommendations for the Nigerian health care system, this study also aims at reviewing the dynamics of health care in the United States, Britain, and Europe with regards to methods of medical intelligence/surveillance. Materials and Methods: Databases were searched for relevant literatures using the following keywords: Nigerian health care, Nigerian health care system, and Nigerian primary health care system. Additional keywords used in the search were as follows: United States (OR Europe) health care dynamics, Medical Intelligence, Medical Intelligence systems, Public health surveillance systems, Nigerian medical intelligence, Nigerian surveillance systems, and Nigerian health information system. Literatures were searched in scientific databases Pubmed and African Journals OnLine. Internet searches were based on Google and Search Nigeria. Results: Medical intelligence and surveillance represent a very useful component in the health care system and control diseases outbreak, bioattack, etc. There is increasing role of automated-based medical intelligence and surveillance systems, in addition to the traditional manual pattern of document retrieval in advanced medical setting such as those in western and European countries. Conclusion: The Nigerian health care system is poorly developed. No adequate and functional surveillance systems are developed. To achieve success in health care in this modern era, a system well grounded in routine surveillance and medical

  4. Nebulized antibiotics. An adequate option for treating ventilator-associated respiratory infection?

    PubMed

    Rodríguez, A; Barcenilla, F

    2015-03-01

    Ventilator-associated tracheobronchitis (VAT) is a frequent complication in critical patients. The 90% of those who develop it receive broad-spectrum antibiotic (ATB) treatment, without any strong evidence of its favorable impact. The use of nebulized ATB could be a valid treatment option, to reduce the use of systemic ATB and the pressure of selection on the local flora. Several studies suggest that an adequate nebulization technique can ensure high levels of ATB even in areas of lung consolidation, and to obtain clinical and microbiological cure. New studies are needed to properly assess the impact of treatment with nebulized ATB on the emergence of resistance.

  5. Computer synthesis of human motion as a part of an adequate motion analysis experiment

    NASA Astrophysics Data System (ADS)

    Ivanov, Alexandre A.; Sholukha, Victor A.; Zinkovsky, Anatoly V.

    1999-05-01

    The role of problem of computer synthesis of a human motion for a traditional problem of control generalized and muscular forces determination is discussed. It is emphasized significance of computer model choice for adequate analysis kinematic and dynamic experimental data. On the basis of an imitation computer model influence of model's parameters values is demonstrated. With help of non-stationary constraints we can simulate human motions that satisfy to the most significant parameters of the concerned class of motion. Some results of simulation are discussed. We arrive at a conclusion that for correct interpretation of an experiment mixed problem of bodies system dynamics must be solved.

  6. Practical Diagnostics for Evaluating Residential Commissioning Metrics

    SciTech Connect

    Wray, Craig; Walker, Iain; Siegel, Jeff; Sherman, Max

    2002-06-11

    In this report, we identify and describe 24 practical diagnostics that are ready now to evaluate residential commissioning metrics, and that we expect to include in the commissioning guide. Our discussion in the main body of this report is limited to existing diagnostics in areas of particular concern with significant interactions: envelope and HVAC systems. These areas include insulation quality, windows, airtightness, envelope moisture, fan and duct system airflows, duct leakage, cooling equipment charge, and combustion appliance backdrafting with spillage. Appendix C describes the 83 other diagnostics that we have examined in the course of this project, but that are not ready or are inappropriate for residential commissioning. Combined with Appendix B, Table 1 in the main body of the report summarizes the advantages and disadvantages of all 107 diagnostics. We first describe what residential commissioning is, its characteristic elements, and how one might structure its process. Our intent in this discussion is to formulate and clarify these issues, but is largely preliminary because such a practice does not yet exist. Subsequent sections of the report describe metrics one can use in residential commissioning, along with the consolidated set of 24 practical diagnostics that the building industry can use now to evaluate them. Where possible, we also discuss the accuracy and usability of diagnostics, based on recent laboratory work and field studies by LBNL staff and others in more than 100 houses. These studies concentrate on evaluating diagnostics in the following four areas: the DeltaQ duct leakage test, air-handler airflow tests, supply and return grille airflow tests, and refrigerant charge tests. Appendix A describes those efforts in detail. In addition, where possible, we identify the costs to purchase diagnostic equipment and the amount of time required to conduct the diagnostics. Table 1 summarizes these data. Individual equipment costs for the 24

  7. [Quality in ambulatory medicine].

    PubMed

    Raetzo, M A

    2001-11-01

    The perspectives of the insurance companies, medical associations and practitioners about quality in outpatient care are different. After a brief discussion of each of these views, a proposal for quality improvement through continuous medical education is presented. It applies to the doctor-patient relationship, the diagnostic and therapeutic strategies and the handling of uncertainty. Practically, simulations can help the physicians to understand the theory behind continuous quality improvement and apply it to the process of outpatient care.

  8. Comparison of the quality of smears in transbronchial fine-needle aspirates using two staining methods for rapid on-site evaluation.

    PubMed

    Louw, Mercia; Brundyn, Karen; Schubert, Pawel T; Wright, Colleen A; Bolliger, Chris T; Diacon, Andreas H

    2012-09-01

    Transbronchial needle aspiration (TBNA) via flexible bronchoscopy is a well-established sampling modality for lung masses. The procedure is useful in the diagnosis of neoplastic and non-neoplastic lesions as well as for staging of bronchogenic carcinoma. Rapid on-site evaluation (ROSE) adds value as it has the advantage of triaging material during the procedure so avoiding a battery of investigations. Frequently used rapid stains are the modified Wright-Giemsa water-based stain (WG-ROSE) and the alcohol-based modified Papanicolaou stain (Pap-ROSE). Final review of laboratory-based Giemsa and Pap stains supplemented by ancillary investigations is essential for quality assurance. To investigate whether and how ROSE influenced the quantity and quality of the material submitted to the laboratory we randomized 126 patients to WG-ROSE, requiring only one pathologist on-site, or combined WG- and Pap-ROSE, requiring an additional person on-site to assist with staining. In those patients with positive TBNA we graded the laboratory-based slides of the first pass containing diagnostic material into insufficient, suspicious, adequate and excellent. The first diagnostic pass was found after 3.06 ± 1.94 (SD) passes and 3.13 ± 2.16 passes with WG-ROSE and combined ROSE (P = 0.87), respectively. Following WG-ROSE and combined ROSE 69% and 71.1% (P = 0.509) of slides were diagnostic (adequate or excellent) on laboratory-based Giemsa stains, and 93.3% and 100% (P = 0.134) were scored adequate or excellent on laboratory-based Pap stains. We concluded that the less costly and labour intensive WG-ROSE procedure is adequate for TBNA. This has cost implications especially in resource poor settings.

  9. [Incidence of primary malignant lesions in clinically benign teratoma: on the problem of adequate surgical procedure].

    PubMed

    Kindermann, G; Jung, E M; Maassen, V; Bise, K

    1996-08-01

    The Problem of an Adequate Surgical Approach: Frequency of malignant teratomas is, according to the literature, 2%-10%. Examining 194 own cases (1983-1993) it was 1.5%. We found one squamous cell carcinoma (0.5%). Additionally we found 2 immature teratomas (1%). We point out the different biological behaviour of malignant mature teratomas and immature teratomas. We agree with the majority of authors that the method of choice is the intact removal of all teratomas without iatrogen rupture or contamination of the abdominal cavity by contents of the teratoma. This adequate surgical procedure can and should be performed by laparotomy or laparoscopy with endobag. The often practised method of cutting open the cyst during laparoscopy, sucking off the contents or cutting the teratoma into pieces, has been proven to lead to implantation and worsening the prognosis in case of a malignant teratoma. Even the rinsing of the abdominal cavity, usually carried out with this method, could not compensate always for the disadvantage of this "dirty" endoscopical method compared with usual oncological standards. This is pointed out by case reports in the literature and the first analysis of a German survey with early-follow-up of 192 laparoscopically managed ovarian malignancies [11a]. The principle of intact removal of every teratoma should again be kept in mind.

  10. MRI can determine the adequate area for debridement in the case of Fournier's gangrene.

    PubMed

    Yoneda, Akira; Fujita, Fumihiko; Tokai, Hirotaka; Ito, Yuichiro; Haraguchi, Masashi; Tajima, Yoshitsugu; Kanematsu, Takashi

    2010-01-01

    A 57-year-old man was transferred to our hospital because of gluteal pain. His right buttock had flare and swelling. Complete blood count showed leukocytosis, and renal failure was evident. Pelvic computed tomography (CT) revealed that the abscess, including gas, was widespread into the hypodermal tissue of the right buttock. Fournier's gangrene had been suspected, and immediate drainage was performed on the right buttock. The symptom and the condition improved rapidly, but on the day after the operation, the patient became drowsy and fell into endotoxic shock. Magnetic resonance imaging (MRI) revealed strong inflammation along the entire fascia of the right femur and necrotizing fasciitis. MRI was very useful for identification of the necrotic range. Immediately, an emergency operation was performed; 3 wide incisions were made on the right thigh and crus for drainage. The patient was cared for intensively under a sedated condition, and irrigation and debridement were repeated every day. Culture of the pus revealed mixed infection of Escherichia coli and anaerobic bacteria, and a large quantity of antimicrobial drug was used. The inflammatory reaction decreased, and the patient's general condition tentatively improved. With Fournier's gangrene, initiating adequate surgical and medical treatment is essential. Therefore, MRI should be used in the early exact diagnosis of this disease to obtain knowledge of the extent of necrosis and to determine the adequate area for debridement.

  11. Duration of Pulmonary Tuberculosis Infectiousness under Adequate Therapy, as Assessed Using Induced Sputum Samples

    PubMed Central

    Ko, Yousang; Shin, Jeong Hwan; Lee, Hyun-Kyung; Lee, Young Seok; Lee, Suh-Young; Park, So Young; Mo, Eun-Kyung; Kim, Changhwan

    2017-01-01

    Background A sputum culture is the most reliable indicator of the infectiousness of pulmonary tuberculosis (PTB); however, a spontaneous sputum specimen may not be suitable. The aim of this study was to evaluate the infectious period in patients with non–drug-resistant (DR) PTB receiving adequate standard chemotherapy, using induced sputum (IS) specimens. Methods We evaluated the duration of infectiousness of PTB using a retrospective cohort design. Results Among the 35 patients with PTB, 22 were smear-positive. The rates of IS culture positivity from baseline to the sixth week of anti-tuberculosis medication in the smear-positive PTB group were 100%, 100%, 91%, 73%, 36%, and 18%, respectively. For smear-positive PTB cases, the median time of conversion to culture negativity was 35.0 days (range, 28.0–42.0 days). In the smear-negative PTB group (n=13), the weekly rates of positive IS culture were 100%, 77%, 39%, 8%, 0%, and 0%, respectively, and the median time to conversion to culture-negative was 21.0 days (range, 17.5–28.0 days). Conclusion The infectiousness of PTB, under adequate therapy, may persist longer than previously reported, even in patients with non-DR PTB. PMID:28119744

  12. Narita Target Heart Rate Equation Underestimates the Predicted Adequate Exercise Level in Sedentary Young Boys

    PubMed Central

    Siahkouhian, Marefat; Khodadadi, Davar

    2013-01-01

    Purpose Optimal training intensity and the adequate exercise level for physical fitness is one of the most important interests of coaches and sports physiologists. The aim of this study was to investigate the validity of the Narita et al target heart rate equation for the adequate exercise training level in sedentary young boys. Methods Forty two sedentary young boys (19.07±1.16 years) undertook a blood lactate transition threshold maximal treadmill test to volitional exhaustion with continuous respiratory gas measurements according to the Craig method. The anaerobic threshold (AT) of the participants then was calculated using the Narita target heart rate equation. Results Hopkin's spreadsheet to obtain confidence limit and the chance of the true difference between gas measurements and Narita target heart rate equation revealed that the Narita equation most likely underestimates the measured anaerobic threshold in sedentary young boys (168.76±15 vs. 130.08±14.36) (Difference ±90% confidence limit: 38.1±18). Intraclass correlation coefficient (ICC) showed a poor agreement between the criterion method and Narita equation (ICC= 0.03). Conclusion According to the results, the Narita equation underestimates the measured AT. It seems that the Narita equation is a good predictor of aerobic not AT which can be investigated in the future studies. PMID:24427475

  13. Maintaining Adequate CO2 Washout for an Advanced EMU via a New Rapid Cycle Amine Technology

    NASA Technical Reports Server (NTRS)

    Chullen, Cinda; Conger, Bruce

    2012-01-01

    Over the past several years, NASA has realized tremendous progress in Extravehicular Activity (EVA) technology development. This has been evidenced by the progressive development of a new Rapid Cycle Amine (RCA) system for the Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support Subsystem (PLSS). The PLSS is responsible for the life support of the crew member in the spacesuit. The RCA technology is responsible for carbon dioxide (CO2) and humidity control. Another aspect of the RCA is that it is on-back vacuum-regenerable, efficient, and reliable. The RCA also simplifies the PLSS schematic by eliminating the need for a condensing heat exchanger for humidity control in the current EMU. As development progresses on the RCA, it is important that the sizing be optimized so that the demand on the PLSS battery is minimized. As well, maintaining the CO2 washout at adequate levels during an EVA is an absolute requirement of the RCA and associated ventilation system. Testing has been underway in-house at NASA Johnson Space Center and analysis has been initiated to evaluate whether the technology provides exemplary performance in ensuring that the CO2 is removed sufficiently and the ventilation flow is adequate for maintaining CO2 washout in the AEMU spacesuit helmet of the crew member during an EVA. This paper will review the recent developments of the RCA unit, testing planned in-house with a spacesuit simulator, and the associated analytical work along with insights from the medical aspect on the testing. 1

  14. [Genetic diagnostic testing in inherited retinal dystrophies].

    PubMed

    Kohl, S; Biskup, S

    2013-03-01

    Inherited retinal dystrophies are clinically and genetically highly heterogeneous. They can be divided according to the clinical phenotype and course of the disease, as well as the underlying mode of inheritance. Isolated retinal dystrophies (i.e., retinitis pigmentosa, Leber's congenital amaurosis, cone and cone-rod dystrophy, macular dystrophy, achromatopsia, congenital stationary nightblindness) and syndromal forms (i.e., Usher syndrome, Bardet-Biedl syndrome) can be differentiated. To date almost 180 genes and thousands of distinct mutations have been identified that are responsible for the different forms of these blinding illnesses. Until recently, there was no adequate diagnostic genetic testing available. With the development of the next generation sequencing technologies, a comprehensive genetic screening analysis for all known genes for inherited retinal dystrophies has been established at reasonable costs and in appropriate turn-around times. Depending on the primary clinical diagnosis and the presumed mode of inheritance, different diagnostic panels can be chosen for genetic testing. Statistics show that in 55-80 % of the cases the genetic defect of the inherited retinal dystrophy can be identified with this approach, depending on the initial clinical diagnosis. The aim of any genetic diagnostics is to define the genetic cause of a given illness within the affected patient and family and thereby i) confirm the clinical diagnosis, ii) provide targeted genetic testing in family members, iii) enable therapeutic intervention, iv) give a prognosis on disease course and progression and v) in the long run provide the basis for novel therapeutic approaches and personalised medicine.

  15. Multi-Reader Multi-Case Studies Using the Area under the Receiver Operator Characteristic Curve as a Measure of Diagnostic Accuracy: Systematic Review with a Focus on Quality of Data Reporting

    PubMed Central

    Dendumrongsup, Thaworn; Plumb, Andrew A.; Halligan, Steve; Fanshawe, Thomas R.; Altman, Douglas G.; Mallett, Susan

    2014-01-01

    Introduction We examined the design, analysis and reporting in multi-reader multi-case (MRMC) research studies using the area under the receiver-operating curve (ROC AUC) as a measure of diagnostic performance. Methods We performed a systematic literature review from 2005 to 2013 inclusive to identify a minimum 50 studies. Articles of diagnostic test accuracy in humans were identified via their citation of key methodological articles dealing with MRMC ROC AUC. Two researchers in consensus then extracted information from primary articles relating to study characteristics and design, methods for reporting study outcomes, model fitting, model assumptions, presentation of results, and interpretation of findings. Results were summarized and presented with a descriptive analysis. Results Sixty-four full papers were retrieved from 475 identified citations and ultimately 49 articles describing 51 studies were reviewed and extracted. Radiological imaging was the index test in all. Most studies focused on lesion detection vs. characterization and used less than 10 readers. Only 6 (12%) studies trained readers in advance to use the confidence scale used to build the ROC curve. Overall, description of confidence scores, the ROC curve and its analysis was often incomplete. For example, 21 (41%) studies presented no ROC curve and only 3 (6%) described the distribution of confidence scores. Of 30 studies presenting curves, only 4 (13%) presented the data points underlying the curve, thereby allowing assessment of extrapolation. The mean change in AUC was 0.05 (−0.05 to 0.28). Non-significant change in AUC was attributed to underpowering rather than the diagnostic test failing to improve diagnostic accuracy. Conclusions Data reporting in MRMC studies using ROC AUC as an outcome measure is frequently incomplete, hampering understanding of methods and the reliability of results and study conclusions. Authors using this analysis should be encouraged to provide a full description of

  16. Medical diagnostic applications and sources.

    PubMed

    Whittingham, T A

    2007-01-01

    The ways in which ultrasound is used in medical diagnosis are reviewed, with particular emphasis on the ultrasound source (probe) and implications for acoustic exposure. A brief discussion of the choice of optimum frequency for various target depths is followed by a description of the general features of diagnostic ultrasound probes, including endo-probes. The different modes of diagnostic scanning are then discussed in turn: A-mode, M-mode, B-mode, three-dimensional (3D) and 4D scanning, continuous wave (CW) Doppler, pulse-wave spectral Doppler and Doppler imaging. Under the general heading of B-mode imaging, there are individual descriptions of the principles of chirps and binary codes, B-flow, tissue harmonic imaging and ultrasound contrast agent-specific techniques. Techniques for improving image quality within the constraints of real-time operation are discussed, including write zoom, parallel beam forming, spatial compounding and multiple zone transmission focusing, along with methods for reducing slice thickness. At the end of each section there is a summarising comment on the basic features of the acoustic output and its consequences for patient safety.

  17. Revisiting Tversky's diagnosticity principle

    PubMed Central

    Evers, Ellen R. K.; Lakens, Daniël

    2013-01-01

    Similarity is a fundamental concept in cognition. In 1977, Amos Tversky published a highly influential feature-based model of how people judge the similarity between objects. The model highlights the context-dependence of similarity judgments, and challenged geometric models of similarity. One of the context-dependent effects Tversky describes is the diagnosticity principle. The diagnosticity principle determines which features are used to cluster multiple objects into subgroups. Perceived similarity between items within clusters is expected to increase, while similarity between items in different clusters decreases. Here, we present two pre-registered replications of the studies on the diagnosticity effect reported in Tversky (1977). Additionally, one alternative mechanism that has been proposed to play a role in the original studies, an increase in the choice for distractor items (a substitution effect, see Medin et al., 1995), is examined. Our results replicate those found by Tversky (1977), revealing an average diagnosticity-effect of 4.75%. However, when we eliminate the possibility of substitution effects confounding the results, a meta-analysis of the data provides no indication of any remaining effect of diagnosticity. PMID:25161638

  18. Development of companion diagnostics

    SciTech Connect

    Mankoff, David A.; Edmonds, Christine E.; Farwell, Michael D.; Pryma, Daniel A.

    2015-12-12

    The goal of individualized and targeted treatment and precision medicine requires the assessment of potential therapeutic targets to direct treatment selection. The biomarkers used to direct precision medicine, often termed companion diagnostics, for highly targeted drugs have thus far been almost entirely based on in vitro assay of biopsy material. Molecular imaging companion diagnostics offer a number of features complementary to those from in vitro assay, including the ability to measure the heterogeneity of each patient’s cancer across the entire disease burden and to measure early changes in response to treatment. We discuss the use of molecular imaging methods as companion diagnostics for cancer therapy with the goal of predicting response to targeted therapy and measuring early (pharmacodynamic) response as an indication of whether the treatment has “hit” the target. We also discuss considerations for probe development for molecular imaging companion diagnostics, including both small-molecule probes and larger molecules such as labeled antibodies and related constructs. We then describe two examples where both predictive and pharmacodynamic molecular imaging markers have been tested in humans: endocrine therapy for breast cancer and human epidermal growth factor receptor type 2–targeted therapy. Lastly, the review closes with a summary of the items needed to move molecular imaging companion diagnostics from early studies into multicenter trials and into the clinic.

  19. Development of companion diagnostics

    DOE PAGES

    Mankoff, David A.; Edmonds, Christine E.; Farwell, Michael D.; ...

    2015-12-12

    The goal of individualized and targeted treatment and precision medicine requires the assessment of potential therapeutic targets to direct treatment selection. The biomarkers used to direct precision medicine, often termed companion diagnostics, for highly targeted drugs have thus far been almost entirely based on in vitro assay of biopsy material. Molecular imaging companion diagnostics offer a number of features complementary to those from in vitro assay, including the ability to measure the heterogeneity of each patient’s cancer across the entire disease burden and to measure early changes in response to treatment. We discuss the use of molecular imaging methods asmore » companion diagnostics for cancer therapy with the goal of predicting response to targeted therapy and measuring early (pharmacodynamic) response as an indication of whether the treatment has “hit” the target. We also discuss considerations for probe development for molecular imaging companion diagnostics, including both small-molecule probes and larger molecules such as labeled antibodies and related constructs. We then describe two examples where both predictive and pharmacodynamic molecular imaging markers have been tested in humans: endocrine therapy for breast cancer and human epidermal growth factor receptor type 2–targeted therapy. Lastly, the review closes with a summary of the items needed to move molecular imaging companion diagnostics from early studies into multicenter trials and into the clinic.« less

  20. Development of Companion Diagnostics.

    PubMed

    Mankoff, David A; Edmonds, Christine E; Farwell, Michael D; Pryma, Daniel A

    2016-01-01

    The goal of individualized and targeted treatment and precision medicine requires the assessment of potential therapeutic targets to direct treatment selection. The biomarkers used to direct precision medicine, often termed companion diagnostics, for highly targeted drugs have thus far been almost entirely based on in vitro assay of biopsy material. Molecular imaging companion diagnostics offer a number of features complementary to those from in vitro assay, including the ability to measure the heterogeneity of each patient's cancer across the entire disease burden and to measure early changes in response to treatment. We discuss the use of molecular imaging methods as companion diagnostics for cancer therapy with the goal of predicting response to targeted therapy and measuring early (pharmacodynamic) response as an indication of whether the treatment has "hit" the target. We also discuss considerations for probe development for molecular imaging companion diagnostics, including both small-molecule probes and larger molecules such as labeled antibodies and related constructs. We then describe two examples where both predictive and pharmacodynamic molecular imaging markers have been tested in humans: endocrine therapy for breast cancer and human epidermal growth factor receptor type 2-targeted therapy. The review closes with a summary of the items needed to move molecular imaging companion diagnostics from early studies into multicenter trials and into the clinic.

  1. MJO Simulation Diagnostics

    SciTech Connect

    Waliser, D; Sperber, K; Hendon, H; Kim, D; Maloney, E; Wheeler, M; Weickmann, K; Zhang, C; Donner, L; Gottschalck, J; Higgins, W; Kang, I; Legler, D; Moncrieff, M; Schubert, S; Stern, W; Vitart, F; Wang, B; Wang, W; Woolnough, S

    2008-06-02

    The Madden-Julian Oscillation (MJO) interacts with, and influences, a wide range of weather and climate phenomena (e.g., monsoons, ENSO, tropical storms, mid-latitude weather), and represents an important, and as yet unexploited, source of predictability at the subseasonal time scale. Despite the important role of the MJO in our climate and weather systems, current global circulation models (GCMs) exhibit considerable shortcomings in representing this phenomenon. These shortcomings have been documented in a number of multi-model comparison studies over the last decade. However, diagnosis of model performance has been challenging, and model progress has been difficult to track, due to the lack of a coherent and standardized set of MJO diagnostics. One of the chief objectives of the US CLIVAR MJO Working Group is the development of observation-based diagnostics for objectively evaluating global model simulations of the MJO in a consistent framework. Motivation for this activity is reviewed, and the intent and justification for a set of diagnostics is provided, along with specification for their calculation, and illustrations of their application. The diagnostics range from relatively simple analyses of variance and correlation, to more sophisticated space-time spectral and empirical orthogonal function analyses. These diagnostic techniques are used to detect MJO signals, to construct composite life-cycles, to identify associations of MJO activity with the mean state, and to describe interannual variability of the MJO.

  2. Automated quality assessment in three-dimensional breast ultrasound images.

    PubMed

    Schwaab, Julia; Diez, Yago; Oliver, Arnau; Martí, Robert; van Zelst, Jan; Gubern-Mérida, Albert; Mourri, Ahmed Bensouda; Gregori, Johannes; Günther, Matthias

    2016-04-01

    Automated three-dimensional breast ultrasound (ABUS) is a valuable adjunct to x-ray mammography for breast cancer screening of women with dense breasts. High image quality is essential for proper diagnostics and computer-aided detection. We propose an automated image quality assessment system for ABUS images that detects artifacts at the time of acquisition. Therefore, we study three aspects that can corrupt ABUS images: the nipple position relative to the rest of the breast, the shadow caused by the nipple, and the shape of the breast contour on the image. Image processing and machine learning algorithms are combined to detect these artifacts based on 368 clinical ABUS images that have been rated manually by two experienced clinicians. At a specificity of 0.99, 55% of the images that were rated as low quality are detected by the proposed algorithms. The areas under the ROC curves of the single classifiers are 0.99 for the nipple position, 0.84 for the nipple shadow, and 0.89 for the breast contour shape. The proposed algorithms work fast and reliably, which makes them adequate for online evaluation of image quality during acquisition. The presented concept may be extended to further image modalities and quality aspects.

  3. Healthcare Costs Associated with an Adequate Intake of Sugars, Salt and Saturated Fat in Germany: A Health Econometrical Analysis.

    PubMed

    Meier, Toni; Senftleben, Karolin; Deumelandt, Peter; Christen, Olaf; Riedel, Katja; Langer, Martin

    2015-01-01

    Non-communicable diseases (NCDs) represent not only the major driver for quality-restricted and lost life years; NCDs and their related medical treatment costs also pose a substantial economic burden on healthcare and intra-generational tax distribution systems. The main objective of this study was therefore to quantify the economic burden of unbalanced nutrition in Germany--in particular the effects of an excessive consumption of fat, salt and sugar--and to examine different reduction scenarios on this basis. In this study, the avoidable direct cost savings in the German healthcare system attributable to an adequate intake of saturated fatty acids (SFA), salt and sugar (mono- & disaccharides, MDS) were calculated. To this end, disease-specific healthcare cost data from the official Federal Health Monitoring for the years 2002-2008 and disease-related risk factors, obtained by thoroughly searching the literature, were used. A total of 22 clinical endpoints with 48 risk-outcome pairs were considered. Direct healthcare costs attributable to an unbalanced intake of fat, salt and sugar are calculated to be 16.8 billion EUR (CI95%: 6.3-24.1 billion EUR) in the year 2008, which represents 7% (CI95% 2%-10%) of the total treatment costs in Germany (254 billion EUR). This is equal to 205 EUR per person annually. The excessive consumption of sugar poses the highest burden, at 8.6 billion EUR (CI95%: 3.0-12.1); salt ranks 2nd at 5.3 billion EUR (CI95%: 3.2-7.3) and saturated fat ranks 3rd at 2.9 billion EUR (CI95%: 32 million-4.7 billion). Predicted direct healthcare cost savings by means of a balanced intake of sugars, salt and saturated fat are substantial. However, as this study solely considered direct medical treatment costs regarding an adequate consumption of fat, salt and sugars, the actual societal and economic gains, resulting both from direct and indirect cost savings, may easily exceed 16.8 billion EUR.

  4. Beamlet laser diagnostics

    SciTech Connect

    Burkhart, S.C.; Behrendt, W.C.; Smith, I.

    1996-06-01

    Beamlet is instrumented extensively to monitor the performance of the overall laser system and many of its subsystems. Beam diagnostics, installed in key locations, are used to fully characterize the beam during its propagation through the multipass cavity and the laser`s output section. This article describes the diagnostics stations located on Beamlet and discusses the design, calibration, and performance of the Beamlet calorimeters. The authors used Nova`s diagnostics packages to develop the Beamlet design to determine beam energy, spatial profile, temporal profile, and other beam parameters. Technologic improvements within the last several years in controls, charge-coupled device (CCD) cameras, and fast oscilloscopes have allowed the authors to obtain more accurate measurements on the Beamlet laser system. They briefly cover some of these techniques, including a description of their LabVIEW based data acquisition system.

  5. [Peripheral neuropathies: Diagnostic strategy].

    PubMed

    Magy, L

    2017-02-28

    Diagnosing a peripheral neuropathy is sometimes challenging, as the causes are diverse and the clinical pictures heterogeneous. Overall, diagnosing a patient with peripheral neuropathy will require some knowledge in almost every field of medicine. Therefore, it appears crucial to adopt a diagnostic strategy that is based on solid clinical and neurophysiological grounds. The present paper describes a three-step diagnostic strategy: (1) to delineate a clinico-pathologic entity from clinical and electrodiagnostic findings; (2) to propose a list of plausible causes based on step one, history and clinical context; (3) to use appropriate workup in order to determine the cause or mechanism of the neuropathy. The three steps of this diagnostic strategy necessitate a high level of expertise and interaction between physicians is highly desirable. Finally, an aggressive course and a severe impairment should lead to relentlessly look for a curable cause.

  6. [Molecular diagnostics in pathology].

    PubMed

    Stenzinger, A; Penzel, R; Endris, V; Weichert, W

    2013-05-01

    Tissue-based molecular diagnostics is a fast growing diagnostic field, which already complements morphologic classifications in many cases. Pathology based molecular diagnosis is performed almost exclusively on paraffin embedded material and always in conjunction with histopathology. Besides the classic field of tissue based detection of pathogenic organisms such as bacteria, viruses and fungi, molecular diagnostics of tumor tissue is one of the current hot topics in oncology. In this context the detection of predictive molecular biomarkers, such as specific mutations, allows patient stratification for individually tailored treatment strategies and thereby is one of the key components of individualized patient care in oncology. The rapidly growing number of clinically relevant predictive biomarkers together with impressive technical advances, specifically the development of massive parallel sequencing, will modify the care of patients with malignant diseases. Pathology, therefore, has returned in the very center of interdisciplinary patient care.

  7. ORION laser target diagnostics.

    PubMed

    Bentley, C D; Edwards, R D; Andrew, J E; James, S F; Gardner, M D; Comley, A J; Vaughan, K; Horsfield, C J; Rubery, M S; Rothman, S D; Daykin, S; Masoero, S J; Palmer, J B; Meadowcroft, A L; Williams, B M; Gumbrell, E T; Fyrth, J D; Brown, C R D; Hill, M P; Oades, K; Wright, M J; Hood, B A; Kemshall, P

    2012-10-01

    The ORION laser facility is one of the UK's premier laser facilities which became operational at AWE in 2010. Its primary mission is one of stockpile stewardship, ORION will extend the UK's experimental plasma physics capability to the high temperature, high density regime relevant to Atomic Weapons Establishment's (AWE) program. The ORION laser combines ten laser beams operating in the ns regime with two sub ps short pulse chirped pulse amplification beams. This gives the UK a unique combined long pulse/short pulse laser capability which is not only available to AWE personnel but also gives access to our international partners and visiting UK academia. The ORION laser facility is equipped with a comprehensive suite of some 45 diagnostics covering optical, particle, and x-ray diagnostics all able to image the laser target interaction point. This paper focuses on a small selection of these diagnostics.

  8. The development of a dental diagnostic terminology.

    PubMed

    Kalenderian, Elsbeth; Ramoni, Rachel L; White, Joel M; Schoonheim-Klein, Meta E; Stark, Paul C; Kimmes, Nicole S; Zeller, Gregory G; Willis, George P; Walji, Muhammad F

    2011-01-01

    There is no commonly accepted standardized terminology for oral diagnoses. The purpose of this article is to report the development of a standardized dental diagnostic terminology by a work group of dental faculty members. The work group developed guiding principles for decision making and adhered to principles of terminology development. The members used an iterative process to develop a terminology incorporating concepts represented in the Toronto/University of California, San Francisco/Creighton University and International Classification of Diseases (ICD)-9/10 codes and periodontal and endodontic diagnoses. Domain experts were consulted to develop a final list of diagnostic terms. A structure was developed, consisting of thirteen categories, seventy-eight subcategories, and 1,158 diagnostic terms, hierarchically organized and mappable to other terminologies and ontologies. Use of this standardized diagnostic terminology will reinforce the diagnosis-treatment link and will facilitate clinical research, quality assurance, and patient communication. Future work will focus on implementation and approaches to enhance the validity and reliability of diagnostic term utilization.

  9. Fuzzy intelligent quality monitoring model for X-ray image processing.

    PubMed

    Khalatbari, Azadeh; Jenab, Kouroush

    2009-01-01

    Today's imaging diagnosis needs to adapt modern techniques of quality engineering to maintain and improve its accuracy and reliability in health care system. One of the main factors that influences diagnostic accuracy of plain film X-ray on detecting pathology is the level of film exposure. If the level of film exposure is not adequate, a normal body structure may be interpretated as pathology and vice versa. This not only influences the patient management but also has an impact on health care cost and patient's quality of life. Therefore, providing an accurate and high quality image is the first step toward an excellent patient management in any health care system. In this paper, we study these techniques and also present a fuzzy intelligent quality monitoring model, which can be used to keep variables from degrading the image quality. The variables derived from chemical activity, cleaning procedures, maintenance, and monitoring may not be sensed, measured, or calculated precisely due to uncertain situations. Therefore, the gamma-level fuzzy Bayesian model for quality monitoring of an image processing is proposed. In order to apply the Bayesian concept, the fuzzy quality characteristics are assumed as fuzzy random variables. Using the fuzzy quality characteristics, the newly developed model calculates the degradation risk for image processing. A numerical example is also presented to demonstrate the application of the model.

  10. [Complex diagnostics of osteosarcomas].

    PubMed

    Muradov, Kh K; Sadykhova, G G

    2014-01-01

    It was analyzed the examination results of 156 patients with osteosarcoma. The data show that definition of histogenetic source, diagnostics and prognosis of treatment results are possible and expedient in case of analysis of signs reflecting tumor cells specificity. These signs may be determined by using of clinical parameters, X-ray imaging and light microscopy in case of moderately and highly differentiated sarcomas. Ample opportunities of flow citometry and immunohistochemistry allow to perform histogenetic identification, differential diagnostics and prognosis for low-grade sarcomas.

  11. Diagnostic hematology of reptiles.

    PubMed

    Stacy, Nicole I; Alleman, A Rick; Sayler, Katherine A

    2011-03-01

    The hematologic evaluation of reptiles is an indispensable diagnostic tool in exotic veterinary practice. The diversity of reptile species, their characteristic physiologic features, and effects of intrinsic and extrinsic factors present unique challenges for accurate interpretation of the hemogram. Combining the clinical presentation with hematologic findings provides valuable information in the diagnosis and monitoring of disease and helps guide the clinician toward therapy and further diagnostic testing. This article outlines the normal and pathologic morphology of blood cells of reptile species. The specific comparative aspects of reptiles are emphasized, and structural and functional abnormalities in the reptilian hemogram are described.

  12. Diagnostic radiology in the tropics: technical considerations.

    PubMed

    Ng, Kwan-Hoong; McLean, Ian Donald

    2011-11-01

    An estimated two thirds of the world's population is currently without access to diagnostic radiology services, and most of them live in resource-limited tropical regions with harsh environments. Most patients are diagnosed and treated in poorly equipped government-funded hospitals and clinics that have insufficiently trained staff and are barely operational. Any available imaging equipment is likely to be functioning suboptimally and be poorly maintained. The root of the problem is usually a lack of know-how and a quality culture, combined with insufficient basic equipment and infrastructure. Radiological imaging is an essential aspect of primary care and used in the critical diagnosis and management of trauma, tuberculosis, pneumonia, acquired immunodeficiency syndrome, cancer, and other respiratory and abdominal diseases. Considerations such as quality management and infrastructure, personnel, equipment, and radiation protection and safety are important to ensure the proper functioning and rational use of a diagnostic radiology facility in the tropics.

  13. 45 CFR 1159.15 - Who has the responsibility for maintaining adequate technical, physical, and security safeguards...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... disclosure or destruction of manual and automatic record systems. These security safeguards shall apply to... use of records contained in a system of records are adequately trained to protect the security and... adequate technical, physical, and security safeguards to prevent unauthorized disclosure or destruction...

  14. 21 CFR 740.10 - Labeling of cosmetic products for which adequate substantiation of safety has not been obtained.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 7 2012-04-01 2012-04-01 false Labeling of cosmetic products for which adequate..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS COSMETIC PRODUCT WARNING STATEMENTS Warning Statements § 740.10 Labeling of cosmetic products for which adequate substantiation of safety has not...

  15. 21 CFR 740.10 - Labeling of cosmetic products for which adequate substantiation of safety has not been obtained.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 7 2014-04-01 2014-04-01 false Labeling of cosmetic products for which adequate..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS COSMETIC PRODUCT WARNING STATEMENTS Warning Statements § 740.10 Labeling of cosmetic products for which adequate substantiation of safety has not...

  16. 21 CFR 740.10 - Labeling of cosmetic products for which adequate substantiation of safety has not been obtained.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Labeling of cosmetic products for which adequate..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS COSMETIC PRODUCT WARNING STATEMENTS Warning Statements § 740.10 Labeling of cosmetic products for which adequate substantiation of safety has not...

  17. 21 CFR 740.10 - Labeling of cosmetic products for which adequate substantiation of safety has not been obtained.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Labeling of cosmetic products for which adequate..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS COSMETIC PRODUCT WARNING STATEMENTS Warning Statements § 740.10 Labeling of cosmetic products for which adequate substantiation of safety has not...

  18. 21 CFR 740.10 - Labeling of cosmetic products for which adequate substantiation of safety has not been obtained.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 7 2013-04-01 2013-04-01 false Labeling of cosmetic products for which adequate..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS COSMETIC PRODUCT WARNING STATEMENTS Warning Statements § 740.10 Labeling of cosmetic products for which adequate substantiation of safety has not...

  19. Matching occupation and self: does matching theory adequately model children's thinking?

    PubMed

    Watson, Mark; McMahon, Mary

    2004-10-01

    The present exploratory-descriptive cross-national study focused on the career development of 11- to 14-yr.-old children, in particular whether they can match their personal characteristics with their occupational aspirations. Further, the study explored whether their matching may be explained in terms of a fit between person and environment using Holland's theory as an example. Participants included 511 South African and 372 Australian children. Findings relate to two items of the Revised Career Awareness Survey that require children to relate personal-social knowledge to their favorite occupation. Data were analyzed in three stages using descriptive statistics, i.e., mean scores, frequencies, and percentage agreement. The study indicated that children perceived their personal characteristics to be related to their occupational aspirations. However, how this matching takes place is not adequately accounted for in terms of a career theory such as that of Holland.

  20. Adequate connexin-mediated coupling is required for proper insulin production

    PubMed Central

    1995-01-01

    To assess whether connexin (Cx) expression contributes to insulin secretion, we have investigated normal and tumoral insulin-producing cells for connexins, gap junctions, and coupling. We have found that the glucose-sensitive cells of pancreatic islets and of a rat insulinoma are functionally coupled by gap junctions made of Cx43. In contrast, cells of several lines secreting insulin abnormally do not express Cx43, gap junctions, and coupling. After correction of these defects by stable transfection of Cx43 cDNA, cells expressing modest levels of Cx43 and coupling, as observed in native beta-cells, showed an expression of the insulin gene and an insulin content that were markedly elevated, compared with those observed in both wild-type (uncoupled) cells and in transfected cells overexpressing Cx43. These findings indicate that adequate levels of Cx-mediated coupling are required for proper insulin production and storage. PMID:8522612

  1. Switching off angiogenic signalling: creating channelled constructs for adequate oxygen delivery in tissue engineered constructs.

    PubMed

    Cheema, U; Alekseeva, T; Abou-Neel, E A; Brown, R A

    2010-10-06

    A major question in biomimetic tissue engineering is how much of the structure/function of native vasculature needs to be reproduced for effective tissue perfusion. O2 supplied to cells in 3D scaffolds in vitro is initially dependent upon diffusion through the scaffold and cell consumption. Low O2 (3%) enhances specific cell behaviours, but where O2 is critically low (pathological hypoxia) cell survival becomes compromised. We measured real-time O2 in 3D scaffolds and introduced micro-channelled architecture to controllably increase delivery of O2 to cells and switch off the hypoxic response. Simple static micro-channelling gives adequate perfusion and can be used to control cell generated hypoxia-induced signalling.

  2. Adaptive robust image registration approach based on adequately sampling polar transform and weighted angular projection function

    NASA Astrophysics Data System (ADS)

    Wei, Zhao; Tao, Feng; Jun, Wang

    2013-10-01

    An efficient, robust, and accurate approach is developed for image registration, which is especially suitable for large-scale change and arbitrary rotation. It is named the adequately sampling polar transform and weighted angular projection function (ASPT-WAPF). The proposed ASPT model overcomes the oversampling problem of conventional log-polar transform. Additionally, the WAPF presented as the feature descriptor is robust to the alteration in the fovea area of an image, and reduces the computational cost of the following registration process. The experimental results show two major advantages of the proposed method. First, it can register images with high accuracy even when the scale factor is up to 10 and the rotation angle is arbitrary. However, the maximum scaling estimated by the state-of-the-art algorithms is 6. Second, our algorithm is more robust to the size of the sampling region while not decreasing the accuracy of the registration.

  3. Precise femtosecond laser ablation of dental hard tissue: preliminary investigation on adequate laser parameters

    NASA Astrophysics Data System (ADS)

    Hikov, Todor; Pecheva, Emilia; Montgomery, Paul; Antoni, Frederic; Leong-Hoi, Audrey; Petrov, Todor

    2017-01-01

    This work aims at evaluating the possibility of introducing state-of-the-art commercial femtosecond laser system in restorative dentistry by maintaining well-known benefits of lasers for caries removal, but also in overcoming disadvantages such as thermal damage of irradiated substrate. Femtosecond ablation of dental hard tissue is investigated by changing the irradiation parameters (pulsed laser energy, scanning speed and pulse repetition rate), assessed for enamel and dentin. The femtosecond laser system used in this work may be suitable for cavity preparation in dentin and enamel, due to the expected effective ablation and low temperature increase when using ultra short laser pulses. If adequate laser parameters are selected, this system seems to be promising for promoting a laser-assisted, minimally invasive approach in restorative dentistry.

  4. J-modulated ADEQUATE experiments using different kinds of refocusing pulses.

    PubMed

    Thiele, Christina M; Bermel, Wolfgang

    2007-10-01

    Owing to the recent developments concerning residual dipolar couplings (RDCs), the interest in methods for the accurate determination of coupling constants is renascenting. We intended to use the J-modulated ADEQUATE experiment by Kövér et al. for the measurement of (13)C - (13)C coupling constants at natural abundance. The use of adiabatic composite chirp pulses instead of the conventional 180 degrees pulses, which compensate for the offset dependence of (13)C 180 degrees pulses, led to irregularities of the line shapes in the indirect dimension causing deviations of the extracted coupling constants. This behaviour was attributed to coupling evolution, during the time of the adiabatic pulse (2 ms), in the J-modulation spin echo. The replacement of this pulse by different kinds of refocusing pulses indicated that a pair of BIPs (broadband inversion pulses), which behave only partially adiabatic, leads to correct line shapes and coupling constants conserving the good sensitivity obtained with adiabatic pulses.

  5. 40 CFR 1033.112 - Emission diagnostics for SCR systems.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... POLLUTION CONTROLS CONTROL OF EMISSIONS FROM LOCOMOTIVES Emission Standards and Related Requirements § 1033... diagnostic system must monitor reductant quality and tank levels and alert operators to the need to refill... specified in § 1033.110 and an audible alarm. You do not need to separately monitor reductant quality if...

  6. A Nomogram to Predict Adequate Lymph Node Recovery before Resection of Colorectal Cancer

    PubMed Central

    Zhang, Zhen-yu; Li, Cong; Gao, Wei; Yin, Xiao-wei; Luo, Qi-feng; Liu, Nan; Basnet, Shiva; Dai, Zhen-ling; Ge, Hai-yan

    2016-01-01

    Increased lymph node count (LNC) has been associated with prolonged survival in colorectal cancer (CRC), but the underlying mechanisms are still poorly understood. The study aims to identify new predictors and develop a preoperative nomogram for predicting the probability of adequate LNC (≥ 12). 501 eligible patients were retrospectively selected to identify clinical-pathological factors associated with LNC ≥ 12 through univariate and multivariate logistic regression analyses. The nomogram was built according to multivariate analyses of preoperative factors. Model performance was assessed with concordance index (c-index) and area under the receiver operating characteristic curve (AUC), followed by internal validation and calibration using 1000-resample bootstrapping. Clinical validity of the nomogram and LNC impact on stage migration were also evaluated. Multivariate analyses showed patient age, CA19-9, circulating lymphocytes, neutrophils, platelets, tumor diameter, histology and deposit significantly correlated with LNC (P < 0.05). The effects were marginal for CEA, anemia and CRC location (0.05 < P < 0.1). The multivariate analyses of preoperative factors suggested decreased age, CEA, CA19-9, neutrophils, proximal location, and increased platelets and diameter were significantly associated with increased probability of LNC ≥ 12 (P < 0.05). The nomogram achieved c-indexes of 0.75 and 0.73 before and after correction for overfitting. The AUC was 0.75 (95% CI, 0.70–0.79) and the clinically valid threshold probabilities were between 10% and 60% for the nomogram to predict LNC < 12. Additionally, increased probability of adequate LNC before surgery was associated with increased LNC and negative lymph nodes rather than increased positive lymph nodes, lymph node ratio, pN stages or AJCC stages. Collectively, the results indicate the LNC is multifactorial and irrelevant to stage migration. The significant correlations with preoperative circulating markers may

  7. Use of Linear Programming to Develop Cost-Minimized Nutritionally Adequate Health Promoting Food Baskets

    PubMed Central

    Tetens, Inge; Dejgård Jensen, Jørgen; Smed, Sinne; Gabrijelčič Blenkuš, Mojca; Rayner, Mike; Darmon, Nicole; Robertson, Aileen

    2016-01-01

    Background Food-Based Dietary Guidelines (FBDGs) are developed to promote healthier eating patterns, but increasing food prices may make healthy eating less affordable. The aim of this study was to design a range of cost-minimized nutritionally adequate health-promoting food baskets (FBs) that help prevent both micronutrient inadequacy and diet-related non-communicable diseases at lowest cost. Methods Average prices for 312 foods were collected within the Greater Copenhagen area. The cost and nutrient content of five different cost-minimized FBs for a family of four were calculated per day using linear programming. The FBs were defined using five different constraints: cultural acceptability (CA), or dietary guidelines (DG), or nutrient recommendations (N), or cultural acceptability and nutrient recommendations (CAN), or dietary guidelines and nutrient recommendations (DGN). The variety and number of foods in each of the resulting five baskets was increased through limiting the relative share of individual foods. Results The one-day version of N contained only 12 foods at the minimum cost of DKK 27 (€ 3.6). The CA, DG, and DGN were about twice of this and the CAN cost ~DKK 81 (€ 10.8). The baskets with the greater variety of foods contained from 70 (CAN) to 134 (DGN) foods and cost between DKK 60 (€ 8.1, N) and DKK 125 (€ 16.8, DGN). Ensuring that the food baskets cover both dietary guidelines and nutrient recommendations doubled the cost while cultural acceptability (CAN) tripled it. Conclusion Use of linear programming facilitates the generation of low-cost food baskets that are nutritionally adequate, health promoting, and culturally acceptable. PMID:27760131

  8. Maintaining Adequate CO2 Washout for an Advanced EMU via a New Rapid Cycle Amine Technology

    NASA Technical Reports Server (NTRS)

    Chullen, Cinda

    2011-01-01

    Over the past several years, NASA has realized tremendous progress in Extravehicular Activity (EVA) technology development. This has been evidenced by the progressive development of a new Rapic Cycle Amine (RCA) system for the Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support Subsystem (PLSS). The PLSS is responsible for the life support of the crew member in the spacesuit. The RCA technology is responsible for carbon dioxide (CO2) and humidity control. Another aspect of the RCA is that it is on-back vacuum-regenerable, efficient, and reliable. The RCA also simplifies the PLSS schematic by eliminating the need for a condensing heat exchanger for humidity control in the current EMU. As development progresses on the RCA, it is important that the sizing be optimized so that the demand on the PLSS battery is minimized. As well, maintaining the CO2 washout at adequate levels during an EVA is an absolute requirement of the RCA and associated ventilation system. Testing has been underway in-house at NASA Johnson Space Center and analysis has been initiated to evaluate whether the technology provides exemplary performance in ensuring that the CO2 is removed sufficiently enough and the ventilation flow is adequate enough to maintain CO2 1 Project Engineer, Space Suit and Crew Survival Systems Branch, Crew and Thermal Systems Division, 2101 NASA Parkway, Houston, TX 77058/EC5. washout in the AEMU spacesuit helmet of the crew member during an EVA. This paper will review the recent developments of the RCA unit, the testing results performed in-house with a spacesuit simulator, and the associated analytical work along with insights from the medical aspect on the testing.

  9. When one is not enough: prevalence and characteristics of homes not adequately protected by smoke alarms

    PubMed Central

    Peek-Asa, C; Allareddy, V; Yang, J; Taylor, C; Lundell, J; Zwerling, C

    2005-01-01

    Objective: The National Fire Protection Association (NFPA) has specific recommendations about the number, location, and type of smoke alarms that are needed to provide maximum protection for a household. No previous studies have examined whether or not homes are completely protected according to these guidelines. The authors describe the prevalence and home characteristics associated with compliance to recommendations for smoke alarm installation by the NFPA. Design, setting, and subjects: Data are from the baseline on-site survey of a randomized trial to measure smoke alarm effectiveness. The trial was housed in a longitudinal cohort study in a rural Iowa county. Of 1005 homes invited, 691 (68.8%) participated. Main outcome measures: Information about smoke alarm type, placement, and function, as well as home and occupant characteristics, was collected through an on-site household survey. Results: Although 86.0% of homes had at least one smoke alarm, only 22.3% of homes (approximately one in five) were adequately protected according to NFPA guidelines. Fourteen percent of homes had no functioning smoke alarms. More than half of the homes with smoke alarms did not have enough of them or had installed them incorrectly, and 42.4% of homes with alarms had at least one alarm that did not operate. Homes with at least one high school graduate were nearly four times more likely to be fully protected. Homes that had multiple levels, a basement, or were cluttered or poorly cleaned were significantly less likely to be fully protected. Conclusion: These findings indicate that consumers may not be knowledgeable about the number of alarms they need or how to properly install them. Occupants are also not adequately maintaining the alarms that are installed. PMID:16326772

  10. Residual triose phosphate isomerase activity and color measurements to determine adequate cooking of ground beef patties.

    PubMed

    Sair, A I; Booren, A M; Berry, B W; Smith, D M

    1999-02-01

    The objectives were to (i) compare the use of triose phosphate isomerase (TPI) activity and internal color scores for determination of cooking adequacy of beef patties and (ii) determine the effect of frozen storage and fat content on residual TPI activity in ground beef. Ground beef patties (24.4% fat) were cooked to five temperatures ranging from 60.0 to 82.2 degrees C. TPI activity decreased as beef patty cooking temperature was increased from 60.0 to 71.1 degrees C; however, no difference (P > 0.05) in activity (6.3 U/kg meat) was observed in patties cooked to 71.1 degrees C and above. Degree of doneness color scores, a* values and b* values, of ground beef patties decreased as internal temperature was increased from 60.0 to 71.1 degrees C; however, temperature had no effect on L* values. TPI activity in raw ground beef after five freeze-thaw cycles did not differ from the control. Three freeze-thaw cycles of raw ground beef resulted in a 57.2% decrease in TPI activity after cooking. TPI activity of cooked beef increased during 2 months of frozen storage, but TPI activity in ground beef stored for 3 months or longer did not differ from the unfrozen control. While past research has shown color to be a poor indicator of adequate thermal processing, our results suggest that undercooked ground beef patties could be distinguished from those that had been adequately cooked following U.S. Department of Agriculture guidelines using residual TPI activity as a marker.

  11. Equivalent Diagnostic Classification Models

    ERIC Educational Resources Information Center

    Maris, Gunter; Bechger, Timo

    2009-01-01

    Rupp and Templin (2008) do a good job at describing the ever expanding landscape of Diagnostic Classification Models (DCM). In many ways, their review article clearly points to some of the questions that need to be answered before DCMs can become part of the psychometric practitioners toolkit. Apart from the issues mentioned in this article that…

  12. Sexual Addiction: Diagnostic Problems

    ERIC Educational Resources Information Center

    Giugliano, John R.

    2009-01-01

    In recent years clinicians report a great deal of concern about definition, diagnostic assessment, and treatment modalities when dealing with what might be called out-of-control sexual behavior. Many terms have been used to describe the phenomenon of problematic sexual behavior. Many of these concepts overlap, some are no longer popular, and some…

  13. Rocket Engine Oscillation Diagnostics

    NASA Technical Reports Server (NTRS)

    Nesman, Tom; Turner, James E. (Technical Monitor)

    2002-01-01

    Rocket engine oscillating data can reveal many physical phenomena ranging from unsteady flow and acoustics to rotordynamics and structural dynamics. Because of this, engine diagnostics based on oscillation data should employ both signal analysis and physical modeling. This paper describes an approach to rocket engine oscillation diagnostics, types of problems encountered, and example problems solved. Determination of design guidelines and environments (or loads) from oscillating phenomena is required during initial stages of rocket engine design, while the additional tasks of health monitoring, incipient failure detection, and anomaly diagnostics occur during engine development and operation. Oscillations in rocket engines are typically related to flow driven acoustics, flow excited structures, or rotational forces. Additional sources of oscillatory energy are combustion and cavitation. Included in the example problems is a sampling of signal analysis tools employed in diagnostics. The rocket engine hardware includes combustion devices, valves, turbopumps, and ducts. Simple models of an oscillating fluid system or structure can be constructed to estimate pertinent dynamic parameters governing the unsteady behavior of engine systems or components. In the example problems it is shown that simple physical modeling when combined with signal analysis can be successfully employed to diagnose complex rocket engine oscillatory phenomena.

  14. Tele diagnostic by web

    NASA Astrophysics Data System (ADS)

    Sugiyama, Shigeki

    2006-03-01

    Because of the development of multimedia technologies like Web and Internet, it now becomes possible to think about Tele Medicine and Tele Diagnostic for a distant place where no doctors and no nurses are situated at or are available. And also some kind of intelligence can be added onto them, which makes possible to give certain kind of medical treatment assistance or suggestions for a patient from a computer diagnostic base through the Internetworking. For doing this, here considers about a basic system of "Tele Diagnostic for a remote place" where it dose not have a doctor and a medical assistance. In order to implement the system, JAVA, VRML, HTML, and CORTONA are used as a basic language and a viewer. And also in order to add a kind of intelligence, Augmented Knowledge In Agent (AKIA) by using Back Propagation Neural Networks (BPNN) is used. And by this study, here can introduce the system that has the following basic mechanisms; By inputting physical data like temperature or blood pressure, the system would show a diagnostic assistance by TEXT. And also the bad place of body would be shown graphically if there were any. The system can be put onto Web, so that anybody could have this assistance at any place ubiquitously only if a person has Internetworking access.

  15. ESPC Integrated Skill Diagnostics

    DTIC Science & Technology

    2015-09-30

    monitoring systems for gauging performance of the ESPC. This is an integral part of the overall ESPC goal of developing a global coupled system between...1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. ESPC Integrated Skill Diagnostics Maria Flatau Naval...quantitative skill metrics to assess the advancements in the Earth System Prediction Capability (ESPC). This work will also implement automated

  16. Diagnostic peritoneal lavage - slideshow

    MedlinePlus

    ... Indication URL of this page: //medlineplus.gov/ency/presentations/100159.htm Diagnostic peritoneal lavage - series—Indication To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 4 Go to slide 2 ...

  17. Diagnostics for induction accelerators

    SciTech Connect

    Fessenden, T.J.

    1996-04-01

    The induction accelerator was conceived by N. C. Christofilos and first realized as the Astron accelerator that operated at LLNL from the early 1960`s to the end of 1975. This accelerator generated electron beams at energies near 6 MeV with typical currents of 600 Amperes in 400 ns pulses. The Advanced Test Accelerator (ATA) built at Livermore`s Site 300 produced 10,000 Ampere beams with pulse widths of 70 ns at energies approaching 50 MeV. Several other electron and ion induction accelerators have been fabricated at LLNL and LBNL. This paper reviews the principal diagnostics developed through efforts by scientists at both laboratories for measuring the current, position, energy, and emittance of beams generated by these high current, short pulse accelerators. Many of these diagnostics are closely related to those developed for other accelerators. However, the very fast and intense current pulses often require special diagnostic techniques and considerations. The physics and design of the more unique diagnostics developed for electron induction accelerators are presented and discussed in detail.

  18. Diagnosing Diagnostic Language Assessment

    ERIC Educational Resources Information Center

    Lee, Yong-Won

    2015-01-01

    Diagnostic language assessment (DLA) is gaining a lot of attention from language teachers, testers, and applied linguists. With a recent surge of interest in DLA, there seems to be an urgent need to assess where the field of DLA stands at the moment and develop a general sense of where it should be moving in the future. The current article, as the…

  19. Beam Diagnostics for FACET

    SciTech Connect

    Li, S.Z.; Hogan, M.J.; /SLAC

    2011-08-19

    FACET, the Facility for Advanced Accelerator and Experimental Tests, is a new facility being constructed in sector 20 of the SLAC linac primarily to study beam driven plasma wakefield acceleration beginning in summer 2011. The nominal FACET parameters are 23GeV, 3nC electron bunches compressed to about 20 {micro}m long and focussed to about 10 {micro}m wide. Characterization of the beam-plasma interaction requires complete knowledge of the incoming beam parameters on a pulse-to-pulse basis. FACET diagnostics include Beam Position Monitors, Toroidal current monitors, X-ray and Cerenkov based energy spectrometers, optical transition radiation (OTR) profile monitors and coherent transition radiation (CTR) bunch length measurement systems. The compliment of beam diagnostics and their expected performance are reviewed. Beam diagnostic measurements not only provide valuable insights to the running and tuning of the accelerator but also are crucial for the PWFA experiments in particular. Beam diagnostic devices are being set up at FACET and will be ready for beam commissioning in summer 2011.

  20. [Point-of-care diagnostics compared to standard coagulation tests in multiple trauma. Pros and cons].

    PubMed

    Johanning, K

    2014-02-01

    The haemostasiological management of patients with multiple injuries requires rapid and adequate therapy decisions due to the highly dynamic surroundings. For this, diagnostic techniques which have the ability to detect and differentiate coagulation disorders that are commonly present in multiple trauma patients are necessary. Widely used routine coagulation tests (e.g., aPTT or PT) sensitively measure impairments of the intrinsic or extrinsic pathway, but without further identification or differentiation. Important influencing parameters like acidosis, hypothermia, fibrinolysis or polymerization dysfunction but especially the clot quality are not detectable. Moreover, the turn around times of these tests are about 30-60 min. However, thrombelastography measures clot strength and stability in whole blood under the present conditions of the injured patient. Impairments of clot quality can be differentiated. Because of the visualization of the clot formation, a patient's coagulation capacity can be assessed within minutes. Admittedly the use of these point-of-care devices in the operation theatre requires human and temporal resources.

  1. Tuberculosis Diagnostics: State of the Art and Future Directions.

    PubMed

    Pai, Madhukar; Nicol, Mark P; Boehme, Catharina C

    2016-10-01

    Rapid and accurate diagnosis is critical for timely initiation of anti-tuberculosis (TB) treatment, but many people with TB (or TB symptoms) do not have access to adequate initial diagnosis. In many countries, TB diagnosis is still reliant on sputum microscopy, a test with known limitations. However, new diagnostics are starting to change the landscape. Stimulated, in part, by the success and rollout of Xpert MTB/RIF, an automated, molecular test, there is now considerable interest in new technologies. The landscape looks promising with a pipeline of new tools, particularly molecular diagnostics, and well over 50 companies actively engaged in product development, and many tests have been reviewed by WHO for policy endorsement. However, new diagnostics are yet to reach scale, and there needs to be greater convergence between diagnostics development and the development of shorter TB drug regimens. Another concern is the relative absence of non-sputum-based diagnostics in the pipeline for children, and of biomarker tests for triage, cure, and latent TB progression. Increased investments are necessary to support biomarker discovery, validation, and translation into clinical tools. While transformative tools are being developed, high-burden countries will need to improve the efficiency of their health care delivery systems, ensure better uptake of new technologies, and achieve greater linkages across the TB and HIV care continuum. While we wait for next-generation technologies, national TB programs must scale up the best diagnostics currently available, and use implementation science to get the maximum impact.

  2. Defense Logistics Agency Can Improve Its Product Quality Deficiency Report Processing

    DTIC Science & Technology

    2015-07-01

    in a series of audits on DLA processing product quality deficiency reports. Finding DLA Aviation quality assurance personnel conducted adequate...4 Finding. Defense Logistics Agency Aviation Did Not Adequately Process Product Quality...Deficiency Reports _________________________________________________________________5 Defense Logistics Agency Aviation Product Quality Deficiency

  3. [Interviews with physicians in private practice as a starting point for quality improvement in hospitals].

    PubMed

    Spiessl, H; Semsch, I; Cording, C; Klein, H E

    2001-07-01

    Subjective criteria gain importance in care research and quality management. Therefore, psychiatrists in private practice and general practitioners working in the catchment area of a psychiatric hospital were surveyed by questionnaire evaluating expectations and satisfaction concerning their collaboration with the hospital. Psychiatrists and general practitioners rated legible interim discharge letters, good in-patient treatment, adequate diagnostics, and direct referral to the hospital as most important. Psychiatrists express dissatisfaction regarding prescription of expensive drugs, lack of involvement in planning new psychiatric institutions, delivery of discharge summaries, referring back the patient after in-patient care, and delay of hospital admission. As conclusion, quality management should pay more attention to ambulatory care physicians' points of view to reduce problems of interaction between clinicians and their colleagues in private practice and to improve the treatment continuity of psychiatric patients.

  4. [Optimisation of diagnostics and differential diagnostics disseminated pulmonary tuberculosis].

    PubMed

    Demikhova, O V; Karpina, N L; Lepekha, L N; Bagirov, M A; Amansakhedov, R B

    2012-01-01

    One of the reasons of dramatic situation with tuberculosis in Russia is untimely diagnostics of tuberculosis. The aim of the study was to identify the causes of diagnostic mistakes when we deal with disseminated pulmonary tuberculosis at current stage and to modernize the diagnostic process. The analysis of the diagnostic activity of the consultative diagnostic center of Central Tuberculosis Research Institute of Russian Academy Medical Sciences for 2011 was performed with special attention on the results of the survey of 505 patients with pulmonary dissemination. The frequency of discrepancies of disseminated pulmonary tuberculosis diagnostics was 96.1%. Based on the studies carried out the main causes diagnostic mistakes in patients with disseminated pulmonary tuberculosis were determined. New directions of improving of tuberculosis diagnostics were developed: overall high-technology examination of patient, adherence to the diagnostic procedure, developed by consultative diagnostic center of Central Tuberculosis Research Institute (CTRI), timely performing fiber-optic bronchoscopy with complex biopsy and diagnostic surgery procedures, further training of primary health care doctors. Implementation of proposed activities will significantly (by 3-5 times) reduce the time for diagnostics of respiratory system disease.

  5. The Marine Air-Ground Team: Still Not Adequately Training for the Urban Fight/The Marine Air-Ground Team: Still Not Adequately Trained for the Urban Fight

    DTIC Science & Technology

    2006-02-01

    1 The Marine Air-Ground Team: Still Not Adequately Training for the Urban Fight Subject Area Training EWS 2006...The Marine Air-Ground Team: Still Not Adequately Training for the Urban Fight Submitted by Captain RC Rybka to Majors GC Schreffler and RR...estimated to average 1 hour per response , including the time for reviewing instructions, searching existing data sources, gathering and maintaining the

  6. Impact of Horizontal Approach in Vertical Program: Continuous Quality Improvement of Malaria and Tuberculosis Diagnostic Services at Primary-Level Medical Laboratories in the Context of HIV Care and Treatment Program in Ethiopia

    PubMed Central

    Marinucci, Francesco; Manyazewal, Tsegahun; Paterniti, Antonio D.; Medina-Moreno, Sandra; Wattleworth, Matthew; Hagembe, Juliana; Redfield, Robert R.

    2013-01-01

    The use of standardized tools for continuous quality improvement of laboratory services is crucial to identify service gaps, plan targeted interventions, and prove successes. Laboratory quality improvement tools (LQITs) were developed and applied for 18 months at five health centers and one faith-based hospital laboratories in Southwest Showa Zone in Ethiopia to assess and monitor the quality of malaria and acid-fast bacilli (AFB) microscopy total testing processes. For the six laboratories, baseline malaria microscopy scores were 55%, 42%, 52%, 55%, 54%, and 61%. Similarly, baseline AFB microscopy scores were 49%, 41%, 46%, 58%, 44%, and 70%. On the sixth quarter for the first four laboratories and the fourth quarter for the last two laboratories, malaria microscopy scores were 89%, 88%, 88%, 90%, 88%, and 89%, whereas AFB microscopy scores were 90%, 88%, 89%, 95%, 88%, and 90%. All laboratories scored above 85% for both services at the end of interventions. PMID:23324221

  7. Impact of horizontal approach in vertical program: continuous quality improvement of malaria and tuberculosis diagnostic services at primary-level medical laboratories in the context of HIV care and treatment program in Ethiopia.

    PubMed

    Marinucci, Francesco; Manyazewal, Tsegahun; Paterniti, Antonio D; Medina-Moreno, Sandra; Wattleworth, Matthew; Hagembe, Juliana; Redfield, Robert R

    2013-03-01

    The use of standardized tools for continuous quality improvement of laboratory services is crucial to identify service gaps, plan targeted interventions, and prove successes. Laboratory quality improvement tools (LQITs) were developed and applied for 18 months at five health centers and one faith-based hospital laboratories in Southwest Showa Zone in Ethiopia to assess and monitor the quality of malaria and acid-fast bacilli (AFB) microscopy total testing processes. For the six laboratories, baseline malaria microscopy scores were 55%, 42%, 52%, 55%, 54%, and 61%. Similarly, baseline AFB microscopy scores were 49%, 41%, 46%, 58%, 44%, and 70%. On the sixth quarter for the first four laboratories and the fourth quarter for the last two laboratories, malaria microscopy scores were 89%, 88%, 88%, 90%, 88%, and 89%, whereas AFB microscopy scores were 90%, 88%, 89%, 95%, 88%, and 90%. All laboratories scored above 85% for both services at the end of interventions.

  8. Molecular diagnostics for low resource settings

    NASA Astrophysics Data System (ADS)

    Weigl, Bernhard H.

    2010-03-01

    As traditional high quality diagnostic laboratories are not widely available or affordable in developing country health care settings, microfluidics-based point-of-care diagnostics may be able to address the need to perform complex assays in under-resourced areas. Many instrument-based as well as non-instrumented microfluidic prototype diagnostics are currently being developed. In addition to various engineering challenges, the greatest remaining issue is the search for truly low-cost disposable manufacturing methods. Diagnostics for global health, and specifically microfluidics and molecular-based low resource diagnostics, have become a very active research area over the last five years, thanks in part to new funding that became available from the Bill and Melinda Gates Foundation, the National Institutes of Health, and other sources. This has led to a number of interesting prototype devices that are now in advanced development or clinical validation. These devices include disposables and instruments that perform multiplexed PCR-based lab-on-a-chips for enteric, febrile, and vaginal diseases, as well as immunoassays for diseases such as malaria, HIV, and various sexually transmitted diseases. More recently, instrument-free diagnostic disposables based on isothermal nucleic acid amplification have been developed as well. Regardless of platform, however, the search for truly low-cost manufacturing methods that would result in cost of goods per disposable of around US1/unit at volume remains a big challenge. This talk will give an overview over existing platform development efforts as well as present some original research in this area at PATH.

  9. The placental pursuit for an adequate oxidant balance between the mother and the fetus

    PubMed Central

    Herrera, Emilio A.; Krause, Bernardo; Ebensperger, German; Reyes, Roberto V.; Casanello, Paola; Parra-Cordero, Mauro; Llanos, Anibal J.

    2014-01-01

    The placenta is the exchange organ that regulates metabolic processes between the mother and her developing fetus. The adequate function of this organ is clearly vital for a physiologic gestational process and a healthy baby as final outcome. The umbilico-placental vasculature has the capacity to respond to variations in the materno-fetal milieu. Depending on the intensity and the extensity of the insult, these responses may be immediate-, mediate-, and long-lasting, deriving in potential morphostructural and functional changes later in life. These adjustments usually compensate the initial insults, but occasionally may switch to long-lasting remodeling and dysfunctional processes, arising maladaptation. One of the most challenging conditions in modern perinatology is hypoxia and oxidative stress during development, both disorders occurring in high-altitude and in low-altitude placental insufficiency. Hypoxia and oxidative stress may induce endothelial dysfunction and thus, reduction in the perfusion of the placenta and restriction in the fetal growth and development. This Review will focus on placental responses to hypoxic conditions, usually related with high-altitude and placental insufficiency, deriving in oxidative stress and vascular disorders, altering fetal and maternal health. Although day-to-day clinical practice, basic and clinical research are clearly providing evidence of the severe impact of oxygen deficiency and oxidative stress establishment during pregnancy, further research on umbilical and placental vascular function under these conditions is badly needed to clarify the myriad of questions still unsettled. PMID:25009498

  10. Prevention of mother to child transmission lay counsellors: Are they adequately trained?

    PubMed

    Thurling, Catherine H; Harris, Candice

    2012-06-05

    South Africa's high prevalence of human immunodeficiency virus (HIV) infected women requires a comprehensive health care approach to pregnancy because of the added risk of their HIV status. As a result of the shortage of health care workers in South Africa, lay counsellors play important roles in the prevention of mother to child transmission of HIV (PMTCT). There is no standardization of training of lay counsellors in South Africa, and training varies in length depending on the training organisation. The study aimed to investigate the training of lay counsellors by analysing their training curricula and interviewing lay counsellors about their perceptions of their training. A two phase research method was applied. Phase one documented an analysis of the training curricula. Phase two was semi-structured interviews with the participants. Purposive sampling was undertaken for this study. The total sample size was 13 people, with a final sample of 9 participants, determined at the point of data saturation. The research was qualitative, descriptive and contextual in design. The curricula analysed had different styles of delivery, and the approaches to learning and courses varied, resulting in inconsistent training outcomes. A need for supervision and mentorship in the working environment was also noted. The training of lay counsellors needs to be adapted to meet the extended roles that they are playing in PMTCT. The standardization of training programmes, and the incorporation of a system of mentorship in the work environment, would ensure that the lay counsellors are adequately prepared for their role in PMTCT.

  11. Improved ASTM G72 Test Method for Ensuring Adequate Fuel-to-Oxidizer Ratios

    NASA Technical Reports Server (NTRS)

    Juarez, Alfredo; Harper, Susana Tapia

    2016-01-01

    The ASTM G72/G72M-15 Standard Test Method for Autogenous Ignition Temperature of Liquids and Solids in a High-Pressure Oxygen-Enriched Environment is currently used to evaluate materials for the ignition susceptibility driven by exposure to external heat in an enriched oxygen environment. Testing performed on highly volatile liquids such as cleaning solvents has proven problematic due to inconsistent test results (non-ignitions). Non-ignition results can be misinterpreted as favorable oxygen compatibility, although they are more likely associated with inadequate fuel-to-oxidizer ratios. Forced evaporation during purging and inadequate sample size were identified as two potential causes for inadequate available sample material during testing. In an effort to maintain adequate fuel-to-oxidizer ratios within the reaction vessel during test, several parameters were considered, including sample size, pretest sample chilling, pretest purging, and test pressure. Tests on a variety of solvents exhibiting a range of volatilities are presented in this paper. A proposed improvement to the standard test protocol as a result of this evaluation is also presented. Execution of the final proposed improved test protocol outlines an incremental step method of determining optimal conditions using increased sample sizes while considering test system safety limits. The proposed improved test method increases confidence in results obtained by utilizing the ASTM G72 autogenous ignition temperature test method and can aid in the oxygen compatibility assessment of highly volatile liquids and other conditions that may lead to false non-ignition results.

  12. Cardiac catecholamines in rats fed copper deficient or copper adequate diets containing fructose or starch

    SciTech Connect

    Scholfield, D.J.; Fields, M.; Beal, T.; Lewis, C.G.; Behall, K.M. )

    1989-02-09

    The symptoms of copper (Cu) deficiency are known to be more severe when rats are fed a diet with fructose (F) as the principal carbohydrate. Mortality, in males, due to cardiac abnormalities usually occurs after five weeks of a 62% F, 0.6 ppm Cu deficient diet. These effects are not observed if cornstarch (CS) is the carbohydrate (CHO) source. Studies with F containing diets have shown increased catecholamine (C) turnover rates while diets deficient in Cu result in decreased norepinephrine (N) levels in tissues. Dopamine B-hydroxylase (EC 1.14.17.1) is a Cu dependent enzyme which catalyzes the conversion of dopamine (D) to N. An experiment was designed to investigate the effects of CHO and dietary Cu on levels of three C in cardiac tissue. Thirty-two male and female Sprague-Dawley rats were fed Cu deficient or adequate diets with 60% of calories from F or CS for 6 weeks. N, epinephrine (E) and D were measured by HPLC. Statistical analysis indicates that Cu deficiency tends to decrease N levels, while having the reverse effect on E. D did not appear to change. These findings indicate that Cu deficiency but not dietary CHO can affect the concentration of N and E in rat cardiac tissue.

  13. Are neurodegenerative disorder and psychotic manifestations avoidable brain dysfunctions with adequate dietary omega-3?

    PubMed

    Saugstad, Letten F

    2006-01-01

    The present mismatch between what our brain needs, and the modern diet neglects our marine heritage. Last century, the priority in nutrition and food production was to achieve a high protein diet and somatic growth and function. The dietary content of omega-3 (N-3) required by the brain was neglected although evidence for the essentiality of certain fatty acids was published in 1929 and specifically re-affirmed for omega 3 in the brain in the 1970s. Cognitive decline with age and neurodegenerative disorder with dementia are now rising. This review describes signs of N-3 deficit in Alzheimer and Parkinson Disease, where maximum change involves the primary sites: olfactory cortex and the hippocampus. The olfactory agnosia observed in schizophrenia supports an N-3 deficit as does a reduction of key ologodendrocyte- and myelin-related genes in this disorder and affective disorder, where a rise in dementia accords with a deficit of N-3 also in this disorder. N-3 normalizes cerebral excitability at all levels. That the two disorders are localized at the extremes of excitability, is supported by their opposing treatments: convulsant neuroleptics and anti-epileptic antidepressants. An adequate N-3 diet will probably prevent most psychotic episodes and prove that neurodegenerative disorder with dementia is also to a large extent not only preventable but avoidable.

  14. Are neurodegenerative disorder and psychotic manifestations avoidable brain dysfunctions with adequate dietary omega-3?

    PubMed

    Saugstad, Letten F

    2006-01-01

    The present mismatch between what our brain needs, and the modern diet neglects our marine heritage. Last century, the priority in nutrition and food production was to achieve a high protein diet and somatic growth and function. The dietary content of omega-3 (N-3) required by the brain was neglected although evidence for the essentiality of certain fatty acids was published in 1929 and specifically re-affirmed for omega 3 in the brain in the 1970s. Cognitive decline with age and neurodegenerative disorder with dementia are now rising. This review describes signs of N-3 deficit in Alzheimer and Parkinson Disease, where maximum change involves the primary sites: olfactory cortex and the hippocampus. The olfactory agnosia observed in schizophrenia supports an N-3 deficit as does a reduction of key ologodendrocyte- and myelin-related genes in this disorder and affective disorder, where a rise in dementia accords with a deficit of N-3 also in this disorder. N-3 normalizes cerebral excitability at all levels. That the two disorders are localized at the extremes of excitability, is supported by their opposing treatments: convulsant neuroleptics and anti-epileptic anti-depressants. An adequate N-3 diet will probably prevent most psychotic episodes and prove that neurodegenerative disorder with dementia is also to a large extent not only preventable but avoidable.

  15. A high UV environment does not ensure adequate Vitamin D status

    NASA Astrophysics Data System (ADS)

    Kimlin, M. G.; Lang, C. A.; Brodie, A.; Harrison, S.; Nowak, M.; Moore, M. R.

    2006-12-01

    Queensland has the highest rates of skin cancer in the world and due to the high levels of solar UV in this region it is assumed that incidental UV exposure should provide adequate vitamin D status for the population. This research was undertaken to test this assumption among healthy free-living adults in south-east Queensland, Australia (27°S), at the end of winter. This research was approved by Queensland University of Technology Human Research Ethics Committee and conducted under the guidelines of the Declaration of Helsinki. 10.2% of the sample had serum vitamin D levels below 25nm/L (deficiency) and a further 32.3% had levels between 25nm/L and 50nm/L (insufficiency). Vitamin D deficiency and insufficiency can occur at the end of winter, even in sunny climates. The wintertime UV levels in south-east Queensland (UV index 4-6) are equivalent to summertime UV levels in northern regions of Europe and the USA. These ambient UV levels are sufficient to ensure synthesis of vitamin D requirements. We investigated individual UV exposure (through a self reported sun exposure questionnaire) and found correlations between exposure and Vitamin D status. Further research is needed to explore the interactions between the solar UV environment and vitamin D status, particularly in high UV environments, such as Queensland.

  16. Determination of the need for selenium by chicks fed practical diets adequate in vitamin E

    SciTech Connect

    Combs, G.F. Jr.; Su, Q.; Liu, C.H.; Sinisalo, M.; Combs, S.B.

    1986-03-01

    Experiments were conducted to compare the dietary needs for selenium (Se) by chicks fed either purified (amino acid-based) or practical (corn- and soy-based) diets that were adequate with respect to vitamin E (i.e., contained 100 IU/kg) and all other known nutrients with the single exception of Se (i.e., contained only 0.10 ppm Se). Studies were conducted in Ithaca using Single Comb White Leghorn chicks fed the purified basal diet and in Beijing using chicks of the same breed fed either the same purified basal diet or the practical diet formulated to be similar to that used in poultry production in some parts of China and the US. Results showed that each basal diet produced severe depletion of Se-dependent glutathione peroxidase (SeGSHpx) in plasma, liver and pancreas according to the same time-course, but that other consequences of severe uncomplicated Se deficiency were much more severe among chicks fed the purified diet (e.g., growth depression, pancreatic dysfunction as indicated by elevated plasma amylase and abnormal pancreatic histology). Chicks fed the practical Se-deficient diet showed reduced pancreas levels of copper, zinc and molybdenum and elevated plasma levels of iron; they required ca. 0.10 ppm dietary Se to sustain normal SeGSHpx in several tissues and to prevent elevated amylase in plasma. The dietary Se requirement of the chick is, therefore, estimated to be 0.10 ppm.

  17. Salt, blood pressure and cardiovascular risk: what is the most adequate preventive strategy? A Swiss perspective

    PubMed Central

    Burnier, Michel; Wuerzner, Gregoire; Bochud, Murielle

    2015-01-01

    Among the various strategies to reduce the incidence of non-communicable diseases reduction of sodium intake in the general population has been recognized as one of the most cost-effective means because of its potential impact on the development of hypertension and cardiovascular diseases. Yet, this strategic health recommendation of the WHO and many other international organizations is far from being universally accepted. Indeed, there are still several unresolved scientific and epidemiological questions that maintain an ongoing debate. Thus what is the adequate low level of sodium intake to recommend to the general population and whether national strategies should be oriented to the overall population or only to higher risk fractions of the population such as salt-sensitive patients are still discussed. In this paper, we shall review the recent results of the literature regarding salt, blood pressure and cardiovascular risk and we present the recommendations recently proposed by a group of experts of Switzerland. The propositions of the participating medical societies are to encourage national health authorities to continue their discussion with the food industry in order to reduce the sodium intake of food products with a target of mean salt intake of 5–6 grams per day in the population. Moreover, all initiatives to increase the information on the effect of salt on health and on the salt content of food are supported. PMID:26321959

  18. PG medical training and accreditation: responsibility of the government for the adequate health service delivery.

    PubMed

    Bhattarai, M D

    2012-09-01

    On one hand there is obvious inadequate health coverage to the rural population and on the other hand the densely populated urban area is facing the triple burden of increasing non-communicable and communicable health problems and the rising health cost. The postgraduate medical training is closely interrelated with the adequate health service delivery and health economics. In relation to the prevailing situation, the modern medical education trend indicates the five vital issues. These are i). Opportunity needs to be given to all MBBS graduates for General Specialist and Sub-Specialist Training inside the country to complete their medical education, ii). Urgent need for review of PG residential training criteria including appropriate bed and teacher criteria as well as entry criteria and eligibility criteria, iii). Involvement of all available units of hospitals fulfilling the requirements of the residential PG training criteria, iv). PG residential trainings involve doing the required work in the hospitals entitling them full pay and continuation of the service without any training fee or tuition fee, and v). Planning of the proportions of General Specialty and Sub-Specialty Training fields, particularly General Practice (GP) including its career and female participation. With increased number of medical graduates, now it seems possible to plan for optimal health coverage to the populations with appropriate postgraduate medical training. The medical professionals and public health workers must make the Government aware of the vital responsibility and the holistic approach required.

  19. A test of the cerebellar hypothesis of dyslexia in adequate and inadequate responders to reading intervention.

    PubMed

    Barth, Amy E; Denton, Carolyn A; Stuebing, Karla K; Fletcher, Jack M; Cirino, Paul T; Francis, David J; Vaughn, Sharon

    2010-05-01

    The cerebellar hypothesis of dyslexia posits that cerebellar deficits are associated with reading disabilities and may explain why some individuals with reading disabilities fail to respond to reading interventions. We tested these hypotheses in a sample of children who participated in a grade 1 reading intervention study (n = 174) and a group of typically achieving children (n = 62). At posttest, children were classified as adequately responding to the intervention (n = 82), inadequately responding with decoding and fluency deficits (n = 36), or inadequately responding with only fluency deficits (n = 56). Based on the Bead Threading and Postural Stability subtests from the Dyslexia Screening Test-Junior, we found little evidence that assessments of cerebellar functions were associated with academic performance or responder status. In addition, we did not find evidence supporting the hypothesis that cerebellar deficits are more prominent for poor readers with "specific" reading disabilities (i.e., with discrepancies relative to IQ) than for poor readers with reading scores consistent with IQ. In contrast, measures of phonological awareness, rapid naming, and vocabulary were strongly associated with responder status and academic outcomes. These results add to accumulating evidence that fails to associate cerebellar functions with reading difficulties.

  20. Ipragliflozin effectively reduced visceral fat in Japanese patients with type 2 diabetes under adequate diet therapy.

    PubMed

    Yamamoto, Chiho; Miyoshi, Hideaki; Ono, Kota; Sugawara, Hajime; Kameda, Reina; Ichiyama, Mei; Yamamoto, Kohei; Nomoto, Hiroshi; Nakamura, Akinobu; Atsumi, Tatsuya

    2016-06-30

    To investigate if ipragliflozin, a novel sodium-glucose co-transporter 2 inhibitor, alters body composition and to identify variables associated with reductions in visceral adipose tissue in Japanese patients with type 2 diabetes mellitus. This prospective observational study enrolled Japanese participants with type 2 diabetes mellitus. Subjects were administered ipragliflozin (50 mg/day) once daily for 16 weeks. Body composition, visceral adipose tissue volume and plasma variables were measured at 0, 8, and 16-weeks. The subjects' lifestyle habits including diet and exercise were evaluated at baseline and 16 weeks. The primary endpoint was defined as the decrease of visceral adipose tissue mass. Twenty-four of 26 enrolled participants completed the study. The visceral adipose tissue decreased significantly (110 ± 33 to 101 ± 36 cm(2), p = 0.005) as well as other parameters for metabolic insufficiency including hemoglobin A1c. Seventy-one % of the total body weight reduction (-2.49 kg) was estimated by a decrease in fat mass (-1.77 kg), and the remaining reduction (22%) by water volume (-0.55 kg). A minor but significant reduction in the skeletal muscle index was also observed. Correlation analyses were performed to identify variables associated with changes in visceral adipose tissue and the only significant variable identified was diet therapy (Spearman's r = -0.416, p = 0.043). Ipragliflozin significantly decreased visceral adipose tissue, and improved parametres for metabolic dysfunction. Adequate diet therapy would be necessary to induce and enhance the therapeutic merit.

  1. Gaussian membership functions are most adequate in representing uncertainty in measurements

    NASA Technical Reports Server (NTRS)

    Kreinovich, V.; Quintana, C.; Reznik, L.

    1992-01-01

    In rare situations, like fundamental physics, we perform experiments without knowing what their results will be. In the majority of real-life measurement situations, we more or less know beforehand what kind of results we will get. Of course, this is not the precise knowledge of the type 'the result will be between alpha - beta and alpha + beta,' because in this case, we would not need any measurements at all. This is usually a knowledge that is best represented in uncertain terms, like 'perhaps (or 'most likely', etc.) the measured value x is between alpha - beta and alpha + beta.' Traditional statistical methods neglect this additional knowledge and process only the measurement results. So it is desirable to be able to process this uncertain knowledge as well. A natural way to process it is by using fuzzy logic. But, there is a problem; we can use different membership functions to represent the same uncertain statements, and different functions lead to different results. What membership function do we choose? In the present paper, we show that under some reasonable assumptions, Gaussian functions mu(x) = exp(-beta(x(exp 2))) are the most adequate choice of the membership functions for representing uncertainty in measurements. This representation was efficiently used in testing jet engines to airplanes and spaceships.

  2. Aurally-adequate time-frequency analysis for scattered sound in auditoria

    NASA Astrophysics Data System (ADS)

    Norris, Molly K.; Xiang, Ning; Kleiner, Mendel

    2005-04-01

    The goal of this work was to apply an aurally-adequate time-frequency analysis technique to the analysis of sound scattering effects in auditoria. Time-frequency representations were developed as a motivated effort that takes into account binaural hearing, with a specific implementation of interaural cross-correlation process. A model of the human auditory system was implemented in the MATLAB platform based on two previous models [A. Härmä and K. Palomäki, HUTear, Espoo, Finland; and M. A. Akeroyd, A. Binaural Cross-correlogram Toolbox for MATLAB (2001), University of Sussex, Brighton]. These stages include proper frequency selectivity, the conversion of the mechanical motion of the basilar membrane to neural impulses, and binaural hearing effects. The model was then used in the analysis of room impulse responses with varying scattering characteristics. This paper discusses the analysis results using simulated and measured room impulse responses. [Work supported by the Frank H. and Eva B. Buck Foundation.

  3. DIAGNOSTICS OF BNL ERL

    SciTech Connect

    POZDEYEV,E.; BEN-ZVI, I.; CAMERON, P.; GASSNER, D.; KAYRAN, D.; ET AL.

    2007-06-25

    The ERL Prototype project is currently under development at the Brookhaven National Laboratory. The ERL is expected to demonstrate energy recovery of high-intensity beams with a current of up to a few hundred milliamps, while preserving the emittance of bunches with a charge of a few nanocoulombs produced by a high-current SRF gun. To successfully accomplish this task the machine will include beam diagnostics that will be used for accurate characterization of the three dimensional beam phase space at the injection and recirculation energies, transverse and longitudinal beam matching, orbit alignment, beam current measurement, and machine protection. This paper outlines requirements on the ERL diagnostics and describes its setup and modes of operation.

  4. ICF diagnostics. Revision 1

    SciTech Connect

    Coleman, L.W.

    1982-12-17

    In the past several years there have been significant advances and accomplishments in the field of Inertial Confinement Fusion (ICF) research which are directly attributable to an active experimental program supported by the development and applications of sophisticated and specialized diagnostics instruments and techniques. The continued development of high temporal-and spatial-resolution diagnostics, although with a somewhat different technical emphasis than previously, is essential for maintaining progress in ICF. With the generation of inertial fusion drivers now becoming available progress toward higher density compression of fusion fuel will be attained at the expense of temperature, and consequently emissions from the targets will be limited. At the same time since the targets are being driven to higher density they are more opaque to the low-to-moderate energy x-rays (up to a few keV) and particles (alpha particles, protons, and knock-on charged particles) that have been utilized for diagnosing target performance.

  5. Viral Hemorrhagic Fever Diagnostics

    PubMed Central

    Racsa, Lori D.; Kraft, Colleen S.; Olinger, Gene G.; Hensley, Lisa E.

    2016-01-01

    There are 4 families of viruses that cause viral hemorrhagic fever (VHF), including Filoviridae. Ebola virus is one virus within the family Filoviridae and the cause of the current outbreak of VHF in West Africa. VHF-endemic areas are found throughout the world, yet traditional diagnosis of VHF has been performed in large reference laboratories centered in Europe and the United States. The large amount of capital needed, as well as highly trained and skilled personnel, has limited the availability of diagnostics in endemic areas except in conjunction with governmental and nongovernmental entities. However, rapid diagnosis of VHF is essential to efforts that will limit outbreaks. In addition, increased global travel suggests VHF diagnoses may be made outside of the endemic areas. Thus, understanding how to diagnose VHF is imperative for laboratories worldwide. This article reviews traditional and current diagnostic modalities for VHF. PMID:26354968

  6. Cardiovascular modeling and diagnostics

    SciTech Connect

    Kangas, L.J.; Keller, P.E.; Hashem, S.; Kouzes, R.T.

    1995-12-31

    In this paper, a novel approach to modeling and diagnosing the cardiovascular system is introduced. A model exhibits a subset of the dynamics of the cardiovascular behavior of an individual by using a recurrent artificial neural network. Potentially, a model will be incorporated into a cardiovascular diagnostic system. This approach is unique in that each cardiovascular model is developed from physiological measurements of an individual. Any differences between the modeled variables and the variables of an individual at a given time are used for diagnosis. This approach also exploits sensor fusion to optimize the utilization of biomedical sensors. The advantage of sensor fusion has been demonstrated in applications including control and diagnostics of mechanical and chemical processes.

  7. Advances in diagnostic radiology.

    PubMed

    Runge, Val M

    2010-12-01

    Recent advances in diagnostic radiology are discussed on the basis of current publications in Investigative Radiology. Publications in the journal during 2009 and 2010 are reviewed, evaluating developments by modality and anatomic region. Technological advances continue to play a major role in the evolution and clinical practice of diagnostic radiology, and as such constitute a major publication focus. In the past 2 years, this includes advances in both magnetic resonance and computed tomography (in particular, the advent of dual energy computed tomography). An additional major focus of publications concerns contrast media, and in particular continuing research involving nephrogenic systemic fibrosis, its etiology, and differentiation of the gadolinium chelates on the basis of in vivo stability.

  8. Endodontic diagnostic terminology update.

    PubMed

    McClannahan, Scott B; Baisden, Michael K; Bowles, Walter R

    2011-01-01

    Determination of the etiology of the patient's chief complaint and a correct diagnosis are paramount prior to a recommendation of endodontic therapy. Reproduction of the patient's chief complaint is critical. If the chief complaint cannot be reproduced, consider consultation with or referral to an endodontist or orofacial pain specialist. The diagnostic terminology presented in this update provides for a more accurate description and communication of the health or pathological conditions of both pulpal and apical tissues. This information is summarized in Table I.

  9. PROcess Based Diagnostics PROBE

    NASA Technical Reports Server (NTRS)

    Clune, T.; Schmidt, G.; Kuo, K.; Bauer, M.; Oloso, H.

    2013-01-01

    Many of the aspects of the climate system that are of the greatest interest (e.g., the sensitivity of the system to external forcings) are emergent properties that arise via the complex interplay between disparate processes. This is also true for climate models most diagnostics are not a function of an isolated portion of source code, but rather are affected by multiple components and procedures. Thus any model-observation mismatch is hard to attribute to any specific piece of code or imperfection in a specific model assumption. An alternative approach is to identify diagnostics that are more closely tied to specific processes -- implying that if a mismatch is found, it should be much easier to identify and address specific algorithmic choices that will improve the simulation. However, this approach requires looking at model output and observational data in a more sophisticated way than the more traditional production of monthly or annual mean quantities. The data must instead be filtered in time and space for examples of the specific process being targeted.We are developing a data analysis environment called PROcess-Based Explorer (PROBE) that seeks to enable efficient and systematic computation of process-based diagnostics on very large sets of data. In this environment, investigators can define arbitrarily complex filters and then seamlessly perform computations in parallel on the filtered output from their model. The same analysis can be performed on additional related data sets (e.g., reanalyses) thereby enabling routine comparisons between model and observational data. PROBE also incorporates workflow technology to automatically update computed diagnostics for subsequent executions of a model. In this presentation, we will discuss the design and current status of PROBE as well as share results from some preliminary use cases.

  10. Microsphere based saliva diagnostics

    NASA Astrophysics Data System (ADS)

    Rissin, David M.; DiCesare, Christopher; Hayman, Ryan B.; Blicharz, Timothy M.; Walt, David R.

    2005-11-01

    Saliva presents a minimally invasive alternative medium to blood for performing diagnostics1. Microsphere sensors for ions, small organic molecules, and proteins are currently being developed and optical microarrays containing thousands of these sensors will be used for simultaneous multi-analyte analysis. The fiber bundle platform in use is 1mm in diameter and contains approximately 50,000 individually addressable 3.1μm fibers, each with an etched well capable of housing a single 3.1μm microsphere sensor. Micron-sized bead-based chemistries are produced in house, followed by deposition onto a fiber-optic bundle platform, allowing for multiplexed analysis. The ultimate goal is to develop a universal diagnostic system using saliva as the diagnostic medium. This platform will permit multiplexed analysis of a sample by integrating microfluidics with the optical arrays loaded with sensors capable of detecting relevant biomarkers associated with a wide range of disease states. Disease states that are currently under investigation include end stage renal disease (ESRD) and Sjoegrens Syndrome (SS).

  11. [Histopathological meniscus diagnostic].

    PubMed

    Fisseler-Eckhoff, A; Müller, K-M

    2009-06-01

    Menisci fulfill many functions within the complex biomechanics of the knee joint. In the case of meniscus lesions, sparing arthroscopic resections and operative refixation are the treatments of choice. With regard to diagnostics, this means that in general terms, the histopathologic diagnostics are carried out on detached meniscus fragments of between 5 mm and 2 cm in size. An experienced pathologist's knowledge of physiologically possible cellular and fibrous histological meniscus damage, as opposed to nonphysiological change regarded as normal with respect to age, is essential during a diagnostic meniscus evaluation. The clinician expects clear statements from the pathologist regarding the severity of previous or secondary degenerative meniscus damage, the age and type of traumatic tears, and appraisal of the relationship between trauma and meniscus damage from an insurance point of view. Close cooperation between the clinician and the pathologist allows for fast and unambiguous correlation of anamnesis, the clinical picture, and morphological reporting so that cases involving insurance problems - which are numerous, often long-term, and often unsatisfactory - can be clarified quickly.

  12. Alpha Particle Diagnostic

    SciTech Connect

    Fisher, Ray, K.

    2009-05-13

    The study of burning plasmas is the next frontier in fusion energy research, and will be a major objective of the U.S. fusion program through U.S. collaboration with our international partners on the ITER Project. For DT magnetic fusion to be useful for energy production, it is essential that the energetic alpha particles produced by the fusion reactions be confined long enough to deposit a significant fraction of their initial ~3.5 MeV energy in the plasma before they are lost. Development of diagnostics to study the behavior of energetic confined alpha particles is a very important if not essential part of burning plasma research. Despite the clear need for these measurements, development of diagnostics to study confined the fast confined alphas to date has proven extremely difficult, and the available techniques remain for the most part unproven and with significant uncertainties. Research under this grant had the goal of developing diagnostics of fast confined alphas, primarily based on measurements of the neutron and ion tails resulting from alpha particle knock-on collisions with the plasma deuterium and tritium fuel ions. One of the strengths of this approach is the ability to measure the alphas in the hot plasma core where the interesting ignition physics will occur.

  13. 45 CFR 2508.10 - Who has the responsibility for maintaining adequate technical, physical, and security safeguards...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... adequate technical, physical, and security safeguards to prevent unauthorized disclosure or destruction of... security safeguards to prevent unauthorized disclosure or destruction of manual and automatic record..., and security safeguards to prevent unauthorized disclosure or destruction of manual and...

  14. 45 CFR 2508.10 - Who has the responsibility for maintaining adequate technical, physical, and security safeguards...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... adequate technical, physical, and security safeguards to prevent unauthorized disclosure or destruction of... security safeguards to prevent unauthorized disclosure or destruction of manual and automatic record..., and security safeguards to prevent unauthorized disclosure or destruction of manual and...

  15. 45 CFR 2508.10 - Who has the responsibility for maintaining adequate technical, physical, and security safeguards...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... adequate technical, physical, and security safeguards to prevent unauthorized disclosure or destruction of... security safeguards to prevent unauthorized disclosure or destruction of manual and automatic record..., and security safeguards to prevent unauthorized disclosure or destruction of manual and...

  16. The quality assurance role in the Deep Space Network

    NASA Technical Reports Server (NTRS)

    Sirpilla, R. L.

    1981-01-01

    The quality assurance section provides skilled personnel who perform the following functions: quality hardware engineering, quality software engineering, inspection and testing, and an independent assessment to quality, engineering and project requirements. The quality assurance section provides specifications, workmanship standards, process specifications and quality assurance procedures in support of DSN equipment. In addition, the quality assurance section reviews DSN engineering documents to ensure that appropriate and adequate quality provisions are included.

  17. Homodecoupled 1,1- and 1,n-ADEQUATE: Pivotal NMR Experiments for the Structure Revision of Cryptospirolepine.

    PubMed

    Saurí, Josep; Bermel, Wolfgang; Buevich, Alexei V; Sherer, Edward C; Joyce, Leo A; Sharaf, Maged H M; Schiff, Paul L; Parella, Teodor; Williamson, R Thomas; Martin, Gary E

    2015-08-24

    Cryptospirolepine is the most structurally complex alkaloid discovered and characterized thus far from any Cryptolepis specie. Characterization of several degradants of the original, sealed NMR sample a decade after the initial report called the validity of the originally proposed structure in question. We now report the development of improved, homodecoupled variants of the 1,1- and 1,n-ADEQUATE (HD-ADEQUATE) NMR experiments; utilization of these techniques was critical to successfully resolving long-standing structural questions associated with crytospirolepine.

  18. 2012 HIV Diagnostics Conference: the molecular diagnostics perspective.

    PubMed

    Branson, Bernard M; Pandori, Mark

    2013-04-01

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

  19. Maintaining Adequate Carbon Dioxide Washout for an Advanced Extravehicular Mobility Unit

    NASA Technical Reports Server (NTRS)

    Chullen, Cinda; Navarro, Moses; Conger, Bruce; Korona, Adam; McMillin, Summer; Norcross, Jason; Swickrath, Mike

    2013-01-01

    Over the past several years, NASA has realized tremendous progress in technology development that is aimed at the production of an Advanced Extravehicular Mobility Unit (AEMU). Of the many functions provided by the spacesuit and portable life support subsystem within the AEMU, delivering breathing gas to the astronaut along with removing the carbon dioxide (CO2) remains one of the most important environmental functions that the AEMU can control. Carbon dioxide washout is the capability of the ventilation flow in the spacesuit helmet to provide low concentrations of CO2 to the crew member to meet breathing requirements. CO2 washout performance is a critical parameter needed to ensure proper and sufficient designs in a spacesuit and in vehicle applications such as sleep stations and hygiene compartments. Human testing to fully evaluate and validate CO2 washout performance is necessary but also expensive due to the levied safety requirements. Moreover, correlation of math models becomes challenging because of human variability and movement. To supplement human CO2 washout testing, a breathing capability will be integrated into a suited manikin test apparatus to provide a safe, lower cost, stable, easily modeled alternative to human testing. Additionally, this configuration provides NASA Johnson Space Center (JSC) the capability to evaluate CO2 washout under off-nominal conditions that would otherwise be unsafe for human testing or difficult due to fatigue of a test subject. Testing has been under way in-house at JSC and analysis has been initiated to evaluate whether the technology provides sufficient performance in ensuring that the CO2 is removed sufficiently and the ventilation flow is adequate for maintaining CO2 washout in the AEMU spacesuit helmet of the crew member during an extravehicular activity. This paper will review recent CO2 washout testing and analysis activities, testing planned in-house with a spacesuit simulator, and the associated analytical work

  20. Ensuring Adequate Health and Safety Information for Decision Makers during Large-Scale Chemical Releases

    NASA Astrophysics Data System (ADS)

    Petropoulos, Z.; Clavin, C.; Zuckerman, B.

    2015-12-01

    The 2014 4-Methylcyclohexanemethanol (MCHM) spill in the Elk River of West Virginia highlighted existing gaps in emergency planning for, and response to, large-scale chemical releases in the United States. The Emergency Planning and Community Right-to-Know Act requires that facilities with hazardous substances provide Material Safety Data Sheets (MSDSs), which contain health and safety information on the hazardous substances. The MSDS produced by Eastman Chemical Company, the manufacturer of MCHM, listed "no data available" for various human toxicity subcategories, such as reproductive toxicity and carcinogenicity. As a result of incomplete toxicity data, the public and media received conflicting messages on the safety of the contaminated water from government officials, industry, and the public health community. Two days after the governor lifted the ban on water use, the health department partially retracted the ban by warning pregnant women to continue avoiding the contaminated water, which the Centers for Disease Control and Prevention deemed safe three weeks later. The response in West Virginia represents a failure in risk communication and calls to question if government officials have sufficient information to support evidence-based decisions during future incidents. Research capabilities, like the National Science Foundation RAPID funding, can provide a solution to some of the data gaps, such as information on environmental fate in the case of the MCHM spill. In order to inform policy discussions on this issue, a methodology for assessing the outcomes of RAPID and similar National Institutes of Health grants in the context of emergency response is employed to examine the efficacy of research-based capabilities in enhancing public health decision making capacity. The results of this assessment highlight potential roles rapid scientific research can fill in ensuring adequate health and safety data is readily available for decision makers during large

  1. Determining median urinary iodine concentration that indicates adequate iodine intake at population level.

    PubMed Central

    Delange, François; de Benoist, Bruno; Burgi, Hans

    2002-01-01

    OBJECTIVE: Urinary iodine concentration is the prime indicator of nutritional iodine status and is used to evaluate population-based iodine supplementation. In 1994, WHO, UNICEF and ICCIDD recommended median urinary iodine concentrations for populations of 100- 200 micro g/l, assuming the 100 micro g/l threshold would limit concentrations <50 micro g/l to 100 micro g/l. The total population was 55 892, including 35 661 (64%) schoolchildren. Median urinary iodine concentrations were 111-540 (median 201) micro g/l for all populations, 100-199 micro g/l in 23 (48%) populations and >/=200 micro g/l in 25 (52%). The frequencies of values <50 micro g/l were 0-20.8 (mean 4.8%) overall and 7.2% and 2.5% in populations with medians of 100-199 micro g/l and >200 micro g/l, respectively. The frequency reached 20% only in two places where iodine had been supplemented for <2 years. CONCLUSION: The frequency of urinary iodine concentrations <50 micro g/l in populations with median urinary iodine concentrations >/=100 micro g/l has been overestimated. The threshold of 100 micro g/l does not need to be increased. In populations, median urinary iodine concentrations of 100-200 micro g/l indicate adequate iodine intake and optimal iodine nutrition. PMID:12219154

  2. Defining an adequate sample of earlywood vessels for retrospective injury detection in diffuse-porous species.

    PubMed

    Arbellay, Estelle; Corona, Christophe; Stoffel, Markus; Fonti, Patrick; Decaulne, Armelle

    2012-01-01

    Vessels of broad-leaved trees have been analyzed to study how trees deal with various environmental factors. Cambial injury, in particular, has been reported to induce the formation of narrower conduits. Yet, little or no effort has been devoted to the elaboration of vessel sampling strategies for retrospective injury detection based on vessel lumen size reduction. To fill this methodological gap, four wounded individuals each of grey alder (Alnus incana (L.) Moench) and downy birch (Betula pubescens Ehrh.) were harvested in an avalanche path. Earlywood vessel lumina were measured and compared for each tree between the injury ring built during the growing season following wounding and the control ring laid down the previous year. Measurements were performed along a 10 mm wide radial strip, located directly next to the injury. Specifically, this study aimed at (i) investigating the intra-annual duration and local extension of vessel narrowing close to the wound margin and (ii) identifying an adequate sample of earlywood vessels (number and intra-ring location of cells) attesting to cambial injury. Based on the results of this study, we recommend analyzing at least 30 vessels in each ring. Within the 10 mm wide segment of the injury ring, wound-induced reduction in vessel lumen size did not fade with increasing radial and tangential distances, but we nevertheless advise favoring early earlywood vessels located closest to the injury. These findings, derived from two species widespread across subarctic, mountainous, and temperate regions, will assist retrospective injury detection in Alnus, Betula, and other diffuse-porous species as well as future related research on hydraulic implications after wounding.

  3. Defining an Adequate Sample of Earlywood Vessels for Retrospective Injury Detection in Diffuse-Porous Species

    PubMed Central

    Arbellay, Estelle; Corona, Christophe; Stoffel, Markus; Fonti, Patrick; Decaulne, Armelle

    2012-01-01

    Vessels of broad-leaved trees have been analyzed to study how trees deal with various environmental factors. Cambial injury, in particular, has been reported to induce the formation of narrower conduits. Yet, little or no effort has been devoted to the elaboration of vessel sampling strategies for retrospective injury detection based on vessel lumen size reduction. To fill this methodological gap, four wounded individuals each of grey alder (Alnus incana (L.) Moench) and downy birch (Betula pubescens Ehrh.) were harvested in an avalanche path. Earlywood vessel lumina were measured and compared for each tree between the injury ring built during the growing season following wounding and the control ring laid down the previous year. Measurements were performed along a 10 mm wide radial strip, located directly next to the injury. Specifically, this study aimed at (i) investigating the intra-annual duration and local extension of vessel narrowing close to the wound margin and (ii) identifying an adequate sample of earlywood vessels (number and intra-ring location of cells) attesting to cambial injury. Based on the results of this study, we recommend analyzing at least 30 vessels in each ring. Within the 10 mm wide segment of the injury ring, wound-induced reduction in vessel lumen size did not fade with increasing radial and tangential distances, but we nevertheless advise favoring early earlywood vessels located closest to the injury. These findings, derived from two species widespread across subarctic, mountainous, and temperate regions, will assist retrospective injury detection in Alnus, Betula, and other diffuse-porous species as well as future related research on hydraulic implications after wounding. PMID:22761707

  4. Adequate antigen availability: a key issue for novel approaches to tumor vaccination and tumor immunotherapy.

    PubMed

    Accolla, Roberto S; Tosi, Giovanna

    2013-03-01

    A crucial parameter for activation of the anti-tumor immune response is an adequate antigen availability (AAA) defined here as the optimal tumor antigen dose and related antigen processing and MHC-II-restricted presentation necessary to efficiently trigger tumor-specific TH cells. We will discuss two distinct experimental systems: a) a preventive anti-tumor vaccination system; b) a therapy-induced anti-tumor vaccination approach. In the first case tumor cells are rendered constitutively MHC-II+ by transfecting them with the MHC-II transcriptional activator CIITA. Here AAA is generated by the function of tumor's newly expressed MHC-II molecules to present tumor-associated antigens to tumor-specific TH cells. In the second case, AAA is generated by treating established tumors with neovasculature-targeted TNFα. In conjuction with Melphalan, targeted TNFα delivery produces extensive areas of tumor necrosis that generate AAA capable of optimally activate tumor-specific TH cells which in turn activate CTL immune effectors. In both experimental systems tumor rejection and persistent and long-lived TH cell anti-tumor memory, responsible of defending the animals from subsequent challenges with tumor cells, are achieved. Based on these and other investigators' results we propose that AAA is a key element for triggering adaptive immune functions resulting in subversion from a pro-tumor to an anti-tumor microenvironment, tumor rejection and acquisition of anti-tumor immune memory. Hypotheses of neuro-immune networks involved in these approaches are discussed. These considerations are important also for the comprehension of how chemotherapy and/or radiation therapies may help to block and/or to eradicate the tumor and for the construction of suitable anti-tumor vaccine strategies.

  5. The adequate stimulus for avian short latency vestibular responses to linear translation

    NASA Technical Reports Server (NTRS)

    Jones, T. A.; Jones, S. M.; Colbert, S.

    1998-01-01

    Transient linear acceleration stimuli have been shown to elicit eighth nerve vestibular compound action potentials in birds and mammals. The present study was undertaken to better define the nature of the adequate stimulus for neurons generating the response in the chicken (Gallus domesticus). In particular, the study evaluated the question of whether the neurons studied are most sensitive to the maximum level of linear acceleration achieved or to the rate of change in acceleration (da/dt, or jerk). To do this, vestibular response thresholds were measured as a function of stimulus onset slope. Traditional computer signal averaging was used to record responses to pulsed linear acceleration stimuli. Stimulus onset slope was systematically varied. Acceleration thresholds decreased with increasing stimulus onset slope (decreasing stimulus rise time). When stimuli were expressed in units of jerk (g/ms), thresholds were virtually constant for all stimulus rise times. Moreover, stimuli having identical jerk magnitudes but widely varying peak acceleration levels produced virtually identical responses. Vestibular response thresholds, latencies and amplitudes appear to be determined strictly by stimulus jerk magnitudes. Stimulus attributes such as peak acceleration or rise time alone do not provide sufficient information to predict response parameter quantities. Indeed, the major response parameters were shown to be virtually independent of peak acceleration levels or rise time when these stimulus features were isolated and considered separately. It is concluded that the neurons generating short latency vestibular evoked potentials do so as "jerk encoders" in the chicken. Primary afferents classified as "irregular", and which traditionally fall into the broad category of "dynamic" or "phasic" neurons, would seem to be the most likely candidates for the neural generators of short latency vestibular compound action potentials.

  6. Emotional Experiences of Obese Women with Adequate Gestational Weight Variation: A Qualitative Study

    PubMed Central

    Faria-Schützer, Débora Bicudo; Surita, Fernanda Garanhani de Castro; Alves, Vera Lucia Pereira; Vieira, Carla Maria; Turato, Egberto Ribeiro

    2015-01-01

    Background As a result of the growth of the obese population, the number of obese women of fertile age has increased in the last few years. Obesity in pregnancy is related to greater levels of anxiety, depression and physical harm. However, pregnancy is an opportune moment for the intervention of health care professionals to address obesity. The objective of this study was to describe how obese pregnant women emotionally experience success in adequate weight control. Methods and Findings Using a qualitative design that seeks to understand content in the field of health, the sample of subjects was deliberated, with thirteen obese pregnant women selected to participate in an individual interview. Data was analysed by inductive content analysis and includes complete transcription of the interviews, re-readings using suspended attention, categorization in discussion topics and the qualitative and inductive analysis of the content. The analysis revealed four categories, three of which show the trajectory of body care that obese women experience during pregnancy: 1) The obese pregnant woman starts to think about her body;2) The challenge of the diet for the obese pregnant woman; 3) The relation of the obese pregnant woman with the team of antenatal professionals. The fourth category reveals the origin of the motivation for the change: 4) The potentializing factors for change: the motivation of the obese woman while pregnant. Conclusions During pregnancy, obese women are more in touch with themselves and with their emotional conflicts. Through the transformations of their bodies, women can start a more refined self-care process and experience of the body-mind unit. The fear for their own and their baby's life, due to the risks posed by obesity, appears to be a great potentializing factor for change. The relationship with the professionals of the health care team plays an important role in the motivational support of the obese pregnant woman. PMID:26529600

  7. The rat adequately reflects human responses to exercise in blood biochemical profile: a comparative study

    PubMed Central

    Goutianos, Georgios; Tzioura, Aikaterini; Kyparos, Antonios; Paschalis, Vassilis; Margaritelis, Nikos V; Veskoukis, Aristidis S; Zafeiridis, Andreas; Dipla, Konstantina; Nikolaidis, Michalis G; Vrabas, Ioannis S

    2015-01-01

    Animal models are widely used in biology and the findings of animal research are traditionally projected to humans. However, recent publications have raised concerns with regard to what extent animals and humans respond similar to physiological stimuli. Original data on direct in vivo comparison between animals and humans are scarce and no study has addressed this issue after exercise. We aimed to compare side by side in the same experimental setup rat and human responses to an acute exercise bout of matched intensity and duration. Rats and humans ran on a treadmill at 86% of maximal velocity until exhaustion. Pre and post exercise we measured 30 blood chemistry parameters, which evaluate iron status, lipid profile, glucose regulation, protein metabolism, liver, and renal function. ANOVA indicated that almost all biochemical parameters followed a similar alteration pattern post exercise in rats and humans. In fact, there were only 2/30 significant species × exercise interactions (in testosterone and globulins), indicating different responses to exercise between rats and humans. On the contrary, the main effect of exercise was significant in 15/30 parameters and marginally nonsignificant in other two parameters (copper, P = 0.060 and apolipoprotein B, P = 0.058). Our major finding is that the rat adequately mimics human responses to exercise in those basic blood biochemical parameters reported here. The physiological resemblance of rat and human blood responses after exercise to exhaustion on a treadmill indicates that the use of blood chemistry in rats for exercise physiology research is justified. PMID:25677548

  8. Advances in sarcoma diagnostics and treatment

    PubMed Central

    Dancsok, Amanda R; Asleh-Aburaya, Karama; Nielsen, Torsten O

    2017-01-01

    The heterogeneity of sarcomas with regard to molecular genesis, histology, clinical characteristics, and response to treatment makes management of these rare yet diverse neoplasms particularly challenging. This review encompasses recent developments in sarcoma diagnostics and treatment, including cytotoxic, targeted, epigenetic, and immune therapy agents. In the past year, groups internationally explored the impact of adding mandatory molecular testing to histological diagnosis, reporting some changes in diagnosis and/or management; however, the impact on outcomes could not be adequately assessed. Transcriptome sequencing techniques have brought forward new diagnostic tools for identifying fusions and/or characterizing unclassified entities. Next-generation sequencing and advanced molecular techniques were also applied to identify potential targets for directed and epigenetic therapy, where preclinical studies reported results for agents active within the receptor tyrosine kinase, mTOR, Notch, Wnt, Hedgehog, Hsp90, and MDM2 signaling networks. At the level of clinical practice, modest developments were seen for some sarcoma subtypes in conventional chemotherapy and in therapies targeting the pathways activated by various receptor tyrosine kinases. In the burgeoning field of immune therapy, sarcoma work is in its infancy; however, elaborate protocols for immune stimulation are being explored, and checkpoint blockade agents advance from preclinical models to clinical studies. PMID:27732970

  9. Aquagenic urticaria: diagnostic and management challenges

    PubMed Central

    Rothbaum, Robert; McGee, Jean S

    2016-01-01

    Aquagenic urticaria (AU) is a rare inducible form of physical urticaria, which occurs in response to cutaneous exposure to water, including sweat and tears. Patients present with characteristic 1–3 mm folliculocentric wheals with surrounding 1–3 cm erythematous flares within 20–30 minutes following skin contact with water. In rare cases, there are concomitant systemic symptoms, such as wheezing or shortness of breath. The pathogenesis of AU is poorly understood at this time, and it appears to be mediated in both a histamine-dependent and independent manner. Diagnosis is based on eliciting a thorough clinical history combined with a water challenge test. Some patients may need to undergo further testing to exclude other physical urticarias. Rarely, multiple physical urticarias can be present in one patient, which can complicate diagnosis and treatment. Currently, the first-line therapy for AU is an oral administration of nonsedating, second-generation H1 antihistamines, but many patients may require further interventions to have adequate symptomatic control. In this review, we discuss the diagnostic and management challenges of AU. We review the key diagnostic features that differentiate AU from other physical urticarias. We additionally describe a therapeutic ladder for the treatment of AU and the rationale supporting these treatments. PMID:27942227

  10. Diagnostic Assessment and Treatment of Reading Difficulties: A Case Study of Dyslexia

    ERIC Educational Resources Information Center

    Oviedo, Paula Outon; Gonzalez, Rebeca Abal

    2013-01-01

    Dyslexia is a specific learning disability in reading and writing, which requires adequate early intervention to prevent future school failure. We describe the diagnostic assessment of a 7-year-old boy labelled "dyslexic", the evaluation of his family, social, medical, developmental, and academic status as a preliminary for the design…

  11. On the survivability of diagnostic windows in the CIT (Compact Ignition Tokamak) reactor

    SciTech Connect

    Taylor, A.

    1988-11-01

    The problem of radiation induced stresses in CIT diagnostic windows is discussed. Existing data indicate windows of existing design will probably survive if placed on the periphery of the reactor. There is a lack of adequate engineering data upon which the design and survivability of windows can be based. 22 refs., 5 figs., 2 tabs.

  12. What does a diagnostic label of 'polycystic ovary syndrome' really mean in adolescence? A review of current practice recommendations.

    PubMed

    Morris, S; Grover, S; Sabin, M A

    2016-02-01

    Polycystic ovary syndrome (PCOS) is the most common female endocrine disorder, with many women initially presenting during adolescence. Diagnosis during this period is particularly challenging, yet many emphasize the importance of an early diagnosis given the long-term metabolic and reproductive health consequences associated with the syndrome. The objective of this study was to review the current literature to determine whether the diagnostic label 'PCOS' is necessary to effectively manage adolescent girls presenting with features of the syndrome. A literature search was conducted (PubMed, Medline, Informit Health and the Cochrane Database of Systematic Reviews) identifying papers addressing the diagnosis and management of PCOS during adolescence. Articles were selected based on date of publication, relevance of material and the quality of evidence presented. A total of 427 papers were screened, with 40 of these selected from the initial search. A subsequent 154 were included from manual review of reference lists from key papers identified in the initial search. Current guidelines recommend treating the individual manifestations of PCOS. In doing so, there is good evidence identifying that this approach adequately targets the underlying metabolic and reproductive changes associated with the syndrome. This suggests that providing a diagnostic label of PCOS is not actually necessary to effectively manage adolescent girls with features of this syndrome.

  13. AIR KERMA TO Hp(3) CONVERSION COEFFICIENTS FOR IEC 61267 RQR X-RAY RADIATION QUALITIES: APPLICATION TO DOSE MONITORING OF THE LENS OF THE EYE IN MEDICAL DIAGNOSTICS.

    PubMed

    Principi, S; Guardiola, C; Duch, M A; Ginjaume, M

    2016-09-01

    Recent studies highlight the fact that the new eye lens dose limit can be exceeded in interventional radiology procedures and that eye lens monitoring could be required for these workers. The recommended operational quantity for monitoring of eye lens exposure is the personal dose equivalent at 3 mm depth Hp(3) (ICRU 51). However, there are no available conversion coefficients in international standards, while in the literature coefficients have only been calculated for monoenergetic beams and for ISO 4037-1 X-ray qualities. The aim of this article is to provide air kerma to Hp(3) conversion coefficients for a cylindrical phantom made of ICRU-4 elements tissue-equivalent material for RQR radiation qualities (IEC-61267) from 40 to 120 kV and for angles of incidence from 0 to 180°, which are characteristic of medical workplace. Analytic calculations using interpolation techniques and Monte Carlo modelling have been compared.

  14. Scientometric Dilemma: Is H-index Adequate for Scientific Validity of Academic's Work?

    PubMed

    Masic, Izet; Begic, Edin

    2016-07-16

    H-index is an index that attempts to measure the productivity and impact of published work of scientists. H-index has several advantages - it combines productivity with echo, is not sensitive to extreme values in terms of articles without citation or to articles with above-average number of citations and directly enables the identification of the most relevant articles with regard to the number of citations received. H-index has great potential in the academic community, but it still has not realistic indicator of the quality of work of one author. Authors described most used indices for scientific assessment.

  15. Scientometric Dilemma: Is H-index Adequate for Scientific Validity of Academic’s Work?

    PubMed Central

    Masic, Izet; Begic, Edin

    2016-01-01

    H-index is an index that attempts to measure the productivity and impact of published work of scientists. H-index has several advantages – it combines productivity with echo, is not sensitive to extreme values in terms of articles without citation or to articles with above-average number of citations and directly enables the identification of the most relevant articles with regard to the number of citations received. H-index has great potential in the academic community, but it still has not realistic indicator of the quality of work of one author. Authors described most used indices for scientific assessment. PMID:27708482

  16. Planetary Transmission Diagnostics

    NASA Technical Reports Server (NTRS)

    Lewicki, David G. (Technical Monitor); Samuel, Paul D.; Conroy, Joseph K.; Pines, Darryll J.

    2004-01-01

    This report presents a methodology for detecting and diagnosing gear faults in the planetary stage of a helicopter transmission. This diagnostic technique is based on the constrained adaptive lifting algorithm. The lifting scheme, developed by Wim Sweldens of Bell Labs, is a time domain, prediction-error realization of the wavelet transform that allows for greater flexibility in the construction of wavelet bases. Classic lifting analyzes a given signal using wavelets derived from a single fundamental basis function. A number of researchers have proposed techniques for adding adaptivity to the lifting scheme, allowing the transform to choose from a set of fundamental bases the basis that best fits the signal. This characteristic is desirable for gear diagnostics as it allows the technique to tailor itself to a specific transmission by selecting a set of wavelets that best represent vibration signals obtained while the gearbox is operating under healthy-state conditions. However, constraints on certain basis characteristics are necessary to enhance the detection of local wave-form changes caused by certain types of gear damage. The proposed methodology analyzes individual tooth-mesh waveforms from a healthy-state gearbox vibration signal that was generated using the vibration separation (synchronous signal-averaging) algorithm. Each waveform is separated into analysis domains using zeros of its slope and curvature. The bases selected in each analysis domain are chosen to minimize the prediction error, and constrained to have the same-sign local slope and curvature as the original signal. The resulting set of bases is used to analyze future-state vibration signals and the lifting prediction error is inspected. The constraints allow the transform to effectively adapt to global amplitude changes, yielding small prediction errors. However, local wave-form changes associated with certain types of gear damage are poorly adapted, causing a significant change in the

  17. Invasive mycoses: diagnostic challenges.

    PubMed

    Ostrosky-Zeichner, Luis

    2012-01-01

    Despite the availability of newer antifungal drugs, outcomes for patients with invasive fungal infections (IFIs) continue to be poor, in large part due to delayed diagnosis and initiation of appropriate antifungal therapy. Standard histopathologic diagnostic techniques are often untenable in at-risk patients, and culture-based diagnostics typically are too insensitive or nonspecific, or provide results after too long a delay for optimal IFI management. Newer surrogate markers of IFIs with improved sensitivity and specificity are needed to enable earlier diagnosis and, ideally, to provide prognostic information and/or permit therapeutic monitoring. Surrogate assays should also be accessible and easy to implement in the hospital. Several nonculture-based assays of newer surrogates are making their way into the medical setting or are currently under investigation. These new or up-and-coming surrogates include antigens/antibodies (mannan and antimannan antibodies) or fungal metabolites (d-arabinitol) for detection of invasive candidiasis, the Aspergillus cell wall component galactomannan used to detect invasive aspergillosis, or the fungal cell wall component and panfungal marker β-glucan. In addition, progress continues with use of polymerase chain reaction- or other nucleic acid- or molecular-based assays for diagnosis of either specific or generic IFIs, although the various methods must be better standardized before any of these approaches can be more fully implemented into the medical setting. Investigators are also beginning to explore the possibility of combining newer surrogate markers with each other or with more standard diagnostic approaches to improve sensitivity, specificity, and capacity for earlier diagnosis, at a time when fungal burden is still relatively low and more responsive to antifungal therapy.

  18. Planning 4-Dimensional Computed Tomography (4DCT) Cannot Adequately Represent Daily Intrafractional Motion of Abdominal Tumors

    SciTech Connect

    Ge, Jiajia; Santanam, Lakshmi; Noel, Camille; Parikh, Parag J.

    2013-03-15

    Purpose: To evaluate whether planning 4-dimensional computed tomography (4DCT) can adequately represent daily motion of abdominal tumors in regularly fractionated and stereotactic body radiation therapy (SBRT) patients. Methods and Materials: Intrafractional tumor motion of 10 patients with abdominal tumors (4 pancreas-fractionated and 6 liver-stereotactic patients) with implanted fiducials was measured based on daily orthogonal fluoroscopic movies over 38 treatment fractions. The needed internal margin for at least 90% of tumor coverage was calculated based on a 95th and fifth percentile of daily 3-dimensional tumor motion. The planning internal margin was generated by fusing 4DCT motion from all phase bins. The disagreement between needed and planning internal margin was analyzed fraction by fraction in 3 motion axes (superior-inferior [SI], anterior-posterior [AP], and left-right [LR]). The 4DCT margin was considered as an overestimation/underestimation of daily motion when disagreement exceeded at least 3 mm in the SI axis and/or 1.2 mm in the AP and LR axes (4DCT image resolution). The underlying reasons for this disagreement were evaluated based on interfractional and intrafractional breathing variation. Results: The 4DCT overestimated daily 3-dimensional motion in 39% of the fractions in 7 of 10 patients and underestimated it in 53% of the fractions in 8 of 10 patients. Median underestimation was 3.9 mm, 3.0 mm, and 1.7 mm in the SI axis, AP axis, and LR axis, respectively. The 4DCT was found to capture irregular deep breaths in 3 of 10 patients, with 4DCT motion larger than mean daily amplitude by 18 to 21 mm. The breathing pattern varied from breath to breath and day to day. The intrafractional variation of amplitude was significantly larger than intrafractional variation (2.7 mm vs 1.3 mm) in the primary motion axis (ie, SI axis). The SBRT patients showed significantly larger intrafractional amplitude variation than fractionated patients (3.0 mm vs 2

  19. Perinatal substance abuse and human subjects research: are privacy protections adequate?

    PubMed

    Marshall, Mary Faith; Menikoff, Jerry; Paltrow, Lynn M

    2003-01-01

    moral responsibility to understand local, state and national policies and laws governing perinatal substance abuse. Investigators and IRB members should balance the harms of punitive interventions against the protections that may, or may not be afforded to prospective research subjects as well as the prospective benefits, individual and social, of the research. In situations where criminal or punitive policies are in effect, investigators and IRB members should consider whether adequate protections can be achieved. In the context of inadequate protections, potential risks to prospective research subjects and their families may outweigh the individual or social benefits that accrue from the research. Clinical researchers are professionally obligated to work toward amending laws and policies that are not in the best interests of prospective research subjects.

  20. Global Uranium And Thorium Resources: Are They Adequate To Satisfy Demand Over The Next Half Century?

    NASA Astrophysics Data System (ADS)

    Lambert, I. B.

    2012-04-01

    This presentation will consider the adequacy of global uranium and thorium resources to meet realistic nuclear power demand scenarios over the next half century. It is presented on behalf of, and based on evaluations by, the Uranium Group - a joint initiative of the OECD Nuclear Energy Agency and the International Atomic Energy Agency, of which the author is a Vice Chair. The Uranium Group produces a biennial report on Uranium Resources, Production and Demand based on information from some 40 countries involved in the nuclear fuel cycle, which also briefly reviews thorium resources. Uranium: In 2008, world production of uranium amounted to almost 44,000 tonnes (tU). This supplied approximately three-quarters of world reactor requirements (approx. 59,000 tU), the remainder being met by previously mined uranium (so-called secondary sources). Information on availability of secondary sources - which include uranium from excess inventories, dismantling nuclear warheads, tails and spent fuel reprocessing - is incomplete, but such sources are expected to decrease in market importance after 2013. In 2008, the total world Reasonably Assured plus Inferred Resources of uranium (recoverable at less than 130/kgU) amounted to 5.4 million tonnes. In addition, it is clear that there are vast amounts of uranium recoverable at higher costs in known deposits, plus many as yet undiscovered deposits. The Uranium Group has concluded that the uranium resource base is more than adequate to meet projected high-case requirements for nuclear power for at least half a century. This conclusion does not assume increasing replacement of uranium by fuels from reprocessing current reactor wastes, or by thorium, nor greater reactor efficiencies, which are likely to ameliorate future uranium demand. However, progressively increasing quantities of uranium will need to be mined, against a backdrop of the relatively small number of producing facilities around the world, geopolitical uncertainties and

  1. Diagnostics at the ELBE Bremsstrahlung Facility

    NASA Astrophysics Data System (ADS)

    Evthushenko, P.; Lehnert, U.; Michel, P.; Schilling, K. D.; Schurig, R.; Teichert, J.

    2004-11-01

    The ELBE (Electron Linear accelerator with high Brilliance and low Emittance) machine is currently under transition from commissioning to regular user operation. The linac produces electron beams up to 40 MeV and 1 mA (CW), which are used to generate various kinds of secondary radiation. While the IR-FEL and X-ray facilities are still under construction, comprehensive nuclear physics experiments have been conducted at the Bremsstrahlung facility. Both, to meet the experimenter's demands on beam quality, stability and reproducibility and to ensure a safe operation of the machine, several diagnostic elements were developed. These devices, including backward OTR viewers, radiator temperature diagnostics, stripline detectors to monitor the beam incidence angle on the radiator, and a four-quadrant loss monitor, were developed, installed, and tested. These devices are described and results are presented in this paper.

  2. Diagnostic and vaccine chapter.

    PubMed

    Wolfram, J H; Kokanov, S K; Verkhovsky, O A

    2010-10-01

    The first report in this chapter describes the development of a killed composite vaccine. This killed vaccine is non-infectious to humans, other animals, and the environment. The vaccine has low reactivity, is non-abortive, and does not induce pathomorphological alterations to the organs of vaccinated animals. The second report of this chapter describes the diagnostic value of a competitive enzyme-linked immunosorbent assay for detecting Brucella-specific antibodies and its ability to discriminate vaccinated cattle from infected cattle. The results indicated that the competitive enzyme-linked immunosorbent assay is more sensitive than traditional tests for detecting antibodies to Brucella abortus in naturally and experimentally infected cattle.

  3. Diagnostics for hybrid reactors

    NASA Astrophysics Data System (ADS)

    Orsitto, Francesco Paolo

    2012-06-01

    The Hybrid Reactor(HR) can be considered an attractive actinide-burner or a fusion assisted transmutation for destruction of transuranic(TRU) nuclear waste. The hybrid reactor has two important subsystems: the tokamak neutron source and the blanket which includes a fuel zone where the TRU are placed and a tritium breeding zone. The diagnostic system for a HR must be as simple and robust as possible to monitor and control the plasma scenario, guarantee the protection of the machine and monitor the transmutation.

  4. [Molecular diagnostics in neuropathology].

    PubMed

    Dietmaier, W; Lorenz, J; Riemenschneider, M J

    2015-03-01

    As in only few other areas of oncology, molecular markers in neurooncology have become an integral part of clinical decision-making. This development is driven by a bustling scientific activity exploring the molecular basis and pathogenesis of human brain tumors. In addition, a high percentage of brain tumor patients are included in clinical studies in which molecular markers are assessed and linked with clinical informativeness. First steps towards more differentiated therapeutic strategies against brain tumors have thus been taken. The implementation in the clinical and diagnostic routine requires a detailed knowledge and a close collaboration between all medical disciplines involved.

  5. Diagnostic Antigens of Leishmania.

    DTIC Science & Technology

    1994-01-31

    braziliensis (MHOM/BR/75/M2903), L. chagasi (MJOM/BR/82/BA-2,C 1), L. donovani (MHOMiEt/67iHU3), Leishmania guyanensis (MIHOMJBR/75/M4147), L. infantum (IPT-1...comparative test to a variety of other recombinant Leishmania antigens including L. chagasi hsp70, L. braziliensis hsp83/90, L. braziliensis eIF4A, L...34 4. AD CONTRACT NO: DAMD17-92-C-2082 EC•£ 2 j 994 ’i, L TITLE: DIAGNOSTIC ANTIGENS OF LEISHMANIA L PRINCIPAL INVESTIGATOR: Steven G. Reed, Ph.D

  6. Diagnostics for hybrid reactors

    SciTech Connect

    Orsitto, Francesco Paolo

    2012-06-19

    The Hybrid Reactor(HR) can be considered an attractive actinide-burner or a fusion assisted transmutation for destruction of transuranic(TRU) nuclear waste. The hybrid reactor has two important subsystems: the tokamak neutron source and the blanket which includes a fuel zone where the TRU are placed and a tritium breeding zone. The diagnostic system for a HR must be as simple and robust as possible to monitor and control the plasma scenario, guarantee the protection of the machine and monitor the transmutation.

  7. [Diagnostic reference levels in interventional radiology].

    PubMed

    Vañó Carruana, E; Fernández Soto, J M; Sánchez Casanueva, R M; Ten Morón, J I

    2013-12-01

    This article discusses the diagnostic reference levels for radiation exposure proposed by the International Commission on Radiological Protection (ICRP) to facilitate the application of the optimization criteria in diagnostic imaging and interventional procedures. These levels are normally established as the third quartile of the dose distributions to patients in an ample sample of centers and are supposed to be representative of good practice regarding patient exposure. In determining these levels, it is important to evaluate image quality as well to ensure that it is sufficient for diagnostic purposes. When the values for the dose received by patients are systematically higher or much lower than the reference levels, an investigation should determine whether corrective measures need to be applied. The European and Spanish regulations require the use of these reference values in quality assurance programs. For interventional procedures, the dose area product (or kerma area product) values are usually used as reference values together with the time under fluoroscopy and the total number of images acquired. The most modern imaging devices allow the value of the accumulated dose at the entrance to the patient to be calculated to optimize the distribution of the dose on the skin. The ICRP recommends that the complexity of interventional procedures be taken into account when establishing reference levels. In the future, diagnostic imaging departments will have automatic systems to manage patient dosimetric data; these systems will enable continuous dosage auditing and alerts about individual procedures that might involve doses several times above the reference values. This article also discusses aspects that need to be clarified to take better advantage of the reference levels in interventional procedures.

  8. WE-D-213-02: Preparing for Part 2 of the ABR Diagnostic Physics Exam

    SciTech Connect

    Zambelli, J.

    2015-06-15

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics

  9. WE-D-213-00: Preparing for the ABR Diagnostic and Nuclear Medicine Physics Exams

    SciTech Connect

    2015-06-15

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics

  10. WE-D-213-01: Preparing for Part 1 of the ABR Diagnostic Physics Exam

    SciTech Connect

    Simiele, S.

    2015-06-15

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics

  11. WE-D-213-03: Preparing for Part 3 of the ABR Diagnostic Physics Exam

    SciTech Connect

    Bevins, N.

    2015-06-15

    Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics

  12. NIO1 diagnostics

    NASA Astrophysics Data System (ADS)

    Zaniol, B.; Barbisan, M.; Cavenago, M.; De Muri, M.; Mimo, A.; Pasqualotto, R.; Serianni, G.

    2015-04-01

    The radio frequency ion source NIO1, jointly developed by Consorzio RFX and INFN-LNL, will generate a 60kV-135mA hydrogen negative ion beam, composed of 9 beamlets over an area of about 40 × 40 mm2. This experiment will operate in continuous mode and in conditions similar to those foreseen for the larger ion sources of the Neutral Beam Injectors for ITER. The modular design of NIO1 is convenient to address the several still open important issues related to beam extraction, optics, and performance optimization. To this purpose a set of diagnostics is being implemented. Electric and water cooling plant related measurements will allow monitoring current, pressure, flow, and temperature. The plasma in the source will be characterized by emission spectroscopy, cavity ring-down and laser absorption spectroscopy. The accelerated beam will be analyzed with a fast emittance scanner, its intensity profile and divergence with beam emission spectroscopy and visible tomography. The power distribution of the beam on the calorimeter will be monitored by thermocouples and by an infrared camera. This contribution presents the implementation and initial operation of some of these diagnostics in the commissioning phase of the experiment, in particular the cooling water calorimetry and emission spectroscopy.

  13. Laboratory Diagnostics of Botulism

    PubMed Central

    Lindström, Miia; Korkeala, Hannu

    2006-01-01

    Botulism is a potentially lethal paralytic disease caused by botulinum neurotoxin. Human pathogenic neurotoxins of types A, B, E, and F are produced by a diverse group of anaerobic spore-forming bacteria, including Clostridium botulinum groups I and II, Clostridium butyricum, and Clostridium baratii. The routine laboratory diagnostics of botulism is based on the detection of botulinum neurotoxin in the patient. Detection of toxin-producing clostridia in the patient and/or the vehicle confirms the diagnosis. The neurotoxin detection is based on the mouse lethality assay. Sensitive and rapid in vitro assays have been developed, but they have not yet been appropriately validated on clinical and food matrices. Culture methods for C. botulinum are poorly developed, and efficient isolation and identification tools are lacking. Molecular techniques targeted to the neurotoxin genes are ideal for the detection and identification of C. botulinum, but they do not detect biologically active neurotoxin and should not be used alone. Apart from rapid diagnosis, the laboratory diagnostics of botulism should aim at increasing our understanding of the epidemiology and prevention of the disease. Therefore, the toxin-producing organisms should be routinely isolated from the patient and the vehicle. The physiological group and genetic traits of the isolates should be determined. PMID:16614251

  14. NIO1 diagnostics

    SciTech Connect

    Zaniol, B. Barbisan, M.; Pasqualotto, R.; Serianni, G.; Cavenago, M.; De Muri, M.; Mimo, A.

    2015-04-08

    The radio frequency ion source NIO1, jointly developed by Consorzio RFX and INFN-LNL, will generate a 60kV-135mA hydrogen negative ion beam, composed of 9 beamlets over an area of about 40 × 40 mm{sup 2}. This experiment will operate in continuous mode and in conditions similar to those foreseen for the larger ion sources of the Neutral Beam Injectors for ITER. The modular design of NIO1 is convenient to address the several still open important issues related to beam extraction, optics, and performance optimization. To this purpose a set of diagnostics is being implemented. Electric and water cooling plant related measurements will allow monitoring current, pressure, flow, and temperature. The plasma in the source will be characterized by emission spectroscopy, cavity ring-down and laser absorption spectroscopy. The accelerated beam will be analyzed with a fast emittance scanner, its intensity profile and divergence with beam emission spectroscopy and visible tomography. The power distribution of the beam on the calorimeter will be monitored by thermocouples and by an infrared camera. This contribution presents the implementation and initial operation of some of these diagnostics in the commissioning phase of the experiment, in particular the cooling water calorimetry and emission spectroscopy.

  15. Thioaptamer Diagnostic System (TDS)

    NASA Technical Reports Server (NTRS)

    Yang, Xianbin

    2015-01-01

    AM Biotechnologies, LLC, in partnership with Sandia National Laboratories, has developed a diagnostic device that quickly detects sampled biomarkers. The TDS quickly quantifies clinically relevant biomarkers using only microliters of a single sample. The system combines ambient-stable, long shelf-life affinity assays with handheld, microfluidic gel electrophoresis affinity assay quantification technology. The TDS is easy to use, operates in microgravity, and permits simultaneous quantification of 32 biomarkers. In Phase I of the project, the partners demonstrated that a thioaptamer assay used in the microfluidic instrument could quantify a specific biomarker in serum in the low nanomolar range. The team also identified novel affinity agents to bone-specific alkaline phosphatase (BAP) and demonstrated their ability to detect BAP with the microfluidic instrument. In Phase II, AM Biotech expanded the number of ambient affinity agents and demonstrated a TDS prototype. In the long term, the clinical version of the TDS will provide a robust, flight-tested diagnostic capability for space exploration missions.

  16. Instrumentation and diagnostics

    SciTech Connect

    Nakaishi, C.V.; Bedick, R.C.

    1990-12-01

    This Technology Status Report describes research and accomplishments for the Instrumentation and Diagnostics (I D) Projects within the Advanced Research and Technology Development (AR TD) Program of the United States Department of Energy (DOE) Office of Fossil Energy (FE). Process understanding and control can be improved through the development of advanced instrumentation and diagnostics. The thrust of the I D Projects is to further develop existing measurement and control techniques for application to advanced coal-based technologies. Project highlights are: an inductively coupled plasma (ICP) instrument has been developed to analyze trace elements in gasification and combustion process streams. An in situ two-color Mie scattering technique with LSS can simultaneously measure the size, velocity, and elemental composition of coal particles during combustion. A high-temperature, fluorescence thermometry technique has accurately measured gas temperatures during field testing in combustion and gasification environments. Expert systems have been developed to improve the control of advanced coal-based processes. Capacitance flowmeters were developed to determine the mass flowrate, solid volume fraction, and particle velocities of coal slurries. 32 refs., 9 figs.

  17. ICRP publication 121: radiological protection in paediatric diagnostic and interventional radiology.

    PubMed

    Khong, P-L; Ringertz, H; Donoghue, V; Frush, D; Rehani, M; Appelgate, K; Sanchez, R

    2013-04-01

    Paediatric patients have a higher average risk of developing cancer compared with adults receiving the same dose. The longer life expectancy in children allows more time for any harmful effects of radiation to manifest, and developing organs and tissues are more sensitive to the effects of radiation. This publication aims to provide guiding principles of radiological protection for referring clinicians and clinical staff performing diagnostic imaging and interventional procedures for paediatric patients. It begins with a brief description of the basic concepts of radiological protection, followed by the general aspects of radiological protection, including principles of justification and optimisation. Guidelines and suggestions for radiological protection in specific modalities - radiography and fluoroscopy, interventional radiology, and computed tomography - are subsequently covered in depth. The report concludes with a summary and recommendations. The importance of rigorous justification of radiological procedures is emphasised for every procedure involving ionising radiation, and the use of imaging modalities that are non-ionising should always be considered. The basic aim of optimisation of radiological protection is to adjust imaging parameters and institute protective measures such that the required image is obtained with the lowest possible dose of radiation, and that net benefit is maximised to maintain sufficient quality for diagnostic interpretation. Special consideration should be given to the availability of dose reduction measures when purchasing new imaging equipment for paediatric use. One of the unique aspects of paediatric imaging is with regards to the wide range in patient size (and weight), therefore requiring special attention to optimisation and modification of equipment, technique, and imaging parameters. Examples of good radiographic and fluoroscopic technique include attention to patient positioning, field size and adequate collimation, use

  18. Optimization of pharmacotherapy in chronic heart failure: is heart rate adequately addressed?

    PubMed

    Franke, Jennifer; Wolter, Jan Sebastian; Meme, Lillian; Keppler, Jeannette; Tschierschke, Ramon; Katus, Hugo A; Zugck, Christian

    2013-01-01

    bpm (p <0.01). Likewise, comparing the groups ≥75 and <75 bpm, the primary endpoint was significantly increased in the group of patients with heart rates ≥75 bpm 27 vs. 12.2 %; p < 0.01). 5-year event-free survival was significantly lower among patients with heart rates ≥70 bpm as compared to those with <70 bpm (log-rank test p < 0.05) and among patients in the ≥75 bpm group versus <75 bpm group (log-rank test p < 0.01). In conclusion, in clinical practice, 53 % of CHF patients have inadequate heart rate control (heart rates ≥75 bpm) despite concomitant beta-blocker therapy. In this non-randomized cohort, adequate heart rate control under individually optimized beta-blocker therapy was associated with improved mid- and long-term clinical outcome up to 5 years. As further up titration of beta-blockers is not achievable in many patients, the administration of a selective heart rate lowering agent, such as ivabradine adjuvant to beta-blockers may pose an opportunity to further modulate outcome.

  19. [An aphasic man with high fever; difficulty with diagnostic procedure].

    PubMed

    Potjewijd, J; Buijs, J

    2008-07-12

    A 73-year-old man, with known motor aphasia presented with high fever, dyspnoea, and vomiting. Only after several days it appeared that these signs were due to a sepsis as a consequence of a phlegmon of the neck, caused by an aspired part of his set of false teeth. The delay before diagnosis was due to the fact that adequate medical history taking was difficult because of the aphasia and attempts at non-verbal communication were poorly understood. The localization of the corpus alienum was a second pitfall, because it could not be visualized during physical examination or on the initial chest X-ray. The increased risk of colonization of dentures with pathogenic micro-organisms in nursing home residents may have played a role in the severe course of this infection. This case illustrates the diagnostic problems that may exist in patients who are unable to communicate adequately.

  20. External quality assessment scheme for haematology in Germany.

    PubMed

    Heller, S

    1995-01-01

    Quality control in haematology is performed in Germany for 20 years. Both cell count, haemoglobin measurement and differential count on smear with morphology exercise and probably diagnosis will be demanded by the participants. Until now this quality control is not mandatory, even efforts are done to change this circumstance, given by the main input of diagnostic value due to haematology results. So this regulation will be changed very soon, in order to submit haematological laboratories to governmental control, effected by the BAK (Bundesärztekammer), as already is done in clinical chemistry. For this EQA the participants cannot expected any financial support by any organization, nor public health, nor private assurance. The role of referee laboratories and reference values as well as difficulties for the adequate reference material are discussed. For the differential count other limits have to be established: recognition of pathological blood films is one of the most important point (in sense of morphological exercise) to ensure broad knowledge of "flag interpretation". Since the last year quality control for reticulocyte count and flow cytometry for immune status and leukemia-differentiation has been established.

  1. Rig Diagnostic Tools

    NASA Technical Reports Server (NTRS)

    Soileau, Kerry M.; Baicy, John W.

    2008-01-01

    Rig Diagnostic Tools is a suite of applications designed to allow an operator to monitor the status and health of complex networked systems using a unique interface between Java applications and UNIX scripts. The suite consists of Java applications, C scripts, Vx- Works applications, UNIX utilities, C programs, and configuration files. The UNIX scripts retrieve data from the system and write them to a certain set of files. The Java side monitors these files and presents the data in user-friendly formats for operators to use in making troubleshooting decisions. This design allows for rapid prototyping and expansion of higher-level displays without affecting the basic data-gathering applications. The suite is designed to be extensible, with the ability to add new system components in building block fashion without affecting existing system applications. This allows for monitoring of complex systems for which unplanned shutdown time comes at a prohibitive cost.

  2. Diagnostics and Microelectronics

    SciTech Connect

    Balch, J.W.

    1993-03-01

    This report discusses activities of the Diagnostics and Microelectronics thrust area which conducts activities in semiconductor devices and semiconductor fabrication technology for programs at Lawrence Livermore National Laboratory. Our multidisciplinary engineering and scientific staff use modern computational tools and semi-conductor microfabrication equipment to develop high-performance devices. Our work concentrates on three broad technologies of semiconductor microdevices: (1) silicon on III-V semiconductor microeletronics, (2) lithium niobate-based and III-V semiconductor-based photonics, and (3) silicon-based micromaching for application to microstructures and microinstruments. In FY-92, we worked on projects in seven areas, described in this report: novel photonic detectors; a wideband phase modulator; an optoelectronic terahertz beam system; the fabrication of microelectrode electrochemical sensors; diamond heatsinks; advanced micromachining technologies; and electrophoresis using silicon microchannels.

  3. Diagnostic paediatric imaging

    SciTech Connect

    Hall, C.M.; Lingam, S.

    1986-01-01

    This book is a case study teaching manual presenting radiographs and examples of other imaging modalities from 100 paediatric patients. The material comes from the radiological teaching collection at the Hospital for Sick Children at Great Ormond Street in London and was compiled over a ten year period. With each case a short clinical history is given and a series of questions posed, similar to those encountered in postgraduate medical examinations. Sample answers with comments and more illustrations are presented on the following page. The last decade has seen a rapid expansion in the range and sophistication of diagnostic imaging modalities which are available to clinicians. Since it is impossible to achieve comprehensive coverage in a book of this size, the authors have selected examples of cases which illustrate the range of imaging modalities currently available and which may be encountered in both clinical practice and in examinations.

  4. Balloon gondola diagnostics package

    NASA Astrophysics Data System (ADS)

    Cantor, K. M.

    1986-10-01

    In order to define a new gondola structural specification and to quantify the balloon termination environment, NASA developed a balloon gondola diagnostics package (GDP). This addition to the balloon flight train is comprised of a large array of electronic sensors employed to define the forces and accelerations imposed on a gondola during the termination event. These sensors include the following: a load cell, a three-axis accelerometer, two three-axis rate gyros, two magnetometers, and a two axis inclinometer. A transceiver couple allows the data to be telemetered across any in-line rotator to the gondola-mounted memory system. The GDP is commanded 'ON' just prior to parachute deployment in order to record the entire event.

  5. Alpha-particle diagnostics

    SciTech Connect

    Young, K.M.

    1991-01-01

    This paper will focus on the state of development of diagnostics which are expected to provide the information needed for {alpha}- physics studies in the future. Conventional measurement of detailed temporal and spatial profiles of background plasma properties in DT will be essential for such aspects as determining heating effectiveness, shaping of the plasma profiles and effects of MHD, but will not be addressed here. This paper will address (1) the measurement of the neutron source, and hence {alpha}-particle birth profile, (2) measurement of the escaping {alpha}-particles and (3) measurement of the confined {alpha}-particles over their full energy range. There will also be a brief discussion of (4) the concerns about instabilities being generated by {alpha}-particles and the methods necessary for measuring these effects. 51 refs., 10 figs.

  6. Diagnostic Evaluation of Rhabdomyolysis

    PubMed Central

    Nance, Jessica R.; Mammen, Andrew L.

    2015-01-01

    Rhabdomyolysis is characterized by severe acute muscle injury resulting in muscle pain, weakness, and/or swelling with release of myofiber contents into the bloodstream. Symptoms develop over hours to days following an inciting factor and may be associated with dark pigmentation of the urine. Serum creatine kinase and urine myoglobin levels are markedly elevated. The clinical examination, history, laboratory studies, muscle biopsy, and genetic testing are useful tools for diagnosis of rhabdomyolysis, and they can help differentiate acquired from inherited causes of rhabdomyolysis. Acquired causes include substance abuse, medication or toxic exposures, electrolyte abnormalities, endocrine disturbance, and autoimmune myopathies. Inherited predisposition to rhabdomyolysis can occur with disorders of glycogen metabolism, fatty acid beta-oxidation, and mitochondrial oxidative phosphorylation. Less common inherited causes of rhabdomyolysis include structural myopathies, channelopathies, and sickle cell disease. This review focuses on the differentiation of acquired and inherited causes of rhabdomyolysis and proposes a practical diagnostic algorithm. PMID:25678154

  7. Optical Diagnostics in Medicine

    NASA Astrophysics Data System (ADS)

    Iftimia, Nicusor

    2003-03-01

    Light has a unique potential for non-invasive tissue diagnosis. The relatively short wavelength of light allows imaging of tissue at the resolution of histopathology. While strong multiple scattering of light in tissue makes attainment of this resolution difficult for thick tissues, most pathology emanates from epithelial surfaces. Therefore, high-resolution diagnosis of many important diseases may be achieved by transmitting light to the surface of interest. The recent fiber-optic implementation of technologies that reject multiple scattering, such as confocal microscopy and optical low coherence interferometry, have brought us one step closer to realizing non-invasive imaging of architectural and cellular features of tissue. Optical coherence tomography (OCT) can produce high-resolution cross-sectional images of biological structures. Clinical OCT studies conducted in the gastrointestinal tract and cardiovascular system have shown that OCT is capable of providing images of the architectural (> 20 µm) microanatomy of a variety of epithelial tissues, including the layered structure of squamous epithelium and arterial vessels. Fine Needle Aspiration- Low Coherence Interferometry (FNA-LCI) is another optical diagnostics technique, which is a suitable solution to increase the effectiveness of the FNA procedures. LCI is capable of measuring depth resolved (axial, z) tissue structure, birefringence, flow (Doppler shift), and spectra at a resolution of several microns. Since LCI systems are fiber-optic based, LCI probes may easily fit within the bore of a fine gauge needle, allowing diagnostic information to be obtained directly from the FNA biopsy site. Fiber optic spectrally encoded confocal microscopy (SECM) is a new confocal microscopy method, which eliminates the need for rapid beam scanning within the optical probe. This advance enables confocal microscopy to be performed through small diameter probes and will allow assessment of internal human tissues in vivo at

  8. Oral vs. salivary diagnostics

    NASA Astrophysics Data System (ADS)

    Marques, Joana; Corby, Patricia M.; Barber, Cheryl A.; Abrams, William R.; Malamud, Daniel

    2015-05-01

    The field of "salivary diagnostics" includes studies utilizing samples obtained from a variety of sources within the oral cavity. These samples include; whole unstimulated saliva, stimulated whole saliva, duct saliva collected directly from the parotid, submandibular/sublingual glands or minor salivary glands, swabs of the buccal mucosa, tongue or tonsils, and gingival crevicular fluid. Many publications state "we collected saliva from subjects" without fully describing the process or source of the oral fluid. Factors that need to be documented in any study include the time of day of the collection, the method used to stimulate and collect the fluid, and how much fluid is being collected and for how long. The handling of the oral fluid during and post-collection is also critical and may include addition of protease or nuclease inhibitors, centrifugation, and cold or frozen storage prior to assay. In an effort to create a standard protocol for determining a biomarker's origin we carried out a pilot study collecting oral fluid from 5 different sites in the mouth and monitoring the concentrations of pro- and anti-inflammatory cytokines detected using MesoScaleDiscovery (MSD) electrochemiluminesence assays. Our data suggested that 3 of the cytokines are primarily derived from the submandibular gland, while 7 of the cytokines come from a source other than the major salivary glands such as the minor salivary glands or cells in the oral mucosae. Here we review the literature on monitoring biomarkers in oral samples and stress the need for determining the blood/saliva ratio when a quantitative determination is needed and suggest that the term oral diagnostic be used if the source of an analyte in the oral cavity is unknown.

  9. Diagnostics development plan for ZR.

    SciTech Connect

    Hanson, David Lester

    2003-09-01

    The Z Refurbishment (ZR) Project is a program to upgrade the Z machine at SNL with modern durable pulsed power technology, providing additional shot capacity and improved reliability as well as advanced capabilities for both pulsed x-ray production and high pressure generation. The development of enhanced diagnostic capabilities is an essential requirement for ZR to meet critical mission needs. This report presents a comprehensive plan for diagnostic instrument and infrastructure development for the first few years of ZR operation. The focus of the plan is on: (1) developing diagnostic instruments with high spatial and temporal resolution, capable of low noise operation and survival in the severe EMP, bremsstrahlung, and blast environments of ZR; and (2) providing diagnostic infrastructure improvements, including reduced diagnostic trigger signal jitter, more and flexible diagnostic line-of-sight access, and the capability for efficient exchange of diagnostics with other laboratories. This diagnostic plan is the first step in an extended process to provide enhanced diagnostic capabilities for ZR to meet the diverse programmatic needs of a broad range of defense, energy, and general science programs of an international user community into the next decade.

  10. Can developing countries achieve adequate improvements in child health outcomes without engaging the private sector?

    PubMed Central

    Bustreo, Flavia; Harding, April; Axelsson, Henrik

    2003-01-01

    The private sector exerts a significant and critical influence on child health outcomes in developing countries, including the health of poor children. This article reviews the available evidence on private sector utilization and quality of care. It provides a framework for analysing the private sector's influence on child health outcomes. This influence goes beyond service provision by private providers and nongovernmental organizations (NGOs). Pharmacies, drug sellers, private suppliers, and food producers also have an impact on the health of children. Many governments are experimenting with strategies to engage the private sector to improve child health. The article analyses some of the most promising strategies, and suggests that a number of constraints make it hard for policy-makers to emulate these approaches. Few experiences are clearly described, monitored, and evaluated. The article suggests that improving the impact of child health programmes in developing countries requires a more systematic analysis of how to engage the private sector most effectively. The starting point should include the evaluation of the presence and potential of the private sector, including actors such as professional associations, producer organizations, community groups, and patients' organizations. PMID:14997241

  11. Does limited data availability prevent adequate water use estimates on farm scale?

    NASA Astrophysics Data System (ADS)

    Kayatz, Benjamin; Kuster, Benjamin; Percy, Barbara; Hillier, Jonathan; Freese, Dirk; Wattenbach, Martin

    2015-04-01

    Increasing food production for a growing world population and at the same time mitigating climate change as well as adapting to its consequences is one of the key global challenges. Therefore producing crops with fewer resources such as water and fertilizers and less emissions of greenhouse gases is an important question that has to be answered on farm scale. The cool farm tool (CFT) is a farm scale emission calculator and was developed in 2010 to help farmers to reduce their carbon footprint. In order to adapt to future climate change an easy to use and at the same time robust water footprinting tool is needed for the CFT to take a more holistic approach on environmental sustainability. However data on farm level is often scarce. We investigated the effect of limited data on actual evapotranspiration using the FAO56 standard to assess the quality of farm water footprint estimates. Calculations are based on various agricultural sites from the Fluxnet database and estimates are compared to eddy covariance measurements. Results show that higher data availability is not directly linked to more accurate estimates of actual evapotranspiration. Estimates based only on temperature and relative humidity are still able to reproduce daily patterns. However cumulative values over one growing season show a considerable offset to eddy covariance observations for all data input levels. Finding the optimum between data requirements and an accuracy that fulfills farmer needs is crucial. Engagement of farmers and using a global network as the Fluxnet database will help to achieve this goal.

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

    PubMed

    Frueh, Felix W; Quinn, Bruce

    2014-09-01

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

  13. Upgrades of Diagnostic Techniques and Technologies for JET next D-T Campaigns

    SciTech Connect

    Murari, Andrea

    2015-07-01

    JET next D-T campaign is presently scheduled for the year 2017. The main scientific objectives include the assessment of the isotopic effects on various plasma aspects: mainly on confinement, on the threshold to access the H mode and on ELM behaviour. From a technical point of view, the total yield of the entire D-T phase is expected to be 1.7 1021 neutrons, about a factor of six higher than the previous main D-T campaign on JET, DTE1. Therefore the radiation field will be quite relevant for next step devices, since the neutron flux at the first wall (∼10{sup 16} n/cm{sup 2}s), for example, will be comparable to the one in ITER behind the blanket. From a point of view of diagnostics developments, for many years JET diagnostics have been upgraded in order to provide adequate support for the scientific exploitation of a D-T campaign. The main efforts have concentrated on improving three main aspects of JET measuring capability: 1) the quality of the measurements of the electron and ion fluids to support the plasma physics programme 2) the diagnostic for the fusion products 3) diagnostic technologies for ITER. In terms of general diagnostic capability, compared to the previous DTE1, JET diagnostics have a much better spatial and temporal resolution of both the ion and electron fluid (about one order of magnitude improvement for each parameter). The consistency of the various independent measurements of the same parameters has also increased significantly; the three independent measurements of the electron temperature, for example, agree now within 5%. Moreover, solutions are being addressed to operate some cameras, both visible and IR, even during the full D-T phase to provide imaging of the plasma and the first wall. Various upgrades of neutral particle analysis are being considered, mainly to measure the isotopic composition. A new set of reflectometers is expected to provide valuable information about the changes in the turbulence with the different fuel mixtures

  14. Measurements and Diagnostics of Diamond Films and Coatings

    NASA Technical Reports Server (NTRS)

    Miyoshi, Kazuhisa; Wu, Richard L. C.

    1999-01-01

    The commercial potential of chemical-vapor-deposited (CVD) diamond films has been established and a number of applications have been identified through university, industry, and government research studies. This paper discusses the methodologies used for property measurement and diagnostic of CVD diamond films and coatings. Measurement and diagnostic techniques studied include scanning electron microscopy, transmission electron microscopy, atomic force microscopy, stylus profilometry, x-ray diffraction, electron diffraction, Raman spectroscopy, Rutherford backscattering, elastic recoil spectroscopy, and friction examination. Each measurement and diagnostic technique provides unique information. A combination of techniques can provide the technical information required to understand the quality and properties of CVD diamond films, which are important to their application in specific component systems and environments. In this study the combination of measurement and diagnostic techniques was successfully applied to correlate deposition parameters and resultant diamond film composition, crystallinity, grain size, surface roughness, and coefficient of friction.

  15. The DSM diagnostic criteria for female sexual arousal disorder.

    PubMed

    Graham, Cynthia A

    2010-04-01

    This article reviews and critiques the DSM-IV-TR diagnostic criteria for Female Sexual Arousal Disorder (FSAD). An overview of how the diagnostic criteria for FSAD have evolved over previous editions of the DSM is presented and research on prevalence and etiology of FSAD is briefly reviewed. Problems with the essential feature of the DSM-IV-TR diagnosis-"an inability to attain, or to maintain...an adequate lubrication-swelling response of sexual excitement"-are identified. The significant overlap between "arousal" and "desire" disorders is highlighted. Finally, specific recommendations for revision of the criteria for DSM-V are made, including use of a polythetic approach to the diagnosis and the addition of duration and severity criteria.

  16. Myeloid sarcoma in children – diagnostic and therapeutic difficulties

    PubMed Central

    Samborska, Magdalena; Skalska-Sadowska, Jolanta; Kurzawa, Paweł; Wachowiak, Jacek

    2017-01-01

    Myeloid sarcoma (MS) is a malignant extramedullary tumour, which consists of immature cells of myeloid origin. It may occur de novo, concurrently or precede the diagnosis of acute myeloid leukemia (AML), myelodysplastic syndrome (MDS) or chronic myeloid leukemia (CML). MS can also be a manifestation of the relapse of the disease. The more frequent sites of involvement are the skin, orbit, bone, periosteum, lymph nodes, gastrointestinal tract, soft tissue, central nervous system and testis. Because of its different localization and symptoms, and the lack of diagnostics algorithm, myeloid sarcoma is a real diagnostic challenge, in particular in patients without initial bone marrow involvement. The correct diagnosis of MS is important for adequate therapy, which is often delayed because of a high misdiagnosis rate. In the paper, the role of immunohistochemistry, cytogenetic and molecular genetic analyses is emphasized as well as the breadth of unclear aspects of this disorder in children. PMID:28239280

  17. Diagnostic strategies in osteomyelitis

    SciTech Connect

    Wheat, J.

    1985-06-28

    Technetium-/sup 99/ pyrophosphate bone scanning often identifies patients with osteomyelitis before roentgenographic findings appear. However, recent studies have shown that /sup 99/Tc bone scanning often gives false-negative results, especially in neonates. The accuracy of computed tomographic scanning and indium-111 leukocyte scanning for diagnosis of early osteomyelitis has not been established. /sup 99/Tc bone scanning often gives false-positive results in patients with other conditions leading to bone injury and repair, such as trauma or recent surgery, further limiting the usefulness of this imaging procedure. Newer imaging techniques have not been adequately evaluated to establish their specificity. Because of their high cost and unproved accuracy, these new imaging procedures should not be routinely applied until their usefulness has been established. Bone biopsy remains the procedure of choice for establishing the diagnosis in patients suspected clinically to have osteomyelitis with negative findings on roentgenography and /sup 99/Tc bone scanning. Although Staphylococcus aureus is the leading cause of osteomyelitis, other pathogens cause 30 to 40 percent of cases. Aspiration or biopsy of the involved bone is usually required to choose appropriate antibiotic therapy. Bone biopsy is essential in chronic osteomyelitis, since cultures of sinus drainage are unreliable. Osteomyelitis in diabetics with foot infection and in association with decubitus ulcers presents special problems. Radionuclide scanning often give false-positive results in these patients. Proper diagnosis usually requires careful assessment of clinical and roentgenographic findings. 33 references.

  18. 78 FR 1149 - Approval and Promulgation of Implementation Plans and Designation of Areas for Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-08

    ... requirements in 40 CFR part 58 (``Ambient Air Quality Surveillance''). Clark County DAQ's commitment in the... Plan clearly identify specific contingency measures, contain adequate tracking and...

  19. Diagnostic approaches to respiratory sleep disorders

    PubMed Central

    2015-01-01

    Sleep disordered breathing (SDB) comprises a number of breathing disturbances occurring during sleep including snoring, the obstructive sleep apnoea/hypopnea syndrome (OSAHS), central sleep apnoea (CSA) and hypoventilation syndromes. This review focuses on sleep disordered breathing and diagnostic approaches in adults, in particular clinical assessment and overnight assessment during sleep. Although diagnostic approaches to respiratory sleep disorders are reasonably straightforward, they do require a degree of clinical acumen when it comes to assessing severity and management options. Diagnosing respiratory sleep disorders on clinical features alone has limitations. Monitoring and measuring respiration during sleep has undergone many advances in the last 40 years in respect of quality and validity, largely regarding OSAHS. Despite the improvement in our diagnostic standards and recognition of sleep disordered breathing, many limitations still need to be overcome. Apart from assessing the individual patient, population screening for sleep disorders continues to preoccupy health professionals and policy makers in many countries. Research in the field is pushing current boundaries in terms of simplifying diagnosis and enhancing screening for sleep disordered breathing in large populations. At present, a number of these newer approaches require further validation. PMID:26380763

  20. Adequate Funding of Education Programs for At-Risk Children: An Econometric Application of Research-Based Cost Differentials

    ERIC Educational Resources Information Center

    Alexander, Kern; Wall, Andrew

    2006-01-01

    This article contributes to the ongoing discussion of the adequacy of funding for public schools, specifically with regard to the provision of programs for at-risk children. Of particular concern is the determination of realistic, research-based costs of adequately funded programs. This article has three basic parts: the definition and measurement…